Ethical Dilemma #1
You are the Principal of Pleasantville High School, located in an area twenty-five miles from the center of a large Midwestern city. Originally semi-rural, the area has undergone rapid growth and social change over the past two decades. Completion of a major expressway has brought high tech growth and large numbers of engineers, scientists, and other professional people with extremely diverse ethnic and religious backgrounds.
Ahmed Said, a student at Pleasantville High School, browses the shelves of the school library one day in search of sources for his history paper on the historical roots of the Arab-Israeli conflict. His eyes fall upon a volume entitled “The Protocols of the Elders of Zion* which he looks over and decides to check out. The next day at school he tells other students about the contents of the book. A Jewish student, David Greenburg, overhears Ahmed’s description of The Protocols and tells his parents about it.
Deeply disturbed, David’s parents contact the B’nai Brith Anti Defamation League ((ADL), a group devoted to combating anti-Semitism). After verifying that Pleasantville High School’s library in fact has a shelf copy of The Protocols of the Elders of Zion, the ADL lodges a furiously angry protest with the Principal of Pleasantville High School (i.e. yourself). You, in turn, investigate the situation and learn the following. It appears that in the early years of the high school, when it opened in the late 1960’s, there was an assistant school librarian with anti-Semitic inclinations who worked for the high school only a short time before being let go for unsatisfactory work. This individual, however, during her short tenure, had the responsibility of ordering books, and it is believed that, without authorization, she had The Protocols of the Elders of Zion purchased by the library.
*The Protocols of the Elders of Zion is a notorious tract of anti-Semitic propaganda, widely used to stir up anti Semitic passions in Europe in the late nineteenth and early twentieth century. Purporting to be the manifesto of a tightly knit Jewish conspiracy bent on dominating the world, The Protocols is a fraud, in all likelihood, the work of secret police in czarist Russia during the late nineteenth century, who wanted to provoke widespread anti-Semitic violence against Russian Jews.
Ethical Dilemma #2
Recently the FDA voted narrowly (7-6) to continue a ban on gay men donating blood that it imposed in 1985. Dr. F. Blaine Hollinger, Chair of the FDA Blood Products Advisory Committee said, however: “Personally, I’m very open to a change. It’s discriminatory. We have to see all the data first. If it can be done without changing the safety of the blood supply, it ought to be done.”
Gay activists argue that the ban unfairly discriminates against gay men. They note that a heterosexual woman who has had sex with an AIDS infected partner may donate after a year. Similarly, promiscuous heterosexuals are also at risk for HIV infection, but are not prevented from donating blood. Jeffrey Haviland, a gay man who once lied in order to donate blood argues, “The question should not be, ‘Are you homosexual,’ [but] ‘What risk factors have you engaged in'”
New testing procedures have increased the likelihood of detecting HIV in donated blood. Ten years ago, tests searched for HIV antibodies, which take as long as a year to appear. Now tests use nucleic acids, which can detect tiny amounts of virus even before antibodies emerge – as early as eleven days after infection.
However, some blood experts worry that easing the ban could result in an increased in the number of HIV infected donations. Dr. Michael Bush, UC San Francisco, said, “The tests are not perfect. And even though they are very good — there remains a small but significant rate of test error.” In fact, each year approximately 10 HIV infected units of blood (of 12 million units donated) escape detection and result in 2-3 cases of HIV infection. Put another way, each year one in every 675,000 people who receive blood donations nationwide receives HIV infected blood.
If the lifetime ban were changed to a five year ban, an estimated 62,300 men who have had sex with men would be eligible to donate. If the lifetime ban were changed to a one year ban, an estimated 112,000 previously ineligible man could give blood. This information comes at a time when the nation’s blood banks are increasingly short of donors. The National Blood Data Resource Center predicts that in 2001 demand will exceed supply by 200,000 units.
Nonetheless, the American Red Cross recommends retaining the ban, contending that the increased benefit is not worth the very small increased risk of HIV infection. The Red Cross insists that gay men are not singled out unfairly. Any group posing a risk to blood recipients, says the Red Cross, is restricted — e.g. IV drug users, prostitutes, and persons with infectious diseases, such as hepatitis. Other blood bank organizations disagree, however. In this regard there is approximately an even split on the issue among blood bank organizations.
Ethical Dilemma #3
In the early 1970’s, when Quincy Troupe was an adjunct faculty member at the College of Staten Island, someone told him that he would never be hired as a tenure-track professor unless he had a bachelor’s degree. He had attended Grambling, but not graduated. He changed his resume to say that he had graduated from Grambling.
Over the years, high accomplishments and fame increased, and he held several prestigious teaching positions, including an appointment as a full Professor at the University of California at San Diego. He became recognized as one of the best poets in the country as well as a gifted teacher who unstintingly gave back to the community in which he lived.
In 2002, Troupe was nominated as California’s Poet Laureate—the first time this appointment was made in a non-political way. Prior to his appointment, the Governor’s chief of staff had an interview with him to make sure that there were no skeletons in the closet.
Shortly after his appointment, the state legislature’s staffers completed their screening and discovered that Troupe had not graduated from Grambling, despite the fact that this is listed on his resume. They contact Troupe to ask him about this discrepancy, and he immediately confirmed that he had not graduated. Shortly thereafter, he submitted his resignation as California Poet Laureate. He also immediately informed UCSD of what had happened. Imagine that you are on the committee charged with the responsibility for deciding what the university ought to do in response to these revelations about Troupe. What should the administrators of UCSD do in response to discovering that Troupe had falsely claimed to have a bachelor’s degree from Grambling. What should Troupe himself do What factors ought to be considered in making this decision
Ethical Dilemma #4
According to rough estimates, 1 in every 1000-2000 infants born each year has ambiguous genitalia. These inter-sexed infants display various combinations of both female and male genitalia (e.g., an enlarged clitoris without a vaginal opening and with undescended testes).
According to the American Academy of Pediatrics (AAP), “The birth of a child with ambiguous genitalia constitutes a social emergency.” Parents, understandably, are distraught, and the AAP notes that both the ambiguity of the child’s sex and the parents’ reactions to that ambiguity carry significant implications for the child’s long term well-being. The most acute quandary is to determine whether the child will be raised as a girl or boy; in fact, parents are typically advised not to name the child or register the birth until the child can be assigned a sex.
Typically, genetic evaluations are undertaken to determine the infant’s genetic sex (i.e., whether the child’s chromosomal pattern is XX of XY) and the cause of the sexual ambiguity. Additional pediatric, urological, endocrinological and gynecological evaluations determine how best to assign potential fertility capacity for normal sexual function, endocrine function, potential for malignant degeneration, and intrauterine testosterone imprinting. Following sex assignment, surgical interventions are undertaken to revise the genitalia to conform to the selected sex.
While surgical reconstruction is not urgently required for medical reasons in most cases, the majority of pediatricians believe that sex selection should be completed as quickly as possible. Since parents and other family members, as well as members of society, interact differently with boys and girls; until the child’s sex is established, say the pediatricians who favor immediate sex selection, interactions are likely to be stilted, stunted, aberrant, confusing, or discomfited. In addition to the distress of the parents and others, say the majority of pediatricians, the child whose sex is undefined may experience ostracism and suffer from confused self-identity and self-understanding.
This assumption, and accordingly, the propriety of early surgical correction, has come under increasing challenge. Medical ethicists have recently argued that, as intersexuality is seldom threatening to life or health, the surgery should be postponed until the person who will be most affected — the intersexed individual — can give autonomous consent. Moreover, autonomous consent requires a full explanation of burdens and benefits, the nature of which have yet to be determined. In opposition to the assumption that early treatment is always in the child’s best interests, intersexed adults have begun to come forward to report various harmful effects of early surgical intervention. For example, first-person accounts testify to the pain and loss of trust that arise upon learning that one’s parents and physicians have deceived them about the nature of one’s gender. This loss of trust is often accompanied by a perception that the deceit stems from embarrassment or from seeing the intersexed person as a “freak.” Further, surgery that involves reducing the size of a penis or clitoris often results in loss of sensation and of orgasmic capacity.
Ethical Dilemma #5
In May, 2002, workers in a county garbage sorting center in Storm Lake, a small town in Iowa made a gruesome discovery: the body of a newborn boy, which had been dismembered by the sorting machines. The body was so damaged that identification of the body was impossible.
Police officials reasoned that the child had been abandoned in a dumpster at birth, probably by the mother. Unable to determine the baby’s identity, the police decided to see if there were any women who had been pregnant and now were not pregnant but did not have a baby. The first step in this process was to identify all the women who have been pregnant at the appropriate time in this same town of 10,000 residents. Police subpoenaed the records of Planned Parenthood to obtain the names of women who had received positive results on pregnancy tests in the previous nine months.
Planned Parenthood refused to comply with the subpoena, arguing that a woman’s decision about her pregnancy is among the most private of matters. Those who came to Planned Parenthood to determine whether they were pregnant ought to not be subjected, nine months later, to police officers knocking on their doors and asking details about the outcome of their pregnancy. They also point out that there is no guarantee that the woman even got a pregnancy test or that she was a local resident, so the search of the records could turn out to be futile.
Question: Should Planned Parenthood be forced to turn over to the police the records of women who tested positive for pregnancy Why or why not What are the competing considerations in this case To what extent do women seeking a pregnancy test have a right to privacy in such a situation To what extent do criminal investigators have a right to access otherwise-confidential information Why doe one outweigh the other