Mid-Term Case Assignment: A Non-Interval Tubal Ligation at a Catholic Hospital
Relevant Facts
TJ, the patient, is a 35 year old woman who is four months pregnant with her fourth child. She will deliver at a catholic facility and will have a c-section with the same obstetrician, Dr. Jan, who delivered her three other children. In a previous pregnancy Mrs. J was hospitalized for pulmonary emboli when she presented to the ER with shortness of breath. Currently, Mrs. TJ is experiencing deep vein thrombosis as a result of her pregnancy. Even though Dr. Jan believes her current pregnancy will be successful, another pregnancy would jeopardize her health, her life, the life of the unborn child and her ability to support and raise her present children.
Due to repeated c-sections she now has extensive scar tissue that is invading her endometrial cavity In order to prevent added risk from two surgical procedures and double anesthesia Dr. Jan has suggested that she should get a tubal ligation at the time of her c-section. Of course the Catholic ERD objects to because the procedure would not be indirect in their perspective.
Ethical
The three ethical issues at stake in Mrs. TJ's case are benevolence, non-malevolence, and autonomy. The first principles that apply to Mrs. TJ's situation are beneficence and non-malevolence. Dr. Jan wants to perform the tubal ligation not for the sole purpose to sterilize and prevent procreation but to prevent the consequences a pregnancy might inflict on her health and life. Looking after her best interest and preventing harm is essential in Mrs. TJ's case. The interest to live for her husband, existing children, and the one on the way out-weights the bad effects of tubal ligation. Dr. Jan's duty of non-malevolence is the reason why ...