An Ethical Dilemma Surrounding a Vaccination Case Study | NRSG-2003 Legalities, Standards, and Ethical Reasoning in Professional Nursing

ii need to write a scholarly paper about the ethical dilemma on frozen embryos . i attached the paper example with it . Please follow the paper example i will also try to add the rubric with that too. thanks

Running head: ETHICAL DILEMMA
An Ethical Dilemma Surrounding a Vaccination Case Study
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Red River College
NRSG-2003 Legalities, Standards, and Ethical Reasoning in Professional Nursing
Instructor: Tara Roberts

Running head: ETHICAL DILEMMA
Title: Ethical dilemma surrounding frozen embryo
This paper will give an insight into the ethical dilemma faced by practitioners
regarding taking decisions related to storage or donating/discarding of frozen embryo.
The paper will extend the discussion by first reporting about an actual case of ethical
dilemma surrounding the issue. The case study is an example of real life scenario
where some names have been modified for confidentiality purpose. The study by
Gracia, Gracia and Chen (2010) reported about the case scenario. The case is about
Lisa, a 32 year old woman who was diagnosed with metastatic breast cancer. She had
married recently. Before proceeding with her cancer treatment, she banked nine
embryos as part of IVF therapy. However, she died a year later. Her husband was left
with the choice of deciding what to do with the embryo. He did not wished to continue
paying for the storage nor did he wished to give it to another couple. He did not paid
storage fees for six months and now his clinic is unable to reach him. The ethical
dilemmas will be explained further by the use of ethical principles, the Code of Ethics
and the Ethical Decision Making Framework.
Ethical principle
The above case study presents the ethical dilemmas related to deciding whether
the frozen embryo should be discarded or it should be stored even now. Although
earlier it was fair for Lisa to preserve her embryo based on her hope of having biological
children in the future, however going with the decision of preservation when Lisa has
died needs to be considered because this may be an unwise method of utilizing
resources as the embryo will never be used again. Hence, some ethical principles

Running head: ETHICAL DILEMMA
linked to the ethical dilemma include the principle of autonomy, justice and beneficence.
The principle of patient autonomy is an obligation to respect the autonomy of other
person during decision making (McDermott-Levy, Leffers & Mayaka, 2018). This applies
to the case scenario as the decision to discard or store the embryo needs to be taken
by Lisa’s husband. However, his unavailability and the clinic’al staffs discussion to
discard the embryo because of his absence may violate the principle of autonomy. Clark
(2014) highlights that if parents do not voluntarily agree to dispossession of embryo,
then discarding the embryo may lead to violation of the autonomy of patient.
Another ethical principle linked to the ethical conflict in the scenario is that of
principle of beneficence. This principle is based on the notion that no individual should
be harmed and all actions should be taken to promote good of patient (Grace,
2017). This principle applies to the scenario of storing frozen embryos or donation of
embryos too. The action of storing embryo is an act of beneficence as by storing the
embryo, it provides the option of saving the lives of vulnerable at-risk embryos (). This
could lead to well-being of couples who are expecting child in the future as they will
have to suffer from less hardship involved in treatment for fertility related issues. Lisa’s
decision of storing the embryo in an act of proactive beneficence. However, the ethical
issue surrounding the same is that destruction of embryos brings the question whether
the embryo has any moral status or not.
Code of ethics
The scenario also brings the question regarding the permissible duration for embryo
cryopreservation. In the case scenario, Lisa opted for cryopreservation before her

Running head: ETHICAL DILEMMA
treatment. Since one year after birth, the embryo is still being stored. As the clients
involved in the case are not aware about the ethical-legal issues related to permissible
duration of embryo freezing and donation, there is a need for nurse to clearly share
information related to this to the involved parties. This action is in relevant with the
Nursing Code of Ethics of promoting and respecting informed decision making as it
mentions that nurses should provide persons receiving care with information needed to
make informed and autonomous decisions. The information must be given in an open,
accurate and transparent manner (Canadian Nurses Association, 2017). As Lisa’s
husband has not given any wish to discard the embryo, the nurse must intervene in this
situation and get in contact with him to explain about the ethical and legal consequence
of continuing with freezing the embryo for many years. This information will help Liza’s
husband to understand why freezing the embryo is no more a beneficial option as her
wife has already died. The nurse can refer to local laws and obligations related to
acceptable duration of embryo freezing. Such information is likely to clarify his doubts
and make him take better decision regarding storage or donating the embryo.
Ethical decision making framework
This section will suggest the best course of action based on the dilemma by
following the six steps. This includes identifying conflicting moral claims, identifying key
participants, determining moral perspective of key participants, determining desired
outcomes, identifying options, acting on choice and evaluating outcomes of the action.
In response to the case study, the conflicting moral claims is that Lisa’s husband
do wish to discard the stored embryo and the clinical service is not willing to store

Running head: ETHICAL DILEMMA
unless payment is received. The service is aiming to discard the embryos on the count
that it is of no more future benefits to the couples. Hence, the ethical value of autonomy
and beneficence is under conflict according to this scenario. The key parties involved in
the scenario is Lisa’s husband or other couples who wish to store embryo on ground of
infertility issues and the health service staffs who aim to go by legal laws related to
embryo preservation. The third important party is the fetus that will develop from the
embryo.
The moral perspective of Lisa’s husband behind willing to continue with freezing
the embryo is emotional reasons as he believes this is a means to stay connected with
his wife even after death. The main reason for egg freezing in the scenario was to
achieve the possibility of live birth outcomes. According to Inhorn, Birenbaum-Carmeli
and Patrizio (2017), the main rational for oocyte cropreservation is preventing fertility
related regret. Most important it also gives couples the feeling pf psychological comfort.
This emotion is same for Lisa’s husband too. In addition, the moral view point of the
health service staffs were that long term cryopreservation is no more a feasible option.
The legal status of the embryo is in conflict under this situation.
Some of the options available for couples for whom reason for storing the
embryo has gone is to donate it to other infertile couple, discontinuation of cryostorage
and donation to research. The study by Chandy et al. (2019) also revealed that many
couples prefer to donate the embryo rather than discontinue storage. This decision is
based on an overwhelming desire to help couples who are suffering fertility issues. The
best option is one where the couple’s rights are respected as well as embryo
cryopreservation process is regulated in a way that no legal or ethical issues take place.

Running head: ETHICAL DILEMMA
The nurse could take the action to explain the couple about the options available and
pros and cons related to each decision. The best action to preserve rights of all is to
allow Lisa’s husband to donate the embryo to other couple. This will give him new
emotions linked to welfare and it will preserve the ethical principle of parent autonomy
too. Furthermore, this action will eliminate the ethical concerns related to long term
preservation of embryos too.
Conclusion
To conclude, the discussion related to ethical dilemma associated with embryo
storage indicated that this practice is highly controversial. The ethics of the action
depend on the situation, overall purpose and moral perspective behind the decision. To
ensure that effective decisions related to embryo preservation takes place, it is
necessary to refer to existing laws and consider views of both parties before deciding on
the best course of action.

Running head: ETHICAL DILEMMA
References
Canadian Nurses Association (2017). Code of Ethics for Registered nurses. Retrieved from:
https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/code-of-ethics-2017-edition-
secure-interactive
Chandy, A., Waanbah, B., Yadav, B., Kunjummen, A. T., Riley, D. J. S., & Kamath, M. S.
(2019). Knowledge and attitudes of subfertile couples towards disposition of
supernumerary cryopreserved embryos: an Indian perspective. Reproductive
Biomedicine & Society Online.
Clark, P. A. (2014). Ethical implications of embryo adoption. Pluripotent Stem Cell Biology:
Advances in Mechanisms, Methods and Models, 213.
Grace, P. J. (Ed.). (2017). Nursing ethics and professional responsibility in advanced practice.
Jones & Bartlett Learning.
Gracia, C. R., Gracia, J. J., & Chen, S. (2010). Ethical dilemmas in oncofertility: an exploration
of three clinical scenarios. In Oncofertility (pp. 195-208). Springer, Boston, MA.
Inhorn, M. C., Birenbaum-Carmeli, D., & Patrizio, P. (2017). Medical egg freezing and cancer
patients’ hopes: Fertility preservation at the intersection of life and death. Social Science
& Medicine, 195, 25-33.
McDermott-Levy, R., Leffers, J., & Mayaka, J. (2018). Ethical principles and guidelines of global
health nursing practice. Nursing outlook, 66(5), 473-481.

Running head: ETHICAL DILEMMA