A Hasty Move for an Unfounded Fear When Daniel was born, he was found to have the characteristics of a hermaphrodit

e. He had both penile and vaginal physical attributes. As a little kid, he did n ot have any problem associating with other kids until he reached three years of age. His parents could not decide which toilet he should use, especially when he was in the mall. Worried, they consulted pediatric doctor about their predicame nt. A priest was also consulted and even advised them to proceed with the surger y. As the story went, a sex determining surgery was scheduled. The penile part w as removed and she was made to be a girl and guided to act like a girl. This tim e her name was changed to Danielle. His birth certificate was legally applied fo r record changing process to make her officially a girl. When Danielle was seven , surprisingly, she did not behave like a girl, rather her acts and behavior wer e that of the boy. The parents were in a dilemma because this time, Danielle was indeed Daniel. The doctor was also confused. 1. There is evidently haste in the surgical procedure to remove the penile attri bute. Is there ethical accountability from the parents, the doctor, the hospital and even the priest who agreed to the procedure? Yes. It was evident that everybody participated to the decision-making of proced ure. Clearly, anyone who has a contribution to a given situation is held not onl y accountable, but also responsible for the outcomes. Daniel, who was 3 years ol d at that time was not yet capable of sound and mature decision which left his p arents and those who were concerned decide for him. 2. Was there an ethical principle violated in the surgical procedure? Why? Principle of Autonomy. Although parents can decide for their minors, the decisio n made for the procedure was not of immediate concern for survival. It was sex-d etermination procedure of which the child was not aware yet, or even necessitate s his survival. The parents, who were anxious and doubtful, did not wait a littl e longer for the child to express his concern, thus, the haste procedure. Principle of Totality. It is said that the the bodily and psychic lower function s are never sacrificed except for the better functioning of the whole person and even with an effort to compensate for this sacrifice. In this case, Daniel's li fe or well-being was not at stake or in question, that should not left the paren ts decide immediately. It was unfortunate that after few years of expecting a be tter life for the child, physical, social, and psychological, the procedure left him a dilemma. Principle of Beneficence. "Do good and avoid evil." Yes, the parents just wanted a normal life for the child. But as we scrutinized the case, its situation and outcomes, it only seemed that the parents decided for their own goodwill, thinki ng that they can care for the child without confusion, doubt, or self-guilt. Ins tead of giving him 'normal' life they wanted for him, it just resulted into a di lemma in which resolution may not be made, or if, with the littlest possibility. 3. What ethical considerations should have been taken before any surgical proced ure was performed to Danielle? Is the psychologist s role important here? How abou t the ethics committee? Explain. The principles stated above should have been taken into consideration. A psychol ogist advice may be applicable and considered but not to the extent of following it. It could have been better if the parents went through some counseling sessi ons since they feel anxious for the welfare of the child. This may not give them the 'right' thing to choose, but instead, it would help them cope with the feel ings and stress they were going through the process. Ethics committee, since they function to provide ethics consultation with goal o

f promoting the rights of patients and ensuring sound judgment, helping those pe ople decide ethically. 4. Was it ethically sound to advise the parents, doctor and the rest to postpone the surgical procedure up to a time when Danielle could distinctly be assigned the sex to which (s)he belongs? Absolutely. It was the best thing to do above all to wait for the very person in volved in the procedure. Since it is Daniel's life, he is the best person who ca n determine the sex he believes he is.