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First, with regard to autonomy in decision making, the clinical personnel had partly taken into consideration the extent of applicability of self determination in the case of the brain injured patient. According to Cantor and Zasler (2004), the immediate time frame that follows someone’s suffering from severe injury of the brain, the emotions that follow are characterized with shock, disbelief, anger, and denial, which may impair the capacity of the family members to think and act fairly. Hence, in as much as the husband may has the right to justify his actions, there is a high chance that by seeing that his wife could still respond to tactile stimulations, he may have been tempted to engage in sexual intercourse without properly considering the implications.
Secondly, with regard to beneficence, the clinical personnel and the brothers of the affected victim are justified because they intend to promote positive morals. However, there are some technicalities in that the victim has not been completely satisfied as being in a vegetative state. Nevertheless, the basic requirement to promote moral good is strongly expressed by the brothers and the clinical personnel. Indeed, allowing someone who has severe brain damage to become pregnant is a risky affair because there are high chances that the resultant birth may end up to be premature. In the current state of the victim, we cannot adequately forecast whether there are high chances of the victim recovering fully such that she can give birth and provide the required nutrition for the developing fetus. Family members are usually interested in prognosis, hence, there is need to communicate prognosis in the most understandable fashion, which is attained by characterizing recovery as the probability of the patient achieving a certain degree of functionality (Cantor & Zasler, 2004).
Thirdly, with regard to non-malfeasance, the clinical personnel are concerned with the possibility of harm occurring to the victim and the developing fetus. However, the husband’s actions lack an element of non-malfeasance because he seems to be overlooking the impact of the final outcome on his spouse. Despite the fact that the spouse could respond to tactile could partly justify his actions, but allowing conception to proceed to actual birth will be detrimental to her health status. Hence, the decision by the clinical personnel suits the current circumstances.
Fourthly, with regard to stewardship, there is overall concern to preserve the dignity and self being of the victim. Indeed, in as much as much as the spouse appeared to be partly aware of her surroundings, she could not still not clearly express herself; hence, the act of having sexual intercourse with someone suffering from brain injury can be seen is lacking an element of stewardship . Even though the husband could legally be the appropriate surrogate when it comes to decision making, still his actions to do meet the standards of stewardship. In essence, sexual intercourse is intended to be a consensual matter between two people. The husband seems to take advantage that fact that their marriage was still in progression; hence, the mutual association he had with his wife is still active even though we know that his wife is in a passive state of mind.
Fifthly, with regard to justice, the victim deserves to receive just treatment for the issues that took place. Allowing conception to take place in a personal suffering from severe brain injury was not justified. In fact, having a child should be a consensual decision between the two spouses. In this case, one of the affected parties cannot clearly make a decision. The husband has no legal binding to ensure this happens. The clinical personnel are also justified in ending the conception.
Consequences & Goodness of Actions
First, terminating the pregnancy will have an element of goodness in that it will save the affected victim from grave harm. Since the victim is partly aware of her surrounding, the physical manifestation of the womb as the growth of the fetus progresses will be emotionally and psychologically harmful for her recovery.
Secondly, the action of the brothers to seek legal counsel will have some element of goodness in that it will effectively protect her from further harm. Thus, this will effectively protect the affected victim from the actions of the husband, who seems to be psychologically affected by the condition of his spouse.
Ethical Decision Making Model
The ethical decision making model proposed by Bush and the American Academy of Clinical Neuropsychology (2007) consists of eight major steps, which entail the following: identification of the problem; consideration of the level of significance in the context and setting; identification of available ethical and legal resources; consideration of personal values and beliefs; development of a suitable solution framework; consideration of the potential consequences to the proposed solution framework; selection and implementation of the recommended course of action; and finally, assessment of the outcome and proposal of improvements (pg. 24).
Using this ethical decision making model, I would prefer that the pregnancy is terminated and a fiduciary appointed to take care of the affairs of the affected victim. Taking into consideration the fact that the husband seems to be using the binding agreement expressed in marriage to justify his sexual actions, there are high chances he is emotionally and psychologically affected. In his world, his wife is still functional like a normal human being. In the event the patient cannot manage his/her own affairs, especially for an extended period of time, there is need to appoint a trial lawyer who will adjudicate the patient as incompetent, which allow a fiduciary to be appointed to represent the affected patient (Cantor & Zasler, 2004).
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