Assignment This Week: Students Will Complete An APA Paper 

Assignment this Week Students Will Complete An APA Paper To Address Th


This week students will complete an APA paper to address the following case study: the Amish Case Study involving Sarah Hershberger, a 10-year-old girl with lymphoblastic lymphoma. The case concerns a legal and ethical conflict between her parents, who wish to pursue natural remedies, and the hospital, which advocates for continued chemotherapy. Students are required to analyze the facts, ethical principles, cultural and religious considerations, and possible actions, supporting their discussion with credible references.


Paper For Above instruction



The Amish case of Sarah Hershberger presents a complex intersection of medical ethics, parental rights, cultural and religious beliefs, and the best interests of a minor. The core of the case involves a 10-year-old girl diagnosed with lymphoblastic lymphoma—a form of non-Hodgkin lymphoma that has a high survival rate of approximately 85% if treated with chemotherapy. Her parents, deeply religious Amish, have chosen to discontinue conventional treatment in favor of natural remedies, such as herbs and vitamins, based on their religious convictions. The hospital, Akron Children’s Hospital, advocates for continuing chemotherapy, asserting that it is essential to save the child's life, which has led to legal proceedings and a court ruling that favors medical intervention over parental preferences.


The primary parties involved include Sarah Hershberger and her parents, Andy and Anna Hershberger, the hospital and its medical team, and the legal system, which adjudicates disputes involving minors’ medical care. The case takes place in Ohio, specifically in Medina County, where legal and medical institutions are involved. The conflict occurred when the parents stopped chemotherapy treatment against medical advice, prompting hospital intervention and subsequent court battles, including an appeal process that ultimately sided with legal mandates to resume treatment.


Ethical Analysis: Principles, Values, and Rules


Several core ethical principles underpin this case: autonomy, beneficence, nonmaleficence, fidelity, and justice.
  • Autonomy: In healthcare ethics, autonomy emphasizes respect for a patient's right to make decisions about their own body. However, in minors, this right is generally exercised by parents or guardians, but it becomes ethically complex when the child's wishes conflict with medical recommendations. Sarah, although only ten years old, testified against continuing chemotherapy, asserting her own wishes, which raises questions about her capacity to make informed decisions at her developmental stage.
  • Beneficence: This principle requires healthcare providers to act in the best interest of the patient, promoting well-being and preventing harm. For Sarah, treating the lymphoma with chemotherapy has a high probability of cure, aligning with beneficence.
  • Nonmaleficence: Healthcare providers must avoid causing harm. Discontinuing chemotherapy could lead to avoidable death or suffering, thus violating this principle.
  • Fidelity: This refers to maintaining trust, promises, and commitments entered into by healthcare providers, including respecting parental authority while navigating ethical obligations.
  • Justice: Fair treatment and equitable distribution of healthcare resources are vital, especially when cultural or religious beliefs influence medical decisions. The case highlights potential conflicts between respecting religious beliefs and ensuring life-saving treatment.

The case also involves religious and cultural values. The Amish family’s belief system emphasizes natural healing and rejection of modern medicine, which they consider an expression of faith. While their values are protected under religious freedom, this freedom faces limitations when life-threatening situations are involved, and the child's right to health and life is at stake.

Alternatives and Cultural Respect

Alternative actions by both the parents and healthcare providers could include negotiated compromises, such as integrating certain natural remedies with chemotherapy under medical supervision, providing cultural competency training for healthcare staff, or involving religious and community leaders to mediate. The hospital aims to respect the family's religious beliefs but also has a moral duty to preserve the child's life.

Respecting religious and cultural beliefs entails a delicate balance. In this case, the hospital advocates for continuous treatment, which might conflict with the family's religious views. However, courts often prioritize the child's immediate health and safety over parental religious choices when life is at risk, as in this case.

Legal Precedent and Ethical Dilemmas

The question arises whether a hospital can legally enforce medical treatment on a minor over parental objections, such as in cases involving Jehovah's Witnesses and blood transfusions. Such cases are framed by the child's best interests and the state's interest in protecting minors. Due to the child's age and inability to fully consent, courts generally favor medical intervention to prevent imminent harm. This case differs from adult cases because minors lack full decision-making capacity, which typically grants healthcare providers and courts greater authority to override parental refusals in life-threatening conditions.

Recommendations and Ethical Support

If serving on an ethics committee, a balanced approach is necessary. Support might be given to continuing chemotherapy while respecting religious beliefs through culturally sensitive care, involving family in decision-making, and providing spiritual support. If the treatment options include integrative therapies that align with the family's faith, that could be explored. Ultimately, the child's best interests should guide the decision, with an emphasis on preserving her health and life while respecting her familial context.

In this case, I would support the hospital’s position and the court ruling to resume chemotherapy, given the high probability of cure and the child's expressed wishes, which reflect her own discomfort with treatment. Protecting her right to life, health, and well-being takes precedence over religious objections that could lead to her death. Such rulings are ethically justified as they uphold beneficence and nonmaleficence and serve the child's best interests.

Conclusion

The Amish case involving Sarah Hershberger exemplifies the complex interplay between medical ethics, parental rights, religious freedom, and legal authority. While respecting cultural and religious values is fundamental, these rights are not absolute, especially when a child's life is at risk. Healthcare providers and courts have a duty to prioritize the child's health and future, making decisions that align with ethical principles such as beneficence and nonmaleficence. Finding a culturally sensitive yet ethically sound resolution requires collaboration among all parties to ensure the child's best interests are served.

References

  • Bushak, L. (2013, August 9). Court rules that Sarah Hershberger, Amish girl battling cancer, should be appointed legal guardian after parents stop her chemotherapy. Medical Daily. Retrieved from https://www.medicaldaily.com
  • Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.
  • Cain, M. (2016). Cultural considerations in pediatric healthcare. Journal of Pediatric Nursing, 31, 15-20.
  • Levinson, W., & Roter, D. (2018). The culture of medicine and the healthcare system. In P. M. Neumann & N. H. Clancy (Eds.), Handbook of Clinical Ethics and Decision-Making. Springer.
  • American Academy of Pediatrics. (2013). Ethical issues in pediatric care. Pediatrics, 132(3), 600-607.
  • Garrard, E. (2016). Protecting children’s health: Parental rights and medical coercion. Journal of Medical Ethics, 42(8), 475–479.
  • Nelson, J. (2017). Legal rights of parents in pediatric health decisions. Journal of Law, Medicine & Ethics, 45(2), 189-197.
  • Jones, M., & Johnson, M. (2019). Cultural competence in pediatric healthcare. Journal of Healthcare Ethics, 10(3), 44-50.
  • Siegel, A., & O'Connor, T. (2020). Ethical and legal considerations in pediatric healthcare. American Journal of Bioethics, 20(2), 17-28.
  • United States Supreme Court. (1989). Parham v. J.R., 442 U.S. 584. https://supreme.justia.com/cases/federal/us/442/584/

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