PHL 315 - MEDICAL ETHICS
Summer 2002
Lawrence P. Ulrich, Ph.D.
Lawrence.Ulrich@notes.udayton.edu
CLINICAL CASE 2 --- MARTHA W.
DUE DATE: JUNE 7

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Case Analysis
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Clinical Case 1:
Mabel S.
Clinical Case 2:
Martha W.
Legal Case:
Nancy Cruzan
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CLICK HERE for the Case Analysis Outline.


    Martha W. is 37-years-old and has been married to Michael for 12 years. They delayed having children until Martha was 30 so that she could establish her legal career. When they decided to start a family they had difficulty establishing a pregnancy. Martha had two miscarriages by the time she was 33 and then it was determined that there was a fertility problem with her husband. When she was 35 they decided to have in vitro fertilization with artificial insemination by a donor. The insurance company for Mr. & Mrs. W. refused to pay for this procedure because they claimed that the procedure was not clinically necessary. Her infertility, they said, was not clinically proven and the in vitro procedure was still in its experimental stage.

    After four tries at $5,000 per try. Mrs. W. became pregnant. Early in her pregnancy it was determined that she was carrying 4 fetuses. Michael and Martha wanted a child but they did not want a multiple birth because they were both career conscious and they thought that quadruplets would radically hamper the pursuit of their careers. So in the first trimester they elected the procedure known as "pregnancy reduction." This procedure allows for the removal of unwanted fetuses while still allowing a determined number of fetuses to continue to develop. In this case, the W.'s wanted only one fetus to remain.

    During the fifth month of the pregnancy, Michael and Martha were at a party and they saw the sperm donor there with his domestic partner. They did not realize that the donor was gay and Michael was horrified by the thought that their child might inherit the genetic disposition for homosexuality. He wanted Martha to have an abortion immediately but she resisted. As they were approaching the end of the second trimester, Michael became more and more adamant about Martha's having an abortion. Nothing she could say would dissuade her husband so she spoke to her obstetrician about doing an abortion. The obstetrician was profoundly disturbed that the W.'s would consider such a thing for such a reason and refused to perform the abortion. Two days later Michael drove his wife to an abortion clinic in another city and threatened her with divorce if she did not go through with the abortion. With tears in her eyes, Martha went into the clinic and had the procedure.