WaS's bioethics discussion thread. Warning - penguins ahead!

jobbingmusician

WaS is a lovely poster who has started a bioethics course and is sharing some of the issues with a few of her friends on another thread. On the other thread we subscribe to the 'a friend is just a stranger you haven't met yet' ethic, for starters, so do feel free to join in!

On the other thread, we use the word 'penguin' if we feel that the thread might contain issues which could upset people, or relate to painful issues in their past. So we'll flash up a 'penguin' warning, and ask others to do the same, if we need to discuss especially painful issues.

So....

The challenge WaS set was

Have you ever objected to something based on your conscience? Was it easy or hard to do? What reaction did you experience? Do you still believe that it was the right decision and if not, why not? Explain how you used (or if you did use) the following values in making your decision-

Understanding of the situation.
Appreciation of the consequences.
Reasoning.
Personal choice.
Moral beliefs.

This is going to be a lengthy post, I'm afraid, but I hope it will be interesting. I'm sorry it discusses a fictional situation, but as you will see, the fictional situation has become quite archtypical for me, so I think it's worth unpicking. (oops, just realised unintentional/Freudian pun, as you will see.)

The thing I objected to.

When I was a teenager or young adult, I read many 'classic' novels, and annoyingly I can't remember which novel this was from. French, definitely, maybe Maupassant? There was a saintly young girl (SYG)(probably the heroine of the story?) and the story described intense urban poverty in an earlier time, probably late 19th century. Part of the story (probably a very minor part) was that there was an old lady, almost blind, who sat in a corner and made lace all day every day. The lace was actually rubbish because she couldn't see. The saintly young girl took it from her every evening, and unpicked it and reworked it without her knowledge.


Thinking it through


This seemed to me, as a young adult, totally wrong. It was lying to the old lady, and ruining the young girl’s health (a point which was made in the story). It was an easy decision to make as a young adult, and made me feel very angry.


I am no longer sure that this is the right decision. My understanding of the consequences has changed over the years – probably the simplest reason for my change. As a young adult I could not appreciate the consequences of the action. It seemed to me wrong to maintain the older woman’s pride with a lie. Now the spectre of the workhouse is one I can appreciate much more. In theory the heroine was keeping the old lady from the workhouse (French equivalent of) and certain death by pretending she could support herself through her lacemaking. (Reason still tells me, however, that there was no logical reason for her to enter the workhouse since SYG was supporting her anyway.)


I still don’t know exactly what I feel about this – although I do think about it often, still, and how it relates to other situations. Here are my morals which come into conflict in this situation.

• · It’s right to help people
• · It’s wrong to lie to people
• · It’s patronising to support people without their knowledge
• · It’s also good to support people without their knowledge
• · It’s stupid to ruin your own health to give short term benefit to someone else
• · SYG was being a ‘rescuer’ – old lady would doubtless have preferred the workhouse to being indebted. Or would she?

And, just to ensure this dilemma does come under the heading of bioethics..

• How does this relate to the Mental Capacity Act? I can't remember enough about the story to judge whether the old lady had capacity, but suspect she did. Wasn't SYG guilty of 'assuming she knew best' by depriving the old lady of all the facts about her situation?

Is that enough???? And if anyone can identify the novel, do let me know!

whitewing

I am going to enjoy this thread.

mgdavid

!!!!!!?
many of the western world's problems are exacerbated by people over-thinking the issue.

Waves_and_Smiles

I was once the subject of an ethical dilemma so can see it from the other side. My family were abusive but also very physically unwell and I was their carer as a child. I had very little socialisation and had no idea how to be with other children. I was placed into a children's home for a while but then my mother asked me to return home. My social workers at the time decided to leave that decision up to me and I did choose to return.

It seems like an odd decision for them to make but I had no idea how to talk to the other children in the home and was bullied because I was so odd, I had also never spent a night away from my family home beforehand and was basically terrified. I had tremendous guilt because I felt so responsible for my families welfare and hated myself for leaving them when they were so ill. So it was decided to leave me to choose but give me daily meetings with various professionals as a back-up and pull me out of there quickly if anything went wrong which they eventually ended up doing.

I still don't know if it was the correct decision to return a 14 year old back into an abusive situation but I also know that I couldn't live with the guilt of feeling as if I had let my family down, I had already attempted suicide once before due to guilt and feeling as if I had failed them.

It was purely a judgement call between two bad situations, no harm came to me and I did have daily checks on me. This was over 30 years ago and I wonder if the same sort of decision would be made now? I don't envy my caseworkers being forced to choose which was the right thing to offer me.

whitewing

Wouldn't you have been more likely to be put in foster care now? A good foster home could have potentially allowed you to make a different decision. (ETA: or the same decision but with better support that reduced your mh issues).

I think it was wrong to let you make the decision but I also think that at the time it probably did seem the right thing to do.

meritaten

I think children act on emotions - then become young adults and act on reason and in teens particularly, situations are very 'black and white'. with maturity it becomes more shades of grey. old age returns them to 'black and white'. what I am trying to say (and making a complete mess of) is that you will make different decisions about the same situation at different stages of life. people also mature differently (or don't mature at all).
If you want an example, a friend of mine got pregnant and had an abortion. I was horrified. at the time I thought it the worst decision ever. abortion was WRONG. full stop, end of. 40 years later and I think the opposite. I think it was the right decision. Why? because if she hadn't had the abortion her parents would have forced a marriage to a man who was abusive. he had shown signs of this before she got pregnant - and his temper was worse after she told him she was pregnant, then he seemed to calm down and want the baby. they split up when she had the abortion. he got another girl pregnant a few years later,and he was very abusive to her, she even lost the baby. Now I can look back and think that' that could have been my friend'.

pukkamum

Okay this may be a penguin issue.

I had a friend, lets call her Julie, she lived on the same street as me and we were good friends.
She had 2 sons and a husband with a good job and though they only lived in a 2 bed council house they weren't struggling for money.
She talked constantly about her desire for a girl but confessed her mother, who lived next door and was a very controlling woman constantly told her having a 3rd
would be a huge mistake.
I myself at the time had one son and had been trying for a second baby for 2 years
with no luck.
Julie fell pregnant.
I was, I admit, slightly jealous but over the moon for her.
I didn't see Julie for a couple of weeks and the next time I saw her she was in bits,
she told me that she had had an abortion.
I was stunned.
I asked her was there a problem with the baby, had her husband objected to the
pregnancy?
Her reasoning was this, she couldn't bring herself to have the baby for fear of her mum's reaction.
I was gobsmacked, this was a 28 yr old mother of 2 with a husband and a nice house, I felt sick to my stomach thinking of the baby I was so desperate to have and the one she had got rid of.
I did my best to comfort and support her but I couldn't meet her eye without a
surge of upsetting feelings, so I began to pull away from her even though I knew
she needed me.
She moved away not long after and a year later her mum died.

More information

Julies eldest child was born when she was 15, before she met her husband, she hid her pregnancy from her mum, a recent widow, when her mum found out they
had a huge fight which resulted in Julie falling down the stairs and going into early labour.
Julie lived with her mum after having the baby but mum was extremely controlling and critical making Julie feel she wasn't good enough.
Eventually Julie met Rob, he was a lovely man with a good job and prospects, they got together and bought a house.
Julies mum again interfered, convincing Julie that she needed to buy this and that for the house, go on foreign holidays, buy the boys designer clothes.
Julie paid for all this with loans etc that Rob didn't know about.
Julie and Rob ended up in masses of debt and lost their house, they ended up in a council house next door to mum who interfered constantly, unfortunately neither Julie or Rob, could stand up to her.

Thinking it through.

When I think back now, having had baby number 2 and then a third, I know my
reaction was based purely on my own feelings at the time.
I should have been able to see how much control Julies mother had over her life and how desperate Julie must have felt, so desperate that despite wanting the baby, was so fearful of her mothers reaction that she had an abortion.

My conclusion.
Had it not been for my own fertility issues clouding my judgement I could have seen all the above and helped a friend through a major crisis in her life.
A crisis that ultimately led to her having a breakdown, mum died a year later and Julie admitted that one of the thoughts she could not get out of her mind was that she had aborted her baby for a woman who would not have been there a year later.

I still see Julie occasionally and we chat and it's lovely but I still can't meet her eye, now because of guilt for not being there when she desperately needed me.

I hope that hasn't upset but I think its a classic case of reacting to a situation with emotion rather than rationale.
I know put in the same situation now I would be nothing but fully supportive and there for her.

jobbingmusician

mgdavid wrote: »

!!!!!!?
many of the western world's problems are exacerbated by people over-thinking the issue.

Can I gently suggest you google bioethics to see what we are actually talking about? Or perhaps you are suggesting that serious medical decisions shouldn't be thought about too much

I agree that my example is not so directly related to a medical problem so may have been misleading, but it does match the guidelines originally set, so I'm sure it will become clearer as our discussion of the issues continues.

WaS - I dunno! The wishes of the child are supposed to be paramount nowadays, aren't they? I don't know how much of the abuse the powers that be actually knew about, but I can all too easily imagine a parallel situation today - especially if it saved money I've never worked with children though so I'm sure there are others who would be able to give a more informed opinion.

Waves_and_Smiles

I was thinking that, whitewing. Now foster care would probably have been another option but back then no one particularly wanted teenagers with a label of being disturbed unfortunately. My carers were between a rock and hard place, send me home and risk further abuse or keep me in the home and risk my mental health to become even worse than it was due to the guilt I felt (and remember I had already attempted suicide within the last 6 months), again it was purely a moral/ethical decision for them, whichever option they went for would have put me at risk. As it turns out it didn;t work and the situation became so bad that they had to place me back into care but I didn;t have the guilt because I knew I had tried.

I still don't know if it was the correct decision or if indeed there was a correct one?

pukkamum

Waves and smiles first of all gosh was a terrible situation you were in, a situation that even as an adult would be hard to deal with but as a child mindblowing.
Second I truly think that the decisions we made in the past felt right to us at the time therefore were an inevitable thing. Of course with hindsight we might have made a different one but nobody has that znd the choices made were based upon feelings and events at that time.

Waves_and_Smiles

Aw, thank you, pukkamum. I do think as Meritatan said it was very black and white for me as a teenager and purely emotional which my case workers had to take into account. They were dealing with a teenagers way of thinking, and on top of that a teenager who was never really allowed to be a child so I was very mature in some respects but very immature in others.

Thinking back they had the following to consider-

The situation at home was abusive and I was in danger.
I carried huge guilt over my families illnesses and my ability to care for them
I had previously attempted suicide due to that guilt
I had no socialisation with other children and therefore didn't fit in with them
Taking me out of the home situation could have made my mental health much worse
Putting me back into my home could have made my mental health much worse
There were people involved who could monitor me daily
I was still at huge risk being in the family environment even with back up
There was less physical risk if I remained in care
What type of children's home would have been appropriate for me? (they placed me in one for disturbed teenagers which meant a lot had aggressive behaviours and fought authority and I was just the opposite, I was used to running a house and adult responsibilities)

Somehow they had to weigh these up and choose the safest solution but I really don't know what I would do if I was in their shoes. I think that I would have probably kept me in care nowadays and looked for foster care urgently but back then it wasn't really an option. Being a foster parent to me would never have been easy because emotionally I was a mess and it was very hard to place teenagers in general.