The nursing study will evaluate end of life and other contemporary ethical dilemmas that health practitioners face. Some of the quandaries that would be addressed include the differences between physician-assisted suicide or personal suicide, the controversies that surround the confidentiality and privacy of the caregiver versus the right to know for a patient, the moral conundrums around wrongful conception, wrongful life, and wrongful birth, issues related to abortion, and why even in the modern age of science there is still moral grey areas in stem cell and genetic markers research. Pozgar (2013) will inform much of the discussion since he has covered a lot of the contemporary moral issues where healthcare practitioners have to choose between two unpleasant alternatives. Nonetheless, thoughts from other scholars would also be incorporated into the study and will provide a guide for the discussion.
One of the most controversial topics that have permeated all areas of social discussion is abortion. Two camps, one pro-life and the other pro-choice, each has their definition of an embryo’s or fetus’ viability and who has rights either the mother, the fetus or both. This discussion will rage on until a time when there will be consensus on when life begins. Nonetheless, the morality and legality of partial birth abortions have been discussed in length and it seems that both camps are in agreement against it. Pro-choice advocates find the abortion procedures for partial birth abortions to be grotesque. Additionally, many find it difficult to differentiate the procedure from infanticide since according to the law set forth by the Roe ruling when a fetus is at the stage of live birth then that cannot be considered an abortion. However, opponents of the ban on partial birth abortions insist that reproductive rights are under the domain of the woman (Calhoun, 2010). Additionally, they cite that the Roe is inapplicable argument tries to circumvent the abortion jurisprudence and also seeks to cloud the abortion argument.
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Another significant moral and legal issue are the consequences that arise from improper sterilization such as wrongful conception, birth, and life. However, the litigation of such cases is made hard by the rapid advancement in biotechnology which has outpaced ethics, public policy, and law. For instance, cases that seek financial restitution for the injury of being born are usually unsuccessful (Pozgar, 2013). The courts still maintain that the joy of getting a child outweighs the sadness or inconvenience of rearing the child. Other more clear-cut issues, such as when the sterilization procedure proves unsuccessful and a couple gets a child, are compensated. Additionally, the physicians are held liable if they do not obtain informed consent and their negligence leads to the birth of a child with defects.
Human genetics, the new frontier in medicine, is also facing some ethical issues. For instance, there has been a lot of controversy over the use of fetal stem cells for research instead of adult stem cells. Planned Parenthood is being investigated for using fetuses for profit since they are unsubstantiated claims that the company sells aborted fetuses to research institutions (House Committee on Oversight and Reform, 2019). Nonetheless, stem cell research promises to solve a lot of medical problems which require growing new tissues or organs. Additionally, clinical genetics which seeks to understand the genetic markers of diseases is a controversial area. If used properly, the technology can assist health practitioners to locate particular genes or traits that may lead to potential health risks. However, such information when released to other health stakeholders, for example, insurance companies, may reduce health access as premiums for individuals with health risks may be unaffordable. Therefore, prognostic genetic tests may result in discriminatory practices.
The Acquired Immune Deficiency Syndrome (AIDS) is one of the deadliest epidemics that humankind has faced. However, recent research and advancement in antiretroviral drugs has led to a better quality of life. Nonetheless, there are still a lot of misconceptions around the syndrome with many being unaware of how it is spread and treated. For instance, some people are concerned that physicians with AIDS may pass the infection to patients during invasive surgery. Although such a situation may occur, there are guidelines that reduce its likelihood. Surgeons with the infection are barred from performing surgeries as the risk of infection is high. Additionally, there is controversy over the issue of confidentiality and information. The dilemma arises from balancing between protecting the public from the deadly disease and maintaining an individual’s 4 th amendment right (Pozgar, 2013). However, various states have enacted confidentiality laws that make the sharing of AIDS-related information without consent a criminal offense. In spite of that, some cases create a compelling need to disclose a physician’s HIV status if there is a conceivable risk that patients were or could be exposed to HIV transmission. Notifying patients at risk of HIV infection from their physicians is necessary since the lack of information may lead to further infections. The welfare of the people is considered supreme above all other principles.
Discussions surrounding the end-of-life decisions are also plagued with moral dilemmas. Apart from the issues discussed above, end-of-life dilemmas are one of the most thought-provoking discourses that health practitioners participate. The struggle about the end of life decisions can be summarized as the right to die versus the right to quality of life. Additionally, there are a lot of cultural components that surround palliative care. It has become necessary for health practitioners to not only understand palliative care but they should also be able to engage in effective end of life discussions that take into consideration all cultural and personal components. For instance, a patient’s health literacy, his or her spiritual beliefs, their mistrust of the hospital system, medical and language interpretations, among others are some of the issues that complicate end-of-life conversations.
Advances in medicine have allowed for the prolonging of life. However, the same technology has been applied to prolonging death. Patients in comas, vegetative states, and others with long-term suffering are the most affected (Pozgar, 2013). Issues arise when a patient’s quality of life deteriorates to a point where family members wish to end the pain, the physician insists in saving their life, or the physician assists the patient to end their life. Some of the times, however, lifesaving actions may prove futile and physicians can then withdraw care and allow for the patient to die a natural death. This is referred to as passive euthanasia. Physician assisted suicide is highly controversial since it involves the health practitioner aiding a patient to end their life. For instance, the physician provides the patient with lethal doses of medication that end life.
Conclusion
The study sought to understand the various moral dilemmas and legal precedents that affect many areas of health care. The discussion shows that much of dilemmas have tried to be resolved through legal precedent but there are extenuating circumstances that complicate the process of providing. For instance, in wrong life, conception, and birth issues, decisions are based on context. Additionally, end-of-life discussions are complicated due to the various underlying factors that must be considered. Cultural and personal components affect the discourse making it very difficult to resolve legally. However, what is clear is that ethical issues will arise in all forms of care, and it is the health practitioner’s duty to consider the patient’s welfare at all times and to act within the bounds of the law.
References
Calhoun, S. (2010). 'Partial-birth abortion' is not abortion: Carhart II's fundamental misapplication of Roe'. Mississippi Law Journal , 79 (4), 1-55. Retrieved from https://papers.ssrn.com/sol3/papers.cfm?abstract_id=1374539.
House Committee on Oversight and Reform. (2019). Planned Parenthood: Fact v. fiction. Retrieved from https://oversight.house.gov/planned-parenthood-fact-v-fiction.
Pozgar, G. (2013). Legal and ethical issues for health professionals (3rd ed.). Burlington, MA: Jones & Bartlett.
