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Bioethics Dilemma

royalpaladin
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2/8/2013 4:26:34 PM
Posted: 3 years ago
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?
royalpaladin
Posts: 22,357
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2/8/2013 4:27:29 PM
Posted: 3 years ago
At 2/8/2013 4:27:11 PM, royalpaladin wrote:
Alternatively, you could pass it off as a mutation in the germ line.

Even though you know it actually is not.
Franz_Reynard
Posts: 1,227
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2/8/2013 4:31:58 PM
Posted: 3 years ago
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

Yes.
Franz_Reynard
Posts: 1,227
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2/8/2013 4:34:27 PM
Posted: 3 years ago
There's two issues at hand here.

First, there's the fact that if the woman were not unfaithful, then clearly, their child wouldn't have had an incurable, lifelong condition that would likely kill the kid within or before his or her twenties.

Secondly, there's the fact that the man deserves to know whether he's raising his own child.

I'd even say that if he truly loves that kid, it wouldn't matter, anyway.
royalpaladin
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2/8/2013 4:39:49 PM
Posted: 3 years ago
At 2/8/2013 4:34:27 PM, Franz_Reynard wrote:
There's two issues at hand here.

First, there's the fact that if the woman were not unfaithful, then clearly, their child wouldn't have had an incurable, lifelong condition that would likely kill the kid within or before his or her twenties.


Secondly, there's the fact that the man deserves to know whether he's raising his own child.

I'd even say that if he truly loves that kid, it wouldn't matter, anyway.

What about the fact that you will destroy the child's life even further by tearing the family apart? This omission of fact or white lie could prevent it from suffering more.
royalpaladin
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2/8/2013 4:40:14 PM
Posted: 3 years ago
At 2/8/2013 4:34:27 PM, Franz_Reynard wrote:
There's two issues at hand here.


Secondly, there's the fact that the man deserves to know whether he's raising his own child.

Why? I'm not saying I disagree-I just want to know your reasoning.
royalpaladin
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2/8/2013 4:41:53 PM
Posted: 3 years ago
At 2/8/2013 4:40:20 PM, Kinesis wrote:
Yes, because it has implications for future children born to those those parents.

Explain
Franz_Reynard
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2/8/2013 4:43:37 PM
Posted: 3 years ago
At 2/8/2013 4:39:49 PM, royalpaladin wrote:
At 2/8/2013 4:34:27 PM, Franz_Reynard wrote:
There's two issues at hand here.

First, there's the fact that if the woman were not unfaithful, then clearly, their child wouldn't have had an incurable, lifelong condition that would likely kill the kid within or before his or her twenties.


Secondly, there's the fact that the man deserves to know whether he's raising his own child.

I'd even say that if he truly loves that kid, it wouldn't matter, anyway.

What about the fact that you will destroy the child's life even further by tearing the family apart? This omission of fact or white lie could prevent it from suffering more.

Yes, I did take that under consideration... but, ultimately, I decided that this responsibility is up to the parents, not a doctor. A doctor isn't a moral agent, she or he is a medical scientist. Truth or nothing. Grey morality at best.

And, also, that's why I indicated that last part. If that father really cares, if he really loves the kid, then he wouldn't allow that to get between them.

Moreover, I notice a lot of anger in kids that have been lied to. If the child ever finds out, there would be so much inner rage, it would probably cause even more damage.

The truth hurts, but I find that it is still necessary.
bladerunner060
Posts: 7,126
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2/8/2013 4:45:33 PM
Posted: 3 years ago
At 2/8/2013 4:41:53 PM, royalpaladin wrote:
At 2/8/2013 4:40:20 PM, Kinesis wrote:
Yes, because it has implications for future children born to those those parents.

Explain

It would be worth knowing that this was not a result of the couple's genetics; if they thought it was because of their genetics, they might not have another kid, because they wouldn't want to risk it.

The real answer to your question is that you just tell them the facts. "Mom, you are a carrier. Dad, you are not."

"Does that mean she cheated on me?"

"I don't know. I can only tell you the genetics".

Of course, if you're doing genetic testing, you do know if the genetics match, in which case you say

"All I can say is that the DNA indicates that this child is not biologically yours".
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tmar19652
Posts: 727
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2/8/2013 4:51:28 PM
Posted: 3 years ago
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

Yes, you should. That way the father knows he can leave "no-strings attached" when the medical bills go into the millions. Not to be heartless, but he deserves to know!
"Politics is supposed to be the second-oldest profession. I have come to realize that it bears a very close resemblance to the first." -Ronald Reagan

"The notion of political correctness declares certain topics, certain ex<x>pressions even certain gestures off-limits. What began as a crusade for civility has soured into a cause of conflict and even censorship." -George H.W. Bush
royalpaladin
Posts: 22,357
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2/8/2013 4:54:45 PM
Posted: 3 years ago
At 2/8/2013 4:43:37 PM, Franz_Reynard wrote:
At 2/8/2013 4:39:49 PM, royalpaladin wrote:
At 2/8/2013 4:34:27 PM, Franz_Reynard wrote:
There's two issues at hand here.

First, there's the fact that if the woman were not unfaithful, then clearly, their child wouldn't have had an incurable, lifelong condition that would likely kill the kid within or before his or her twenties.


Secondly, there's the fact that the man deserves to know whether he's raising his own child.

I'd even say that if he truly loves that kid, it wouldn't matter, anyway.

What about the fact that you will destroy the child's life even further by tearing the family apart? This omission of fact or white lie could prevent it from suffering more.

Yes, I did take that under consideration... but, ultimately, I decided that this responsibility is up to the parents, not a doctor. A doctor isn't a moral agent, she or he is a medical scientist. Truth or nothing. Grey morality at best.

Is the doctor obligated to do this though? She wasn't specifically requested to.

I do think that she is a moral agent in this case, and it's very clear that her decision can have horrible implications if she tells the father the truth.
And, also, that's why I indicated that last part. If that father really cares, if he really loves the kid, then he wouldn't allow that to get between them.

He's probably divorce his wife though, wouldn't he? That would tear the family apart.
Moreover, I notice a lot of anger in kids that have been lied to. If the child ever finds out, there would be so much inner rage, it would probably cause even more damage.

How is the child ever going to find this out if nobody tells him?
The truth hurts, but I find that it is still necessary.
royalpaladin
Posts: 22,357
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2/8/2013 4:56:10 PM
Posted: 3 years ago
At 2/8/2013 4:51:28 PM, tmar19652 wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

Yes, you should. That way the father knows he can leave "no-strings attached" when the medical bills go into the millions. Not to be heartless, but he deserves to know!

Is fatherhood just about genetics? I don't think so. I think it's about the bonds that you build with the child.
tmar19652
Posts: 727
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2/8/2013 4:58:10 PM
Posted: 3 years ago
At 2/8/2013 4:56:10 PM, royalpaladin wrote:
At 2/8/2013 4:51:28 PM, tmar19652 wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

Yes, you should. That way the father knows he can leave "no-strings attached" when the medical bills go into the millions. Not to be heartless, but he deserves to know!

Is fatherhood just about genetics? I don't think so. I think it's about the bonds that you build with the child.
If its not your child, and the child is young, why ruin your life.
"Politics is supposed to be the second-oldest profession. I have come to realize that it bears a very close resemblance to the first." -Ronald Reagan

"The notion of political correctness declares certain topics, certain ex<x>pressions even certain gestures off-limits. What began as a crusade for civility has soured into a cause of conflict and even censorship." -George H.W. Bush
royalpaladin
Posts: 22,357
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2/8/2013 5:01:38 PM
Posted: 3 years ago
At 2/8/2013 4:58:10 PM, tmar19652 wrote:
At 2/8/2013 4:56:10 PM, royalpaladin wrote:
At 2/8/2013 4:51:28 PM, tmar19652 wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

Yes, you should. That way the father knows he can leave "no-strings attached" when the medical bills go into the millions. Not to be heartless, but he deserves to know!

Is fatherhood just about genetics? I don't think so. I think it's about the bonds that you build with the child.
If its not your child, and the child is young, why ruin your life.

In what sense is it not your child though? If parents adopt, are they not the parents of the child? The father is still the parent because he bonded with the child.

Like suppose I change the situation and a father randomly discovers that his 11 year old son is not related to him genetically. He has bonded with this child for the past 11 years. Why is he not the father?
tmar19652
Posts: 727
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2/8/2013 5:03:38 PM
Posted: 3 years ago
At 2/8/2013 5:01:38 PM, royalpaladin wrote:
At 2/8/2013 4:58:10 PM, tmar19652 wrote:
At 2/8/2013 4:56:10 PM, royalpaladin wrote:
At 2/8/2013 4:51:28 PM, tmar19652 wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

Yes, you should. That way the father knows he can leave "no-strings attached" when the medical bills go into the millions. Not to be heartless, but he deserves to know!

Is fatherhood just about genetics? I don't think so. I think it's about the bonds that you build with the child.
If its not your child, and the child is young, why ruin your life.

In what sense is it not your child though? If parents adopt, are they not the parents of the child? The father is still the parent because he bonded with the child.

Like suppose I change the situation and a father randomly discovers that his 11 year old son is not related to him genetically. He has bonded with this child for the past 11 years. Why is he not the father?

He is the "father", but in the case of the sick child might be useful to know that your wife cheated on you and that you are not liable for child support.
"Politics is supposed to be the second-oldest profession. I have come to realize that it bears a very close resemblance to the first." -Ronald Reagan

"The notion of political correctness declares certain topics, certain ex<x>pressions even certain gestures off-limits. What began as a crusade for civility has soured into a cause of conflict and even censorship." -George H.W. Bush
royalpaladin
Posts: 22,357
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2/8/2013 5:05:42 PM
Posted: 3 years ago
At 2/8/2013 5:03:38 PM, tmar19652 wrote:
At 2/8/2013 5:01:38 PM, royalpaladin wrote:
At 2/8/2013 4:58:10 PM, tmar19652 wrote:
At 2/8/2013 4:56:10 PM, royalpaladin wrote:
At 2/8/2013 4:51:28 PM, tmar19652 wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

Yes, you should. That way the father knows he can leave "no-strings attached" when the medical bills go into the millions. Not to be heartless, but he deserves to know!

Is fatherhood just about genetics? I don't think so. I think it's about the bonds that you build with the child.
If its not your child, and the child is young, why ruin your life.

In what sense is it not your child though? If parents adopt, are they not the parents of the child? The father is still the parent because he bonded with the child.

Like suppose I change the situation and a father randomly discovers that his 11 year old son is not related to him genetically. He has bonded with this child for the past 11 years. Why is he not the father?

He is the "father", but in the case of the sick child might be useful to know that your wife cheated on you
Why tear the family apart if you agree he is the father?
and that you are not liable for child support.

Actually, he would still be obligated to pay child support if his name is the one on the birth certificate. The fact that he is not biologically related to the child does not exempt him from this duty. So, he's still going to be supporting the child anyways.
Franz_Reynard
Posts: 1,227
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2/8/2013 5:06:37 PM
Posted: 3 years ago
At 2/8/2013 4:54:45 PM, royalpaladin wrote:


Is the doctor obligated to do this though? She wasn't specifically requested to.

Yes. Inasmuch as the doctor is obligated to inform them of their child's issue, they are obligated to indicate the source. That's quite unfair to the father, don't you think? He can very well have healthy children, but may be afraid to for the rest of his life.

I do think that she is a moral agent in this case, and it's very clear that her decision can have horrible implications if she tells the father the truth.

I disagree. It wouldn't necessarily be quite so horrible. It would be up to the parents to decide what happens from there. I mean, what about the real father? Doesn't he hold any responsibility?

And, also, that's why I indicated that last part. If that father really cares, if he really loves the kid, then he wouldn't allow that to get between them.

He's probably divorce his wife though, wouldn't he? That would tear the family apart.

Nah. First, he may not. That's not inconceivable. But, even if he does, that would be the wife's fault, not the kid's. He could still keep the kid in his life. Or, of course, the real father could step in.

Moreover, I notice a lot of anger in kids that have been lied to. If the child ever finds out, there would be so much inner rage, it would probably cause even more damage.

How is the child ever going to find this out if nobody tells him?

What if the child ends up a medical scientist him or herself? What if there is some genetic testing done that the child becomes aware of? Take, for example, the biological centers they have now that allow biological testing for anyone that participates. I mean, it may be improbable, but certainly not impossible.

The truth hurts, but I find that it is still necessary.
tmar19652
Posts: 727
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2/8/2013 5:08:43 PM
Posted: 3 years ago
At 2/8/2013 5:05:42 PM, royalpaladin wrote:
At 2/8/2013 5:03:38 PM, tmar19652 wrote:
At 2/8/2013 5:01:38 PM, royalpaladin wrote:
At 2/8/2013 4:58:10 PM, tmar19652 wrote:
At 2/8/2013 4:56:10 PM, royalpaladin wrote:
At 2/8/2013 4:51:28 PM, tmar19652 wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

Yes, you should. That way the father knows he can leave "no-strings attached" when the medical bills go into the millions. Not to be heartless, but he deserves to know!

Is fatherhood just about genetics? I don't think so. I think it's about the bonds that you build with the child.
If its not your child, and the child is young, why ruin your life.

In what sense is it not your child though? If parents adopt, are they not the parents of the child? The father is still the parent because he bonded with the child.

Like suppose I change the situation and a father randomly discovers that his 11 year old son is not related to him genetically. He has bonded with this child for the past 11 years. Why is he not the father?

He is the "father", but in the case of the sick child might be useful to know that your wife cheated on you
Why tear the family apart if you agree he is the father?
and that you are not liable for child support.

Actually, he would still be obligated to pay child support if his name is the one on the birth certificate. The fact that he is not biologically related to the child does not exempt him from this duty. So, he's still going to be supporting the child anyways.
Actually he is the father-figure, not the father, hence the quotes.

And if you are not the father, the birth certificate can be amended
http://www.dshs.state.tx.us...
so that you are not liable.
"Politics is supposed to be the second-oldest profession. I have come to realize that it bears a very close resemblance to the first." -Ronald Reagan

"The notion of political correctness declares certain topics, certain ex<x>pressions even certain gestures off-limits. What began as a crusade for civility has soured into a cause of conflict and even censorship." -George H.W. Bush
000ike
Posts: 11,196
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2/8/2013 5:10:04 PM
Posted: 3 years ago
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

He shouldn't outright tell him "you're not the father" but he should let the man make the conclusion himself, by pointing out that both parents must have the gene, and he does not.

Saying explicitly "you're not the father" is outside the business or concern of the counselor.
"A stupid despot may constrain his slaves with iron chains; but a true politician binds them even more strongly with the chain of their own ideas" - Michel Foucault
royalpaladin
Posts: 22,357
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2/8/2013 5:11:16 PM
Posted: 3 years ago
At 2/8/2013 5:08:43 PM, tmar19652 wrote:
At 2/8/2013 5:05:42 PM, royalpaladin wrote:
At 2/8/2013 5:03:38 PM, tmar19652 wrote:
At 2/8/2013 5:01:38 PM, royalpaladin wrote:
At 2/8/2013 4:58:10 PM, tmar19652 wrote:
At 2/8/2013 4:56:10 PM, royalpaladin wrote:
At 2/8/2013 4:51:28 PM, tmar19652 wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

Yes, you should. That way the father knows he can leave "no-strings attached" when the medical bills go into the millions. Not to be heartless, but he deserves to know!

Is fatherhood just about genetics? I don't think so. I think it's about the bonds that you build with the child.
If its not your child, and the child is young, why ruin your life.

In what sense is it not your child though? If parents adopt, are they not the parents of the child? The father is still the parent because he bonded with the child.

Like suppose I change the situation and a father randomly discovers that his 11 year old son is not related to him genetically. He has bonded with this child for the past 11 years. Why is he not the father?

He is the "father", but in the case of the sick child might be useful to know that your wife cheated on you
Why tear the family apart if you agree he is the father?
and that you are not liable for child support.

Actually, he would still be obligated to pay child support if his name is the one on the birth certificate. The fact that he is not biologically related to the child does not exempt him from this duty. So, he's still going to be supporting the child anyways.
Actually he is the father-figure, not the father, hence the quotes.

He is the father according to the birth certificate, his own beliefs, the bond he formed, and the law.
And if you are not the father, the birth certificate can be amended
http://www.dshs.state.tx.us...
so that you are not liable.

That's one state, and I think you need the consent of both parents to do that. Men are still held liable for their children, even if they are not genetically related to them.

https://www.nytimes.com...
royalpaladin
Posts: 22,357
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2/8/2013 5:17:06 PM
Posted: 3 years ago
At 2/8/2013 5:10:04 PM, 000ike wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

He shouldn't outright tell him "you're not the father" but he should let the man make the conclusion himself, by pointing out that both parents must have the gene, and he does not.

Saying explicitly "you're not the father" is outside the business or concern of the counselor.

That's exactly what I was thinking.
Franz_Reynard
Posts: 1,227
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2/8/2013 5:18:03 PM
Posted: 3 years ago
At 2/8/2013 5:10:04 PM, 000ike wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

He shouldn't outright tell him "you're not the father" but he should let the man make the conclusion himself, by pointing out that both parents must have the gene, and he does not.

Saying explicitly "you're not the father" is outside the business or concern of the counselor.

Nah ah ah... if we're talking about "business" and "concern," then we're talking real terms, which brings in the law, rathe than only morality.

In that regard, a doctor is obligated by law to indicate this fact to the father.
royalpaladin
Posts: 22,357
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2/8/2013 5:22:06 PM
Posted: 3 years ago
At 2/8/2013 5:06:37 PM, Franz_Reynard wrote:
At 2/8/2013 4:54:45 PM, royalpaladin wrote:


Is the doctor obligated to do this though? She wasn't specifically requested to.

Yes. Inasmuch as the doctor is obligated to inform them of their child's issue, they are obligated to indicate the source. That's quite unfair to the father, don't you think? He can very well have healthy children, but may be afraid to for the rest of his life.

Why does this mean she has to tell the father that he is not related to the child? Why not say that he is a carrier and there may have been a mutation in the one sex cell that fertilized the egg?
I do think that she is a moral agent in this case, and it's very clear that her decision can have horrible implications if she tells the father the truth.

I disagree. It wouldn't necessarily be quite so horrible. It would be up to the parents to decide what happens from there. I mean, what about the real father? Doesn't he hold any responsibility?

The child doesn't have a familial bond with the genetic donor. I'm sure the kid wouldn't like to find out that his father isn't really his "father".
And, also, that's why I indicated that last part. If that father really cares, if he really loves the kid, then he wouldn't allow that to get between them.

He's probably divorce his wife though, wouldn't he? That would tear the family apart.

Nah. First, he may not. That's not inconceivable. But, even if he does, that would be the wife's fault, not the kid's. He could still keep the kid in his life. Or, of course, the real father could step in.

Why punish the child for the sins of the mother? I'm pretty sure most men would leave the mother, by the way. Monogamous marriage was invented to ensure paternity.
Moreover, I notice a lot of anger in kids that have been lied to. If the child ever finds out, there would be so much inner rage, it would probably cause even more damage.

How is the child ever going to find this out if nobody tells him?

What if the child ends up a medical scientist him or herself?
Most people do not, and someone with cystic fibrosis would be dead by then.
What if there is some genetic testing done that the child becomes aware of? Take, for example, the biological centers they have now that allow biological testing for anyone that participates. I mean, it may be improbable, but certainly not impossible.

You're assuming that he would be able to take the father with him. There's no other way for him to get an uncontaminated DNA sample from the father. Plus, why would he ever doubt his paternity in the future?
The truth hurts, but I find that it is still necessary.
royalpaladin
Posts: 22,357
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2/8/2013 5:22:39 PM
Posted: 3 years ago
At 2/8/2013 5:18:03 PM, Franz_Reynard wrote:
At 2/8/2013 5:10:04 PM, 000ike wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

He shouldn't outright tell him "you're not the father" but he should let the man make the conclusion himself, by pointing out that both parents must have the gene, and he does not.

Saying explicitly "you're not the father" is outside the business or concern of the counselor.

Nah ah ah... if we're talking about "business" and "concern," then we're talking real terms, which brings in the law, rathe than only morality.

In that regard, a doctor is obligated by law to indicate this fact to the father.

Actually, I don't the doctor is. Can you show me which law says that?
Franz_Reynard
Posts: 1,227
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2/8/2013 5:26:42 PM
Posted: 3 years ago
At 2/8/2013 5:22:39 PM, royalpaladin wrote:
At 2/8/2013 5:18:03 PM, Franz_Reynard wrote:
At 2/8/2013 5:10:04 PM, 000ike wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

He shouldn't outright tell him "you're not the father" but he should let the man make the conclusion himself, by pointing out that both parents must have the gene, and he does not.

Saying explicitly "you're not the father" is outside the business or concern of the counselor.

Nah ah ah... if we're talking about "business" and "concern," then we're talking real terms, which brings in the law, rathe than only morality.

In that regard, a doctor is obligated by law to indicate this fact to the father.

Actually, I don't the doctor is. Can you show me which law says that?

Truth Telling and Patient Autonomy

A professional obligation to be truthful does not need linkage with patient autonomy to be justified but in fact it is often so joined. Then, it tends to require what autonomists refer to as full disclosure. For them, it is not sufficient to tell the truth, one has to tell the whole truth. Radical advocates of patient autonomy tend to eliminate physician or nurse discretion and simply require that "everything be revealed" because "only the patient can determine what is appropriate." Other principles, like beneficence, non-maleficence, and confidentiality, may be given little consideration or turned into subordinate obligations.

Autonomists who insist always on full disclosure usually set aside questions about uncertainties which permeate the clinical context. But, medical diagnoses and follow-up therapeutic regimens are rarely a matter of mathematical certainty. Psychiatric diagnoses for example, like diagnoses in many other specialties, develop from hypotheses which are then tested out through continuing symptom evaluation and carefully watched responses to therapeutic interventions. Does every feasible hypothesis require disclosure to a patient? Is every bit of data about a disease or therapy to be considered information to be disclosed?

Generally speaking, relative certainties and realistic uncertainties belong within honest disclosure requirements because they qualify as information that a reasonable person needs to know in order to make right health-care decisions. But reasonable persons do not want full disclosure even if such were feasible. Telling the truth in a clinical context is an ethical obligation but determining just what constitutes the truth remains a clinical judgment. Autonomy cannot be the only principle involved. Truth telling has to be linked with beneficence and justice and protection of the community.

http://www.uchile.cl...
royalpaladin
Posts: 22,357
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2/8/2013 5:28:02 PM
Posted: 3 years ago
At 2/8/2013 5:26:42 PM, Franz_Reynard wrote:
At 2/8/2013 5:22:39 PM, royalpaladin wrote:
At 2/8/2013 5:18:03 PM, Franz_Reynard wrote:
At 2/8/2013 5:10:04 PM, 000ike wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

He shouldn't outright tell him "you're not the father" but he should let the man make the conclusion himself, by pointing out that both parents must have the gene, and he does not.

Saying explicitly "you're not the father" is outside the business or concern of the counselor.

Nah ah ah... if we're talking about "business" and "concern," then we're talking real terms, which brings in the law, rathe than only morality.

In that regard, a doctor is obligated by law to indicate this fact to the father.

Actually, I don't the doctor is. Can you show me which law says that?

Truth Telling and Patient Autonomy

A professional obligation to be truthful does not need linkage with patient autonomy to be justified but in fact it is often so joined. Then, it tends to require what autonomists refer to as full disclosure. For them, it is not sufficient to tell the truth, one has to tell the whole truth. Radical advocates of patient autonomy tend to eliminate physician or nurse discretion and simply require that "everything be revealed" because "only the patient can determine what is appropriate." Other principles, like beneficence, non-maleficence, and confidentiality, may be given little consideration or turned into subordinate obligations.

Autonomists who insist always on full disclosure usually set aside questions about uncertainties which permeate the clinical context. But, medical diagnoses and follow-up therapeutic regimens are rarely a matter of mathematical certainty. Psychiatric diagnoses for example, like diagnoses in many other specialties, develop from hypotheses which are then tested out through continuing symptom evaluation and carefully watched responses to therapeutic interventions. Does every feasible hypothesis require disclosure to a patient? Is every bit of data about a disease or therapy to be considered information to be disclosed?

Generally speaking, relative certainties and realistic uncertainties belong within honest disclosure requirements because they qualify as information that a reasonable person needs to know in order to make right health-care decisions. But reasonable persons do not want full disclosure even if such were feasible. Telling the truth in a clinical context is an ethical obligation but determining just what constitutes the truth remains a clinical judgment. Autonomy cannot be the only principle involved. Truth telling has to be linked with beneficence and justice and protection of the community.

http://www.uchile.cl...

That's a moral position that some people are taking. That's not the law. Just because some people think that doctors should tell the whole truth does not mean that the law requires it.
Franz_Reynard
Posts: 1,227
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2/8/2013 5:33:02 PM
Posted: 3 years ago
At 2/8/2013 5:22:06 PM, royalpaladin wrote:
At 2/8/2013 5:06:37 PM, Franz_Reynard wrote:
At 2/8/2013 4:54:45 PM, royalpaladin wrote:


Is the doctor obligated to do this though? She wasn't specifically requested to.

Yes. Inasmuch as the doctor is obligated to inform them of their child's issue, they are obligated to indicate the source. That's quite unfair to the father, don't you think? He can very well have healthy children, but may be afraid to for the rest of his life.

Why does this mean she has to tell the father that he is not related to the child? Why not say that he is a carrier and there may have been a mutation in the one sex cell that fertilized the egg?

That's messed up, don't you think? Even I can look that up and see that it's a lie. Opens up a serious problem, to begin with, the realization that the physician lied.

I do think that she is a moral agent in this case, and it's very clear that her decision can have horrible implications if she tells the father the truth.

I disagree. It wouldn't necessarily be quite so horrible. It would be up to the parents to decide what happens from there. I mean, what about the real father? Doesn't he hold any responsibility?

The child doesn't have a familial bond with the genetic donor. I'm sure the kid wouldn't like to find out that his father isn't really his "father".

But, in the long run, I'm sure the child would prefer it, to the distrust resulting from realizing that his or her parents lied to him or her their entire lives.

And, also, that's why I indicated that last part. If that father really cares, if he really loves the kid, then he wouldn't allow that to get between them.

He's probably divorce his wife though, wouldn't he? That would tear the family apart.

Nah. First, he may not. That's not inconceivable. But, even if he does, that would be the wife's fault, not the kid's. He could still keep the kid in his life. Or, of course, the real father could step in.

Why punish the child for the sins of the mother? I'm pretty sure most men would leave the mother, by the way. Monogamous marriage was invented to ensure paternity.

Well, then she shouldn't have cheated, eh? That isn't a punishment on the child. A child does not need to experience repercussions from this, per se. I mean, in fact, the majority of children raised in the United States, aren't raised by both parents
married. They are raised by either divorced parents, separated parents, a parent and a step parent, or a single parent.

Perhaps, if this is such a concern, people should avoid cheating, rather than physicians lying.

Moreover, I notice a lot of anger in kids that have been lied to. If the child ever finds out, there would be so much inner rage, it would probably cause even more damage.

How is the child ever going to find this out if nobody tells him?

What if the child ends up a medical scientist him or herself?
Most people do not, and someone with cystic fibrosis would be dead by then.

Tragic. I guess the man should pay for that? I disagree.

What if there is some genetic testing done that the child becomes aware of? Take, for example, the biological centers they have now that allow biological testing for anyone that participates. I mean, it may be improbable, but certainly not impossible.

You're assuming that he would be able to take the father with him. There's no other way for him to get an uncontaminated DNA sample from the father. Plus, why would he ever doubt his paternity in the future?

Because if he assumes himself a carrier and assumes that he had this child with his wife, then I would assume he would avoid having further children, a 25% likelihood notwithstanding.

The truth hurts, but I find that it is still necessary.
Franz_Reynard
Posts: 1,227
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2/8/2013 5:33:45 PM
Posted: 3 years ago
At 2/8/2013 5:28:02 PM, royalpaladin wrote:
At 2/8/2013 5:26:42 PM, Franz_Reynard wrote:
At 2/8/2013 5:22:39 PM, royalpaladin wrote:
At 2/8/2013 5:18:03 PM, Franz_Reynard wrote:
At 2/8/2013 5:10:04 PM, 000ike wrote:
At 2/8/2013 4:26:34 PM, royalpaladin wrote:
Ok, so suppose you are a genetic counselor who is attempting to understand why a child has cystic fibrosis. You test the child and both of the parents and discover that the mother is a carrier and the father is not, which essentially indicates that the "father" is not biologically related to the patient. Should you disclose this fact to the father?

He shouldn't outright tell him "you're not the father" but he should let the man make the conclusion himself, by pointing out that both parents must have the gene, and he does not.

Saying explicitly "you're not the father" is outside the business or concern of the counselor.

Nah ah ah... if we're talking about "business" and "concern," then we're talking real terms, which brings in the law, rathe than only morality.

In that regard, a doctor is obligated by law to indicate this fact to the father.

Actually, I don't the doctor is. Can you show me which law says that?

Truth Telling and Patient Autonomy

A professional obligation to be truthful does not need linkage with patient autonomy to be justified but in fact it is often so joined. Then, it tends to require what autonomists refer to as full disclosure. For them, it is not sufficient to tell the truth, one has to tell the whole truth. Radical advocates of patient autonomy tend to eliminate physician or nurse discretion and simply require that "everything be revealed" because "only the patient can determine what is appropriate." Other principles, like beneficence, non-maleficence, and confidentiality, may be given little consideration or turned into subordinate obligations.

Autonomists who insist always on full disclosure usually set aside questions about uncertainties which permeate the clinical context. But, medical diagnoses and follow-up therapeutic regimens are rarely a matter of mathematical certainty. Psychiatric diagnoses for example, like diagnoses in many other specialties, develop from hypotheses which are then tested out through continuing symptom evaluation and carefully watched responses to therapeutic interventions. Does every feasible hypothesis require disclosure to a patient? Is every bit of data about a disease or therapy to be considered information to be disclosed?

Generally speaking, relative certainties and realistic uncertainties belong within honest disclosure requirements because they qualify as information that a reasonable person needs to know in order to make right health-care decisions. But reasonable persons do not want full disclosure even if such were feasible. Telling the truth in a clinical context is an ethical obligation but determining just what constitutes the truth remains a clinical judgment. Autonomy cannot be the only principle involved. Truth telling has to be linked with beneficence and justice and protection of the community.

http://www.uchile.cl...


That's a moral position that some people are taking. That's not the law. Just because some people think that doctors should tell the whole truth does not mean that the law requires it.

The Hippocratic Oath is an oath historically taken by physicians and other healthcare professionals swearing to practice medicine ethically and honestly.