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Box Analysis
Using the box analysis, this situation would be divided into four main parts namely, medical suggestions, quality of the patient’s life, his/her preferences, as well as the contextual features. According to box analysis method, this condition is best understood when divided into the four groups. The case under study is that of a young child, Ashley, who is six years old and suffers from severe disability that does not allow her to talk, walk, or even move from her position, when she lies down.
She also suffers from low cognitive ability, which is likened to that of a three year old. Diagnosis shows a condition of static encephalopathy, which is thought to have hampered her physical and intellectual capacity. Apart from that, according to her parents, she is jovial and enjoys watching lights and audio from music or TV, she is said to embrace the family, enjoy being cuddled and company. For this reason, the parents are opting to stay with her at home and request for medical intervention, which could inhibit her growth to maturity.
They feel that when she grows, it may deprive her, the joy and flexibility to be moved from one place to another, which she now enjoys. In this context, we shall consider Ashley’s condition and organize it as shown below.
Argument
Ashley’s parents love her and would very much enjoy, caring for her in their home where she feels wanted and cuddled. Her stay at home is described as jovial and full of embracing, this is what Ashley need, and the only problem comes with her future development, which is feared to have the capacity of causing her and care givers greater problems. For instance, the parents fear that she could attract sexual attention, which to them seems irrelevant given her conditions.
Another problem expected is her maturity and weight, which would make it difficult to carry her from one place to another. They therefore request for a string of medical intervention that would inhibit her growth and physical development.
In applying ethical reasoning to this case, there are three methods, they include, Narrative, Casuistry and principlism. Taking principlism method, which allows for philosophical reasoning in ethics, Ashley’s parents should be granted their wish to consider medical intervention in helping their child. First, it is ethically sound, to respect the choice made by Ashley’s parents, this will help the child’s future beneficence. Indeed, with Ashley’s conditions, unless these problems are treated, it would present her several challenges that may bring with it worse repercussions in the future.
In considering Casuistry, the facts of Ashley’s conditions are real, severe disability. In trying to find an analogous case, it would be fair to think of ways in which this condition would be controlled. Questions such as her ability to gain cognitive ability in the future arises and others on her ability to speak or walk later in life. Her feelings in the future when she realizes she has no breasts, in case she will. These arguments sound reluctant to grant the parent’s request.
The same case is with Narrative ethics. Nonetheless, both Casuistry and Narrative methods are bound by the fact that Ashley cannot speak for herself, and her condition seems long-term. Therefore, it would only be ethical to let they proceed with medical interventions as suggested by the parents.
Response to objection
In considering these two cases, they are slightly different. In Ashley’s case, her condition does not cause any harm to her presently while, in the man’s case, he hurts himself. There are several ways of dealing with the mans condition apart from amputation, for instance, use of protective materials that may be used to hold the hand in position so as not to cause more harm, while in Ashley’s case, growth will only cause more harm and unwelcome consequences. In addition, ethically, it is wrong to use harm in order to get a good; furthermore, Ashley’s condition is much more complicated, with several severe disabilities, which calls for a drastic action to help her future, the man only suffers a single problem which is much easier to solve than amputate.
Ethics Recommendation
The medical team should first scrutinize the parent’s request and explore the side effects or future medical consequences, since physical, emotional and possibly mental problems will be kept at bay when the parents take good care of her. If the physicians feel that Ashley’s future medical conditions after these interventions will not overcome the positives expected, then they should proceed with the request. In essence, ethics recommendations suggest a grant of request, unless it is known or believed that severe medical complications will arise after this treatment.
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