Conflict of Autonomy

A 38-year-old father does not want his 18-year-old daughter to have a test done for Huntington’s disease on her fetus. His reason for this is that if the test comes back positive, he will also know that he has Huntington’s which he has carefully thought about in the past and decided he did not want to know. The reason why the daughter wants to have the fetus tested is to avoid bringing a life into this world which has Huntington’s. A conflict of autonomy is clearly present in this case. You have the decision of the daughter to not want a child with Huntington’s versus the decision of the father to maintain ignorance of his condition. What should be done in this situation?

The first step taken in this situation should be to try and activate increased discussion between the father and the daughter in hopes that they may be able to resolve the situation themselves. There are several benefits to this process. It would maintain a strong family bond between the two that might be broken when one of their autonomy is taken away by the other. An increased understanding of the other’s position and the rationale that exists behind there position may also be of benefit in helping to console the individual who has just lost a certain amount of autonomy. Only after serious attempts to reach a consensus have been tried and failed, should the consideration to override autonomy be made.

It will be assumed that is it is morally acceptable to abort the fetus if it is found to have Huntington’s. The reason for this is so that the issue of autonomy can be addressed rather than the ethical dilemma of aborting due to Huntington’s. It is a total dismissal of the case to say that the autonomy of the father should be respected because the autonomous decision of the daughter is morally wrong in the first place and then go on to argue for the immorality of abortions on fetuses with Huntington.

The proper course of action in this situation is to respect the daughter’s autonomy while overriding the autonomy of the father. There are three main reasons for accepting this course of action. The first is that accepting the daughter’s autonomy only potentially affects one life while accepting the father’s potentially affects two. The second reason is based on the amount of life which will be affected by following the autonomy of the father over the daughter. The final reason is that the autonomy of someone should never be allowed to override the autonomy of another when dealing with matters of health.

If the father’s autonomy is accepted it will potentially affect not only the daughter’s life but also the fetus’s life. Thus the autonomy of one individual will be imposed on two lives. If the daughter’s autonomy is followed then only one individual, the father, is being imposed upon. It is reasonable to pick the path which will impose autonomous beliefs on the fewest people. One objection to this might be that in both cases the autonomy of an individual is actually being imposed on two people, the father, and fetus, or the daughter and fetus. To include the fetus in one count and not another, it might be said, cannot be justified. This is not true, however. If one looks at how decisions for extremely young children are made, it will be seen that the values and beliefs of the parent are assumed to be that of the child except on rare occasions.

The autonomy of the father is less important than the daughter’s because it will only affect at most, the next ten years of his life. After ten years pass he will know whether he has Huntington’s or not while the autonomy of the daughter will affect not only many years of her life, but also many years of the fetus’s life. It is utterly selfish of the father to demand that the daughter refrains from testing the fetus so that he may remain in ignorance for only several more years, while the daughter is forced to bring into the world against her wishes someone who may have Huntington’s. The autonomy of one individual cannot be given such force that it overrides two lives for the sake of ignorance, especially when the ignorance that the father cherishes so much will be over shortly regardless.

The father really has no say in this matter. The daughter being pregnant and eighteen years of age is considered an emancipated minor, a child able to make their own medical decisions. When it comes to health issues there needs to be a much stronger reason to override someone’s autonomy in favour of someone else’s, than a desire to remain ignorant. To allow the father’s autonomy to override that of his daughters would be analogous to allowing someone to veto medical research for fear that it may contain results that the person does not want to know. This is unacceptable, as is giving the father veto power over the daughter’s medical decisions.

The autonomy of the daughter should be followed over the autonomy of the father. When dealing with medical decisions the will of the patient is followed, not a third parties desire to stay ignorant. The father’s ignorance will expire in such a short time the amount of life affected by that autonomy is insignificant when compared to the amount of life which will be affected by following the daughter’s autonomy. Furthermore, it is clear that the father’s autonomy will be imposed on two lives, whereas the daughters preferably are imposed upon only one person. As with any conflict, the autonomy of either the daughter or father should only be overridden as a last resort after serious attempts at a compromise have been attempted.