Patient-Centered Ethics: Challenges Faced by Healthcare Professionals

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Case Scenario

John is 70 and Jane is 66 years old. They have been living together for thirty years and have no other living relatives. Having established their business and feeling financially secure, John and Jane began attempts to conceive a child many years ago. Unfortunately, they were unable to conceive. Other alternative reproductive technologies were costly and unsuccessful. Their attempts to adopt a newborn were blocked for varying reasons.

In a last-ditch effort, John and Jane place an ad in a magazine for donors of egg and sperm, as well as a surrogate to carry the child. After reviewing and interviewing those responding to the ad, John and Jane decided on the following: Thomas – sperm, Diane – eggs, Gina – surrogate. None of the donors know one another. The fertilization and implantation were successful and Gina was in her 4th month of pregnancy when the fetus was diagnosed with a genetic disorder requiring gender reclassification after birth. John and Jane decide they no longer want the child and ask Gina to abort the fetus. Gina very much wants the child and has recently converted to a religion that forbids abortion thus refuses to abort. She also has second thoughts about giving up the baby.

Ethics are moral principles of action or conduct based on moral values that define the way people conduct themselves in a framework of their culture. Various scenarios in medical practice present critical ethical dilemmas.

The basis of the ethical conflict about gamete donation is that the involved parties, the donors, the offspring and the recipients may have competing interests. In the case scenario present the sticking issue borders on who must decide on the gender reclassification of the offspring. The recipients have interests in receiving healthy offspring that will not pose critical rearing challenges to them.

It is also important to note that offerings have interests in bearing healthy and living in the knowledge that their health threats are such that preemptive and preventative measures can be implemented. The decision on gender reclassification owing to known genetic complications must be based entirely on the pre-donation agreement between the donors and the surrogate. The underlying assumption is that the pre-donation agreement is made in the premise of the considerations and hence the central point of the interests and legal rights and responsibilities of all the parties enlisting the offspring, the recipients, the surrogate and the donors.

Williamson, R. (1999) underscores the program that facilitate gamete donation must recognize the parties agreement and inform all the concerned parties, the donors, recipient and the surrogate of about the set principles and policies with regard what the clinics or the program administers must take in light of known medical conditions of the developing baby. In the given case, the decision on gender classification must be drawn from the program administers policy on how to act regard knowledge of the genetic complications of developing a baby warranting the gender reclassification. A decision must be made by the program administers on gender reclassification and the decision must be made in tandem with the concerns and interests of the concerned parties as encapsulated in the pre-donation agreement.

Jones, M et al (1998), States, “Programs must adequately inform all the concerned parties clearly on what decisions will be taken and actions will be implemented in particular eventualities or possible change the developing child’s medical conditions”.

The child must be born in the its current set and that state if, definite must be maintained until a point when the child can be subjected to a diagnosis test to determine the existence of potential gender dyisphoria. As notes, for the diagnosis to be conduct warranting gender reclassification there must be strong indication for the child in form of conduct and behavior and characteristics that there it cross -gender identification in the make up of the child. In this case reclassification will have be made according to the results of the gender dyisphoria diagnosis outcomes.

Various reasons necessitated adoption of assisted reproductive technology. One of the factors is indeed the age factor. The sticking issues are on the considerations of the impact of the knowledge of the ‘parents; age by the offspring, on how of the age factor will impact on the offspring. The order important consideration which makes the ART method a feasible option for the two prospective parents is that the woman has grown past her reproductive years and the man has also grown past the age range in which he can sire health y offspring. Te ART method with its own implications and limitations though, becomes one of the feasible the prospective parent has.

References

Bellieni, C. and Buonocore, G. (2006). ASSISTED PROCREATION: TOO LITTLE CONSIDERATION FOR THE BABIES? Ethics and Medicine 22 (2), pg. 93. Web.

Chervenak, F. A. and McCullough, L. B. (2003). The Cornell University Experience. Fetal Diagnosis and Therapy 18 (4); 217. Web.

Duin, J. (1999). Reckless reproduction? Insight on the News 15 (26), 41. Web.

Rossiter, K. & Diehl, S. (1998). Gender reassignment in children: Ethical conflicts in surrogate decision making. Pediatric Nursing 24 (1), 59. Web.

Report from the Institute for Philosophy and Public Policy (1997). Genetic Encores: The Ethics of Human Cloning. Web.

Haederle, M. (1999). Going too far? People Weekly 51 (2), 101. Retrieved on May 22, 2008 from Proquest.

Jones, M. & Neimark, J. (1998). Messing with mother (nature). Psychology Today 31 (2), 8. Web.

McClachlan, H. (1997. Bodies, rights and abortion. Journal of Medical Ethics 23 (3), 176. Web.

Williamson, R. (1999). Human reproductive cloning is unethical because it undermines autonomy: Commentary on Savulescu. Journal of Medical Ethics 25 (2), 96.

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Patient-Centered Ethics: Challenges Faced by Healthcare Professionals

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