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dnf777
12-03-2009, 06:03 PM
I just attended a conference on hereditary cancer. One speaker was an attorney who spoke to the legality of informing patients and their potentially affected children/relatives, and potential liability for failure to do so.

One case that actually went to trial was a person who had a genetic defect, who sued his parents doctor for failing to inform them of genetic testing that could have alerted them to the potential condition, and allowed them to abort while still able.

Bottom line is the person is suing the doctor for not giving the parents the needed information to commit abortion, thus resulting in a "wrongful life" suit. The person said he would NOT want to have been born if he knew what he would have! (a close relative to this is when parents of an afflicted child sue their doctor because THEY would not have wanted to give birth to a "defective child"!)

What say the anti-abortion Christians to this? Should a doctor be held liable for not aiding and abetting murder, as I'm to understand? Or should a doctor be held to the standard that they must give information to parents, knowing it will result in abortion most likely? Does an anti-abortion doctor have the right to withhold information if he/she thinks it's "best" for the unborn child?

subroc
12-03-2009, 06:43 PM
a doctor should give them the information they pay for.

dnf777
12-03-2009, 07:12 PM
a doctor should give them the information they pay for.

True, but these cases held the doctor liable for not offering the testing. Most patients don't know what they need, so it's up to the doctor to provide them in an honest, ethical manner, what they need. Now the courts, through disgruntled family members, are doling out punishment.

This is purely a personal value issue, that the legal system is imposing upon. I did not ask this to start flaming or to argue, but rather to hear what different people's opinions are on this. Ever since about 1970 or so, medical technology has far surpassed our grasp of medical ethics. Not that we're "unethical", just that there are many questions that we haven't answered, to keep up with what the technology can provide.

subroc
12-03-2009, 07:38 PM
...This is purely a personal value issue, that the legal system is imposing upon. I did not ask this to start flaming or to argue...

sounds good...

WRL
12-03-2009, 08:36 PM
I'm not pro-abortion for ME....but would not take that right away from others.

However, as a PARENT, I would want to know if my child was likely or definitely going to be born with a life-altering ailment.

When I was pregnant, they did a protein test I believe (its used for testing for down syndrome). When they told me about the test, I was certainly concerned that there might be a problem.

But had my child been affected, I would have wanted to know at the earliest opportunity.

I can't say I would or would not have kept the child. But I would have wanted the info. Fortunately, I have never been faced with the decision to abort or not.


WRL

Terry Britton
12-03-2009, 11:03 PM
The doctors I have seen will not willingly give out any information unless you ask specific questions. They do inform on conditions that need treated immediately. It takes a lot of trust that you won't sue before a doctor will start giving out all information without questions asked.

WaterDogRem
12-04-2009, 12:58 AM
One case that actually went to trial was a person who had a genetic defect, who sued his parents doctor for failing to inform them of genetic testing that could have alerted them to the potential condition, and allowed them to abort while still able.


Since he thinks he should of been aborted, sounds like this person needs to remove himself from this planet and do us all a favor.

dnf777
12-04-2009, 06:10 AM
Since he thinks he should of been aborted, sounds like this person needs to remove himself from this planet and do us all a favor.

The ultimate "late term abortion"! I get your point. Not to belittle that person's feelings, but on one hand you have doctors being sued for NOT facilitating abortions, on the other, being harassed and in some cases threatened with imprisonment for performing them.

I wonder if that doc could mount as his legal defense, that he is a Christian who believes life begins at conception, and holding him to such standards as requested by this plaintiff, would amount to compelling him to commit murder, according to his beliefs.

ducknwork
12-04-2009, 07:55 AM
I just attended a conference on hereditary cancer. One speaker was an attorney who spoke to the legality of informing patients and their potentially affected children/relatives, and potential liability for failure to do so.

One case that actually went to trial was a person who had a genetic defect, who sued his parents doctor for failing to inform them of genetic testing that could have alerted them to the potential condition, and allowed them to abort while still able.

Bottom line is the person is suing the doctor for not giving the parents the needed information to commit abortion, thus resulting in a "wrongful life" suit. The person said he would NOT want to have been born if he knew what he would have! (a close relative to this is when parents of an afflicted child sue their doctor because THEY would not have wanted to give birth to a "defective child"!)

What say the anti-abortion Christians to this? Should a doctor be held liable for not aiding and abetting murder, as I'm to understand? Or should a doctor be held to the standard that they must give information to parents, knowing it will result in abortion most likely? Does an anti-abortion doctor have the right to withhold information if he/she thinks it's "best" for the unborn child?


I really don't know what to say...I don't know enough about what a doctor is required to do or not do. I would like to know more details before I could have much of an answer to your questions. I couldn't imagine being in the doctor's shoes in that situation because I would feel as though I contributed to the death of an innocent child if I knew that would be the decision. I would imagine that the doctor would not be 'aiding and abetting murder' though, because unfortunately, abortion is not viewed as murder by our legal system (unless someone kills a pregnant woman:rolleyes:Nice consistency...). I don't guess any doctor has the right to withhold information that may be pertinent to the health of the patient...That would be similar to what 'all of us republicans:rolleyes:' have complained about with Obamacare deciding what care we can and cannot receive, right?

If the doctors personal morals and values would make him anti abortion and he feels certain that a test or information would almost certainly result in the parents decided to abort the child, his best course of action would probably be to refer the parents to another doctor. That's probably the best solution that I would be able to come up with if I was in that situation.


On a side note, there are people that argue that abortion should be okay up to the point of viability outside the womb. Of course, this would be a legal nightmare and incredibly difficult to define, based on many, many factors, but here is a monkey wrench...I read online last night about a baby that was born at 22 WEEKS and has survived thusfar. 22 WEEKS. That is just incredible. I saw pictures of the child and I can't imagine anyone killing there own flesh and blood and feeling like it's not wrong. If you choose to have an abortion of convenience, you should be forced to look at your child after it has been removed from your body.

ducknwork
12-04-2009, 07:58 AM
I wonder if that doc could mount as his legal defense, that he is a Christian who believes life begins at conception, and holding him to such standards as requested by this plaintiff, would amount to compelling him to commit murder, according to his beliefs.

If a member of the military can choose not to go to war due to religious reasons (Muhammed Ali comes to mind) then what would make a doctor any different? A doctor should not be forced by law to do something that directly violates his morals, but given the state of the legal system, his best course of action would probably be to refer the patient to another doctor.

dnf777
12-04-2009, 10:08 AM
...I don't know enough about what a doctor is required to do or not do.


When it comes to those issues, nobody does. That's what the courts are trying to define as we speak. (like they're the best to make those decisions!)

When I was a medical student at Jefferson Hospital in Philly, our NICU would try to save premies down to 24 weeks. At that time ('92) 24 wks was considered the age of viability, with a 50% survival rate. Even with those "odds" many decided for comfort measures, and let the baby return to peace, given the high rate of complications and so forth. NOW, we're down to 20 weeks, and the REAL ethical issue is becoming the "artificial womb". As technology advances, we may move beyond the test-tube baby having to be implanted into a woman AT ALL! I mention that to demonstrate the HUGE ethical issues we'll be facing soon. Surrogate mothers will be obsolete. Gay male couples will be able to have a baby "made" for them if they choose! If a mom is caught three times with drugs on board, could a court order her fetus removed and placed in the "protective custody" of an artificial womb for it's own good?

These may seem obscure or extreme, but they are questions that we as humans, and supposedly "free" society, will be facing. The questions I originally posted here are going on right now. There was one doc at the conference who gives ALL his patients a letter encouraging them to share all their medical conditions with their children and relatives, so in case one of them turns out to be hereditary, he can say he "warned" them! Crazy, huh?

Thanks for your reply, I'm fascinated by what others think about this stuff. I don't think there's any right or wrong answers, and if anyone else does, I find that interesting too!

cheers,
dave

Gerry Clinchy
12-04-2009, 11:00 AM
If the doctors personal morals and values would make him anti abortion and he feels certain that a test or information would almost certainly result in the parents decided to abort the child, his best course of action would probably be to refer the parents to another doctor. That's probably the best solution that I would be able to come up with if I was in that situation.


If a member of the military can choose not to go to war due to religious reasons (Muhammed Ali comes to mind) then what would make a doctor any different? A doctor should not be forced by law to do something that directly violates his morals, but given the state of the legal system, his best course of action would probably be to refer the patient to another doctor.

ducknwork, these two quotes seem very consistent. Since an obstetrician has two patients, both the mother and the child, it seems obligatory to let the mother know what genetic tests are available; the costs, etc. It would be easy to put together an educational booklet on that which doctors could give to all pregnant women at their first visit. They would then have the information to decide whether any genetic testing, based on their family background information, seems in order for them. The parents could make their decision to have genetic testing as early in the pregnancy as possible.

Then, if the doctor has any religious or moral issues with performing abortions, he can make that clear early on. The patient can then make their judgment early to seek another doctor for their care.

Like WRL, I would believe that anyone not personally faced with such a decision can second-guess what a mother's/parents' decision might be.

dnf777

There was one doc at the conference who gives ALL his patients a letter encouraging them to share all their medical conditions with their children and relatives, so in case one of them turns out to be hereditary, he can say he "warned" them! Crazy, huh?


No, I don't think this is crazy. It's probably a good thing ... not just as protection against being sued. Some adopted children are encouraged to seek out this information from their birth-parents for this very reason as they reach child-bearing age. I just think it would be better for the AMA (or an obstetrical specialty organization) to come up with such educational material that includes this, as well as a summary of the inherited traits already known to us.

The reality of that artificial womb would not be all bad. There are couples who dearly want a child, but where the mother cannot carry a fetus to viable term. Those couples would welcome such an advance, I would imagine. The question of a pregnant woman's habits seriously endangering an otherwise healthy fetus (v. choosing to abort one that is genetically faulted) would be a different question, I think.

What might be more distressing is the govt actually making the decisions to abort or not abort a fetus. For example, a child with Downs Syndrome could be expected, in many instances, to put a "drain" on a govt-run health care system during their lifetime. Would a govt system of health care, strained for funds and staffing, make it compulsory to abort a Downs Syndrome fetus? In that way, would the govt then be interfering, in some cases, with an individual's freedom of religion? Even now that is a large issue, I think, with parents whose religion interferes with seeking traditional doctor care for their children. Perhaps an even more difficult issue for an unborn?

You are so very correct, DNF, that technological advances present us with issues not faced by previous generations. Only a very few of us (thankfully) would like the chance to "play God" ... many of those who have that bent, turn out to be tyrants and monsters to the rest of us.

dnf777
12-04-2009, 02:56 PM
Gerry,
Thanks for your thoughtful reply. Your hypothetical regarding the gov't wanting to terminate a Down's pregnancy raises excellent questions. I doubt if the gov't or any other entity would outright require that, not that they could, but a much more plausible scenario would be them saying, "fine, carry on, but we're not paying for it on behalf of the other subscribers/citizens". I could see this argument being run parallel to the anti-abortion supporters who want gov't to NOT PAY for abortions. (current event in the health bill) The 'we can't stop you, but we don't have to pay for it' solution.

All very interesting. All the moreso when we realize these are REAL people, REAL lives that are being affected. Odd that the decisions are made in mahogany panelled, rustic courtrooms, far removed from the harsh reality with which they deal!

YardleyLabs
12-04-2009, 03:35 PM
There was a time when physicians routinely made decisions on how much information it was appropriate for a patient to be told. Happily, that time is past. Medicine is one of a limited number of professions where the consumer/patient is assumed to be incapable of making an independent judgment concerning the appropriateness of the services being provided. That is the basis for the various licensure procedures governing the profession and is also the basis for ongoing discussions concerning what is required to obtain informed consent for treatment.

My assumption is that my physician will provide me with a balanced view of the risks associated with my medical condition and any related treatment. I also expect honest answers to the questions I ask. I do not expect the physician to necessarily share my priorities and therefore do not expect that we will necessarily agree on treatment. However, I am also not an average patient as a result of both family background and prior employment.

In most cases, informed consent is difficult to achieve and may be impossible with many patients. Increasingly, doctors have (wisely) resorted to preprinted descriptions of medical conditions and treatments that contain carefully written information. However, while this may be the only way to provide a document trail proving what a patient was told, it is not necessarily an effective communication strategy. For 20 years, I had a physician who believed that his primary role was to make sure I understood my condition and the options available to me. However, as a direct consequence, his average office visits were 30-40 minutes long. That clearly didn't meet the norms required for a "modern" clinical practice and he ultimately moved to a "concierge" practice charging each patient a flat fee of $2000/year for routine care.

With respect to the question you asked, I believe that a physician has an obligation to ask questions concerning the existence of heriditary, environmental, and behavioral risks that could affect the mother and the fetus. The availability of genetic tests should also be discussed along with information allowing the patient to participate in deciding what tests if any to do. That was certainly the case with all three of my wife's pregnancies 27-35 years ago and also the case with my daughters pregnancies over the last seven years. In all of those cases, my daughter and her husband and my wife an I decided not to test for conditions such as Down's Syndrome since no result would have affected our willingness to proceed with the pregnancies. However, that decision belongs exclusively to the patient, not the doctor. In my mind, the doctor has a responsibility for providing the patient with the information. If the patient elects for a legal and medically valid form of treatment that the physician cannot or will not provide, I believe the physician has a professional responsibility for assisting the patient to find a provider that can help.

Gerry Clinchy
12-04-2009, 03:42 PM
dnf777

All very interesting. All the moreso when we realize these are REAL people, REAL lives that are being affected. Odd that the decisions are made in mahogany panelled, rustic courtrooms, far removed from the harsh reality with which they deal!

You said a mouthful there!

I believe that this is the big issue with health care today, and maybe even more so with heavy govt involvement. Will the policy-makers, sitting in their ivory towers, never having to face the patients, be the ones to make life-and-death decisions? It's no wonder that even now a compassionate doctor has to fight a bureaucracy to get the right care for some patients in a timely fashion, or at all. There may be good doctors and bad doctors, but, overall, I'd rather trust medical decisions to a doctor rather than a bureaucrat (private or public!)

Gerry Clinchy
12-04-2009, 03:49 PM
Yardley

In my mind, the doctor has a responsibility for providing the patient with the information. If the patient elects for a legal and medically valid form of treatment that the physician cannot or will not provide, I believe the physician has a professional responsibility for assisting the patient to find a provider that can help.

By golly, I think we may have actually found something upon which we can all agree!

Freedom for the individual ... the doctor gives all information, but can still make his/her individual choice to participate in terminating a pregnancy, or not. The parents also can make their individual choice when they have the information as well. Even if the doctor does not want to participate in terminating a pregnancy, it would be entirely ethical for the doctor to provide the information, even if it were only to prepare the parents for what might happen. If the parents decide not to terminate, then they have had the time to make the preparations for their decision, taking their own personal responsibility for the results of that decision.

Pete
12-05-2009, 09:26 AM
What might be more distressing is the govt actually making the decisions to abort or not abort a fetus. For example, a child with Downs Syndrome could be expected, in many instances, to put a "drain" on a govt-run health care system during their lifetime. Would a govt system of health care, strained for funds and staffing, make it compulsory to abort a Downs Syndrome fetus? In that way, would the govt then be interfering, in some cases, with an individual's freedom of religion? Even now that is a large issue, I think, with parents whose religion interferes with seeking traditional doctor care for their children. Perhaps an even more difficult issue for an unborn


Once you start analizing all the what ifs you will end up with more bureaucratic bull chit paper work.


If aborting is murder than logically you have to investigate every miscarrage,,, that sort of thing.
The more complicated we make this stuff the deeper we sink into a bureaucrtic quagmire, and the more agencies we need to invent to push even more paper around.

Nothing is diffenet than 5o years ago,,,but no wthat we have computers we think we are so smart.
Pete

Gerry Clinchy
12-05-2009, 09:42 AM
Once you start analizing all the what ifs you will end up with more bureaucratic bull chit paper work.

Absolutely. The idea, then, is to keep the govt doing those things that govt appropriately should do, and not inject govt edicts into areas where they are not appropriate.

The problem with our legislators is that they often do not analyze the what if's before they hand down their edicts. Then we are left with bureaucrats trying to figure out how to implement the stuff that the lawmakers didn't anticipate.

Pete
12-05-2009, 09:59 AM
Absolutely. The idea, then, is to keep the govt doing those things that govt appropriately should do, and not inject govt edicts into areas where they are not appropriate

Exactly Gerry.,
the government has its place,,, but anymore they are in everything,,, like an undiciplined little puppy,,, they tear everything up and ruin everything they touch.

Pete

Eric Johnson
12-05-2009, 10:25 AM
dnf777-

Court cases revolve around legal theories. A lawyer puts forward a legal theory supported by case law and the facts of the case and draws a conclusion from it. He hopes to convince the jury or judge that his theory has merit and is a correct one.

I would be interested in know how this case ended. We don't know how old the plaintiff was but suppose s/he was over 21. The theory is that 21 years ago the standards of care and informed consent would have required notification (probably yes) and that the action by the parents to abort would have been rather pro forma. The second part is sort of hard to prove or disprove.

Eric

dnf777
12-05-2009, 10:37 AM
dnf777-

Court cases revolve around legal theories. A lawyer puts forward a legal theory supported by case law and the facts of the case and draws a conclusion from it. He hopes to convince the jury or judge that his theory has merit and is a correct one.

I would be interested in know how this case ended. We don't know how old the plaintiff was but suppose s/he was over 21. The theory is that 21 years ago the standards of care and informed consent would have required notification (probably yes) and that the action by the parents to abort would have been rather pro forma. The second part is sort of hard to prove or disprove.

Eric

I'm having a hard time accepting responsibility for someone else's genetic makeup, their religious and moral stances, and their decisions of what to do with possible information. All of the above figure into whether or not the courts decide who, if anyone is "responsible". Or liable, I should more correctly say. I don't know the outcome of the cases, nor did the attorney discussing them. The young plaintiff in the wrongful life case I believe was a legal minor, but in her teens, and with a good understanding of what's at stake.

I doubt a court would hold a doc responsible for something that wasn't available 20 years ago, but my concern is that nowadays, it is impossible to keep track of what new gene has been mapped and linked to a disease, and what surrogate marker tests are available through a lab in Oklahoma, and I fear docs will he held to that standard. Like I mentioned, one doc at the conference gives his patients a letter saying that anything in the world basically, may be hereditary, so talk to your kids. Probably wouldn't hold water in court, and is ridiculous on it's own merits, but the fact the system has encouraged someone to even entertain such a strategy speaks volumes.

I think the courts should go back at start at about 1940....and deal with the ethical questions that that vintage of technology posed. Once they're answered, start moving forward, and by the time they get to current events, we'll all be outta here! ;-)

road kill
12-05-2009, 11:14 AM
If there would be legal ramifications for a "Wrongful Life," wouldn't that set a precedent for "WRONGFUL DEATH?":confused:

(I wonder if anyone will understand this??)

dnf777
12-05-2009, 11:23 AM
If there would be legal ramifications for a "Wrongful Life," wouldn't that set a precedent for "WRONGFUL DEATH?":confused:

(I wonder if anyone will understand this??)

Absolutely! That is why pro-choice advocates fight against "double-homicide" charges when pregnant women are killed. (lacey Petersen?) They fear that is a back-door way of establishing the definition of "life" in a fetus.

While that may play a role in this discussion, I promise that was NOT the reason I started this. Actually, even more than the wrongful life or wrongful birth issue, I was interested in if a doc should be held liable to not informing (or not knowing himself!) if a condition was potentially inherited to a patient, parents, siblings, children?

I know there is no larger powder-keg than abortion issues, and again, I promise I did not start this thread with that intention. I was tempted to reply to Pete's comment about gov't intervention, but then I would have been guilty of doing exactly what I'm trying to avoid!

Have a good one,
dave

subroc
12-07-2009, 07:04 AM
Absolutely! That is why pro-choice advocates fight against "double-homicide" charges when pregnant women are killed. (lacey Petersen?) They fear that is a back-door way of establishing the definition of "life" in a fetus.


In your view, does the murder of a woman carrying a third term (8 month) viable fetus, and that fetus dies because of that act, constitute a double murder?

I say again "third term (8 month) viable fetus."

ducknwork
12-07-2009, 07:44 AM
In your view, does the murder of a woman carrying a third term (8 month) viable fetus, and that fetus dies because of that act, constitute a double murder?

I say again "third term (8 month) viable fetus."

You don't even have to go to the 8th month. A 22 week old fetus was delivered and is doing well ( I believe it was in Europe??) recently...

dnf777
12-07-2009, 01:15 PM
In your view, does the murder of a woman carrying a third term (8 month) viable fetus, and that fetus dies because of that act, constitute a double murder?

I say again "third term (8 month) viable fetus."

Huge question! Personally, I don't feel there is an answer that will fit all people. Me, personally, if it were my child (in my wife's belly, of course) I would want the SOB who harmed my child from one day after conception, because to ME, that is my future child, that undisturbed WILL become my child someday. You arbitrarily picked 8 months. To those who believe life begins at conception, the timeline is irrelevant. However, I don't see many of those people holding Mass of Funeral rites for early miscarraiges. In fact, MOST conceptions do not develop into term pregnancies. Many go completely undetected, as "late periods" or not even late. Only the advent of super-sensitive EPTs have alerted us to the large number of early pregancy losses. Many if not most are due to specific chromosomal incompatibilities.

Anyway, to answer your question, I don't have an answer, other than for my personal situation. Everyone else's may be different. Just as I don't impose my beliefs on others, I expect the same in return for all other people. I suspect that until the Second Coming of Christ, or global climate armageddon, humans will be debating this topic!

I enjoy this discussion, and if any of my comments were offensive, it was totally unintended, and I apologize in advance.

cheers,
dave

To someone else, that may not be the case, and the science, religion, and law are not clear on when we are endowed with legal "life". Actually, the law has become clear in terms of abortion rights, but not so clear when the fetus is harmed in violent acts.