Case Studies

Sally Bishop
1994 Woodrow Wilson Biology Institute

To The Teacher:

After students have developed their "I Values" and learned how to use the "Decision Making Model," they are ready to apply that knowledge to case studies. Included in our module are three case studies.

Case Study #1

Mr. and Mrs. XY have been married for many years. Both have wished for a small ideal family of one son and one daughter. The son, of course, would ideally be the older of the two children. Unfortunately, Mr. and Mrs. XY have not been blessed with any children.

Mr. and Mrs. XY are now both forty-five years old and well established in their careers. Mrs. XY suddenly begins to experience flu-like symptoms which persist for an inordinately long period of time. Her devoted mate, Mr. XY, insists that she visit her doctor to determine the cause of her discomfort.

Dr. Sue Smith, the family physician, is quick to suggest, among other tests, a pregnancy test. Although Mr. and Mrs. XY are reasonably certain that Mrs. XY cannot be pregnant, they agree to the test. The results come back positive; Mrs. XY is pregnant!

Mr. and Mrs. XY are concerned about this miracle conception. They realize that they'll be almost sixty-five years old when their child graduates from high school and wonder if this is being fair to their prospective child. They're at a point in their careers where they're experiencing great job satisfaction and are enjoying a decent standard of living but they haven't saved any appreciable amount of money. They wonder how much the cost of raising a child will erode their savings and impinge upon their standard of living. They also know that older parents often have a greater chance of producing a genetically deficient child. They worry about that, too. What ought Mr. and Mrs. XY to do?

Case Study #2

Mrs. XX has a family history of breast cancer. Both her maternal grandmother and her mother died from the disease. One of her three sisters recently discovered that she, too, has breast cancer and, after a mastectomy, that sister is undergoing chemotherapy.

Mrs. XX is concerned that she, too, might develop breast cancer. She schedules an appointment with her physician, Dr. Mam, who insists on a mammogram which comes back negative. Because of the familial history of the disease, however, Dr. Mam suggests that Mrs. XX undergo a prophylactic bilateral mastectomy. What ought Mrs. XX do?

Case Study #3

John and Mary have just given birth to a baby boy; they've affectionately named him Joey Jr. Their doctor, Dr. Tris Omy, has asked for a special meeting with John and Mary. The couple is understandably anxious about this meeting.

The appointed time arrives and so does Dr. Tris Omy. His news is not good. John and Mary's baby has Down's Syndrome, a genetic disease which occurs in about l/770 births. While it can affect males and females of all races, it most frequently occurs in the fetuses of older women (Mary is 39). It is a result of having three copies of chromosome #21.

Dr. Omy continues to explain that John and Mary can expect Joey to be mentally retarded. About half of the Down's babies die before their first birthday of things like heart or kidney defects, blockages of the intestine, leukemia or other effects of a suppressed immune system. Dr. Omy points out that some physical traits are or will be present: abnormal palm creases, flat face, sparse straight hair, and short stature. Victims may develop cataracts.

Dr. Omy, a sensitive physician, also tells John and Mary that Down's Syndrome children are often happy children who are trainable to varying degrees. He knows of one young man in California who even graduated from a junior college. He cautions John and Mary, though, not to apply too much pressure for Joey to be more than he can be.

After Dr. Omy leaves, John and Mary have an emotional conversation centering around Baby Joey. The most important focus of that conversation, other than Joey's genetic disorder, is whether or not to have more children. Joey, at this point, is an only child. What ought John and Mary to do about having more children?

Source: Lewis, Ricki, 1994. Human Genetics Concepts and Applications, Wm. C. Brown.

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