Reference no: EM132264937

Jean has her first child at age 14. By the time she is 30, she has five children ranging in age from 5 to 16 years old. Married and divorced twice, she has spent 11 years living on Aid for Dependent Children. During the past five years, however, she has been working in a rehabilitation center, taking courses, and advancing on the job, even though she has no degree. In the process of all this, Jean discovers that she is intelligent and capable of control- ling her own life. She is also aware of her mistakes and is determined to pre- vent her children from making the same mistakes she has made. When she notices her re-year-old becoming overly interested in boys, she enrolls her in a state-supported boarding school for poor families. Despite this, the daughter becomes pregnant. Jean foresees another child at home, a daughter with- out education and work, and the start of another cycle of Aid for Dependent Children. Moreover, tests reveal that the child will have cystic fibrosis and will pose additional burdens on the family. Certainly, such a child will have no chance of adoption. Jean's dream of self-sufficiency appears doomed. She brings all this up at the physician's office while she has a bad case of the flu.

The patient is asking for both medical and moral advice. What can the physician say? Who is responsible for answering the moral questions? Should the presence of cystic fibrosis affect the decision?