Mid-Term Case Assignment: A Non-Interval Tubal Ligation at A Catholic Hospital

Mid-Term Case Assignment: A Non-Interval Tubal Ligation at a Catholic Hospital

Relevant Facts

TJ, the patient, is a 35 year old woman who is four months pregnant with her fourth child. She will deliver at a catholic facility and will have a c-section with the same obstetrician, Dr. Jan, who delivered her three other children. In a previous pregnancy Mrs. J was hospitalized for pulmonary emboli when she presented to the ER with shortness of breath. Currently, Mrs. TJ is experiencing deep vein thrombosis as a result of her pregnancy. Even though Dr. Jan believes her current pregnancy will be successful, another pregnancy would jeopardize her health, her life, the life of the unborn child and her ability to support and raise her present children.

Due to repeated c-sections she now has extensive scar tissue that is invading her endometrial cavity In order to prevent added risk from two surgical procedures and double anesthesia Dr. Jan has suggested that she should get a tubal ligation at the time of her c-section. Of course the Catholic ERD objects to because the procedure would not be indirect in their perspective.

Ethical

The three ethical issues at stake in Mrs. TJ’s case are benevolence, non-malevolence, and autonomy. The first principles that apply to Mrs. TJ’s situation are beneficence and non-malevolence. Dr. Jan wants to perform the tubal ligation not for the sole purpose to sterilize and prevent procreation but to prevent the consequences a pregnancy might inflict on her health and life. Looking after her best interest and preventing harm is essential in Mrs. TJ’s case. The interest to live for her husband, existing children, and the one on the way out-weights the bad effects of tubal ligation. Dr. Jan’s duty of non-malevolence is the reason why he/she wants to perform the procedure at the same time of the c-section. Double anesthesia and two risky surgical procedures can cause pain and danger to Mrs. TJ’s life considering this is her fourth c-section and is experiencing DVT.

The other issue at stake is Mrs. TJ’s right to autonomy. Her decision to do whatever Dr. Jan recommends for her well-being and the fact that she has her own beliefs deserves respect on behalf of the institution. Autonomy is a problem in reconciling the decision that the Catholic hospital has regarding a tubal ligation at the time of birth and the choices Mrs. TJ and Dr. Jan believe are best. The Autonomy of the TJ’s should be respected to the extent of whatever is best for Mrs. TJ health, life and the family.

Theological

The three theological issues at stake are biblical hermeneutics, the sanctity of life, and dignity. Biblical hermeneutics is at stake because The TJ family is Christian but not Catholic therefore their only resource to make theologically right decisions is the bible. To their interpretation there is nothing wrong in having a non-interval tubal ligation. Their argument is that even if the end of the tubal ligation is to prevent procreation they have already ‘fulfilled their Christian calling to be fruitful and multiply.’ Dr. Jan who is Catholic and suggested the non-interval tubal ligation also agrees that the TJ’s have demonstrated the sacramental nature of Christian marriage. Considering that the function of marriage is not just to procreate but to unify, the Catholic institution trying to impose the Catholic beliefs on the couple might be setting a barrier for the TJ’s to fulfill Humanae Vitae. If the TJ’s would change their beliefs to those of the Catholic faith, they will have to abstain from the acts of husband and wife, which create unity in a marriage, to prevent a pregnancy that will endanger Mrs. TJ’s life in accordance to the Catholic teachings because they can not use contraceptives.

Putting Mrs.TJ’s life at risk by exposing her to double anesthesia and the risk of two surgical procedures creates a predicament between biblical hermeneutics and the sanctity of life. The sanctity of life is the idea that life is sacred and should not be undermined by the biblical hermeneutics in this case. Mrs.TJ’s right to life is one of the utmost important issues to protect and consider when it comes to the non-interval tubal ligation. The sanctity of life is connected to her dignity. Mrs. TJ has been made in the Image of the Creator and therefore must be treated with respect and saved from an early painful death.

Anthropological

The anthropological issues are relationality and historicity. Relationality is how we connect to each other as human beings. To make a decision under Mrs. TJ’s condition we must see that no one would like to go through unnecessary surgical procedures.