comment on the blog with their group, their conclusions and reflections on the pdf. of babies called Baby Doe generically and the article by Dr. M. Parra on invasive procedures.
Screening for chromosomal abnormalities in pregnancy can be made by ultrasound findings (nuchal translucency, absent nasal bone, tricuspid regurgitation, altered ductus venosus, etc.) Associated with measurement of serum chorionic gonadotropin and pregnancy-associated placental protein.
The problem with these non-invasive methods is the false positive rate ranging between 3 and
5% due to the implication that it is possible to predict trisomy and finally an infant born normal.
The accurate diagnosis of fetal karyotype is only possible through any invasive procedure
(taking a sample of amniotic fluid, placental tissue or fetal blood), which positively eliminates the uncertainty of false positive, however implies a risk reproductive loss of around 1%.
For this reason, it is important to note that the use of these methods require invasive proper advice, which respects the autonomy of patients and delivered a thorough information on the benefits and disadvantages of the procedure.
On the other hand, we might ask whether the benefits delivered invasive methods outweigh the possible harm to the embryo in a country like Chile, where abortion is not allowed, and these benefits are limited only to a more informed mother and timely management of complications (eg esophageal atresia.)
"The prevalence of invasive procedures in ourA striking difference noted in this study, which concluded that due to good counseling. On the other hand, as you told us an obstetrician at the Hospital San Borja Arriarán, when offered such procedures to patients, not interested.
study was 0.45%, much lower than reported in countries where abortion is
legalized
which are higher than 5%, depending on the type of aneuploidy screening used "
BABY DOE Case Analysis
To give a logical order to help us draw conclusions, we will develop the case from his record. We invite you to read this analysis and also enrich the discussion with their contributions.
Background case:
polypathies Child: Down syndrome, tracheo-esophageal fistula and esophageal atresia.
Possible ways forward:
- Operation gastro-respiratory malformations with 90% probability of success.
- not allow operation with a fatal outcome for the newborn
parental choice:
- not allow operation
Counseling:
- A reference by the obstetrician Walter Owens
type approach in counseling:
- -type persuasive rather than informative
first point to reflect on how medical advice provided in this case the obstetrician Owens. It would have been ethically appropriate provide parents with all available information, the solutions with their advantages and disadvantages, so that in this way they take an informed decision and not to accommodate possible influences of others.
believe at this point the possibility of parental choice, because when there was no case law regarding such situations.
reaction medical settings:
- Rejection of parental decision
Actiontype responsible to a decision that clearly showed the least controversial.
Consequences:
- Hearing before Judge John Baker
- Cited Owens to declare that it maintains its position
- state was quoted BABY DOE's father who disagreed with the position of Owens
hearing Features:
- No records
- No guardian ad litem for BABY DOE
The fact that there are no records or guardian ad litem (click here for its meaning) for Baby Doe gives to think of a process rather than wanting the welfare of children, seeks action self-defense to avoid legal consequences or image to the hospital. Also, the fact that no coach is a sign of lack of awareness of life that develops in utero, and are not considered the best interests of children.
judge's decision and consequences:
- Parents have right to make a decision on whether the child is trying
No legislation, decision set for the law but ethically reprehensible .
- Appeals by the district attorney in both instances. Both failed.
- Last appeal to the U.S. Federal Supreme Court. The case does not reach Washington DC before the child's death at 6 days old.
child's birth date:
- April 9, 1982
implications of your case:
- April 30 of that year the Department of Human Services Health banned discrimination against the disabled in future cases.
- DHHS rules that is illegal and discriminatory suspend food or medical support of patients born with disabilities.
- In 1984, the law is passed "The Baby Doe Rules" which he condemns as abuse and neglect, rather than discrimination, failure of medical treatment given to a child, whatever their status, except in cases exceptional.
Due to media attention and further reflection on this case immediately after the death of Baby Doe, begin to develop policies and laws that protect the life of the disabled. This, unfortunately is late, at least a precedent on the responsibility of the state to protect human life in line with all international human rights treaties.
Finally, using the concepts of law, "The Baby Doe Rules" emphasize that in this case there was a neglect and abuse of this form to a human life, which was abruptly abbreviated due mainly to weak legislation and having as additional factors, poor medical advice, a possible negligence regarding the best interests of the child and that includes all these factors, poor bioethical discussion on cases of this type and its management.
0 comments:
Post a Comment