Chemotherapy; An ethical perspective

by AlexR on February 16, 2015 - 9:33am

The case of the young native Makayla Sault, the girl who refused cancer treatment, raised a lot of debate during the last month. After her first month of chemotherapy, she (and her parents) decided to get on holistic medicine and leave chemo. Unfortunately, Makayla passed away. Her parents claim that her death was caused by the treatment, when specialists blame the cancer itself. Everyone should have the right to decide how to cure (or not) themself, that is why I think not leaving someone make its own choice is unethical.

 Makayla Sault was suffering from a cancer, more precisely an acute lymphoblastic leukemia [ALL]. According to a specialist, 80 to 90% of the children with ALL can be cured today with the “proven medicine”. I put proven medicine in quotes because like the parents of Makayla, I do not believe in chemotherapy. First of all, most anti-cancer drug will cause another cancer later in the life of the patient. According to a study, 17.6 percent of survivors will develop unrelated cancer in the next 15 years (CMJ, 1991).  Also, “heart damage can occur weeks, months or years after treatment, signalled by rapid heart beat, shortness of breath, distended neck veins, swollen ankles, enlarged liver and heart. Up to 30 percent of high-dose Doxorubicin-recipients develop congestive heart failure (CMJ, 1991).” Finally, “immune system damage is almost universal. The whole panoply of blood diseases is seen: thrombocytopenia with its loss of white blood cells that guard against infection; severe bone marrow hypoplasia; inability to synthesize fibrinogen; abnormally long bleeding time; granulocytopenia. Resulting infections can be treated with antibiotics, but these can bring their own set of side effects (CMJ, 1991).” To add to the fact that chemotherapy is a matter of choice, a 17 years old girl from Connecticut decided to say no to chemo because she wanted to enjoy the last day that remains. She claims that she is more interested in the “quality of what life she has left, not the quantity (Shapiro, 2015).” As we can observe using our logic, this “proven medicine” can save your life, but you will be mortgage with health problems for the rest of your life. You don’t survive cancer, you survive chemotherapy.

On the other hand, some people say that chemotherapy is worth doing because it gives you the chance to survive. It’s a fact that some people have survived cancer using chemotherapy, but at what cost? Chemotherapy decreases considerably your life quality and life expectancy. It can causes other diseases and reduce the strength of your immune system. I think one have to ask itself what are their priorities; a short but enjoyable life, or a long but problem-filled life. 

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Original title: Makayla Sault likely died from rebounding cancer, not chemotherapy effects: specialist

Article written by Tom Blackwell for The National Post on January 20, 2015

Active link: http://news.nationalpost.com/2015/01/20/makayla-sault-likely-died-from-rebounding-cancer-not-chemotherapy-effects-specialist/

Work Cited:

"The Truth About Chemotherapy Side Effects." Nutrition Health Review: The Consumer's Medical Journal 58 (1991): 10. Academic Search Premier. Web. 16 Feb. 2015.

Shapiro, Emily. "Home Health Connecticut Teenager Explains Why She Doesn't Want Chemotherapy Treatment." AbcNews 11 Jan. 2015. AbcNews. Web. 16 Feb. 2015. <http://abcnews.go.com/Health/connecticut-teenager-explains-doesnt-chemot....

 

Comments

Let me begin by saying that you did a really good job at summarizing this issue and providing us with the background information necessary to understand the problem! It is very complete, with a lot of relevant detail.

Utilitarianism is an ethical view claiming that what is moral is determined by its consequences. To go even further: what is moral is what brings the most happiness and reduces pain. Looking at this particular issue, a rule utilitarian might say that it is immoral not to provide chemotherapy to an ill patient like Makayla Sault, as it is the only way to "relieve her pain" and give her the chance to live a longer and happier life. However, as someone who believes more in preference utilitarianism, I believe that what would really be unethical would be to force someone to undergo a treatment he or she does not desire. Indeed, according to preference utilitarianism, the moral thing to do is to "fulfill as many preferences as possible" (Gibson 65). So, regardless of the consequences of using chemotherapy or not, what would bring the most happiness without harming others would be to respect Makayla Sault's choice.

Work Cited

Gibson, Kevin. An Introduction to Ethics. New Jersey, USA: Pearson Education, Inc., 2014.

I'd like to first commend you on your desire to test the assumptions of modern medicine and an excellent job concisely synthesizing a lot of information. Before delving into my argument, I want to address the usage of preference utilitarianism in the above comment. Preference utilitarianism is actually a deeply flawed teleological framework because the fulfillment of preferences does not typically fulfill the summum bonum. This is particularly true in the case of refusing cancer treatment, where preferences can easily be skewed, leading to misinformed decisions by patients.

In addition, I'll now apply the teleological framework of ethics to show that refusal of cancer treatment is actually unethical. The overarching goal is to create the greatest happiness for the greatest number; in other words, maximizing pleasure and minimizing pain. In your post, I believe that you generally referred to pleasure or pain in terms of physical sensations. Utilitarian doctrine, however, focuses on higher level pleasures (e.g. pleasures of intellect). I would make the argument that by refusing treatment, the patient is choosing to forego high-value pleasures in order to avoid physical harm. In general, so long as they can remain conscious, patients should try to prolong life as much as possible because of the potential future pleasures.

To start off, I must say this is an issue I found exceptionally thought-provoking. It made me reflect a lot and I can come up to a conclusion which supports the idea of fighting for survival. Undoubtedly, It is true that chemotherapy possibly has many negative side effects to it. Although, another fact is: chemotherapy is misunderstood. A study published in The New England Journal of Medicine revealed that “69 percent of lung cancer patients and 81 percent of those with colon cancer misunderstood the purpose of the very treatment they'd been undergoing” (Span, 2014). I feel that many times there are overreactions concerning these treatments. We should all be aware that when aiming for good, there is and will always be a small possibility where things may go wrong. As you have mentioned, most of the children (80-90% according to a specialist) with ALL can be cured from it and the percentage of survivors that will develop a unrelated cancer in the next 15 years is of 17.6 percent. The 17.6 which is that lower percentage where things may go the opposite way.

Some of these facts tend to scare people right off the start and produce misunderstandings but it would be extremely important for the individuals to acquire unabridged knowledge. After all, the matter is of a battle between life and death.

Read more at: http://newoldage.blogs.nytimes.com/2012/11/12/what-chemo-cant-do/?_r=0

Works Cited:

Span, Paula. "Misunderstanding Chemo." The New York Times. Nov 12. 2012.
Web. May 4. 2015. http://newoldage.blogs.nytimes.com/2012/11/12/what-chemo-cant-do/?_r=0

This is a very well written piece with a significant amount of detail which additionally gives the readers an underlying understanding of the subject. Overall, the different information that you presented furthermore enhances your argument. This is a side of chemotherapy that I had no knowledge of which changes my ethical perspective.

The teleological perspective observes the outcome of an action. To be more specific, the utilitarianism approach determines that a persons actions must lead to a greater happiness. This utilitarian theory would view the force-meant of chemotherapy on a patient immoral.
It is unethical due to the fact that the doctors go against the patients wishes. So, if not receiving chemotherapy leads to greater happiness, thus it is good in these circumstances. In the case of Makayla Sault, she did not undergo chemotherapy, but yet she still lived her life to the fullest. She achieved her own personal happiness by rejecting the treatment. To respect an ill patients wishes is their greatest happiness.

Unlike the teleological perspective, the deontological perspective does not value individuals human rights. It looks at the consequences of ones actions. This is immoral since patients should have the authority to make their own decisions since it is their life.

Therefore, the teleological perspective allows for the ill to make their own judgements. They have the right to decide whether or not they will follow up with chemotherapy or not. This will lead to a greater happiness due to the fact that the patient makes their own decisions over their way of healing.

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