Sandra Sasse June 28, 2011 Ethics and Law

We as scientists yearn and push for the rapid progression of science yet. “home of the world's leading expert in gender identity. the parents were referred to Johns Hopkins Hospital in Baltimore. twin boys to be exact. 2008) Devastated." (Altered Dimensions. burning off his entire penis as a result. (Altered Dimensions. believing Dr. instead of a scalpel. Money when he claimed this would be the only hope . The case I will examine and discuss is horrific and saddening but it teaches us all a lesson on how we must always keep humanity and ethics in mind. psychologist Dr. 2008) Her doctor "used an electro cautery needle. who recommended a surgical sex change.There is a line that calls to be drawn when it comes to the advancement of science and the fragility of humanity. David's parents were young Canadians from farm country. his mother took her sons to the doctor and was advised to have them both circumcised. They fell in love and on August 22. Naturally concerned. Their first few months of life were like any others but David’s mother noticed that her twin boys were having difficulty urinating. 1965 had twins. John Money. there are times we are horrified at the blood that is spilt along the way.”(Calpinto. from male to female. After discussing the details of the case I will examine the ethics that are firmly placed within the healthcare profession that were violated and discuss how the tremendous case changed our laws in the United States and globally. 2004) David's parents agreed to the radical procedure. to excise David’s foreskin during a routine circumcision. We seem to find numerous cases that tragically cross ethical lines in the name of "science".

He became very angry and would tear the dresses he wore off and would fight his brother to play with his toys instead of playing with the dolls that were given to him. a genetic clone raised as a boy. His brother. due to all the issues the family had with . he felt so out of place and dreaded the annual visits to Dr. For Dr. determines gender identity and sexual orientation—an experiment all the more irresistible because David was an identical twin.for their child to have a normal life. Money was gaining a lot of attention and this radical idea of nurture overruling nature got him featured in Time magazine. would provide the perfect matched control. Money’s discovery or success experiment was in fact a disaster. Money. The most tragic was what happened to his twin brother. Understandably David’s frustrating grew as he got older. (Calpinto. Dr. it affected the entire family. David was having a horrible time adjusting to his new “Brenda” role. 2004) Sadly. not nature. The procedure was considered successful and it was documented that the twins were adjusting quite well to their new “roles”. 2004) David's infant "sex reassignment" was the first ever conducted on a “normal” child. Dr. Money where his insistence to be more feminine was reinforced. David’s turmoil didn’t end with him. David was the ultimate opportunity for an experiment to prove that “nurture.” (Calpinto. Brian. His mother feeling horribly guilty attempted suicide and his father became an alcoholic.

Milton Diamond. he still had not recovered from his horrific past and it did cause a lot of problems in his marriage. a psychologist at the University of Hawaii and a longtime rival of Dr. I wasn't crazy. I wasn't some sort of weirdo. Money considered his sex reassignment surgery a success and his case was used to “legitimize the widespread use of infant sex change in cases of hermaphroditism and genital injury.” David stated that "Suddenly it all made sense why I felt the way I did. 2008) When Brenda (David) was 14. “ Outraged. (Milton & Beh. he was convinced he could never marry since he was physically unable to have children. (Altered Dimensions. Money. David agreed to participate in a follow-up by Dr. a local psychiatrist convinced his parents to finally be honest with their child.” It was as if David could never escape the shadow of Dr. 2004) Soon after being told the truth he went through several procedures to change him back into a man. whose myth-shattering paper (coauthored by Dr. Unfortunately. Keith Sigmundson) was published in Archives of Pediatrics . Diamond. 2005) Things began to turn around in David’s life when met a woman and fell in love and got married. All of his procedures were quite long and painful and though the scares may have physically healed his emotional scares were still open. “ To David’s shock he found out that Dr. In his twenties he attempted suicide twice." (Calpinto. By chance David happened to meet “Dr. Money.“Brenda” his brother David felt ignored and acted out with drug use and getting in trouble with the law.

Money propelled him to agree to conduct several interview about what happened to him and eventually he wrote a book called “As Nature Made Him: The Boy Who Was Raised as a Girl “(Milton & Beh. 2001) I would imagine it was a combination of both. Eventually. and how much to the nightmare circumstances into which they had been thrown? “(Ellis & Hartley. Dr. (Milton & Beh. “(Calpinto. . Sadly. 2004) Now David had a voice and helping Dr.and Adolescent Medicine in March 1997 and was featured on front pages across the globe. his traumatic life became too much for him and he ended his life. Perhaps with the right amount of drugs and therapy he could have overcome his unfortunate past. not nature. things began to go downhill again for David. he also made some bad investments with his money and had marriage problems. His mother has been a clinical depressive all her life. his twin Brian died of an overdose of antidepressants in the spring of 2002. He was used to prove an over ambitious scientist’s theory that gender was determined by nurture. How much of the Reimers' misery was due to inherited depression. David is a very good example of a patient becoming a victim of science. his brother suffered from the same disease. David became depressed. 2005) David’s motive for writing his book was partly therapeutic and partly to raise awareness. 2005) “Genetics almost certainly contributed to David's suicide. Diamond expose Dr.

Money theory was proven wrong and it cost an entire family to suffer as a result of his selfish motives. It is now required that they also provide other possible options. Dr. Dr. The first ethical law he violated is justice. Maloney used them for his own theory and research. As a result this case pushed the requirement of informed consent. Reimer’s bravery in coming forward with his story he . Maloney did not keep in mind and violated several areas of his ethical laws. Maloney’s theories. Clearly Dr. he was definitely just used a tool for Dr. They were young farm teenagers from Canada and could be easily manipulated. 2005) He was in fact unfair to the innocent child. Justice is the obligation to be fair to all people clearly justice was not evident with Dr. Thanks to Mr. The poor child did not get justice. There is nothing fair in deciding to change a child’s gender and observe the reactions in order to prove his own theory. They blindly agreed to his recommendation not knowing the tragedy that was to come. Maloney was not completely honest with David's parents. (Pozgar. 2005) Informed consent requires the health provider to explain the negative and positive outcomes of the procedure. He never bothered to explain the possible outcomes from the gender reassignment surgery. They only result of justice from this sad story was that it aided in the requirement of informed consent. Maloney and the patient. (Lloyd.

2005) Therefore. intention. (Pozgar. Doing good also requires that the healthcare provider “have knowledge of the beliefs. The third ethical law that was neglected was beneficence. consider individual circumstances of all patients. (Stanford University. Maloney was definitely in violation of this ethical requirement! He definitely persuaded and misleads Mrs. The second ethical principle he broke was autonomy which requires that the patient have autonomy of thought. culture. and strive for net benefit. and action when making decisions regarding health care procedures. Dr. Demands that health care providers develop and maintain skills and knowledge. yet he was convincing her that it was already proven. This ethical principle requires that the procedure be provided with the intent of doing good for the patient involved. the decision-making process must be free of coercion or coaxing. 2005) In the Reimer case the doctor did not consider the preference of the patient but his . He was actually currently performing the experiment to his theory that nurture is more powerful to nature when it comes to gender.was able to further convince the world that informed consent was necessary in order to protect patients. continually update training. values and preference of the patient”. Reimer when he convinced her to go ahead with the procedure without fully informing her of the possible consequences.

2005) Dr. 2005) Due to the gross negligence of Dr. There was nothing “good” about forcing David to be a girl when he was born a boy. Requires that a procedure does not harm the patient involved or others in society. (Pozgar. I believe the biggest disservice that the . Lastly. Dr. Money capitalized on his success with the Reimer experiment until Milton Diamond's research and a BBC documentary in 1980 questioned the "success" of the experiment.actual preference when it came to David Reimer. Money did not inform the Reimers of any of this information. Dr. Maloney there was a push for protection of patients and their rights. (Pozgar. The Reimer case definitely had a huge influence on the requirement of informed consent. Money’s false experiment was incorrectly used as an argument to preform gender reassignments on babies. If Reimer would have known about the potential risks I seriously doubt that any parent would be willing to put their child in that predicament. non-maleficence was also violated. There is no doubt that Reimer was affected and harmed on so many levels. Their used this case in particular to drive the point that doctors are required to explain exactly what the patient is getting and what are the alternatives. benefits and alternatives of a proposed procedure”. “informed consent is ‘a legal concept that provides that a patient has a right to know the potential risks. His suffering could have been far less if they had raised him a boy and treated him as such. According to our book “Legal and Ethical Issues.

If Dr. . Basically they were lead to believe that the radical gender change was their only option. Now Dr. Maloney has blood on his hands all if in the name of “research and science”. Maloney just went by the ethical code all health professional promise to abide by this tragedy could have been avoided. “A belief in the fundamental adult human right to determine what will be done to his own body is the foundational principle leading to the doctrine of informed consent in the doctor-patient relationship. Sadly. 2002). Perhaps he would still be with us if his mother was properly informed.” (Martin.Reimers received was not to inform that of alternatives. Imagine if Reimer’s mother was clearly informed there is no doubt it could have completely changed the whole course of David Reimer’s life. it took cases like Reimer to change the laws that protect us today.

hu-berlin. 7th ed. MILTON DIAMOND. Ellis.com 2. Janice R. Hartley (2001) Nursing In Today's World: Challenges. Colapinto.com/id/2101678/ 3. (2005) The Right to be Wrong..Sex and Gender Decisions http://www2. & HAZEL GLENN BEH. PH. PH.htm 4.slate. Erin (2005) From the Hospital to the Courtroom: A STATUTORY PROPOSAL FOR RECOGNIZING AND PROTECTING THE LEGAL RIGHTS OF INTERSEX CHILDREN . Philadelphia.References 1. John (2004) Gender Gap http://www. and Celia L.altereddimensions.D.Institute for Paranormal and Esoteric Research (2008) The Story of David Reimer.D.D. PA: Lippincott Williams & Wilkins Publishing 5. Issues and Trends.a boy in girl’s clothing http://www. J. Lloyd.de/sexology/BIB/DIAM/right. Altered Dimensions.

Sudbury: Jones and Bartlett.com/p/articles/mi_go2943/is_2002_Summer/ai_n7042 230/ 8. Stanford University (2009) What are the Basic Concepts of Medical Ethics http://www.https://litigation-essentials.+ %26+Gender+155&srctype=smi&srcid=3B15&key=8ede8c02d34161 436a9c3ed85d7a6851 6.L.com/webcd/app? action=DocumentDisplay&crawlid=1&doctype=cite&docid=12+Cardo zo+J. . Pozgar.htm 7.stanford.edu/class/siw198q/websites/reprotech/New %20Ways%20of%20Making%20Babies/EthicVoc.lexisnexis. Martin. George (2005) Legal and Ethical Issues – For Health Professionals. Patricia (2002) Moving toward an international standard in informed consent: the impact of intersexuality and the Internet on the standard of care http://findarticles.

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