Commentary

Abstract

Don't you just know it. It's a relatively peaceful day and you are getting some quality work done when the phone rings. The caller requests help in the form of an ethics consult. When you first hear about it you think someone is pulling your leg, but no, this is the real world. A case like this exemplifies many of the twists and turns of fact, and belief, that accompany many clinical ethics consultations. Several of the facts of the case generate an immediate emotional response that tempts the mind to run with them down enticing and confusing paths of thought. The “child,” age 19, is a minor in some states, but not in many. This introduces the whole notion of decisionmaking by parents or designated surrogates. Additional information suggests the comatose victim's mother is the prime motivator behind the request. The various motivations for the mother are revealed, primarily her desire to have a grandchild. The patient's own feelings are portrayed as ambivalent and the potential recipient, after the patient's sisters had been excluded because of consanguinity, is a 16-year-old girl who didn't even show up at the care conference. You are also told that the technical feasibility of the medical procedure under consideration is questionable and, of course, your legal department can't give you a straight answer—just hazard a guess.