Health Care and Ethics Term Paper

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Woman Clings to Hope of Having Dead Fiancee's Baby

Today medical science is capable of things only imagined in the past. One of these possibilities stems from the technique of Invitro fertilization and cryobiology. It is now possible to freeze a man's sperm and impregnate a woman with it at some future time. This practice raises many ethical issues as far as the legal professions are concerned, primarily informed consent, ownership of the sperm and many other issues. However, it also raises issues for the medical profession as well. Now it is possible, but the primary question remains, should we? This research will examine the role of the nurse in relation to her ethical obligations and the moral issues imposed upon her concerning this tricky moral issue.

Recently a court case surface where a woman wants to have he fiancee's sperm inseminated into her in order to get pregnant with his child. The couple was not married at the time, although she claims that they had plans to marry and start a family. Family and friends also consider it common knowledge that they wished to have a family some time in the neat future. The fiancee died in an accident and the girlfriend found out that he had been a sperm donor for money while attending college. The girlfriend claims that it is her right to have his baby via the frozen sperm and to do otherwise would be denying a dead man his wishes (Woman clings..., 2003).

While the primary issues surrounding this example remain to be legal, the medical profession becomes involved because they will be the ones who ultimately perform the procedure if the courts allow it. Currently the court is not n favor of allowing this procedure. The medical profession is bound to abide by the law and follow any court order pertaining to a case. It also has an obligation to allow the patient to retain an amount of autonomy in making his or her own decisions. Obviously in this case, the court and the potential patient disagree. Let us pose a hypothetical question. Let's suppose that the patient decides to ignore the court order and comes to an RN for advice on how to get the procedure done, inspite of the court order. How should the RN respond?

The legal answer would say that the RN should advise the patient not to have the procedure and that to do so would be against a court order. However, this answer breaks the nurse's code of ethics that states that she should refrain from making judgements for the patient and that if the patient wishes to have a procedure, then the nurse does not have a right to interfere. The same issues come into play concerning the issue of euthanasia (Davies, 2002). The key issue is where does court jurisdiction end and where do medical ethics override court decisions, or can they? It also brings to the forefront the issue of exactly how much freedom we have in determining what should happen to our bodies. When medicine and the courts cross, there are seldom any easy answers.

The role of the clinical nurse in practice is that of a patient advocate (ANCI, 2002). She cannot let their own feelings interfere with the professional relationship between herself and the patient. Let us consider another case. Soldiers in the U.S. who are getting ready to deeply of the Persian Gulf are depositing their sperm in a sperm bank to be used to impregnate their wives or other designated person in the event that they do not return from war (Reitman, 2003). This is a very different case from a legal and nursing standpoint as the dead person has made legal arrangements for this to happen. In this case, performing the procedure violates no law, and it is obvious what the wishes of the dead person were. This is very different than the case being explored where to perform the procedure directly violates a court order.

The nurse is supposed to provide the patient all of the information necessary in order for the patient to make an informed decision. It maintains that the nurse is supposed to ensure that the patient remains in control of making his or her own decisions. ANCI guidelines (2002) also state that the nurse has a legal responsibility to inform the law of any illegal acts. In this case the nurse cannot comply with all of the ethical guidelines to which she must adhere.

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The ethical guidelines are for the most part straightforward and there is not conflict. However, this particular case creates a contradiction in the rules that govern the issue at hand.

The nurse must choose in this case to follow one set of ethics over the other. One possible solution is that the nurse might choose to use the legal disclaimer as a part of informed consent. She may inform the patient that they will do the procedure if the patient wishes, but that in doing so the patient is making her own decision and is fully aware that she will be in violation of a court order in doing so. This way the patient is still making the ultimate decision and the nurse can continue to act in a non-judgmental way. The nurse might also inform the patient that if the patient decides to have the procedure the nurse would be legally obligated to inform proper authorities. This gets the nurse out of the legal bind, but could destroy trust between the patient and the nurse. There simply is not easy answer.

There are several underlying issues behind the case. From a social standpoint society generally contends that it is better for a child to be born into a household with a father and a mother (Porter, 1997). In this case the child in question would not. However, one must remember that it is not the position of the nurse to impose her own morals and viewpoints on the patient.

The government holds the firm belief that a woman has a right to control her own body and the ANCI code of ethics agrees as well.

Having regard to the objects of the Act (see s.3(b)) and a women's (sic) right to control her own body, a woman's marital status should not determine when and if she is able to receive the medical treatment she seeks. Marital status has no relevance to the type of medical treatment which should be available to women and it should not be a bar to obtaining the medical services which are readily available" (MW, DD, TA and AB v The Royal Women's Hospital, in Porter, 1997.)

This makes it clear that a woman has a right to do as she wishes with her own body and no one has right to deny her this. When one examines this court case, one can clearly see that a women has a right to determine what should happen with her own body. The only contention then becomes the court's particular decision on the current case. The issue at this point is a purely legal one regarding the ownership of a dead man's sperm. The Artificial Conception Act of 1985 states that a woman can be inseminated by the sperm of another man even if they are not married. However, it does not cover the issue of dead men.

This is a case for the court to decide and has no place in the medical profession. MW, DD, TA and AB v The Royal Women's Hospital, makes it cleat that the patient has the ultimate authority over what procedures should be done to her body. This puts all of the other factors presented in the case, such as informed consent from the dead man as to the disposition of his sperm should he die, the fact that they were not legally married and the social issue that the child would be in a single parent home in the realm of the court. The only issue in this case would be the patient's wish to have a medical procedure performed.

At a public hearing on the subject of Invitro fertilization the following changes and additions to current law were proposed, clinic should have the power to determine use, storage and disposal of gametes donated to it for the purposes of IVF. This would be subject, however, to any agreement between the donor and the clinic setting out the terms applicable to the gamete donation (Lawlink, paras 7.18, 7,22).

In the case of storage and disposal of IVF conceptuses, the right to decide the use and disposal of a conceptus should pass to the survivor if one member of the couple dies. In the event of a dispute between the couple, the right to determine use and disposal should pass to the storage facility or clinic (Lawlink, paras 7.23)"

These proposed changes to the law would virtually eliminate the question in the case at hand. The.....

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