The Moral Challenges of Medical Science Part 2/4 Video

In this program we explore the issues around medical science that are forcing us to define life, death, quality of life and patient rights. We confront the moral and ethical questions that arise when facing critical healthcare decisions. Part 2/4
Read the full transcript »

Mark P. Aulisio: Parents hear things that doctors aren’t saying or don’t mean to be saying and they made decisions based on what turn out to be false beliefs about the actual medical circumstances, were false beliefs about the actual prognosis where the likelihood of success in the given intervention. Male: It’s very difficult for doctors and care teams to admit to parents that they have reached the end of the road with regard to treatment possibilities. Dr. Aulisio said that as human beings, natural impulses to blame the messenger instead of accepting what might be the reality of the situation. Mark P. Aulisio: Another dynamic comes up, health professionals who try to be very direct and clear about how grave a terminal situation might be, how advanced the stage of cancer might be, if it’s a cancer case, parents get mad at them because what we do as humans, we shoot the messenger, right? If you bring me bad news, who am I mad at? First, initially right away, I’m mad at you. You told me that, well you’re just the messenger. A lot of times, health professionals in my opinion need to be willing metaphorically, figuratively to be shot. They need to be willing to be the messenger that the parent won't like for a while because they’re delivering bad news and bad news is almost never well received. But it’s a very dangerous dynamic that gets setup in these cases and what I think happens that as parents choose things that they would never otherwise choose for their children. Male: Another extremely complex and difficult decision process is faced when a developing fetus is involved. Dr. Berg addresses the considerations that a pregnant woman faces who learns that she herself has a life threatening illness. Jessica Wilen Berg: Often that means delaying their own treatment. For example, there have been situations of women who’ve had cancer and have chosen not to go ahead with cancer treatments until the fetus is either developed enough that they can have an early delivery or far enough pass the danger period that the treatments in question will be much less harmful. I think it’s an extremely difficult choice to make in those situations. I think some of it depends on where the pregnancy is. Male: The decision to delay medical treatment for the mother is often a simple one if the woman is in the final stages of her pregnancy and treatment is delayed only a few weeks but as Dr. Berg points out, the stakes are raised if the woman is in the early stages of pregnancy, in either case, it is always a weighty decision. Jessica Wilen Berg: I have myself not encountered a woman in that case who have ever said, “I don’t care anything about what happens to the fetus. I’m doing whatever I want.” They’re always making decisions based on what they think would be the best choice in the case and they’re very interested in the well being of their future child. Male: The decision process often involved looking at the medical and scientific facts, religious and moral values and even social and political circumstances. Dr. Berg sees culture and religious beliefs has played a pivotal role in the process. Jessica Wilen Berg: I think they play a fairly significant role for most people, either cultural backgrounds or religious backgrounds or what we call spiritual backgrounds. I think sometimes people don’t articulate well for themselves where their feeling or beliefs are coming from. Male: While some religious traditions have very specific doctrines about what is permissible and what is not, many other religions do not have such clear interpretations available to them. So, how can or should religious doctrine be incorporated into the medical treatment decision making process? Jessica Wilen Berg: That doesn’t necessarily meant that you can identify someone as being from a particular religion and say, “Well, I know them,” what you would certainly choose. There are only a few religions like that and even they are, you’d always want to talk to the patient.

Advertisement
Advertisement
Advertisement