Reproductive Issues

and Nursing Ethics

Maternal-Fetal Conflict
Encompasses the ways that law, social
policies and medical practices
sometimes treat a pregnant womans
interests in opposition to those of the
fetus

Laws Affecting the Maternal-Fetal

Relationship
The Federal Abortion Ban was placed
into law to prohibit physicians from
performing partial-birth abortions (third
trimester) and thereby killing fetuses

Laws Affecting the Maternal-Fetal

Relationship
The Unborn Victims of Violence Act
of 2004 allows any child in utero who
has been killed or injured to be
recognized as a legal victim of a federal
crime of violence

Other Issues Relating to the

Maternal-Fetal Conflict
Historical records have indicated that
multiple and complex ethical, legal, and
political issues have occurred including
criminalization of pregnant women

Other Issues Relating to the

Maternal-Fetal Conflict
Questions of whether the fetus is
viewed as a person, has a right to life,
or is viewed as having equal moral
status to the mother versus a pregnant
womans right to bodily integrity and
right to privacy, dignity, and choice

Reproductive Rights
Moral rights include liberty rights and
claim rights
Liberty rights, including healthcare,
are those rights a person can impose
on others without a fear of someone or
some group preventing those rights
from being exercised

Reproductive Rights
Claim rights are those rights owed to
people through active and positive
steps taken by others or groups to
ensure the claim is met

Moral Standings of Humans

Full moral status has been recognized
as a person having person privileges
person does not refer to human beings but
rather to those beings that have the
capacity to reason, make autonomous
decisions and consider themselves as the
unique subjects of their own varied
experiences

The Biological Approach to

Determining Moral Status
The biological stance is a reasonable,
scientific-based approach for determination of
moral status
Many philosophers and bioethicists have
contended that the sentience of the fetus is
integral to determination of moral status
Sentience requires the fetus to have the
capacity of feelings

Interest Approach to Moral

Status
Possession of interests is a requirement for
moral status
If the sentient being has interests at stake,
those interests must be considered when
there is moral deliberation about that being
Without interests, rights cannot be assumed

Abortion
To give premature birth before the fetus
is capable of sustaining life, as in a
miscarriage or spontaneous abortion, or
a womans intentional termination of a
pregnancy

The Central Ethical Dilemma

The central ethical dilemma of the
abortion debaterights:
the right to life of the fetus or the
womans right to control her own body
by choosing whether or not to carry a
pregnancy to term, have a baby, and
parent it

Pro-Choice View
Common argumentabortion is legally
permissible, regardless of the morality
involved
A woman has a basic right to make up
her own mind about choices of
pregnancy or abortion, and her right
always prevails over any other right,
including any fetal rights

Pro-Life View
The view on personhood stems from a
fundamental understanding that the
embryo or fetus is a person
Common argumentlife and full moral
status begin at conception and that
abortion is immoral and murderous and
should be illegal

Speaking Out
Legal and moral debates about abortion
and womens reproductive rights
continue

Reproductive Technology
Since 1978 more than 1 million babies
have been born worldwide with assisted
reproductive technology
Infertility can be defined as a womans
not being able to become pregnant after
the couple has tried for 1 year

Reproductive Technology
The three types of Assisted
Reproductive Technology are:
In vitro fertilization (IVF)
Gamete intrafallopian transfer (GIFT)
Zygote intrafallopian transfer (ZIFT)

Issues of Other
Reproductive Services
Genetic Screening and Testing
involves professionals counseling
individuals or couples about their risk
for genetically linked diseases

Issues of Other
Reproductive Services
Prenatal genetic diagnosis is
commonly performed through
amniocentesis at 15 weeks of
pregnancy or later or by chorionic villus
sampling (CVS) which is performed
between 10 and 12 weeks of pregnancy

Issues of Other
Reproductive Services
HIV Testing
Many times women who are infected with
HIV do not receive any HIV counseling and
testing until after they discover that they
are pregnant
A major ethical dilemma has been whether
HIV testing should be mandatory for
women upon the diagnosis of pregnancy
and for newborns once they are delivered

Issues of Other
Reproductive Services
Maternal substance abuse is detrimental to
a fetus or newborn
Some pregnant women who abuse drugs do
not seem to understand the potential harm
that they are inflicting on their unborn children
Maternal drug screening is not performed
routinely, and testing a woman or an infant
without informed consent is considered to be
a violation of a patients right to privacy

Cultivating Nursing Care

Nursing management for childbearing women is focused on the
ethical relationship between the
nurse and the woman

Cultivating Nursing Care

Four themes to define relational
ethics:

Environment
Embodiment
mutual respect
engagement