David Vetter free essay sample

On September 21, 1971, an infant was born with severe combined immunodeficiency disease (SCID). The child was David Vetter III, third child of David Joseph Vetter Jr. and Carol Ann Vetter. The first child was Katherine and the second child (also named David Vetter III), died after seven months â€Å"Doctors said that the baby boy had been born with a defective thymus, a gland which is important in the functioning of the immune system, due to a genetic condition, SCID. Each further son the couple might conceive would have a 50% chance of inheriting the same condition. † (Montgomery, South, Wilson, 2006). However, a group of doctors told the Vetters that if they had another child with SCID, the child could be placed in a sterile isolator until a bone marrow transplant could be performed, using the older sister, Katherine, as a donor. The couple was eager to have another child, so, believing that after a short treatment their child could live a normal life, they decided to go through another pregnancy Medical Indications The hospital staff has made a heroic effort to create germ free conditions. After less than twenty seconds of exposure to the world, the baby is placed in a plastic isolator bubble that will protect him from disease. However, after the birth of David, it was discovered that Katherine was not a match, thus removing the possibility of the transplant. There had been no discussion of what would happen in this case, or how long the prospective child would remain in the bubble. The question we now have to ask is what is to be done baring the transplant? How long should or could the young boy survive in this isolation bubble. The ethics of keeping the child alive and isolated for the purpose of research is troubling to say the least, but what other steps can we take? In retrospect, the biggest ethical problem was the failure to plan for the worst-case scenario. In what seemed like an instant, the isolator had gone from a stopgap measure to Davids permanent home. Little more than an inflated balloon, the isolator was fed with a constant flow of filtered air. Comprised of a 5-foot by 3-foot living chamber, it was connected to an even smaller supply bubble. David had to be handled through thick black neoprene gloves, spaced at intervals throughout the isolator. Everything he ate, wore, or touched had to be sterilized with pericidic acid and placed inside steel capsules inserted through a system of air locks. Even Davids doctors were not certain it would hold up. Patient Preferences The initial decision came before David’s conception. This leaves little room or option for the patient, even though at his death at age 12, could he be responsible for his own medical decisions. The original doctors had agreed that they would stop treatment any time David and his family requested it. David was an intelligent and resourceful boy who had access to tools that could have opened up the isolator. David always had the power to step out into the world whenever he wanted. These types of decisions are made by parents for their children every day. Many types of genetic disorders can be detected before birth of a child and only the parent can make the decision to abort or not, the child ends up with a preordained destiny in these regards. Quality of Life Some information suggests that David was clearly terrified of the germ-filled world, does this mean he wanted to continue life in a bubble, maybe a question we can never answer. A psychiatric report indicates that David suffers from severe mood swings, has reverted to thumb sucking and obsessive rocking, and will probably encounter difficulties in his impending adolescence. He went through almost his entire life without human touch and normal interaction. This role of nurturing is very intrinsic to a child’s development, and a lack of nurture may have drastic affects. Children who are not nurtured, and who are socially isolated, may become physiologically and psychologically deformed. Contextual Features The ethics of keeping the child alive and isolated for the purpose of research is troubling to say the least, but what other steps could have been taken? Current bioethics makes equivalence between ending extraordinary life-saving care and never beginning it. That is, removing David from the bubble later in life should be morally equivalent to never having put him in it in the first place. More than 90 percent of infants diagnosed with SCID are now successfully treated with bone marrow transplants. Long-term isolation is no longer offered as a treatment option. One of David’s Doctors â€Å"William Shearer† told the press, Davids life was important, but his greatest contribution medically was his death, because with this information, we will be able to treat other children with this disease. Shearer was prescient, but those who thought he was suggesting that David was more valuable dead than alive easily misinterpreted his statement. The key modifier was medically. Although Davids life support system was revolutionary, new procedures were already superseding them, and no other children were likely to be raised in bubbles. Davids autopsy and blood sample, however, helped researchers understand and repair the immune systems of other children with the same affliction. Case Analysis: David was born lacking the cells needed to fight infections. Therefore, he can get sick and die from ailments most people would not even sneeze at. Once, placed in the bubble, it would be impossible to judge which options should or even could have been taken to prevent the situation prolonged for 12 years. In retrospect, the biggest ethical problem was the failure to plan for the worst-case scenario. It was not until Davids autopsy that the cause of his death became known. Katherines bone marrow had contained traces of a dormant virus. Once inside Davids defenseless body, the virus had spread rapidly, producing hundreds of cancerous tumors. Proof that a virus can cause cancer was probably the most important of the many medical insights that emerged from Davids case. If these discoveries had done little to help David, they would help to treat thousands of immune compromised children in the future. Yet some continued to question whether David himself had borne too high a price for the advancement of medicine. Kept alive for almost 13 years by experimental research, David lived with an incurable disease for his father, who desperately wanted a son, and for the scientists who salivated at the thought of studying him. He did not live for himself.