Ethical

The problem This paper discusses the legal and ethical implications in conjunction with performing surgery on disabled people for social reasons. Ethical Katie is immaturity and she has the right like other non-disabled girls to live with her body in tact and she has the same choice to give birth to her own baby. According to the Family Court in Australia and Family Law Act 1975, no person under 18 should have hysterectomy unless the procedures are necessary to prevent serious physical and psychological damage and to save life (Skene, 2008, p. 38). Medical This surgery is not medically necessary and it is irreversible, persistent, traumatic and painful that it results in the permanent loss of reproductive capacity. The medical complications after surgery will affect the person health. Social There are lacks of access to health services and recourses, social and educational support for her and her family. Katie is lack of the basic human rights, freedoms to work, freedoms to get educa tion and move freely about society. Legal The parents could not consent and the doctor does not have the right to remove the womb of Katie as non-therapeutic surgery requires court approval. This is not just a medical decision for the doctor, but the child’s best interest and the consequences of wrong decision being made. The facts It is estimated in Australia that a child is born with cerebral palsy every 15 hours. There is no pre-birth test and no known cure for cerebral palsy (Levitt, 2010, p. 33). Cerebral palsy is a permanent physical condition that affects movement. It effects can be just a weakness from one hand ranging to almost complete lack of movement (Miller & Browne, 2005, p. 51). People with cerebral palsy may have seizures and other impairments that affect their speech, vision, hearing or intellect. Spastic, Dyskinetic and Ataxic are the three main types of cerebral palsy. A cerebral palsy result from the neurological damage to the child’s developing brain (Miller et al. , 2005, p. 51). There is greater risk in babies born with low birth weight and preterm. Cerebral palsy can be diagnosed through test reflexes, check for hand preference, CT scan, MRI and Ultrasonography. The treatment are physical therapy which consists exercise to keep limbs from weakening, speech therapy can help regain lost control over facial and throat muscles and gaining the ability to communicate effectively, medication help prevent certain effects of cerebral palsy such as seizures and surgery which is performed to cut some of the nerves affected by spasms and minimize muscle contractions (Miller et al. , 2005, p. 52). Four principles Autonomy Autonomy is described as the right to self-determination, the ability to control what happens to us and how we behave (Staunton & Chiarella, 2003, p. 8). This is a significant ethical principle which allows respect for individuals thought, action and their personal space. Katie is believed to understand little of what is said to her but she has no sense of what is happened to her body. Although, she has the right to make her own decision but she could not give valid consent.. Non-maleficence The principle of ‘above all, do no harm ’ ( Pera & Tonder, 2005, p. 34). A strong principle in health care and it forms the basis of nurses’ duty of care. This procedure affects the welfare and health of Katie as it is seriously invasive her personal integrity and human dignity. Health care professionals should avoid emotional, spiritual, moral and physical harm to Katie’s dignity (Pera et al. , 2005, p. 34). Beneficence The principle of ‘above all, do good’ (Staunton & Chiarella, 2003, p. 29). It includes the principle of cost benefit analysis and paternalism. In health care, this principle range from determining the number and type of hospital beds in a given geographic area to the validation of research involving human subjects (Pera & Tonder, 2005, p. 4). In Katie case, she deserve better quality of life that she won’t suffer from menstrual pain, discomfort, mood swings, behavior changes and complication of adulthood. More information about women’s health nowadays and more alternatives options should be given to her parents so that Katie could receives the best and suitable treatment. Justice The p rinciple of justice is the unifying principle in health and nursing ethics. It comprises the justice as fairness and justice of an equal allocation of burdens and benefits (Staunton et al. , 2003, p. 30). Ethical conflicts This case raises fundamental ethical issue about the way the society treats disabled people and the respect for the human rights and reproductive rights of disabled people. There are a few ethical conflicts arise in Katie case. The conflicts are: is the operation in the best interest of the child, is there any risk of making decision wrongly and is it ethically allows having hysterectomy on disabled people below 18 and without their consent. Menstruation is always regarded negative for parents with disabled kids as it is uncomfortable, unclean and devastating. Therefore, most parents wanted hysterectomy on their disabled kids before their menstruation as they thought their disabled kids would not be able to cope and deal with menstruation. But, it is not known that whether hysterectomy is in the best interest of the child as no one could predicts about the future problems to be encountered with menstruation. This is not fair for the disabled people as they have the rights to experience changes of their body and have their body in tact through their life span (Fellowes, 2000). Sterilization is a serious invasion the person honor and self-respect as their womanhood is being stolen. In 1994, Brennan J, the Chief Justice of the High Court of Australia believed that mentally or physical disabled people should enjoy a full decent life, in condition which ensure dignity, promote self-reliance and participate in the community (Fellowes, 2000). There is a significant risk of making the wrong decision to what are the best interests of a child who cannot consent and the consequences of a wrong decision are grave as this procedure is irreversible and invasive. Cincinnati Adolescent Clinic had carried out an interviewed in 1983, 69 parents were interviewed regarding sterilization of their disabled daughters. Almost 80 percents parents had thought of sterilization and their common reason was to protect their daughters from pregnancy (Strahan, 1991). People with disabilities have the equal human rights as all members of the community (Disability Discrimination Act 1992). Katie has the rights to make her own decision and acknowledge what is happened to her body and health

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