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Case Study on Moral Status

Assessment Traits

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Assessment Description

Based on “Case Study: Fetal Abnormality” and the required topic Resources, write a 750-1,000-word reflection that answers the following questions:

1. What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?

2. Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?

3. How does the theory determine or influence each of their recommendations for action?

4. What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?

Remember to support your responses with the topic Resources.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Attachments

Case Study: Fetal Abnormality

Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.

Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears.

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother.

© 2020. Grand Canyon University. All Rights Reserved.

Case Study on Moral Status – Rubric

Collapse All Case Study On Moral Status – RubricCollapse All

Christian View of the Nature of Human Persons and Compatible Theory of Moral Status

60 points

Criteria Description

Christian View of the Nature of Human Persons and Compatible Theory of Moral Status

5. Excellent

60 points

Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear, thorough, and explained with a deep understanding of the relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.

4. Good

51 points

Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear, thorough, and and explains the relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.

3. Satisfactory

45 points

Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear and explains the basic relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.

2. Less Than Satisfactory

39 points

Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is unclear. Explanation is not clearly supported by topic study materials.

1. Unsatisfactory

0 points

Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is insufficient. Explanation is not supported by topic study materials.

Determination of Moral Status

40 points

Criteria Description

Determination of Moral Status

5. Excellent

40 points

The theory or theories that are used by each person to determine the moral status of the fetus is explained clearly and draws insightful relevant conclusions. Rationale for choices made is clearly supported by topic study materials and case study examples.

4. Good

34 points

The theory or theories that are used by each person to determine the moral status of the fetus is explained clearly and draws relevant conclusions. Rationale for choices made is clearly supported by topic study materials and case study examples.

3. Satisfactory

30 points

The theory or theories that are used by each person to determine the moral status of the fetus is explained and draws relevant conclusions. Rationale for choices made is supported by topic study materials and case study examples.

2. Less Than Satisfactory

26 points

The theory or theories that are used by each person to determine the moral status of the fetus is not clearly explained. Rationale for choices made is unclearly supported by topic study materials or case study examples.

1. Unsatisfactory

0 points

The theory or theories that are used by each person to determine the moral status of the fetus is not adequately explained. Rationale for choices made is not supported by topic study materials or case study examples.

Recommendation for Action

40 points

Criteria Description

Recommendation for Action

5. Excellent

40 points

Explanation of how the theory determines or influences each of their recommendations for action is clear, insightful, and demonstrates a deep understanding of the theory and its impact on recommendation for action. Explanation is supported by topic study materials.

4. Good

34 points

Explanation of how the theory determines or influences each of their recommendations for action is clear and demonstrates an understanding of the theory. Explanation is supported by topic study materials.

3. Satisfactory

30 points

Explanation of how the theory determines or influences each of their recommendations for action is clear. Explanation is supported by topic study materials.

2. Less Than Satisfactory

26 points

Explanation of how the theory determines or influences each of their recommendations for action is unclear. Explanation unclearly supported by topic study materials.

1. Unsatisfactory

0 points

Explanation of how the theory determines or influences each of their recommendations for action is insufficient. Explanation is not supported by topic study materials.

Personal Response to Case Study

40 points

Criteria Description

Personal Response to Case Study

5. Excellent

40 points

Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear, relevant, and insightful.

4. Good

34 points

Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear and relevant.

3. Satisfactory

30 points

Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear.

2. Less Than Satisfactory

26 points

Evaluation of which theory is preferable along with how that theory would influence personal recommendations for action is lacking a personal connection.

1. Unsatisfactory

0 points

Evaluation of which theory is personally preferable along with how that theory would influence personal recommendations for action is inadequate.

Organization, Effectiveness, and Format

10 points

Criteria Description

Organization, Effectiveness, and Format

5. Excellent

10 points

Writer is clearly in command of standard, written, academic English.

4. Good

8.5 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

3. Satisfactory

7.5 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

2. Less Than Satisfactory

6.5 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

1. Unsatisfactory

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Documentation of Sources

10 points

Criteria Description

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5. Excellent

10 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

4. Good

8.5 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

3. Satisfactory

7.5 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

2. Less Than Satisfactory

6.5 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

1. Unsatisfactory

0 points

Sources are not documented.

Optional – Joni and Friends

For additional information, the Joni and Friends website is recommended:

https://www.joniandfriends.org/

Optional – Topic 2: Optional Resources

For additional information, see the “Topic 2: Optional Study Resources” that are recommended.

PHI-413V-RS-T2OptionalResources.docx

The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities

Read the attached article, “The Image of God, Bioethics, and Persons With Profound Intellectual Disabilities,” by Devan Stahl and

… Read More

JCID 6.1-6.2 – Article – D. Stahl_J.Kilner – Image of God Bioethics and PWIDs.pdf

Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care

Read Chapters 2 from Practicing Dignity.

https://www.gcumedia.com/digital-resources/grand-canyon-university/2020/practicing-dignity_an-introduction-to-christian-values-and-decision-making-in-health-care_1e.php

Philosophy – Ethics: Moral Status

View the video “Philosophy – Ethics: Moral Status,” by Jeff Sebo, from Wireless Philosophy.

PHI-413V: Ethical and Spiritual
Decision Making in Health Care

God, Humanity, and Human Dignity

1

Meet
The Family

Myself (Steve) with my wife Patty and our children Brent and Carah and her husband Jason

2

The Rest of the Family
Duffy Sheldon Bailey

3

How should we think about human beings?

So what makes the rest of my family different or more valuable than Duffy, Sheldon, and Bailey?

Why do human beings have special worth or value we call human dignity?

What is it about you that makes you, “you” and stays the same through change in your life?

4

On what basis are we truly equal?

Why do we believe there are such things as human rights?

5

Moral status – Which sorts of beings or entities are valuable and have rights to be treated in certain ways?

What kind of a thing is a human person?

In other words, on what basis are we considered valuable or worthy of dignity and respect?

What (if anything) makes a human being valuable and worthy of dignity and respect?

6

What It Means to Be a Human Being

(This is not fundamentally a scientific question, but rather a philosophical question.)

Moral Status

(Question to consider: Does my worldview provide an adequate explanation for my beliefs about human dignity?)

What does it mean to be a human being?

Anthropological axiology (the basis upon which human beings are assigned value in relation to other kinds of beings) contra relativism, cannot be simply dependent upon culture or personal preference but rooted in the nature of what it means to be a human being. Contra scientism, the value and dignity of human beings stands over and above that of other species and cannot be simply reduced to a person’s abilities or function, or the person’s physical constituents. (PHI-413V Lecture 2, GCU)

While it has a been a perennial challenge for secularism to find a basis upon which to assign human beings intrinsic worth and dignity, the concept of human “dignity” and intrinsic value (including its implied ethical principles such as respect for persons, etc.) is inherent in Biblical teaching and Christian tradition. An appreciation and grasp of this question is fundamental for understanding the contemporary religious context and the goals and virtues of medicine. (PHI-413V Lecture 2, GCU)

The question of “personhood” (i.e., the fundamental nature, value, and identity of what it means to be a person) is not fundamentally a scientific question, but rather a philosophical question. One’s answer to this question (which will in some sense be part of a worldview) will determine the person’s definition of other related and common concepts in health care. Primarily, the concepts of “dignity” and “care” are closely connected. Briefly, upon what basis humans should be valued over and above other types of beings or species? Can one’s worldview explain the intrinsic value of human beings? Secondly, the very concept of “care” implicit in health care assumes that its primary object of concern is persons (not, scientific knowledge, or money, notoriety, etc.).

Moral Status

Briefly, the concept of moral status concerns which sorts of beings or entities have rights (in the sense that a moral agent has obligations toward this being or entity). Human rights, for example, are considered to be a prime example of descriptions of obligations a moral agent has to any human being. Furthermore, human beings are taken to have these obligations due to them simply in virtue of being human beings. Another way to describe the concept of a beings moral status is to talk about its value or worth. Thus, to talk about a beings moral status is to talk about a beings value, as well as why it has that value. (PHI-413V Lecture 2, GCU)

Key Point

While there seems to be an innate sense of what it means to be a human being that most people have, one needs to stop and actually think about what this means. It might be assumed that healing and caring are good things because human beings are valuable and ought to be respected, but the question is whether one’s worldview provides an adequate explanation for these beliefs? Are they in some sense relative? Pay attention to how the Christian narrative answers these questions and begin to ask yourself how you would answer them.

7

Moral Status

Five views or theories commonly used by bioethicists:

Human Properties

Cognitive Properties

Moral Agency

Sentience

Relationships

From PHI-413V Topic 2 Overview

Human Properties

The theory based on human properties holds that it is only and distinctively human properties that confer moral status upon a human being. It follows that all and only human beings, or Homo sapiens, have full moral status. Some of the characteristics that would endow a human being with moral status would include being conceived from human parents, or having a human genetic code. In this view, one only needs to be a human being to count as having full moral status.

Cognitive Properties

The theory based on cognitive properties holds that it is not any sort of biological criteria or species membership (such as the theory based on human properties) that endows a human being with moral status. Rather, it is cognitive properties that confer moral status upon a human being. In this context “cognition refers to processes or awareness such as perception, memory, understanding, and thinking…[and] does not assume that only humans have such properties, although the starting model for these properties is again the competent human adult” (Beauchamp & Childress, 2013, p. 69). Notice carefully this is claiming that if a human being does not have these properties, it follows that such a human being does not have moral status or value.

Moral Agency

The theory based on moral agency holds that “moral status derives from the capacity to act as a moral agent”; in this view a human being is considered a moral agent if they “are capable of making judgments about the rightness or wrongness of actions and has motives that can be judged morally” (Beauchamp & Childress, 2013, p. 72).

Sentience

The theory based on sentience holds that having sentience confers moral status on a being. Sentience in this context is “consciousness in the form of feeling, especially the capacity to feel pain and pleasure, as distinguished from consciousness as perception or thought.” (Beauchamp & Childress, 2013, p. 73). According to this theory the capacity of sentience is sufficient for moral status (i.e., the ability to feel pain and pleasure confer moral status to a human being).

Relationships

The theory based on relationships holds that relationships between human beings account for a human being’s moral status. In other words, a human being has moral status only if he or she has a relationship with others who value him or her. Usually these are relationships that establish roles and obligations such as a patient-physician relationship or a parent-child relationship. Of course, there are many types of relationships (family, genetic, legal, work, etc.), even ones in which one party in the relationship does not desire or value the other party. In such a case, a person who holds this theory may be forced to concede that a being’s moral status may change, depending on the other party.

Key Point

Each of these theories will take shape in the context of a particular worldview and may be applied differently based on an individual’s worldview. There may also be considerations for a particular worldview that would not allow one to hold one or more of these theories.

So a person with Christian worldview might apply the human properties theory based on the understanding that humans are made in the image of God and have value or worth because life is sacred, where a person from another worldview may apply the human properties theory based on having a distinct human genetic code.

8

Christian imago dei vs. Scientism vs. Postmodern Relativism

9

Imago Dei

Then God said, “Let us make man in our image, after our likeness. And let them have dominion over the fish of the sea and over the birds of the heavens and over the livestock and over all the earth and over every creeping thing that creeps on the earth.” So God created man in his own image, in the image of God he created him; male and female he created them.

(Genesis 1:26-27 ESV)

The Imago Dei – “image of God”

Class Discussion: What is the Christian concept of the imago dei? How might it be relevant to healthcare, and why is it important?

According to Called to Care by Shelly and Miller, p. 77 –

We are created and distinct from the Creator

We somehow reflect the nature of this God – reason, morality, language, relationships, creativity, etc

God gives us a position of responsibility and authority over creation

According to Dignity and Destiny: Humanity in the Image of God by John Kilner

Jesus is the image, not us: 2 Corinthians 4:4; Colossians 1:15, and he was the prototype for humanity before Adam and Eve: Romans 8:29

We are created in his image: Genesis 1:26-27, and continued to be made according to God’s image after the fall: Genesis 9:6

Sin cannot erase the image: Genesis 5:1; 9:6

Humanity as royalty: Psalm 8:4-6

We have a destiny through the Gospel. We are restored and renewed progressively to conform to the image of Christ, God’s image. We are moving towards him: Colossians 3:9-10; 2 Corinthians 3:18; Romans 8:29

10

Imago Dei

All human beings equally have inherent value and dignity:

“there is no indication that the image is present in one person to a greater degree than in another. Superior natural endowments, such as high intelligence, are not evidence of the presence or degree of the image. [Furthermore], the image is not correlated with any variable…[but is] something in the very nature of humans, in the way in which they were made. It refers to something a human being is rather than something a human being has or does.”

(Erickson, 1998, pp. 557-558)

See Practicing Dignity, chp 2

11

Scientism

Materialism

The doctrine that everything that exists is material. To a materialist there is really only one substance in the universe, and such things as intelligence, feeling, conscience,* volitions, and dispositions are but modified properties of matter. Instead of intelligence creating matter, matter evolved into intelligence. Thus materialism is the antithesis of idealism* and antagonistic to all theism.

Cairns, A. (2002). In Dictionary of Theological Terms (p. 274). Belfast; Greenville, SC: Ambassador Emerald International.

12

Scientism

Materialism

The view that only material objects exist. Materialism is sometimes used as a synonym for physicalism, but some thinkers distinguish the two by allowing that physicalism holds that only matter and energy exist. Some materialists define their view in terms of science and claim that ultimate reality consists of whatever particles or entities are discovered by physicists. See also eliminative materialism; nonreductive materialism.

Evans, C. S. (2002). In Pocket dictionary of apologetics & philosophy of religion (pp. 73–74). Downers Grove, IL: InterVarsity Press.

13

Naturalism

Naturalism

Philosophical or metaphysical naturalism refers to the view that nature is the “whole show.” There is no supernatural realm and/or intervention in the world (see Materialism; Miracles, Arguments Against). In the strict sense, all forms of nontheisms are naturalistic, including atheism, pantheism, deism, and agnosticism.

Geisler, N. L. (1999). Naturalism. In Baker encyclopedia of Christian apologetics (p. 521). Grand Rapids, MI: Baker Books.

14

Postmodern Relativism

The postmodern argument with viewing persons as the image of God (imago Dei) takes a different tack. Drawing from an eclectic array of ancient and newly constructed religions and philosophies, as we have seen, many are beginning to view the earth as a living organism. Kleffel explains, “Humans are one functioning part of the totality and act in harmony within the organism.” In other words, human life is no more valuable than a rock or a raccoon. The philosophy reveals itself in the T-shirt slogan borne by Margie, a junior student: “Save the rats, experiment on people.”

Shelly and Miller (2006). Called to Care (p. 76). InterVarsity Press.

15

Personhood

What does it mean according to:

Christian imago dei

Scientism (Naturalism/Materialism)

Postmodern Relativism

The main point here is to understand that each worldview has it’s own set of assumptions about the fundamental nature of what it means to be human.

16

Case Study: Fetal Abnormality

Central Question: Upon what basis (moral status theory) does or doesn’t the fetus have moral status according to each adult?

Case Study Clarification

In identifying the theories used by the four individuals in the case study you are applying the theory used BY the adult to determine whether or not the fetus has moral status (value or worth). So the theories are applied towards the fetus NOT applied towards the adults.

For example:

If I were to say, “It makes me feel bad to think I could be causing my unborn child to suffer pain from an abortion, so I have to keep my child”, I would be using the theory of Sentience because of my belief that it would be wrong to harm my child who can feel pain (therefore having moral status), not because I myself would feel the emotional pain about going through with the abortion.

Again, if I were to reason that my unborn child wouldn’t be able to live a normal life, creating unnecessary hardship and suffering for both the child and myself due to a condition that would leave the child mentally impaired for life, I would be applying the Cognitive theory based on the child’s assumed lack of cognitive ability, not because I am using my own cognitive ability to reason what I think is best with the medical information I have.

Be careful to use clear reasoning and defend your interpretations logically based on the theory being applied in the study.

Case studies are not always clear and there may be more than one interpretation or how a theory is applied. Do not assume too much about each characters’ psychological states or motivations or read too much into the case.

Pay attention to the last paragraph.

17

Case Study: Four Objectives

What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?

Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?

How does the theory determine or influence each of their recommendations for action?

What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?

18

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