ETHICAL DILEMMA ON WOMEN’S REPRODUCTION CHOICES
Ethical dilemmas happen in maternal and child health nursing and all other areas of nursing. All health caregivers, especially midwives, perinatal and neonatal nurses, face ethical issues every day as they interact with clients in the reproductive age groups. Ethics claims to be a discipline of systematic reflection and analysis designed to enable people to resolve questions about what ought to be done in some sort of consistent and coherent manner (Aderemi, R.A. 2016, p.68). Nurses are responsible for taking action by advocating for women in providing ethically competent care. Aderemi, R.A, in his article, mentioned that “ Ethical principles that guide ethical action include primary moral principles: respect for beneficence, non-maleficence, justice, and autonomy, which upholds the rights of individuals and families (2016, p. 68)”. However, nurses need to understand all these principles to provide comparative and equitable treatment to all childbearing women and adolescent women.
Women are faced with different challenges when making reproductory choices like abortion, prenatal screening, and the issue of selective reduction in multifetal pregnancy and many others.
According to Laufer-Ukeles, P, in his article states “Reproductive decisions involve protected individual liberty interests under the Fourteen Amendment of the U.S Constitution. Courts have determined that reproduction is integral to the very core of human identity; reproduction choices are deemed protected rights belonging to the realm of individuality, privacy, and autonomy free from “unwarranted governmental intrusion.” While the Supreme Court jurisprudence has announced this right to reproduce mainly in the context of contraception, abortion, and the not to undergo sterilization, scholars and lower courts have argued for the expansion of these rights to the realm of procreation and birth decision making as well” (2011, p.569). In other words, the reproductive choice of a woman’s private and individualistic right is not protected with the state and the doctor potentially bearing down on the patient with their interest in the fetus. It is disturbing that women’s choices in the reproductive realm are invalid because of social pressures as well as state and doctor biases.
Abortion is one of the most common procedures performed in the United States. It has become a hotly debated political issue that separates people into two camps: pro-choice and pro-life. The pro-choice group supports any woman’s right to decide about her reproductive funtion based on her own moral and ethical beliefs. In contrast, the pro-life group feels strongly that abortion is murder and that the fetus has the fundamental right to life (Aderemi, R.A, 2016 p.69). In labor and abortion decision, where women’s bodies are more directly involved, the choice must be the woman’s, and government should not be part of the discussion (Laufer-ukeles, P. 2011). Research showed that forty-nine percent of pregnancies in American women are unintended and that 40% of them are terminated by abortion. All women undergoing abortion need emotional support and a stable environment to recover and non-judgemental care throughtout. It is essential for nurses to clarify their personal values and beliefs on this issue and must be able to provide non-biased care before assuming responsibility for clients who might be in a position to consider abortion (Aderemi, R.A, 2016).
Thus, women need to be free to make their own decisions in line with their values with no pressure from the medical system or society regarding which is “correct” decision regarding making choices on reproductive options. Another area of concern is prenatal screening for fetal anomaly, a complex procedure with potentially serious implications. Prenatal screening for the fetal anomaly was introduced to improve pregnancy outcomes and give women more excellent choices in determining the outcome of their pregnancy. However, the screening process nature seems to be shaping and constraining the choices available to women.
Women are not adequately informed about what genetic testing entails; as a result, it does not support the freedom of choice offered to them while testing as an option ( Best Megan, 2018). The study showed that prenatal genetic screening and diagnosis aim to identify life-threatening severe conditions which are treatable, adult-onsets, or only partially penetrable illnesses (such as hereditary cancers) are now also the focus of the investigation. While recommendations have been made that prenatal diagnosis not be used for a minor condition is and how that decision is made is not clear. Besides the ethical problems involved with inadequate disclosure of all facts when women are not fully informed, women may not think through the implications of a positive diagnosis before undergoing the testing. The wide scope of testing makes it possible for the fetus to be tested for other health-related issues. The mother might get unexpected results from the testing they are not expecting. As a result, they might not be prepared to handle the situation (Best, Megan, 2018).
Finally, Elective abortion for fetal abnormality in a wanted pregnancy is quite different from termination of an unwanted pregnancy. It represents the loss of future hopes and entails the risk of severe and complicated grieving. It is a tough decision, especially for women in their old age with infertility problems who might experience pathological levels of distress. Doctors should disclose all the implications involved in the selective reduction of multi-fetal pregnancy and, patients should be given time to weigh the option of carrying the pregnancy. Consideration of termination decisions is complex and can entail ambivalence between commitment to the pregnancy and the desire to protect the child, themselves, and their families from the burden of disability (Best Megan, 2018).
In conclusion, maternal and child health nurses are faced with complex ethical issues. Nurses should advocate, respect, and support all child- bearing