Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true patient care case. You vote on your decision in the case. And next week, we'll reveal how you all made the call. And stay tuned, bioethicist Jacob M. Appel, MD, JD, will weigh in next week with an ethical framework to help you learn and prepare.
The following case is from the forthcoming book,
Jim and Janice are a deaf couple living in a large Midwestern city. Janice has been deaf since birth, while Jim lost his hearing as a result of meningitis at age two. The pair are both active members of the local deaf community. They have a deaf daughter, Abigail, who is age 9.
When considering a second pregnancy, Janice undergoes genetic testing and learns that she carries a gene mutation that means any child she conceives will have a 50% chance of being born deaf. The couple then visits a fertility specialist in order to have a baby through in vitro fertilization (IVF).
They request that the doctor use preimplantation genetic diagnosis to separate out the embryos with the hearing-loss mutation and that the doctor implant one of these embryos, thereby ensuring that they will have a deaf child.
"We want to preserve our deaf culture," explains Janice. "Deafness is part of our family's lifeblood."
And in case you missed the last case: Critical Patient With DNR Tattoo.
Leave comments using the tool below to explain your decision and discuss the dilemma further! And please send in ethical dilemmas you've faced to editorial@medpagetoday.com for possible inclusion in a future Ethics Consult edition.
It should be obvious, but we'll say it anyway -- this is not to be construed in any way as legal or medical advice. Any similarity to actual people is coincidental.
Jacob M. Appel, MD, JD, is Director of Ethics Education in Psychiatry and a member of the Institutional Review Board with the Icahn School of Medicine at Mount Sinai. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College. Appel is the author of the forthcoming book,