CASE STUDY: Fetal Abnormality and Moral Status

CASE STUDY: Fetal Abnormality and Moral Status

Grand Canyon University: PHI413V

Case Study: Fetal Abnormality

Ethics is a moral principle that decides how a person behaves and act (Dictionary.com, 2017). Throughout nursing career, our moral status is daily questioned, as we commit ourselves to serve others, while performing our duties in health and healing (Shelly & Miller, 2006).

Moral Status

On daily basis, Nurses are confronted with questions of morality within their practice. Ethical decision-making requires choosing a “least-worst alternative,” but unfortunately there is often not a good selection (Shelly & Miller, 2006). Questions like Jessica’s case of an unborn fetus with congenital abnormalities and the moral status of choices presented by parties involved, has been asked for many times before.

In the “Case Study: Fetal Abnormality” a family is presented, that has to evaluate their thoughts about ending the life of a fetus with congenital abnormalities, as the child would eventually have an expected lesser quality of life than others. Marco and Jessica are a young couple, living with their aunt, struggling with a rather unstable financial situation as Jessica finds out about her pregnancy. Both of them are working long hours in order to save money to move into their own apartment. Jessica does not seek prenatal care in the beginning due to the financial strain of cost. The first ultrasound reveals the diagnosis of a 25% chance the fetus will have Down Syndrome, as well as a rare condition, that inhibits growth of limbs of the fetus. The husband petitioned with the doctor to no disclose this information to Jessica as he would like to be the first to tell his wife. Dr. Wilson educated Marco, that it is his obligation as a medical professional, to disclose such information to Jessica and present her all available options for to make a decision. Aunt Mariam overhears this conversation and pleads with Jessica to carry out the pregnancy as she believes abortion is not an option. Dr. Wilson overtly explains his view of abortion being the best choice for the couple. Jessica’s husband Marco will support any decision made. All parties within this study view different types of theories in the determination of the moral status of the fetus.

Jessica is presented by Dr. Wilson with all the available options but stresses that abortion is “scientifically and medically a wise choice in this situation” (Grand Canyon University Case Study: Fetal Abnormality, 2015). From his experience and medical knowledge, Dr. Wilson recognizes the strain a child with such diagnosis could have on her family and as well as on the quality of life the child could have in the future. Dr. Wilson is implementing the cognitive property theory with this conversation. This theory “refers to the process or awareness such as perception, memory, understanding, and thinking” (Grand Canyon University, 2015), which a fetus will not possess. This theory is utilized by Dr. Wilson because the unborn child does not possess these attributes yet.

Aunt Maria is trying to convince Jessica to keep her pregnancy and “allow what God intends”. She proclaims her viewpoint by a believe that Jessica does not only has a motherly responsibility to her unborn child but also has a religious responsibility. The presented theory is relationship based as it is between Jessica and God and His will. The relationship with Jessica’s fetus is another responsibility to care for her child regardless of disability. As these two are valid relationships that give the fetus a moral status, the termination would be wrongfully

Jessica’s husband Marco feels very uneasy about the diagnosis and worries about the financial burden with a disabled child, but he is prepared to support Jessica with any decision. This is a demonstration of the relationship theory. “A person who holds this theory may be forced to concede that a being’s moral status may change, depending on the other party” (Grand Canyon University, 2015). It is an affirmation of the couple’s relationship and their moral status toward the fetus and the changes they could face with the decision that is made.

Jessica herself has mixed feelings about which decision she should pursuit due to her religious belief and considerations of financial hardship this would mean to her young family. Jessica’s decision-making of the moral status of her fetus represents the moral agency theory. Class lecture notes state that someone is considered a moral agent when they “are capable of making judgments about the rightness or wrongness of actions and has motives that can be judged morally” (Grand Canyon University, 2015), and in this case study Jessica is acting as the moral agent.

Recommendation for Action

As a Christian, this case study presents conflicted thoughts as to which theory to agree with. However, considering the child’s diagnosis and the anticipated quality of life makes this decision very difficult. Questions arise such us the cognitive abilities and the emotional strain for the child to endure through the life, or would the child even know any different because that’s all he or she knows? This kind of questions and decision need a lot of consideration and thought. Overall the theory of relationship will be the factor that gives the final decision and it is the duty of the mother to protect and nurture their child unconditionally.

Often caring for family is more difficult than doing so for a patient as family dynamics are more complex in their behavior and adaption. We know Marcos request of Dr. Wilson to not tell Jessica is wrong but the consideration of him trying to break the news in a gentle matter is a great idea. It gives an opportunity for the doctor to present all facts and options as the couple works through this situation. Dr. Wilson believed in abortion and stated that it was, scientifically and medically necessary while this may or may not be true it is ultimately up to Jessica and respecting Jessica’s religious background along with Maria’s would have been more professional.

Conclusion and Personal Response

The opinions and values of life are very different for every person in this case study. The Christian belief of abortion is against God’s will but as a nurse, it is not our place to influence the decision making in any way, rather present facts and support the choices made without any judgement. As this decision is very difficult for a mother to make, it is hers to spend the rest of her life with it. It is our job as medical professionals to keep personal opinions remain unbiased.

References

Grand Canyon University, (2015). Case Study: Fetal Abnormality. Pg 1.

Grand Canyon University, (2015). God, Humanity, and Human Dignity [Lecture]. Retrieved January 28th, 2018 from https://lcugrad3.gcu.edu/learningPlatform/user/users.html?operation=loggedIn#/learningPlatform/loudBooks/loudbooks.html?viewPage=current&operation=innerPage¤tTopicname=God,%20Humanity,%20and%20Human%20Dignity&topicMaterialId=6152814b-5947-4506-a333-15cafc8280bb&contentId=dea4915c-b10a-4b7f-a3e3-fafe866ebeb5&

Shelly, J. A., Miller, A.B. (2006). Called to care: A Christian worldview for Nursing. DownersGrove, IL: InterVarsity Press