Question

Sarah is a 17-year-old undocumented immigrant who has been followed at a regional pediatric heart center since age six for single-ventricle Fontan physiology. She lives with her parents and three siblings in a rural community, where her parents struggle to avoid deportation and support their four children by working as agricultural laborers. Although Sarah and two of her siblings immigrated in childhood and are eligible for the Deferred Action for Childhood Arrivals program (DACA), Sarah’s youngest sibling was born in the United States and is an American citizen.

Sarah’s heart condition is now complicated by protein-losing enteropathy, tricuspid regurgitation, and decreased cardiac function. Her cardiologists have diagnosed her with end-stage heart disease and believe she will require a cardiac transplant to survive to adulthood. Due to her anatomy, Sarah is at a higher risk of a poor outcome if transplantation is pursued, and this risk will increase as she gets sicker. She is not a candidate for a ventricular assist device. After a discussion of the risks and benefits of a transplant, Sarah and her parents have indicated that they would like to pursue heart transplantation.

The cardiac transplantation team considers Sarah an acceptable candidate for transplantation despite her increased risk, but it has raised concerns about whether her status as an undocumented immigrant will adversely affect her ability to obtain the health care and medications required to maintain her long-term health following the transplant. In addition, there is a child who is a citizen that also needs a heart transplant on the same floor Sarah is hospitalized in. Her first surgery was performed in Mexico, but subsequent surgeries have been performed at the regional pediatric institution. The regional children’s hospital has committed to providing care and medications until Sarah reaches age 21, but the team has expressed concern about whether she would be able to afford the necessary care and medications after that point.

How does the beneficene theory apply to this scenario and explain why?

Answer 1

The principle of beneficiance is a moral obligation to act for the benefit of others. There are 2 aspects of beneficience -

Providing benefits, balancing benefits and risks/harns

The principle of beneficence support the following moral rules or obligations

Protect and defend the rights of others

Prevent harm from occurring to others

Remove conditions that will cause harm

Help persons with disabilities

Rescue person in danger

Sarah should be considered for surgery as she is a deserving young patient who is in cardiac failure.All life supporting measures and surgery should be carried out in her. And she is of young age.