Attitudes toward and treatment of people with ID has always reflected philosophies of
human existence and human worth.
Source of ethics: rules that guide or govern conduct and define what’s good or bad
Historically, ill treatments of people with ID were accepted as best for society’s interest.
In today’s society, much has been condemned as barbaric and unethical, but many
Each of us operate on the basis of some set of guiding principles that are the basis for a
code of ethics governing our behavior.
Two philosophic positions frame our discussion:
1. Utilitarianism- based on the premise that any action is “right” if it leads to the
greatest good for the greatest number of people. An individual only has those
rights granted by the larger society
•Strictly following this view leads to a tendency for the group with the
greatest power to continue in power and often to expand that power by
limiting the rights of those with less power
2. Deontology – suggests that some acts may be wrong and others right independent
of their consequences
•Strictly following this view leads to the rights of some being maintained
while the rights of others being diminished
Both views represent polarized viewpoints of the rights and worth of individuals
•Defined in Merriam Webster’s Dictionary as: the act of practice of
killing or permitting the death of hopeless or injured individuals in a
relatively painless way for reasons of mercy
•Case of euthanasia was brought into public eye in 1975 when a woman in
new Jersey by the name of Karen Ann Quinlan was admitted into a
hospital on April 1975 and for one year remained alive simply because she
was on a respirator and tube feeding (an artificial support system).
•By March 1976, parents wanted Karen off support system, and medical
personel refused to do so.
•Courts sided with the parents. Karen was taken off support system and
survived in a comatose state.
•Karen finally died in june 1985.
•Terri Schiavo – In 1990, oxygen flow to brain was temporarily stopped
which caused severe brain damage. Terri was only alive through a feeding
tube. Her husband asked that the support system be stopped, but Terri’s
parents pushed that she remain connected to the feeding tube. Under court
order, tube was removed April 2005 and terri died within a few days
Point of view – all lives are equal under the law – written by executive director of
the ARC Steven Eidleman who purports that people with disabilities should be treated
with equality as there are million so disabled people with varying qualities of lives. He
adds that using the term “vegetables” must stop.
•Most specifically used as a form of euthanasia on newborns with ID. Parents may
request withholding of routine surgical or medical treatment needed for the infant
•This used to be unaccepted in the past
•30 years ago, Robertson characterized it as a common practice for parents to ask
for withholding of treatment and for physicians to accept it when dealing with
infants with birth defects
•Duff and Campbell conducted a study in 1973 that investigated 299 consecutive
deaths that were recorded in a special-care nursery. 43 of them involved
withholding treatment. This represents 14% of the sample.
•Topic remains controversial
•Plays significant role in societal dilemmas
•As rights of some individuals are emphasized, others’ rights are diminished
•Utilitarian view would argue that medical equipment and attention should not be
expended on terminally ill individuals on life support, but should go to the greater
good of society.
•Deontological view would argue that an infant with an ID deserves treatment and
medical support because of the infant’s right to life. Competing equities are
evidence as one considers the potential conflict between the right of the infant and
the right of the parent.
Ethical issues are not limited to a given age group but some patterns relate to different
stages of the life cycle
Ethical issues throughout the life cycle
1. Prenatal period
• Concept of preventing or eliminating ID has been considered by society, but the
actual means to achieve this goal (withholding treatment, genetic screening) have
been more controversial
Genetic screening and counseling
•some professionals think this should be routine
•others view it as interference in individual rights and freedom; particularly a
sensitive issue where certain ID are more common with certain ethnicities or
genetic screening – search for certain genes that are predisposed to disease, already
diseased or may lead to disease in future generations of the same family
Attitudes toward and treatment of people with id has always reflected philosophies of human existence and human worth. Source of ethics: rules that guide or govern conduct and define what"s good or bad. Historically, ill treatments of people with id were accepted as best for society"s interest. In today"s society, much has been condemned as barbaric and unethical, but many hypocrisies remain. Each of us operate on the basis of some set of guiding principles that are the basis for a code of ethics governing our behavior. Two philosophic positions frame our discussion: utilitarianism- based on the premise that any action is right if it leads to the greatest good for the greatest number of people. Both views represent polarized viewpoints of the rights and worth of individuals. Terri was only alive through a feeding tube. Her husband asked that the support system be stopped, but terri"s parents pushed that she remain connected to the feeding tube.