Bioethics and its

Application in Various
Health Care Situations
Issues on Contraception, it’s Morality and
Ethico-moral Responsibility of Nurses:
• Nurses should be knowledgeable about the rapidly changing
field of biological, reproductive and genetic breakthroughs so
to be able to engage in informed discussions with the patient.
•Ethics- involves determining what is good, right and fair.
Ethical issues arise every day in healthcare and everyone has a
role to play in ensuring the ethical delivery of care. Health
care givers, particularly midwives, perinatal and neonatal
nurses, face ethical issues possibly because of their interactions
with patients and clients in the reproductive age groups.
 • Nursing is a process that involves judgment and action with
the aim of maintaining, promoting and restoring balance in
human system. The need for judgment and action brought
about the moral questions of right or wrong of duty. The end
purpose of nursing is the welfare of other human beings.
 Sexuality and Human Reproduction

1. Issues On Contraception, Its Morality And Ethico -Moral

Responsibility Of Nurses

2. Morality Of Abortion And Other Problem Related To

Destruction Of Life

3. Issues On Artificial Reproduction And Its Ethico -Moral

Responsibility Of Nurses
Human Reproduction

• Humans reproduce sexually by the uniting of the female and male

sex cells. Although the reproductive systems of the male and female
are different, they are structured to function together to achieve
internal fertilization.
 Reproduction

• Process by which living beings transmit their genes and give birth
to a new generation of living beings.
Issues On Contraception, Its Morality And
Ethico -Moral Responsibility Of Nurses
• "birth control" "fertility control“
• The deliberate use of artificial methods and other techniques to prevent pregnancy as
a
consequence of sexual intercourse.
• How does a woman get pregnant? A woman will get pregnant if a
man's sperm reaches one of her egg cells. Contraception prevents this
from happening. It keeps the sperm and the egg apart, it stops egg
production, and it stops the combined sperm and fertilized egg from
attaching to the lining of the womb (This type of contraceptive is
sometimes called as your 'Plan B' or 'Morning-After-Pill').
• Although preventing pregnancy is the main purpose
of contraception, some types of contraception can also
protect a person's sexual health from STDs.
• Contraception, is by the nature of its very word-
“against life.” A person wills that a life not exist, or come
into existence. It separates the procreative and unitive
meanings of the conjugal act; it destroys the union of life
and love, the very essence of our existence and created
being.
• The use of contraception is completely different morally and practically from
that of Natural family Planning (NFP).
• Cultures and religions support various values that influence individual’s
decisions.
Contraception


• Contraception occurs by either preventing the fertilization of an ovum

(egg) by the sperm cell, or the prevention of implantation of the embryo
(fertilized egg) into the lining of the uterus.
• Not all couples who have sexual intercourse want to have a baby. They might
choose to use methods of contraception (birth control).
• Use effective birth control correctly and consistently. Birth control failure
rates are directly related to the degree of human error possible with each
method.
Different Types of Contraception

• Male and Female Condoms

• Contraceptive Diaphragm/CAP

➢ Inserted in the vagina before sex. Best used with a spermicide

(or a gel that kills sperms). Have to stay in the vagina of a woman
for 6 hours or more after coitus.

• COMBINED PILL

➢ "The pill". It contains artificial female hormones estrogen and

progesterone. Stops the release of egg.
• CONTRACEPTIVE IMPLANT

➢ Placed under your skin by a doctor or a nurse. Lasts for 3 yrs. Releases
progesterone into your blood stream to prevent pregnancy

• CONTRACEPTIVE INJECTION

➢ (Depo-Provera, Sayana Press, Noristerat) Releases progesterone into your

blood stream to prevent pregnancy. 13 weeks/3 months.

 • INTRAUTERINE DEVICE (IUD)

➢ T-shaped plastic and copper device that's put into your womb by doctor or
nurse. Releases copper to stop you from getting pregnant. 5/10 years. "coil"
"copper coil"
 DISADVANTAGE: heavier periods for the first 3-6 months,
may get an infection after being fitted with the IUD, and
cannot protect your from STD so you still need to us a condom

• Natural Family Planning

➢ Basically knowing when you are fertile. Patient has to carefully

follow the instructions of the nurse else it won't work. Basal
Body Temperature method, cervical secretion method, calendar
method.
• Progesterone Only Pill/POP

➢ Needs to be taken every day to work. Prevents pregnancy by

thickening the mucus

• EMERGCENCY CONTRACEPTIONS

➢ IUD and your morning after pill. THIS IS IF YOU HAD

UNPROTECTED SEX without any contraceptions, or you forgot to
take your pills. in the cervix to stop the sperm from reaching
the egg. Can also stop ovulation.
• PERMANENT
 Vasectomy (cuts sperm production to semen)
 Tubal ligation (fallopian tubes)
Are Contraception Anti-Life?

• Contraceptions are unnatural.

• Contraception is a form of abortion.

• Contraception weakens marriage.

• Contraception leads to widespread sexual immorality.

• Contraception really against the procreation of human life. • When

contraceptive methods fail to prevent ovulation or fertilization, the
changing of the uterine lining is used to implanting in the uterine wall.
It is this action that leaves people believing they have crossed an ethical
boundary.
• Moreover, it is quite possible to argue that where
preservation of life would appear to be in conflict with
reproduction, then preservation of life should take precedence.
• Although we, in the medical field, are promoting birth
control or the use of your contraceptives, it doesn't mean
that it is widely accepted because there are still people who
consider contraceptives to be'anti-life'. It's not a lot though, the
people who protest about contraceptions, because let's be
honest, there are a lot of positive things that contraceptions bring .
➢ It supports the human right for "procreative
liberty". A person has the freedom and autonomy
to decide whether or not to have children.
➢ When it comes to health, it prevents conception
of unwanted children and because of that, reduces
the number of abortions. It also enables women
to be sexually active but whose lives would be at risk
if they get pregnant. And finally, it prevents the
transmission of STD.
➢ It prevents the conception of children that the family cannot
longer afford to support

➢ It helps people avoid having more children than the number

that they want

➢ It helps improve marriage: couples enjoy sexual activity

more because there is less worrying about getting pregnant,
couples have fewer children thus spend more time together
with the children they want to have, reduces the cost of marriage
(children are expensive).
➢ It promotes gender equality and autonomy of women: pregnancy and
child-rearing affect women more than men, any restriction of women to get birth
control is discrimination, it allows women to enjoy sexual activity like men
(right to sexual autonomy), without contraception a woman may find herself
having regular pregnancies which can lead to her being economically
dependent on her partner.

➢ It helps in controlling the growing population. Protects the environment

and reduces poverty.

• The moral nature of contraception is completely contrary to the nature of

man. How would the practical use of contraception differ from that of NFP?
How can thepractical use of NFP contribute to the promotion of the moral
dimensions of marriage?
• The sexual act is evil while using artificial pills or devices to
preclude birth and no circumstances or intention can justify one in
doing such use. This not only denies children, but also precludes
total self-giving love from being expressed in such an act. It has the
further result of introducing self-fulfilment as the primary value
into the most important natural act of all, the one which leads
to human life. Natural family planning is not a form of
contraception and so it is objectively completely different in its
moral nature.
CONTRACEPTION IS UNNATURAL

 • ANTIS - Natural consequence of having sexual intercourse is conceiving a child.

It is wrong to interfere with this. PRO - That's a religious idea. Humans interfere
with the natural order all the time example is when doctors cure illnesses.
Some results are good some are bad. So look at the consequences of
contraception to decide whether it is good or bad.
 CONTRACEPTION IS ANTI-LIFE
 • ANTIS - "life is a good thing"; those who use contraception are anti-life because
they intend to prevent a new life from coming into being.BAD INTENTION. It is
always morally wrong to do something with a bad intention.
 • PRO - Human rights come in here. The right to decide.
CONTRACEPTION IS A FORM OF ABORTION

• ANTIS - some contraception prevent the implantation of a

fertilised egg, thus this equals to abortion. Abortion is wrong
then these forms of contraception are wrong.
Ethico-Moral Responsibility of Nurses in
Contraception

• Primary Concern

➢ Welfare of the patient and respecting the autonomy of the patient.

• Secondary Concern

➢ Make sure the patient gets all the information and advice that
they need to be able to choose wisely.

• Patient needs to know: reliability of the method, ease of use of

the method, potential side effects, and health risks. Help the
patient weigh the advantages and disadvantages. Usually the doctor
does this but if the patient will ask you, you also have to know.
• What if I have my own personal views about
contraception? What if I don't agree with it? You have
two options, you can inform the patient about your
views (that you don't agree with it) and advise
them to ask someone else, or you can disregard
your views and just give the patient the UNBIASED
information that he or she is asking for. It is unethical
for a practitioner to give medical advice influenced by
a non-medical factor without disclosing this to the
patient.
• Health care practitioners should respect also the
confidentiality of a patient. The problem here is when
teenagers ask for contraceptive help and make it clear
that they do not want their parents to know about it.
What to do?
 Encourage the minors to inform their parents and
explore the reasons the patient does not want to do so.
Morality of Abortion and Other Problem Related
to Destruction of Life

• Abortion
➢ Traditionally defined as the expulsion or removal of a nonviable
fetus.

• The most controversial ethico-moral issues we must consider is

the issue on abortion.

• That is, a fetus that cannot live outside the uterus at that time.
The definition is relative because the viability of a fetus depends
on where and when the expulsion occurs.
• Some describe this as a conflict between innocent life and
selfishness, while others view it as a conflict between a person’s
right and ability to control her body and the surrender of that
control to others.

• The health habits of the mother during pregnancy can have a

dramatic effect on the health of the child. Is the mother obligated
to alter her behavior to maximize the health of her fetus? For
example, should she not smoke, not drink alcoholic beverages,
obtain prenatal care, and maintain emotional calm? If she does
not, should the health care profession or the society intervene
for the sake of the fetus?
 • In biology, the term fetus is applied at the beginning of
the ninth week of pregnancy, well into the second trimester.
This name change, however, is not of moral significance, and
even expulsions early in the first trimester are still referred
to as abortions. There is debate as to when the human
conceptus (fertilized egg) is to be considered a fetus in a moral
sense and not merely in a biological sense. Only after we have
determined the moral status of the fetus will we be able to say
whether the expulsion of the conceptus, the embryo, or the
biological fetus is ethically significant.
• Based on 2008 data, WHO estimates that there
are approximately 22 million unsafe abortions
annually, resulting in 47 000 deaths and 5 million
complications resulting in hospital admission. Nearly
all unsafe abortions (98%) occurred in low- and middle-
income countries. One of the factors driving unsafe
abortion is the lack of safe abortion services, even
where they are legal.
Two Principal Moral Considerations
1. Moral Status of the Fetus
➢ Is the fetus a person?

At what stage in its development does it becomes a person? Conception? 1st

trimester? Birth?

➢ The central issue is whether the fetus is a person or not.

➢ The term ‘fetus’ is generally used after the first eight weeks of human
development following conception. Believers in the Bible as God’s word support
absolute respect for the human fetus, while most contemporary secular
philosophers hold that a human fetus has no right to life and is not a person.
This chapter explores these two positions and argues that the human fetus is a
person.
2. Rights of the Pregnant Woman

 ➢ Does the pregnant woman have the right to decide if she is going to carry
the baby to term or not?

Ensuring comprehensive legal grounds for abortion

• When there is a threat to the woman’s life.

 Almost all countries (95%) allow abortion to be performed to save the life
of the pregnant woman. This is consistent with the human right to life,
which requires protection by law, including when pregnancy is life-
threatening or the pregnant woman’s life is otherwise endangered. Even
where protecting a woman’s life is the only allowable reason for abortion, it is
essential that there are trained providers of abortion services, that
services are available and known, and that treatment for complications of
unsafe abortion is widely available.

 Saving a woman’s life might be necessary at any point in the pregnancy

and, when required, abortion should be undertaken as promptly as
possible to minimize risks to a woman’s health.
 • When there is a threat to the woman’s health.

 ➢ Sixty-seven per cent of countries allow women to seek abortion to preserve

their physical health and 64% to preserve their mental health. Since all countries that
are members of WHO accept its constitutional description of health as “a state of
complete physical, mental and social well-being and not merely the absence of
disease or infirmity”, this is implied in the interpretation of laws that allow abortion
to protect women’s health.
• When pregnancy is the result of rape or incest.

➢ The protection of women from cruel, inhuman and degrading

treatment requires that those who have become pregnant as the
result of coerced or forced sexual acts can lawfully access safe
abortion services. Others require forensic evidence of sexual
penetration or a police investigation to confirm that intercourse
was involuntary or exploitative. Either situation can lead women
to resort to clandestine, unsafe services to terminate their
pregnancy.
• When there is fetal impairment.

➢ such as those considered to be incompatible with life or

independent life, while others provide lists of impairments. In
some countries, no reference is made in the law to fetal
impairment; rather, health protection or social reasons are
interpreted to include distress of the pregnant woman caused by
the diagnosis of fetal impairment. Prenatal tests and other
medical diagnostic services cannot legally be refused because the
woman may decide to terminate her pregnancy. A woman is
entitled to know the status of her pregnancy and to act on this
information.
• For economic and social reasons.

 ➢ In countries that permit abortion for economic and social reasons, the
legal grounds are interpreted by reference to whether continued pregnancy
would affect the actual or foreseeable circumstances of the woman, including
her achievement of the highest attainable standard of health.

• On request.

➢ Allowing abortion on request has emerged as countries have recognized

that women seek abortions on one – and often more than one – of the above
grounds, and they accept all of these as legitimate, without requiring a specific
reason. This legal ground recognizes the conditions for a woman’s free choice and
that the ultimate decision on whether to continue or terminate her pregnancy
belongs to the woman alone.
Guiding Principles For Health Care Workers In
Abortion
 • Provide Information

 ➢ It is a necessary component of any medical care and should always be

provided to individuals considering abortion. At a minimum, this should include (6):
the available options for abortion methods and pain management; what will be
done before, during and after the procedure, including any tests that may be
performed; what they are likely to experience (e.g. pain and  bleeding) and how
long the procedure and the recovery are likely to take (vaginal bleeding for two
weeks is normal after medical abortion – such bleeding can last up to 45 days in
rare cases); how to recognize potential complications, and how and where to seek
help, if required (individuals should return to the hospital or clinic if they experience
increased intensity of cramping or abdominal pain, heavy vaginal bleeding and/or
fever); when normal activities can be resumed, including sexual intercourse (the
return of fertility can occur within two weeks following abortion); where and how to
access additional services and follow-up care (see section 3.1.4 on the right).
• Rights of the Pregnant Woman

➢ Does the pregnant woman have the right to decide if she is going to carry the
baby to term or not?

Ensuring comprehensive legal grounds for abortion

Ensuring comprehensive legal grounds for abortion

 • When there is a threat to the woman’s life.

➢ Almost all countries (95%) allow abortion to be performed to save the life of the
pregnant woman.

 This is consistent with the human right to life, which requires protection by law,
including when pregnancy is life threatening or the pregnant woman’s life is
otherwise endangered.

 Even where protecting a woman’s life is the only allowable reason for abortion, it is
essential that there are trained providers of abortion services, that services are
available and known, and that treatment for complications of unsafe abortion is
widely available. Saving a woman’s life might be necessary at any point in the
pregnancy and, when required, abortion should be undertaken as promptly as
possible to minimize risks to a woman’s health.
• When there is a threat to the woman’s health.
➢ Sixty-seven per cent of countries allow women to
seek abortion to preserve their physical health and
64% to preserve their mental health. Since all countries
that are members of WHO accept its constitutional
description of health as “a state of complete physical,
mental and social well-being and not merely the
absence of disease or infirmity”, this is implied in the
interpretation of laws that allow abortion to protect
women’s health.
• When pregnancy is the result of rape or incest.
 ➢ The protection of women from cruel, inhuman and
degrading treatment requires that those who have become
pregnant as the result of coerced or forced sexual acts can
lawfully access safe abortion services.
 Others require forensic evidence of sexual penetration or a
police investigation to confirm that intercourse was
involuntary or exploitative.
 Either situation can lead women to resort to clandestine,
unsafe services to terminate their pregnancy.
• When there is fetal impairment.
➢ Several countries specify the kinds of impairment, such as those considered
to be incompatible with life or independent life, while others provide lists of
impairments. In some countries, no reference is made in the law to fetal
impairment; rather, health protection or social reasons are interpreted to
include distress of the pregnant woman caused by the diagnosis of fetal
impairment.

 Prenatal tests and other medical diagnostic services cannot legally be

refused because the woman may decide to terminate her pregnancy. A
woman is entitled to know the status of her pregnancy and to act on this
information.
• For economic and social reasons.
➢ In countries that permit abortion for economic and social
reasons, the legal grounds are interpreted by reference to
whether continued pregnancy would affect the actual or
foreseeable circumstances of the woman, including her
achievement of the highest attainable standard of health.
• On request.
➢ Allowing abortion on request has emerged as countries have
recognized that women seek abortions on one – and often
more than one – of the above grounds, and they accept all of these
as legitimate, without requiring a specific reason. This legal
ground recognizes the conditions for a woman’s free choice and
that the ultimate decision on whether to continue or terminate
her pregnancy belongs to the woman alone.
Guiding Principles For Health Care Workers In
Abortion
• Provide Information
 ➢ It is a necessary component of any medical care and should always be provided to individuals
considering abortion. At a minimum, this should include (6):

1. the available options for abortion methods and pain management;

2. what will be done before,

3. during and after the procedure,

4. including any tests that may be performed;

5. what they are likely to experience (e.g. pain and bleeding)

6. how long the procedure and the recovery are likely to take (vaginal bleeding for two weeks is normal
after medical abortion – such bleeding can last up to 45 days in rare cases); how to recognize potential
complications, and how and where to seek help, if required (individuals should return to the hospital or
clinic if they experience increased intensity of cramping or abdominal pain, heavy vaginal bleeding and/or
fever); when normal activities can be resumed, including sexual intercourse (the return of fertility can
occur within two weeks following abortion); where and how to access additional services and follow-up care.
• Offer Counseling
➢ It is a focused, interactive process through which one
voluntarily receives support, additional information and guidance
from a trained person, in an environment that is conducive to
openly sharing thoughts, feelings and perceptions. When
providing counselling, it is essential to: communicate information
in simple language; maintain privacy; support the individual and
ensure they receive adequate responses to their questions and
needs; and avoid imposing personal values and beliefs.
• Follow-up Care
➢ A routine follow-up visit is recommended only in the case
of medical abortion using misoprostol alone, to assess success
of the abortion. At the follow-up appointment: assess the
individual’s recovery and inquire about any signs or symptoms of
ongoing pregnancy; review any available medical records and
referral documents; ask about any symptoms experienced since
the procedure; perform a focused physical examination in
response to any complaints; and assess the individual’s fertility
goals and need for contraceptive services.
• If no method
was started prior to discharge from the facility, provide
information and offer counselling and the appropriate
contraceptive method, if desired by the client

➢ If a contraceptive method was already started, assess the

method used and note any concerns – where there are no
concerns, resupply as needed; where there are concerns, help
with selection of another appropriate method.
Issues on Artificial Reproduction and its ethico -
moral responsibility of nurses

• Artificial Insemination
• In-Vitro Fertilization
• Surrogate Motherhood
• Patients are briefed with all the necessary
information they need to be able to understand the
methods and procedure, the safety, risks, success or
failure factors, and even the financial support necessary
to carry out the medical and surgical steps needed. The
doctors also explain in detail what different moral and
ethical concerns may be involved.
Artificial Insemination

• Medical procedure of injecting semen into the vagina or uterus.

Intrauterine Insemination (IUI)

 AI - refers to an assisted method of reproduction in which a man’s

semen is deposited into the woman’s reproductive tract through the use of
instruments to bring about conception unattained or unattainable by natural
fertile intercourse.

 The oldest of the new methods of reproduction is artificial insemination

(AI).

 This involves harvesting sperm and inserting it into the woman’s vagina by
means of a syringe.
 MORAL ISSUE ON Artificial Insemination
 • Human procreation dissociated from sexual partners
 ➢ The naturally devised means of transmitting life is no
other than the marital act. Now, by AI, the said act is
deliberately excluded from procreation and replaced with a
medical means, that is, the insertion of a thin and soft catheter
containing sperm into the wife’s reproductive tract – a
procedure enormously contrary to nature.
 Not therapeutic; does not cure infertility or reserve infertility
 Women alone can chose to have a child even without a
husband or a boyfriend. All they need is a sperm donor.
 The use of a donor in Artificial Insemination introduces a new
genetic material to the family, which is foreign to the couple.
 • What are the criteria for choosing a donor? What will be his
relation to the unborn child? Should the husband or partner give
a formal consent that the woman will be inseminated with donor
semen?
Types of Artificial Insemination

1. Homologous

➢ Artificial Insemination Homologous

➢ Husband’s sperm is used

➢ It generally involves masturbation on the part of the man

2. Heterologous

➢ Artificial Insemination Donor

➢ A donor’s sperm is used

➢ It seems to involve adultery, since the woman and the donor are having a
sort of intercourse without being married to one another.
Ethico-Moral Responsibility of Nurse in Artificial
Insemination

• Informed consent

➢ The physician or advanced practice nurse is responsible for informing the

client about the procedure and obtaining consent by providing a detailed
description of the procedure or treatment, its potential risks and benefits, and
alternative methods available.

• Assesses the couple's emotional status relative to infertility.

• Counsels and informs about the side effects of the procedure.

➢ S/E: Nausea, vomiting, ovarian enlargement, occurance of ovarian cysts

 • Describes the legal ramifications of the procedure.

➢ The laws on the subject frequently provide that the children

of the insemination can be told the identity of the donor when
they reach age 18.
 • Assists in interviewing donors for the program.

➢ Thorough medical histories must be taken of all candidates

for anonymous semen donation. All potential donors must also
be screened for infectious or inheritable diseases which could
adversely affect the recipient or the resultant child.
In-Virto Fertilization (IVF)

• Process of fertilization where an egg is combined with sperm outside the body.

• Infertility and to prevent genetic problems and assist with the conception of
a child; advanced age of a woman; damaged of blocked fallopian tubes.
Antibody problem that harms eggs and sperms. Genetic disease of mother and
father. Mature eggs are collected from ovaries and fertilized by sperm in a lab.

 In the Philippines, this is usually 200,000 to 400,000 pesos.

• One of the main problems in IVF are about the left over embryos. For the clinic to
store the frozen embryos, the couple have to pay a fee.

 For ethical and legal reasons, most clinics are reluctant to throw away the
embryos without the consent of the couple.
• Homologous IVF
➢ Involves the gametes from both spouses; no third party is
involved.

• Heterologous IVF
➢ Involves the gametes of a donor (a third party supplies
necessary gametes).
 Surrogate Motherhood

• Practice in which a woman (the surrogate mother) bears a

child for a couple unable to produce children in the usual way,
usually because the wife is infertile or otherwise unable to
undergo pregnancy.

• Surrogacy is one of the most controversial methods of

parenthood and infertility treatment in which a surrogate carries a
fetus for another woman.
• Surrogacy is an arrangement where a surrogate
mother bears and delivers a child for another couple or
person.
Surrogate

➢ A woman who becomes pregnant, carries, and delivers a child on behalf of another
couple.

• FULL surrogacy

➢ gestating woman has NO genetic link to the child

• PARTIAL surrogacy

➢ Gestating woman has a genetic link by providing the oocyte.

• In practice, the surrogate mother has her health care expenses

covered and is paid a fee.
 Compensated Surrogacy

• Also variously called "Commercial surrogacy", "paid

surrogacy", "wombs for rent", "outsourced pregnancies" or
"baby farms"

• It refers to a form of surrogate pregnancy in which a gestational

carrier is paid to carry a child to maturity in her womb and is usually
resorted to by well off infertile couples who can afford the cost
involved.
• This procedure is legal in several countries including
in India where due to excellent medical infrastructure,
high international demand and ready availability of
poor surrogates it is reaching industry proportions.
 Surrogate Motherhood
• The rights of the children produced.

➢ Both parties involved should have voluntarily accepted certain restrictions

on their autonomy. They cannot change their minds after the start of
pregnancy or if they had already implanted the embryo. In cases of divorce,
the agreement still stands and the commissioning parents will still be the
parents. It is only in the case that the commissioning parents die before the
birth of the child will the surrogate have a chance to keep the child or give
it up for adoption. There are a lot of cases, that when the time has come for
the surrogate mom to give birth, she wants to keep the baby.
 PARTIAL surrogacy.
What if it's the sperm that was donated, and then implanted to the
surrogate mother's uterus? Does this child have the right to know who his or
her half-siblings are? The other children who the donated sperm was used on.

➢ The surrogate mother is expected to behave as a responsible woman

(adopt a healthy lifestyle, etc) and to confirm with the agreement of the
commissioning parents to testing and prenatal screening. It is included here a
possibility of terminating the pregnancy in case there is a severe malformation
on the fetus.
• The exploitation of poor and low income women desperate for
money.

➢ There are several arguments that are surrounding this area in

surrogacy.

Those who are opposed to surrogacy say that paying someone to

carry a baby for you is an insult to human dignity, it is an
instrumentalization of the human body, potential exploitation of
vulnerable women and inappropriate inducement/coercion of women.
➢ What are the responsibilities of the nurse to the surrogate
mom? The nurse should give care and attention to the pregnant
surrogate mother as he or she would to any pregnant woman.

➢ The surrogate mother should be screened for HIV, HEPATITIS

B, and HEPATITIS C.
The Roles of the Nurse in Clinical Ethical Decision Making

• Recognizing that nurses have both responsibilities and rights to care for
the whole person, we believe that nurses have a responsibility to:

• Be aware of personal values and how they relate to professional practice.

• Develop a basic knowledge of ethical principles and concepts.

• Understand processes and resources available to assist them in ethical

decision making.

• Be aware of the changing legal and health care policy issues to be

considered during ethical decision making.