Balancing Outcomes and Moral Values

Rosemary Flanigan

June 17, 2010

John Lantos reviewed a book for the latest Hastings Center Report (Vicki Forman. This Lovely Life. Mariner Books 2009) and I thought of our case consults.

The author delivered twins after just twenty-three weeks of gestation. One twin dies. Eight years later, after years of challenges, the other severely disabled twin also dies of acute intestinal blockage.

She tells of the refusal of the neonatologists to write a DNR order (John gnashes his teeth!), of the ongoing daily decisions, of her eventual embrace of the remaining child and his multiple anomalies. So when she is asked, “Knowing what you know now, would you still demand that the twins not be resuscitated?” she answers, “I don’t know.”

We ask questions like that in our consults—and how can we expect others to respond as if the there were no intervening mass of fear, grief, compassion and love?

I shall die urging people to be reflective and to do ethical analyses but we must also admit (as in the Truog case) that it is not an exercise of balancing outcomes or justifying placing one moral value above another. Though these steps are important, sometimes they are not sufficient.

ANY COMMENTS???