Ethical Issues Relating to Life CH 12

Ethical issues relating to birth and life are especially difficult because they carry the extra burden of the our own personal values. Nevertheless, all healthcare professionals must be willing to understand the topics and issues discussed by patients, physicians, and the federal court system. This chapter includes a discussion of fetal development, contraception, sterilization, abortion, assisted or artificial conception, conscience clauses, genetic counseling and testing, wrongful life suits, the human genome project, genetic engineering, gene therapy, and stem cell research.

I. Fetal Development—When Does Life Begin? A. Embryo is the name given to an unborn child between the second and twelfth weeks after conception. B. Fetus is the term used when the embryo reaches the third month of development, starts to develop organs, and has a pronounced heartbeat and a functioning brain. C. The gestational period is the time period before birth occurs, which is usually around forty weeks.

II. Assisted or Artificial Conception A. Artificial insemination (AI) is the injection of seminal fluid that contains male sperm into the female’s vagina from her husband, partner, or donor by some means other than sexual intercourse. B. Artificial insemination by husband (AIH) is a procedure in which sperm from the woman’s husband or partner is used. C. Artificial insemination by donor (AID) is a procedure in which a donor’s sperm is used. A man donates his semen for insemination of a woman who is not his wife. D. Legal status of offspring—The most common legal and ethical concern relates to the legitimacy of the child and the determination of who is responsible for the child’s support. E. In-vitro fertilization is a process in which ovum and sperm cells are combined outside the woman’s body.

F. Surrogate motherhood 1. A surrogate mother is a woman who agrees to bear a child for a couple using the husband’s viable sperm. 2. The Baby M case resulted from a surrogate parenting contract between Mary Beth Whitehead and Mr. and Mrs. Stern. Mrs. Whitehead was inseminated with Mr. Stern’s sperm in 1985. On March 7, 1986, baby M was born.

G. Fertility drugs 1. Increase the female hormones and the production of ova, thus enhancing the ability to conceive and become pregnant. 2. Harvesting is a procedure performed by entering the uterus and removing some of the embryos, leaving only two or three. 3. Fertility drugs enhance a woman’s ability to conceive. However, the use of these drugs increases the woman’s chance of having a multiple birth, as many as eight embryos at a time. Miscarriages, stillbirths, infant deaths, and disabled children can result from the use of fertility drugs.

III. Contraception—Any action taken to prevent a pregnancy from occurring.

IV. Sterilization—The process of medically altering reproductive organs so as to terminate the ability to produce offspring. A. Voluntary sterilization B. Consent for sterilization—A patient, even if a criminal, must grant consent for the surgical procedure of sterilization. C. Therapeutic sterilization—May be necessary if the mother’s life or mental health is threatened. D. Eugenic sterilization—Eugenic, or involuntary, sterilization is the sterilization of certain categories of persons, such as those who are insane, mentally-retarded, cognitively disabled, or epileptic, in order to ensure that they won’t pass on the defective gene to their children. E. Negligence suits related to sterilization F. Ethical issues surrounding sterilization and birth control

V. Abortion A. Abortion is the termination of a pregnancy before it is viable (able to survive outside the uterus). B. A spontaneous abortion is one that occurs naturally without any interference. C. An induced abortion, or one that is caused by artificial means such as medications or surgical procedures, is used to save the life of the mother. D. In Roe v. Wade, the U.S. Supreme Court declared a Texas criminal abortion law that prohibited all abortions not necessary to save the life of the mother to be a violation of the woman’s right to privacy under the Fourteenth Amendment of the Constitution. E. Historical progression of cases affecting abortion—Since Roe v. Wade, a steady progression of abortion cases has reached the Supreme Court to challenge that ruling. F. Partial birth abortion—Abortions occurring late in the pregnancy when the fetus is considered to be viable outside of the uterus (at about 24 weeks). This practice causes much controversy. G. Incompetent persons and abortion—Difficult ethical issues surround situations in which incompetent persons may be subjected to unplanned or unwanted pregnancies.

H. Opposition to abortion I. Employee’s rights to refuse to participate in abortions—Hospital employees have the right to refuse to participate in performing an abortion, and a hospital cannot dismiss employees for insubordination. J. Funding for abortion—Funding for abortions has been another area of great controversy. K. Ethical issues surrounding abortion—Abortion raises a multitude of ethical issues, even for those who believe abortion, in general, should be legal. 1. One of the most vocal opponents of induced abortion is the Catholic Church. 2. Many private citizens do not wish their tax money to be spent on funding abortions for women on Medicaid. 3. Does the fetus have rights? 4. Abortion is always a moral decision, since it results in the loss of human life. 5. Should abortion be used as a means of gender selection of children?

VI. Genetic Counseling and Testing A. Genetics is the study of heredity and its variations. It describes the biological influence that parents have on their offspring. B. Genetic counseling involves investigation and counsel through interview and conferencing with perspective parents to determine potential for passing on genetic traits to their offspring. C. Prenatal testing—The most common means of testing during pregnancy is amniocentesis, a surgical procedure to withdraw amniotic fluid from the pregnant uterus for testing. D. Genetic testing of newborns—Routine genetic screening on newborns has become a standard in many hospitals. E. Ethical questions regarding genetic testing

VII.Wrongful-life suits—In general, the courts have rejected wrongful-life lawsuits brought against hospitals or physicians by children with genetic defects who claim they were injured by the action of being born.

1. Define the glossary terms. Amniocentesis a test for the presence of genetic defects in which a needle is used to withdraw a small amount of amniotic fluid that surrounds the fetus in the uterus. Anencephaly missing a brain and spinal cord. Artificial insemination the injection of seminal fluid that contains male sperm into the female’s vagina from her husband, partner, or donor by some means other than sexual intercourse. Artificial insemination donor (AID) a procedure in which a donor’s sperm is used. Artificial insemination husband (AIH) a procedure in which sperm from the woman’s husband or partner is used. Contraception birth control. Embryo unborn child between the second and twelfth week after conception. Eugenic (involuntary) sterilization sterilization of certain categories of persons, such as the insane and mentally retarded (cognitively disabled), in order to prevent them from passing on defective genes to their children. Eugenics the science that studies methods for controlling certain characteristics in offspring.

Fetus unborn child from the third month after conception until birth. Gestational period time before birth during which the fetus is developing; usually nine months. Induced abortion an abortion caused by artificial means such as medications or surgical procedures. In-vitro fertilization (IVF) the process of combining ovum and sperm outside of a woman’s body. Preimplantation genetic diagnosis (P.G.D.) genetic testing on embryos for genes that cause untreatable or severe diseases. Spontaneous abortion termination of pregnancy that occurs naturally before the fetus is viable. Sterilization the process of medically altering reproductive organs so as to terminate the ability to produce offspring. Surrogate mother a woman who agrees to bear a child for another couple. The husband’s sperm is implanted into this woman’s uterus. Therapeutic sterilization sterilization undertaken to save the mother’s life or protect her health. Viable in the case of a fetus, ability to survive outside of the uterus.