+BIOETHICS AND ITS APPLICATION IN
VARIOUS HEALTH CARE SITUATIONS
A. Sexuality and Human Reproduction
1. Human Sexuality and its Moral Evolution
Human sexuality is the expression of sexual
sensation and related intimacy between human
beings.
Psychologically, sexuality is the means to
express the fullness of love between a man and
a woman. Biologically, it is the means through
which a child is conceived and the lineage is
passed on to the next generation.
Sex vs Gender
Sex - refers to the biological differences
between males and females, such as the
genitalia and genetic differences.
Gender - describes psychological (gender
identity) and sociological (gender role)
representations of biological sex.
▪ Cisgender - individuals’ gender identities
correspond with their birth sexes
▪ Transgender - individuals’ gender
identities do not correspond with their
birth sexes
Sexual orientation refers to a person’s sexual
attraction to others. Sexual orientation may
include attraction to the same gender
(homosexuality), a gender different than your
own (heterosexuality), both men and women
(bisexuality), all genders (pansexual), or neither
(asexuality).
Sexual behavior – is a manner in which humans
experience and express their sexuality.
Sexual fantasies – any mental imagery
that is sexually arousing. (e.g. replacement
fantasy).
Replacement fantasy—fantasizing about
someone other than one’s current partner
Types of Sexual behaviors
▪ Masturbation - physical stimulation of
the body for sexual pleasure. Empirical
evidence links masturbation to
increased levels of sexual and marital
satisfaction, and physical and
psychological health.
▪ Coital Sex - is the term for vaginal-penile
intercourse
▪ Oral sex -sexual activity in which the
genitals of one partner are stimulated
by the mouth of the other. Cunnilingus
oral stimulation of the female’s external
sex organs and fellatio oral stimulation
of the male’s external sex organs.
▪ Anal sex - sexual activity involving
penetration of the anus. Anal sex is not
exclusively a “homosexual behavior.”
SEXUAL CONSENT
Sexual consent refers to the voluntary,
conscious, and empathic participation in a sexual
act, which can be withdrawn at any time
(Jozkowski & Peterson, 2013).
Sexual consent is the baseline for what are
considered normal—acceptable and healthy—
behaviors; whereas, nonconsensual sex—i.e.,
forced, pressured or unconscious participation—
is unacceptable and unhealthy.
Kristen Jozkowski and her colleagues (2014)
found that females tend to use verbal strategies
of consent, whereas males tend to rely on
nonverbal indications of consent.
“The universal principles of pleasure, sexual
behaviors, and consent are intertwined. Consent
is the foundation on which sexual activity needs
to be built. Understanding and practicing
empathic consent requires sexual literacy and an
ability to effectively communicate desires and
limits, as well as to respect others’ parameters.”
MORAL EVALUATION
Sexual acts can be distinguished as:
▪ Morally obligatory
• Morally obligatory acts are morally
right acts one ought to do, one is
morally prohibited from not doing
them, they are moral duties, they
 are acts that are required. In
general, something is 'right' if it is
morally obligatory
• Example: a spouse might have a
moral obligation to engage in sex
with the other spouse
▪ Morally permissible
• Permitted means behavior that is
within the bounds of the moral
system. It is morally permitted to act
in any way that does not cause
others unjustified harms. In short,
"permitted" is the lowest bar for
moral behavior. Anything that is not
morally forbidden is permitted.
• Example: It might be morally
permissible for married couples to
employ contraception while
engaging in coitus
▪ Morally supererogatory
• ‘Supererogatory’ designates any
action which is deemed morally
good, but which carries or implies
no obligation to act.
• Supererogatory actions are also
known as altruistic actions.
• Example: one person’s agreeing to
have sexual relations with another
person when the former has no
sexual desire of his or her own but
does want to please the latter might
be an act of supererogation
▪ Morally wrong
• Morally wrong acts are morally
prohibited, morally impermissible,
acts one ought not to do, and acts
one has a duty to refrain from
doing.
• Example: rape and incest are
commonly thought to be morally
wrong
2. MARRIAGE
Humankind’s most basic and oldest social unit is
the Family. It is a social institution primarily
established by society to ensure its continuity
and to regulate the sexual behavior of its
members.
• Light and Keller (1985) - marriage is a
socially recognized union between two or
more individuals that typically involves
sexual and economic rights and duties.
• Bronislaw Malinowski - marriage is a
contract for the production and
maintenance of children.
• According to the Executive Order No 209 or
the Family Code of the Philippines - marriage
is a special contract of permanent union
between a man and a woman entered into
in accordance with law for the
establishment of conjugal and family life. It
is the foundation of the family and an
inviolable social institution.
Marriage, also called as matrimony or wedlock,
is a legally and socially sanctioned union, usually
between a man and a woman, that is regulated
by laws, rules, customs, beliefs, and attitudes
that prescribe the rights and duties of the
partners and accords status to their offspring (if
any). It is another human construction to ensure
the continuity of the family and the eventual
perpetuation of the human species.
Basic Forms of Marriage:
• Monogamy - an ideal, widespread and
rational type of marriage. It refers to a
marriage of one man with one woman at a
time.
• Polygamy or Plural Marriage - refers to the
marriage of more than one mate at a given
time.
o In India, Malaysia, the Philippines, and
Singapore, the governments only
recognize polygamous marriages for
Muslims. They have specific legislation
for polygamous marriage that only
includes Muslims.
 o The practice of Polygamy is also
commonly found in sub-Saharan Africa,
where 11% of the population lives in
arrangements that include more than
one spouse.
Three forms of Polygamy:
• Polygyny - a type of marriage in which a man
marries more than one wife at a time.
o from Neoclassical Greek word poly-
"many", and gyne "woman" or "wife", is
the most common and accepted form of
polygamy, entailing the marriage of a
man with several women.
• Polyandry - a type of marriage in which a
woman marries several men at a time.
o this is the opposite of polygyny
o from Greek:- poly-, "many" and andry
from the word anēr or adros, "man")
• Endogamy or Group Marriage - a type of
marriage in which a group of men marry a
group of women at a time.
o is common in many cultures and ethnic
groups.
o The Urapmin, which is a small tribe in
Papua New Guinea, practice strict
endogamy.
A. FUNDAMENTALS OF MARRIAGE
- essential elements to any strong and healthy
marriage (or long-term partnership). These
elements, more than any other benefit of
marriage, may be what some people are
seeking.
1. Connection - a relationship in which a
person, thing, or idea is linked or
associated with something else. In
marriage, connection means a bond that
holds partners together in a relationship
and it is one of the most important
strengths for couples to have. Without
this, relationships or marriage can easily
drift apart. A strong connection often
serves as a foundation upon which other
elements are built.
2. Commitment - the state or quality of
being dedicated to something.
Commitment in marriage means that
both parties are willing to do whatever it
takes to make the marriage work. It
means both have to find ways to
compromise to make the relationship
successful.
3. Giving - the act of presenting something
voluntarily and without expecting any
compensation. It is the tangible show of
commitment, of choice, of a deeper
attachment than mere friendship.
4. Respect - may best be defined as the
way you show true appreciation for
another person. Respect is an action,
not just a feeling. It’s a declaration of
value for someone. Respect is shown in
marriage not because one person is
more superior than the other, but
because each person recognizes the
value of the other. It eliminates fear of
being different, upholds healthy
boundaries in the relationship, and
strengthens the relationship.
5. Trust - is an indispensable ingredient in
building and maintaining a healthy
marriage. It is one of the most important
elements of a relationship, and a crucial
element of any lifetime commitment.
Without trust, the quality of the
relationship will deteriorate.
6. Intimacy - In marriage, intimacy is an
essential part to keep the relationship
strong. It involves feelings of emotional
closeness and connectedness with
another person.
Types of Intimacy:
➢ Emotional Intimacy - involves opening
up to deeper authentic feelings by
 sharing emotions verbally or
nonverbally.
➢ Intellectual Intimacy - a cerebral
connection often obtained through
thoughtful conversations such sharing
whatever you are thinking and your
skills. It could be sharing your hopes,
dreams, fears, and experiences.
➢ Physical Intimacy - is about touch and
closeness between bodies. In a romantic
relationship, it might include holding
hands, cuddling, kissing, and sex.
➢ Sexual Intimacy - when people engage in
sensual or sexual activities. It consists of
exploring and sharing sexuality together
— sharing fantasies, foreplay, role-play,
mutual masturbation, or non-genital,
sensual touch.
➢ Spiritual Intimacy - entails sharing a
spiritual or religious connection.
Sexual ethics is the study of human sexuality and
sexual behaviour. In a word, it seeks to
understand and evaluate the moral conduct of
relationships and sexual activities from a
philosophical perspective.
B. ISSUES ON SEX OUTSIDE MARRIAGE AND
HOMOSEXUALITY
These issues include:
• Pre-marital sex — is any sexual activity with
an opposite sex partner or with same sex
partner before he/she has started a
marriage life. The term is usually used to
refer to intercourse before a marriage.
Sexual activities among young people have
been increasing worldwide.
o Disadvantages:
➢ STDs
➢ Having a physical relation with
someone leads to greater
emotional connect
➢ Having multiple partners before
marriage results in a need for
variety
➢ Risk of pregnancy
➢ Adoption
➢ Abortion
• Adultery and Concubinage.
o Adultery is committed by a married
woman and her paramour who knows of
her marital status, when they engage in
sexual intercourse.
o Concubinage is committed by a married
husband by
(a) keeping a mistress in the
conjugal dwelling;
(b) having sexual intercourse under
scandalous circumstances with a woman
who is not his wife; or
(c) cohabiting with her in any other
place.
• Cohabitation — to live together as a couple
without being married.
o Pros:
▪ Your Relationship May Be Deepened
and Enriched
▪ The Stresses Of Getting Married Can
Be Eased
▪ Reducing Your Expenses Can Save
You More Money
o Cons:
▪ Cohabitation is not a permanent
relationship.
▪ There is always uncertainty with
cohabitation.
▪ Couples who cohabitate have less
fulfilling sexual lives.
• Prostitution — Is the practice of engaging in
relatively indiscriminate sexual activity, in
general with someone who is not a spouse
or a friend, in exchange for immediate
payment in money or other valuables.
Prostitutes may be female or male or
transgender, and prostitution may entail
heterosexual or homosexual activity, but
historically most prostitutes have been
women and most clients men.
HOMOSEXUALITY
• It is the attraction of people of the same sex
but can be experienced differently
depending on the circumstances of each
individual.
Types of homosexuality according to the
experience of one’s orientation:
• Egosyntonic homosexuality
• Egodistonic homosexuality
• Latent homosexuality
Below we indicate those scales in which
attraction towards people of the same sex
appears :
• Exclusive Homosexuality
• Predominantly heterosexual with
frequent homosexual contacts
Types according to the existing type of attraction
• Affective-sexual attraction
• Sexual attraction only
• Affective attraction only
Bisexuality
• Considered by many people as a sexual
orientation that lies at the midpoint
between heterosexuality and homosexuality
(although there may be preferences towards
one or the other), bisexuality is
conceptualized as sexual attraction to
people of both the same sex and the
opposite. Thus, both men and women can
be of interest to these people.
Sporadic heterosexual contact
• This category includes all those bisexual
people who, while primarily attracted to
people of the same sex, occasionally feel
desire for some people of the opposite sex.
Frequent heterosexual contact
• There are people who, while generally
attracted to people of the same sex, are also
stimulated and attracted to people of the
opposite sex. It could be considered a form
of bisexuality with a tendency to
homosexual relationships.
Pansexuality
• Pansexuality is defined as sexual attraction
to specific individuals regardless of their
gender. While by definition it can be
confused with bisexuality, in the case of
pansexuals the attraction ignores the
nuance. It is not that these people are
attracted to both men and women, but that
both sex and gender identity are elements
that are not taken into account.
• It will be other aspects that will call the
attention of the pansexual, appearing the
attraction to other characteristics such as
personality. In this way, they can initiate
relationships with people of both the same
sex and the opposite sex.
Polysexuality
• This category refers to people who are
attracted to people because of their gender
identity , not their sex. Attraction occurs
towards groups and collectives with a
specific gender identity, regardless of
whether they are men or women.
Homoromantic heterosexuality/homoromantic
homosexuality
• While it cannot be considered entirely a
type of sexual orientation, to understand
this differentiation it is necessary to consider
the difference between sexual orientation
and romantic orientation. Although they
generally go hand in hand, there are cases in
which people who are sexually attracted to a
particular sex on an affective and romantic
level only feel attached to the opposite.
Asexuality
• Although asexuality is defined by the
absence of sexual desire of any kind, this
does not mean that people with this type of
sexual orientation cannot develop romantic
attachments.
• In other words, just because they are not
sexually attracted or interested in the sexual
aspects does not mean that they cannot fall
in love. And such infatuation can occur with
people of both the opposite sex (asexual
hetero-romantic) and the same sex (asexual
homo-romantic).
C. ISSUES ON CONTRACEPTION, ITS MORALITY,
AND ETHICO-MORAL RESPONSIBILITY OF
NURSES
• Contraception is the use of devices, drugs,
agents, sexual practices, or surgical
procedures to prevent conception or
pregnancy
• Helps a woman plan when and if they want
to have a baby
• Birth control involves actions, sexual
practices, and medications to intentionally
prevent pregnancy
• 3 types of Birth Control: Contraception,
contragestion, chemical/surgical abortion
• Birth control methods: Coitus interruptus,
male and female condom, spermicides, pills,
contraceptive patch and injection,
subdermal implant
i. Issues on Contraception
1. Age
a) Differing age at menarche
• Different populations tend to
have different physical and
emotional maturity. Age at
menarche of European children
is higher than those from the
Caribbean or from the Indian
subcontinent.
b) Risk takers
• Younger people are more likely
to have sex with multiple
partners and engage in other
risk-taking behaviour such as
drugs and alcohol. These
factors, with a less than rigorous
approach to regular pill taking,
may result in a higher rate of
pregnancy.
• Peer pressure, along with media
exposure of sex, may put some
youngsters under pressure to
experiment with sex before they
are ready or mature enough to
do so:
1) There is evidence of
increasing use of
contraception at first
intercourse, but an
underlying trend to earlier
age at first intercourse (now
plateauing) has been found
to be associated with a rise
in teenage pregnancy and
sexually transmitted
diseases.
2) There may also be the
feeling that everyone is
'doing it' (whereas most
may just be 'talking' about
it).
3) Teenagers tend to be aware
of preventing pregnancy but
not as aware of sexually
transmitted infections or
the consequences to
fertility.
2. Culture
a. Cultural attitudes to premarital sex
• In certain cultures, attitudes are
extreme and premarital sex is
considered a matter of great
shame and a loss of family
honour. The consequences of
premarital sex can be so severe
in some cultures that it is
essential to ensure that strict
confidentiality in relation to
these matters is maintained at
all times.
b. Cultural isolation
• Some cultures disapprove of the
education of women. This can
result in women becoming
 isolated, particularly when they
emigrate with their family to a
different country with a
different primary language.
• A special need exists for their
education about the availability
of different choices of
contraceptive methods so that
they can be empowered to
control their fertility according
to their needs.
3. Religion
a. Orthodox religions
• These include Judaism, Islam,
Hinduism and Sikhism. Orthodox
followers of all these religions
tend to:
➢ Regard sex outside marriage
as taboo.
➢ Forbid abortion and regard
menses as unclean.
➢ Extend the taboos against
sex before marriage to sex
outside marriage, ie
adultery.
➢ Forbid seeing any other
man than the husband in
intimate circumstances.
➢ Consider a male physician
often as not acceptable,
even with a chaperone.
• The punishments for adultery or
sex before marriage in certain
countries/cultures can be death.
These cultural taboos are
followed more closely in some
cultures than in others, even if
they are of the same religion.
b. Christianity
• Contraception and abortion are
forbidden in Catholicism.
Micathermic methods of
contraception are acceptable.
• The best course is to ask the
patient if there are any special
considerations you need to be
aware of in view of their religion
or background. This gives you a
better picture of what they
consider important.
ii. Morality of Contraception
1. Many think contraception is inherently
wrong because it is unnatural, anti-life,
form of abortion, separates sex from
reproduction, leads to “immoral
behavior”.
2. It also brings bad consequences which
include health risks, prevents potential
human beings from being conceived,
prevents people who might benefit
humanity from being born and may lead
to depopulation
3. Many believe that it is not wrong
because of the following:
a. Human right benefits: “Procreative
liberty”
b. Health benefits: Prevents
conception of unwanted children
thus reducing the number of
abortions and the use of condoms
help prevent STDs and HIV
c. Family benefits: Prevents the
conception of children that a family
cannot support
d. Enables people to avoid having
more children than they want
e. Improves marriages
f. Benefits for the woman
g. Demographic benefits: It enables
world population to be controlled
and thus protects the environment
and reduces poverty
iii. Ethico-moral Responsibility of Nurses
1.) Doing no harm
The nurse must prioritize the
participant’s safety to avoid harm. The
venue for the process must be held at a
safe environment of their choice.
2.) Voluntary participation
It is the role of the nurse to make sure
that the participants must voluntarily
participate in the process and should
 never be coerced to undergo this
procedure.
3.) Informed consent
The nurse must ensure that the patient
has read and understood everything
before signing the paper. It is also the
responsibility of the
nurse to ensure that the informed
consent is signed and is witnessed by
the nurse themselves.
4.) Confidentiality and anonymity
It is essential to ensure confidentiality to
protect their privacy. The client’s
information must be kept confidential in
the context of the institution’s protocol
unless it is stated or required by law that
it requires disclosure. If such
information needs to be disclosed as the
law suggests, then the client must have
the right to know about it.
5.) Ethical decision making
The nurse must be able to identify
ethical issues that stem from the issue in
order to participate in formal and
informal processes that address ethical
issues to be evaluated afterwards.
Nurses must also recognize that they
have both the responsibility and the
right to care for the patients as a whole,
they must be aware of their own
personal values, understanding
processes and resources available to
utilize for ethical decision making, and
the awareness of the constantly
changing legal and health policies to be
considered in the event of of decision
making process.
3. ISSUES ON ARTIFICIAL REPRODUCTION, ITS
MORALITY AND ETHICO-MORAL RESPONSIBILITY
OF NURSES
Artificial reproduction is the creation of new life
by other than the natural means available to an
organism.It includes all fertility treatments in
which either eggs or embryos are handled.
A. Artificial Insemination
I. What is Artificial Insemination?
It is also known as alternative insemination. It is
the deliberate introduction of sperm into a
female's cervix or uterine cavity for the purpose
of achieving a pregnancy through in vivo
fertilization by means other than sexual
intercourse or in vitro fertilization.
The sperm used in artificial insemination may be
provided by either the woman's husband or
partner (partner sperm) or by a known or
anonymous sperm donor (donor sperm).
sperm bank
-also known as semen bank or cryobank
-a facility or enterprise which purchases, stores
and sells human semen.
Types of insemination:
➢ Intracervical insemination→ injected into the
cervix
➢ Intrauterine insemination→ injected directly
in the uterus
ii. The Ethical Issues of Artificial Insemination·
Ethical Issue #1 : Interception of the natural
reproduction (Natural Law perspective)
Ordinary natural processes expressing proper
development and activity of a natural being
should be respected . AI is unethical since it
involves technology and how it alters the natural
human sexual reproduction, questioning the
God-designed marital union.
Ethical Issue #2: Motives of Sperm Donation
Sperm Donation
➔act of altruism or act of financial
compensation?
Ethical Issue #3: Self- identity
➔ Does the offspring have the right to know
his/her origins for reasons of heredity and self-
identity
Indeed, according to a 2010 study by Karen Clark
and Elizabeth Marquardt, “About half of [people
conceived via sperm donors] have concerns
about or serious objections to donor conception
itself, even if parents tell their children the
truth.”
Two-thirds of adult donor offspring agree with
the statement “My sperm donor is half of who I
am.” Nearly half are disturbed that money was
involved in their conception. More than half say
that when they see someone who resembles
them, they wonder if they are related. About
two-thirds affirm the right of donor offspring to
know the truth about their origins. As a group,
the donor offspring in the study are suffering
more than those who were adopted: hurting
more, feeling more confused, and feeling more
isolated from their families.
Ethical Issue #4: AI by Donor and Single Mother
➔ Is it good to bring a child into a one-parent
family?
➔ Is this woman capable of supporting the child
without public assistance?
➔ Is she mature enough and emotionally stable
enough to provide a healthy home
environment?
PRO : Adoptions by single parents have become
more common. This is justified by the fact that
an orphan is better off with one parent than
with none.
CON: Family would only have one gender as a
role model
Ethical Issue #5: Accidental Incest
Problem: When sperm of a donor is frequently
used in the same geographical area.
Solution: Physicians must take steps to limit the
number of pregnancies resulting from a single
donor source to avoid consanguineous
marriages or reproduction.
B. In-vitro Fertilization
I. What is IVF?
1. IVF is a form of assisted
reproductive technology which
involves combining the sperm and
one or more eggs in a laboratory
setting. This is utilized by couples
who are experiencing infertility.
II. The Ethical Issues of IVF
1. Sanctity of Life
a. In order to increase the chances of
fertilization, more than one egg is
implanted into the uterus.
• Embryos that are no longer
needed may be used for
research purposes or destroyed.
b. Is destroying embryos right or wrong?
• Before we can debate on the
morality of this action let us first
define personhood. Personhood
is a social construct and thus,
due to cultural differences there
are varying views on what
makes a person a person.
• A broadly accepted view in
today’s world is that one
becomes a person at the
moment of birth. Some may
argue that according to recent
research in embryology there is
a period (of up to about 14 days
after conception) during which
it is impossible to ascribe
identity to an embryo as the
cells lack differentiation.
• An opposing viewpoint is that
personhood begins at the
moment of conception and the
Catholic Church is a big
proponent of this idea.
1. If embryo is viewed as a
human being with the
 rights associated with
personhood then this
would be considered
wrong as it constitutes
an act of murder.
2. If embryo is seen as
only a protoplasm then
freezing or destroying
eggs is not perceived as
an immoral action.
2. Preimplantatory Genetic Testing (PGT)
a. This is a technique used to identify
genetic defects in embryos created
through in vitro fertilization (IVF) prior
to implantation.
b. Specifically catered to families with
which a child with a severe monogenetic
disease has previously been born or if
there is a high risk of aneuploidy.
c. Ethical concerns include:
i. What other diseases and
aneuploidies should be assessed?
ii. Could testing be based on non-
disease characteristics with genetic
influences?
iii. Selection of embryos based on sex.
iv. Cases of ‘savior siblings’
v. Select embryos that could produce
children suitable to become donors
of stem cells or tissues for siblings
who suffer from severe diseases
3. Ownership of the Embryos
a. Gamete storage has now enabled us
to plan ahead thus allowing for
untimely demise or social
reproductive choices.
b. Postmortem conception and birth is
now a possibility.
c. There is also the issue of a couple
who has undergone IVF and have
decided to split up. What is the best
course of action to take if one party
wants to use the embryos while the
other party disagrees?
d. In many countries, the legal
situation is not clear. However most
agree that a core principle is not to
reproduce anyone without his or
her permission. Thus, consent
should always be obtained
beforehand.
4. Pregnancy Complications
a. Well being of offspring
i. Multiple pregnancy
1. Embryos in the uterus may be
destroyed by selective
pregnancy reduction.
2. Brings risks such as high rates of
miscarriage and early preterm
rupture of membranes
3. Medical preventive method to
avoid such risks:
a. Limiting number of embryos
transferred to two
b. Better control of the use of
ovulation induction drugs
i. Low birthweight
ii. Preterm birth
iii. Birth defects
1. Children born of IVF have a significantly
greater risk for spina bifida and
transposition of the great vessels
2. Some of the drugs administered to
women to stimulate the production of
eggs increase the risk of serious birth
defects
b. Pregnancy especially with multiples can
take a toll on the mothers physical and
mental health
i. High blood pressure, preeclampsia,
growth retardations and bleeding
are higher in comparison to normal
pregnancies.
ii. Mother has higher chance in
undergoing induction or cesarean
sections.
5.Success Rates of IVF
a. IVF is not always successful in the first
round. Sometimes couples have to
 undergo several IVF cycles in order to
get pregnant.
i. There is an average success rate of
20-35% per cycle, but the likelihood
of getting pregnant decreases with
each successive round,
ii. Other considerations to take is that
IVF is a costly procedure and
expenses will only increase after
each cycle. Also, if multiple IVF
cycles have been done and there is
still no pregnancy, this would take
an emotional toll on the couple.
C. Surrogate Motherhood
SURROGATE MOTHER- Surrogate motherhood,
practice in which a woman (the surrogate
mother) bears a child for a couple unable to
produce children
REASONS WHY OTHERS CHOOSE SURROGACY:
• Health issues prevent a woman from getting
pregnant or carrying a pregnancy to term
(can be due to age).
• Infertility issues prevent couples from either
getting or staying pregnant, like recurrent
miscarriages.
• Same-sex couples who wish to have
children.
• Single people want to have biological
children.
TYPES:
A gestational carrier carries a pregnancy for an
individual or couple using an egg that is not the
carrier’s.
A traditional surrogate both donates her own
egg and carries a pregnancy for an individual or
couple. The pregnancy is usually achieved
through intrauterine insemination (IUI) with
sperm from the intended father. Donor sperm
may also be used.
Criteria for becoming a surrogate
• Age
• Reproductive background
• Lifestyle
• Tests
Intended parents have certain requirements to
meet as well. These involve:
• providing complete health histories
• having physical exams to ensure they
can successfully go through in vitro
fertilization retrieval cycles
• screening for infectious disease
• testing for certain genetic diseases that
could be passed to a child
Ethical Issues
• Labor
Some philosophers argue that surrogacy is
unique when compared to other work. For
instance, they claim that women are intimately
connected to their reproductive capacities and
bodies (so pregnancy and birth are special and
should not be bought), or that being pregnant
requires an unusual time commitment (unlike
other kinds of work, the woman works for 24
hours a day, seven days a week, for nine
months).
• Gender
Intended parenthood raises feminist concerns
too, such as on gendered roles and expectations.
This includes whether women in particular feel
that being mothers is critical to being ‘proper’
women and hence why they might pursue
surrogacy if they cannot carry their own
children. Likewise, women might feel
breastfeeding is what ‘real’ mothers (and
women) do (and why intended mothers – ie,
women who are not pregnant – might want to
induce lactation).
• Exploitation
-Others think that surrogacy is using another
woman for one's own benefit. Issues on who
the real mother should be ( whether the
surrogate or the intended mother) and that the right to care for the patients as a whole,
surrogate mother deserves rights to the child. they must be aware of their own
personal values, understanding
processes and resources available to
Ethico-moral Responsibility of Nurses on utilize for ethical decision making, and
Artificial Reproduction the awareness of the constantly
changing legal and health policies to be
1.) Unbiased Counselling considered in the event of of decision
Nurses have an equally important role making process.
to play in providing unbiased counseling 6.) Keep up with the latest information on ART
to clients, in referring them to Nurses have a responsibility to become
reproductive and genetic specialists and knowledgeable about the rapidly
genetic counselors as required and in changing field of biological, reproductive
translating medical information to those and genetic breakthroughs, so they are
struggling to make choices about their able to engage in informed discussions
use of reproductive and genetic with clients and the public.
technologies.
2.) Voluntary participation
It is the role of the nurse to make sure
that the participants must voluntarily
participate in the process and should
never be coerced to undergo this
procedure.
3.) Informed consent
The nurse must ensure that the patient
has read and understood everything
before signing the paper. It is also the
responsibility of the nurse to ensure that
the informed consent is signed and is
witnessed by the nurse themselves.
4.) Confidentiality and anonymity
It is essential to ensure confidentiality to
protect their privacy. The client’s
information must be kept confidential in
the context of the institution’s protocol
unless it is stated or required by law that
it requires disclosure. If such
information needs to be disclosed as the
law suggests, then the client must have
the right to know about it.
5.) Ethical decision making
The nurse must be able to identify
ethical issues that stem from the issue in
order to participate in formal and
informal processes that address ethical
issues to be evaluated afterwards.
Nurses must also recognize that they
have both the responsibility and the