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Cunyba

Writing

Baltimore City Community College

Description

Ashley

Parents refer to their daughter as "Pillow Angel"

because she does not move from wherever they put her, usually on a pillow.

Case:

A Seattle couple has a nine-year-old daughter, named Ashley, who has static encephalopathy, a rare

brain condition which will not improve. As a result of this condition, Ashley has the mental ability of

a three-month-old baby and cannot walk or talk. Instead of putting her in an institution, the couple

decided, out of love obviously, to take care of her at home. Contrary to Ashley’s quite limited

psychological (mental) development, the rate of her physical growth was normal apart from the fact

that, at six year of age, she was already showing signs of puberty. But, as her body was developing,

Ashley was, like any other girl, getting bigger and heavier; and Dad became the one who was lifting

her from one place to the other. Ashley’s gradual growth in size and weight made the couple realize

that their ability to keep providing her with a more personal type of care will go diminishing as they

get older. At that point in time, they would be forced to consider using a mechanical lift, which is

much more impersonal. To ensure not only that they are able to care for their daughter as long as

they are alive, but also that the latter is provided with the best possible quality of life, the parents

sought and obtained a hormone treatment to limit Ashley’s growth. They further opted for surgery

to block breast growth and had her uterus and appendix removed.

In support of their action, the parents argued that,

1. “because she will remain the weight of a child, it will [would] be easier for them to move her around,

bathe her and involve her in family activities - movement that will benefit her physical and mental well-

being.”

2. “the treatment will help to improve her quality of life.”

3. "a fundamental and universal misconception about the treatment is that it is intended to convenience the

caregiver. Rather, the central purpose of the treatment is to improve Ashley's quality of life."

4. “keeping her "frozen" as a girl rather than letting her go through puberty and growing into a woman

will give her a better life.”

5. “the decision to remove their daughter's uterus and breast buds was for the girl's comfort and safety.”

TASK

1. Use the

CRM Method

in this case.

2. Provide a

one-page abstract—often called “Executive Summary”---of

your

ethical

basis

(moral theories and principles and the way you will use them to make your point)

for moral decision-making in this case.

3. Finally, then

argue, in an essay format,

your way to moral-decision making in light of

the above-mentioned method (AJ).

4. End notes and references should come at the end of the paper. Use

MLA

style (get a

sample from the front desk in the library).

5. Length of the case:

10 pages

(10 pages of text plus 1 page of bibliography and end-

notes, if any).

6. Attach your outline of this case, as a table of contents, to the final copy.


Unformatted Attachment Preview

Case Resolution Model: “CRM” PROCESS Stage 1 Stage 2 Stage 3 Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Step 7 (P) Present Problem-1 (P) Present Problem-2 (L) List Relevant Values (L) List Relevant Values (L) List Relevant Values (D) Decide Pick Morally Better Outcome (D) Defend The Solution Reached Identify the issue to deal with in the moral situation described in the case Collect information most relevant in the situation described in the case. • Define the moral situation. • Formulate the issue in operational terms • List relevant facts in the case, i.e. decisions made and actions taken by the parties involved in the case. Explore Assess List Decide the best rightness and relevant • Take a stand by options and wrongness of values: the choosing the ways to apply various outcomes most morally better theories and (i.e. what results course of action suitable in values from the choice and for the case. the specific involved. application of • Reach case at hand the Solution specific theories & with a view values. • Consider to the best alternatives. moral • This step in the outcome. • Be sensitive to process is one of moral cost/benefit the possibility analysis; that is, an of solutions evaluation of beyond the decisions made & obvious. actions taken by the parties involved the • Look for a middle-of-thecase. Carry out the road situation, a evaluation in the compromise, or light of both the a third choice moral values and where only two theories chosen and have been applied acknowledged. Defend • Justify the decision • Give reasons for decision. • Assess whether they are the strongest ones. Step 8 (R) Reflect Justify Decision Reflect: • Consider first whether anything was lacking in the resolution of the case or in the defense of the decision. • Discuss objections likely to be raised to the decision reached or to the reasons offered. • Consider how the problem or situation could’ve been avoided. • Suggest strategies for avoiding future cases like this one. *Has comprehensive procedure for calculating what is right *Values each person’s good equally *Value of the Individual is respected *Compatibility with Western society ‘s political theory *Recognition of complexity of moral situations *Recognition of nature of the act *Respect of the value of the individual *Person-centeredness *Flexibility based on ability to recognize differences among persons and circumstances *Person-centeredness *Emphasis on communal + emotional nature of human lives *Person-centeredness *Emphasis on consistency and wholeness of a person’s moral life *Focus on consciousness allows for moral concern to be extended to all living beings, including plants *Focus on the primacy human life of life entails respect for the dignity and autonomy of human beings *Focus on the land raises ecological awareness, results in the need to care about and protect the environment *Can’t determine individuals’ rights with certainty *Sacrifices the good of community for individual rights *Sometimes ignores consequences. *Sacrifices the good of community for individual duties *Inability to explain how to move from a virtue to the right action *Can’t be universally applied due to variability of definitions of virtue from person/culture to person/culture *Inability to explain how to move from caring to the right action *Can’t be universally applied due to variability of definitions of virtue from person/culture to person/culture *Inability to explain how to move from a narrative to the right action *Can’t be universally applied due to uniqueness of every narrative *Doesn’t take into account differences among living beings. Doesn’t acknowledge food need for humans vs. animals and for the latter over plants… *Not sensitive enough to the natural balancing act: Ex. overpopulation of some animals may call for herd management *Is likely to bring about conflict and divide people into two for-and-againstecology camps Strengths *Can’t determine consequences with certainty. *Sacrifices individual goods + rights for the sake of the community Weaknesses ASSESSMENT Care Ethics Character Relationships Knowledge of One’s duty Moral Excellence Responsiveness to fellow human beings’ needs Narrative Ethics Past History & Future Plans Sentientist Ethics Unfolding of life within a culture Experience of a range of emotions: pleasure, suffering ASSIGNMENT: Fill out this chart with the strengths and weaknesses of the three types of nature-centered ethics. Consciousness Reverence for Life Respect for the health of biotic pyramids [species in their environment], and for their capacities for self-renewal Virtue Ethics Duties of Individuals Respect for the intrinsic worth of all living things, including plants + no sentient animals Type FOCUS Categ HUMAN-CENTERED ETHICS Every effort should be made to minimize harm and allow “green areas” where animals can flourish Membership-Based Entitlement Deontology The moral rightness of an can be determined only in light of life story +future plans Individuals’ Rights An act is morally right if carried out primarily to meet the needs of someone Consequences of the action. Rights-Based Ethics An act is morally right if done out of moral excellence Name Future of Community An act is morally right if it is carried out out of sense of duty Basis Utilitarianism An act is morally right if it honors the rights of an individual An act is morally right if it produces greatest pleasure for greatest number Principle MORAL DECSIONMAKING PHI 105: CHART OUTLINE 2: MORAL THEORIES & ADDENDUM MORAL THEORIES NATURE-CENTERED ETHICS DOING BEING DOING (Shapes who one is: Being) Interest: the right actions/the right thing to do the kind of person the moral agent ought to be Interest: the right action(s)/the right thing to do Biocentric Ethics Ecocentric Ethics Life Land [Planet] Evolutionary source of all life (D) Defend Justification (J) (C) Decide Satege 3 (A) Asses (B) Outcome: Right o/Wrong Analysis (A) PROCESS € Explore Options Interpret Values Satege 2 PROCESS List Pros & Cons (PC) (L) List Relevant Values Creative ProblemSolving (CPS) © Collect Facts Stzge 1 Information Gathering (IG) (P) Present Problem ETHICAL CASE SOLVING Case Resolution Model CRM Analysis Justification AJ
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Explanation & Answer

Attached.

1
Name
Course
Instructor
Date
Case Resolution-Ashley “Pillow Angel”
Executive Summary
The treatment that Ashley undergoes is experimental and this is due to her condition that
affects her brain development. The need to analyze the controversies and the precedence in the
management of her growth is important as it creates the need to focus on the recommendation
measures and the changes that affect the treatment process. The process of decision making in
the treatment process meant the need to scrutinize the community effect on the ethical
approaches and the concerns that arose burdened the community in raising disables children.
There is skeptic reaction in the impairment of the children and this affects the pharmacological
effects on the children and this interferes with the natural patterns in development. The focus on
different patterns of treatment creates the need to analyze the solutions towards Ashley growth
and this helps in the maximization of benefits in her treatment.
The high levels of estrogen inhibit her growth and this leads to the development of
activities that help in the management of the effect of the treatment. The different issues that
arise seem to be static as people consider the stunting of the growth to be selfish and argue that
she can receive better care with the help of caregivers. It creates the need to focus on the
possibilities of the parents and the fears that they have towards giving the best care to Ashley.
The analysis of the ethical frameworks is essential as it guides the development of the changes
and the rapid effect that shapes the decisions made about the treatment of Ashley. The medical

2
board decisions affect the needs of the child in her growth, and the best decision are what makes
Ashley develop better.

3
Introduction
The case brings questions on medical ethics in the sterilization of the girl to shorten her
growth and make it easier for the parents to take care of her considering the encephalopathy
condition. The condition of the child affects the brain, and this affects her development. The
conditions provide challenges to the caregivers and parents. The arresting of her growth would
imply she remains small in her development and this leads to this according to the parent would
focus on giving her quality life. The analysis of the changes that would lead to the management
of her care at home and make it easier for the parents to provide the required care to Ashley. The
recommendation of the procedure by the Ethics Committee focused on giving a high dosage of
estrogen that would impact her growth and inhibit maturation. The removal of her uterus meant
that she would not have discomfort in menstrual pains and this would have a positive impact in
her life as there is an analysis of the various issues that she is likely to face in her growth. The
removal of her breast bud would protect her from the history of cystic fibrosis and cancer in her
family.
The debate on the treatment measures of Ashley influences the need to focus on the
provision of quality life, and this means the analysis of the child rights towards growth. There are
those that argue that the treatment is to create convenience towards the parents in taking care of
the child and not on her growth. The ethical questions that arise in the case focus on the need to
enhance the ethical and the medical approaches in the interest of the child. The controversies of
the procedures and the vulnerabilities of the people lead to the need to analyze the case and focus
on the interest of the growth of the children.
Ethical Analysis

4
The condition of Ashley is persistent, and this is due to the development challenges of her brain.
The analysis of the deficit in her growth created the analysis of the effects that the condition has
on her development and cognitive abilities. The identification of the changing movements and
the manipulation of the symptoms led to the need to analyze the complexities of her development
and the effect that it had on her capacity in development. The limitation in the mobility of Ashley
gave the caregivers and the parents a hard time and their decision on stunting her growth was to
ensure that she had an easier time and the reduction of the complications that were likely to arise
( Manne 415). The issue has created different concerns from different disciplines, and this meant
the need to focus on the rights of the child in going through the different stages of growth. The
analysis of the ethical framework and theories helps in identification of the consequences of the
treatment procedure and the need to focus on various consequences of the procedures leading to
the application of the ethical approaches.
The utilitarian theoretical approach focuses on the ability to reflect on the consequences
of the actions and in the case of Ashley, checking the changes in the growth of the child affects
the rule created towards the improvement of her life. The respect of Ashley as an individual
would mean analysis of the divide in respect to her as a person, and this encourages the treatment
of the child with dignity. The lack of provision of care to the child would deprive her of quality
care, and this means the violation of the basic rights to her respect as a person. The reliance of
the child on the parents creates the need to focus on the provision of basic demands and the
critical care required for the child. The analysis of the insufficient support that people with
disabilities receive is termed unethical as they are required to be treated as any other person
(Harnacke 145). The parents argue that having a size that is manageable gives the child an

5
opportunity to be accepted in the society and the assurance that there are respect and dignity in
her existence.
The debate on forcing Ashley to be a child affects her infant development as she deserves
to be a grown person. They argue that with the appropriate facilities, it is possible for the child to
get the care that they require ad the assistance on the right size of wheelchairs. With the right
pharmacological assistance, there is focus on the assistance that guides her development. The
solution then is not to interfere with the pattern of her development but focus on the right ways to
ensure there is a moral reflection on the situation (Diekema, Douglas and Norman 39). The
reaction of the parents to the decision is based on the best needs of the children, and this means
looking at the rights of the child and analysis of the situation that affects their growth. The
deontology ethical theory is applied in the case where there is need to focus on engagement of
the parents on their duties and the role that they play in decision making. There is focus on the
conduct that helps in the creation of correct strategies and the consistency that helps in increasing
the child development.
The decisions that the parents make on behalf of the child are focused on the positivity of
implementation, and this means the analysis of the behaviors that they exhibit in the long run. In
the case, the analysis of the doctor’s role creates the need to focus on the wellbeing of the child
and the advocating for the rights of the disabled children. The application of technology is
essential in the analysis of children with different conditions such as spina bifida, cerebral palsy
and other injuries that affect the brain (Spriggs 52). The procedures used in the analysis of the
reproductive systems and the capacity that is exposed to risks create the need for the
standardization of the treatment measures and the reduction of the vulnerabilities that affect

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Ashley. The need to analyze the technological development helps in treating the child with
respect and dignity.
The ethical concerns on the removal of the uterus create debates a...


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