Ethical Issues in Termination of Pregnancy: A Case Study Analysis

This essay analyzes a case study on termination of pregnancy due to fetal anomalies and identifies the ethical issues raised by the events described. It discusses human dignity and human rights, professional code of ethics and conduct, relevant professional policies and legislation, and the principles of healthcare ethics. Recommendations are also provided.

Essay Based on Case Study on Termination of Pregnancy
Essay Based on Case Study on Termination of Pregnancy
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Essay Based on Case Study on Termination of Pregnancy
1. Identify the ethical issues raised by the events described in your chosen case study
Introduction
The world of health care is dynamic and continues to present medical professionals with several
emerging challenges emerging from ethical dilemmas. Making the best choices for patients and
safeguarding healthcare professional policies ends up in a conflicting situation in many times.
These confliction moments affect the decision making process among healthcare professionals.
In these challenging situations, healthcare providers rely on the principles of healthcare ethics:
Autonomy, Beneficence, non-maleficence and justice. Application of these principles is however
dependent on the legal restrictions of a country. In essence, the Australians legislation in
principles of nursing are based on the United Nations declaration of human Rights, International
Covenant of Economic , Social and Cultural Rights and International Covenant on Civil and
Political Rights.
The selected case study is based on the debatable and all controversial topic of termination of
pregnancy on medical grounds where a baby’s health cannot be guaranteed at the pregnancy
term. Termination of a pregnancy due to fetal anomalies is both an ethical and morally
challenging tissue even in the medial field. It is also a legal issue based on a country’s restriction
on abortion as a practice. Ethical dilemmas include conflict between the woman’ s right to
autonomy, the fetus right to personhood and life and the societal moral obligation of the doctor
(Mose, 2008).
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Essay Based on Case Study on Termination of Pregnancy
Case Study
In this case, Sarah has a moral obligation and is bound by medical ethics to fully disclose to the
couple in the simplest of communication language, the state of the fetus, the possible dangers
and suggest to them all possible solutions that are medically sound.
Natalie as parent whose child has been diagnosed with the possibility of being born with an
abnormality is faced with the dilemma of having to raise a disabled child. Weighing her
personal options, she thinks this would be a challenge she cannot go through with the pregnancy.
Her suggestion to terminate the pregnancy may be questioned as to whether she has no respect to
the sanctity of life.
The labour ward nurse, Lily indicates that these days everybody is after the perfect life. Her
assumption is that the couple will opt for abortion since it has become the norm. This is however
unethical since as a medical practitioner, one should inform a patient about abortion a solution to
the medical dilemma but should not advocate for it. In some countries, abortion is supported by
the notion that children should be by choice not by chance. In this case however, the labour ward
worker seems to suggest this as the one solution to the problem. This is professionally unethical
and legally unlawful as it seems to deny the patient a chance to choose. As a medical practitioner
especially working for women’ health. One should be after the wellbeing of the woman and give
advice on each decision and the effect it may have n the mother; emotionally, physiologically
and even financially then let the affected take a personal decision. (Torres, and De Vries, 2009).
This, as the social worker supports.
1.1 Human Dignity and Human Rights
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Essay Based on Case Study on Termination of Pregnancy
Termination of pregnancy before it natural delivery time due to fetal anomalies is an issues that
brings up heated debate at any point of discussion. The debate is always based on ethical and
human rights issues. Abortion is seen as an infringement to human rights as it results to ending
the life of another human. Secondly, it is advocated by people who were given a chance to life
though birth but are now dyeing another person a chance to life by taking away their chance to
be born. (Patil, et. al. 2014). The debate of abortion raises varied opinions some bases on
religious facts and societal expectations. With regards to human dignity, abortion is seen to be a
violation to the sanctity of life. Which the raises the question of; When does life begin?
Religious beliefs are of the opinion that life is holy and starts at conception. In this regard,
abortion is opposed and fetal development encouraged so as to preserve the dignity and sanctity
of life for every person. Medically however, researchers have argued that life begins when the
brain of the fetus starts developing (Francis, 2004). However the debate is still on as the decision
as at when termination of pregnancy can be termed as murder is also measure on morality.
Bhatla, (2001) defines morality as a personal conviction that an action is upright and beneficial
to both self and the society. In the concept of right to life in the case of abortion, two lives are to
be considered; that of the mother and the embryo. In the situation of fetal anomaly, a doctor can
seek to justify the reason for termination in the prevention of bringing to life abnormal children
whose life is assumed based on medical facts to be difficult to lead. (Al-Alaiyan and AlFaleh,
2012).
1.2 Professional Code of Ethics and Conduct
As an important dimension of obstetrics, ethics is defined as the disciplined study of mortality
that provides professional standards. Professional code of ethics in the medical world cut across
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Essay Based on Case Study on Termination of Pregnancy
all fields and should be respected by all regardless of their personal, spiritual or religious views.
(Chervenak and McCullough, 2011).
In this regard, professional ethics carry along the responsibility, morality and values an
individual is expected to display while carrying out his professional duties. As individuals,
obstetricians should always be guided by personal values and ethics that are grounded on the
moral good other and personal convictions. In conduction oneself however, a person should
always made decisions based on the legally accepted practices in the society. (Raghyan, and
Oumachigui, 2014). Medical ethics have evolved from the traditional idea that concern was
based only on the best interest of your patient to now considering legal practices and societal
norms.
1.3 Relevant Professional Policies and Legislation
There is a thin line between ethical and legal matters when it comes to abortion. (Witoonpanich,
2011). Legally, it can be argued that preventing something from coming to life is different from
ending life of an already existing being. Professionally, there is the debate of when life begins.
However, the doctor is bound by professional policies to give medical options with an interest in
the patients’ wellbeing. According to Martin Fischer, the most important medical policy on
ethics is for decisions to be made in the interest of the patient. In the case of abortion however,
interests are of two people which are in every case conflicting (Patil, et. al. 2014). In countries
where abortion is legal in the event of conditions that endanger the mother, then professionally,
the policy to upload the dignity and autonomy of the mother is applicable. However, in countries
where safe abortions are not legal, the doctor is under no obligation to suggest this an option as it
unlawful. However the result is an increased in child mortality and risk in the lives of pregnant
females. (Al-Alaiyan, 2012).
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Essay Based on Case Study on Termination of Pregnancy
1.4 The Principles of Health Care Ethics
Professional code of ethics guide in decision making and are based on the respect for autonomy,
beneficence, nonmaleficence and justice. (Hewson, 2001).
Autonomy – the patient has a right to accept or refuse the proposed clinical treatment based on
her beliefs and moral principles.
Beneficence – balance good over harm with the patient’s bets interest first.
Nonmaleficence – This is the first guide; harm not.
Justice – Fair distribution of resources in ensuring qualiry access of treatment.
These four principles help medical practitioner make an informed decision on deciding who
needs to live in situations where an embryo’s life can endanger that of the woman carrying it.
(Gillon, 2001).
The Australian code of ethics seeks a purpose in; identifying standards and values that are ethical
and endorsed by other professional nursing guidelines and on which the nursing profession is
committed to. These ethics give the nursing professionals a reference point in ethical decision
making and gives an indication to the community on ethical values that nurses should abide to.
Conclusions and Recommendations
Ethical issues in regards to obstetric practices have been evolving over the years. Previously, the
only underlying ethical issue was the interest of the patient. The ethical idea was always to save
the life of the mother until the fetus started being regarded as person with person and humans
rights. In this regard, conflict arises and puts at odds the moral and ethical issue with regards to
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Essay Based on Case Study on Termination of Pregnancy
abortion. The advancement of technology in the medical field has enabled the diagnosis of a
fetus and thereby giving a fetus the potion of a patient; a person with rights. (Mose, 2008).
In the argument against abortion, the procedure is assessed as the involvement killing of a fetus
thereby depriving it of its right to live. It is argued that this is a loss of possible future thereby
making the practice wrong (Raghyan, and Oumachigui, 2014).
This argument, forms the basis for some countries where abortion is illegal. The result however,
is mothers opting for backstreet unsafe procedure that may have long-term negative effects on
the women’s health. (Gun, 2014)The issues of respect for life is not so much on the value placed
on a fetus that does not know of its existence as much as that placed on a mother carrying the
fetus whose life is endangered due to medical conditions.
On other hand, humans have the freedom to choose which should extent to the freedom to make
decisions on whether to terminate a pregnancy based on fetal anomalies. To have women
compelled to keep these pregnancies denies then the right to choose which a denial of freedom
is. Arguments against abortion maintain that killing a fetus is wrong morally. However, based on
medical considerations that aim to improve the quality of life, then the decision to terminate a
pregnancy can be supported. The right to life of a fetus is tied to its personhood. That a fetus is a
person, then forms the basis for a fetus to have the right to life as shown in figure 1. 1
Figure 1.1 showing the balance of life for mother and fetus.
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Personhood
Fetus
Rights to Life

Essay Based on Case Study on Termination of Pregnancy
Recommendations
Abortion, being a procedure that affects the balance of life between a mother and a child and also
affects the life and possible quality of life if not opted for, should only be undertaken after great
ethical considerations. Both the mother and the fetus have a right to life but it goes down to the
quality of the expected life. It would be unfair to force the birth of a child whose life’s quality
will be poor especially in the absence of resources to support his medical condition. It is also a
quite a task to raise disabled children and therefore given the advancement of technology in the
obstetric world, we should apply this knowledge to help humans make the correct decision with
regards to quality of lie of the population for the future.
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Essay Based on Case Study on Termination of Pregnancy
References
Al-Alaiyan, S., & AlFaleh, M. (2012). Aborting A Malformed Fetus: A debatable issue in
Saudi Arabia. J Clin Neonatol 2012; 1(1):6-11. Retrieved September 21, 2018, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761984/
Bhatla, N. (2001). Sterilization and Termination of Pregnancy: Jeffcoate’ Principles of
Gynaecology. 7th International Edition, Jaypee Brothers p.: 824-38. Retrieved September 23,
2018, from http://gynecologyblog.blogspot.com/2016/02/jeffcoates-principles-of-
gynaecology.html
Chervenak, F., & McCullough, L. (2011). Current Progress in Obstetrics and Gynecology. Vol.
5. The Relevance of Ethics in Gynecology Practice. 2011; 27: 3-7.
Francis, M. (2004). Right to life; Medical ethics- Jaypee brothers 2004 edition.
Gillon, R. (2001). Is There a ‘New Ethics Of Abortion’? J Med Ethics 2001; 27 (2): 5-9.
Gun, M. (2014). Ethical Aspects of Medical Termination of Pregnancy. Manual of Medical
Termination of Pregnancy Biman Chakraborty, H. Dasgupta FOGSI 2nd edition. Retrieved
September 23, 2018, from http://medind.nic.in/iaa/t14/i11/iaat14i11p544.pdf
Hewson, B. (2001). Reproductive Autonomy and the Ethics of Abortion. J Med Ethics 2001; 27
77-82
Mose, C. (2008). Aspects of Ethics in Obstetrics Ultrasound. Indones J Obstet Gynecol 2008; 32
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Essay Based on Case Study on Termination of Pregnancy
(2), 65-1
Patil, B., Dode, P., & Ahirrao, A. (2014). Medical Ethics in Abortion. Indian Journal of
Clinical Practice 2014; 25 (6): 87-90
Raghyan, S., & Oumachigui, A. (2014). Essential Obstetrics: Ethical Issues. University Press
Hyderabad
Torres, M., & De Vries, G. (2009). Birthing Ethics: What mothers, families, childbirth
educators, nurses, and physicians should know about the ethics of childbirth. J Perinat
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Witoonpanich, P. (2011). Ethics and Rule in Obstetrics and Gynecology. Rule of Ethics for
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