All forms of contraception including sterilization have a high change of raising ethical debates. There is a wide adherence to a strongly held belief and view that the only moral and legitimate reason for sexual intercourse is reproduction. This is especially true for religious denominations such as Christianity and Islam. From this perspective, sterilization would be unjustifiable unless there are consequential medical reasons to make it justifiable. The main ethical concern revolving around sterilization is what is to be done when there is a failure in sterilization procedure, which leads to pregnancy.
This is from the perspective that sterilization if permitted or allowed as one of the forms of life and family planning (Kuhse and Singer, 2009).There is a strong legal argumentation concerning the impact of negligently performing sterilization procedures. There have been several suits brought under theories of wrongful life, wrongful birth and wrongful conception. Generally, wrongful life suits have often proved unsuccessful because of policy reasons and the unwillingness of the court to allow financial recovery for the claim of bringing an accidental life into the world.
Some success has however resulted in cases of litigation by a patient who alleges to have been sterilized and is later on proved fertile. In accordance to public policy, many courts have ruled that the benefits and joys of having a child are much more than the costs incurred in bringing up a child (Ashcroft, Dawson and Draper, 2007).Wrongful conception is also referred to as wrongful pregnancy. It is defined as an assertion for damages incurred by parents of an accidental child based on a declaration that the child was conceived through neglectful sterilization process or faulty contraceptive devices.
The damages claimed because of negligently performing sterilization may include expenses of delivery, pain and suffering linked with pregnancy and birth, father’s loss of consortium, lost wages, suffering brought about by the presence of an additional family member in the household, emotional and psychological pain damages, damages suffered by a child born with genetic defects and the cost, pain and suffering of subsequent sterilization (Miller, 2006).According to Kuhse and Singer (2009), the item of damages claimed that is most controversial is that of bringing up a normal, healthy child to the adult stage. For instance in the case of Hartke Versus McKelway, the mother had gone through a sterilization procedure in order to avoid posing a threat to her health as a result of pregnancy.
The woman later on became pregnant because of an unsuccessful sterilization procedure. She eventually gave birth to a health child without causing harm to herself. It was ruled out that the jury could not rationally define the birth as a harmful or an injury. Hence, it was not logical to award Hartke the child-rearing expenses.The main concern raised by many courts is based on a general rule postulating that the injured parties ought to take necessary steps to minimize their injuries. This could imply that parents would be necessitated to either undergo an abortion or put a child up to adoption in order to reduce the injuries incurred.
In the year 1998, a federal district court in New Jersey made a ruling that under wrongful conception claims, plaintiffs should not prove of the possibility of aborting the fetus if given accurate data and hold that the parent’s choice to continue a pregnancy would not stop a claim of negligence. Majority of courts that do not generally award the costs of raising a child do permit the special extra expenses incurred in bringing up a disabled child to adult stage (Pozqar, 2005).Unplanned pregnancy is not necessarily caused by negligence on the physician’s side.
Although rare, there have been slight failure incidences of sterilizations. There are some alternatives that could be employed in order to prevent lawsuits. One of the possible alternatives is for the physicians to inform patients either by written consents or orally about the chances of obtaining unsuccessful sterilization procedures. The patients also ought to be informed about the inherent risk associated with sterilization procedures. Patients have a right to know about the aspects that may affect their health either directly or indirectly (Pozqar, 2005).
The inner worth that inheres in every human being is referred to as human dignity. Human dignity is the basis for rights, which can neither be violated nor granted by the society. For this reason, the basis for human rights is human dignity. One normative implication that is direct is that every human being has a right to be acknowledged as an inherent and valuable member of the society or community (Nickel, 2007).The protection and promotion of health and human rights are fundamentally connected.
A patient has a right to receive correct information from a doctor or physician. The same case applies to ethics surrounding wrong conception where a patient should be informed about the possibility of an unsuccessful sterilization procedure. The recent years have been marked by a rising tendency to reduce the burden of public health care on personal freedom or rights. Traditionally, quarantine, notification, mandatory testing and isolation were justifiable on the grounds that the rights of a few individuals were limited for the good of many people. Currently, this concept is no longer ethically permissible in several cases (Schwab and Gelfman, 2005).
The health sector is obliged to make considerations of the ethical implications associated with the key determinants of health, because causes of violation of human dignity may stem from external aspects other than the health sector. Some of the key determinants are economic factors, political system, cultural diversity including women’s role, demographic changes, sustainability of the global ecosystems and technological advancements. Democratization is essential in ensuring that respect for social justice, human rights and equity is upheld. The health care sector should make remarkable progress to ensure that human dignity and equity is attained.
It is the role of academicians, professionals as well as human right groups to give sound choices concerning the benefits of employing an ethical health care code that promotes justice and equity (Pozqar, 2005).Compassion is a driving force that enables an individual to work hard with the aim of stopping the suffering of a fellow creature. Compassion in health care sector entails treating everybody equally with absolute equity, justice and respect. The four fundamental principles of health care ethics are beneficence, autonomy, social justice and non-malfeasance. Autonomy is defined as the freedom to make one’s own decisions concerning healthcare.
A physician or nurse practitioner has an ethical obligation to respect their patient’s autonomy. This should be the case even in situations where the choices made may pose great risk to the patient’s life (Roberts, 2008).An example is a 25 year of patient who seeks Hepatitis C and HIV Testing due to a persistent history of IV drug use. The patient has a job but lacks a few resources including health insurance. The patient later revels that he has knowledge of the risk factors for Hepatitis C and HIV transmission after consulting with a nurse practitioner.
The patient strongly sates that he has no plans to quite the use of drugs at that time because of the fear of losing his job. The nurse practitioner goes on to treat the patient with honesty, compassion and n dignity. Eventually, the patient is educated and referred to a needle exchange managed by the department of public health, where he can gain access to outreach services referral services, clean syringes and free follow-up HIV and Hepatitis C testing (Schwab, 2005).From this example, the nurse practitioner holds respect for the patient’s autonomy even though the decision that the patient makes poses a threat to his life.
The nurse practitioner also demonstrates beneficence through portraying kindness, respect and compassion. While the nurse practitioner creates awareness in the patient in regard to making logical decisions, it is also acceptable that the patient has a right to make those decisions. In this case, there is an ethical dilemma caused by a conflict between autonomy and beneficence. From the above example, the act of referring the patient to a needle exchange program is an illustraration of the principle of non-malfeasance. This principle upholds the concept that a medical practitioner should try as much as possible to cause no harm to a patient. It entails doing the least extent of harm (Kuhse, 2009).
In this case, the nurse practitioner refers the patient to a needle exchange programs with the intention of reducing harm by minimizing exposure to HIV or Hepatitis C. The nurse practitioner demonstrates the social justice principle through treating the patient with dignity and equity. The non-malfeasance principle is coined from the Hippocratic Oath, which sates that no harm should be done in the medical profession. Medical practitioners are ethically expected to provide therapeutic measures that are beneficial and intended to cause no harm to a patient. Beneficence on the other hand entails acting in the patient’s best interests.
Social justice entails giving all patients an equal consideration, implying that each patient has to be accorded an equal opportunity for treatment (Ashcroft, et al, 2007).The implication of autonomy is that each patient is accorded the mandate to make decisions regarding the type and mode of treatment. The principle of autonomy underlies the consent of informed concept whereby patient have a right to gain access to information needed to govern therapeutic decisions. One of the ethical issues that may result from autonomy principle is the claim of nonexistence of autonomy if the patient is not fully informed.
At times a medical practitioner may decide to make choices that ought to be the patient’s ethical right. Truth-telling requires the medical professional to always tell the truth even in cases where doing so may harm the psychological well-being of the patient (Morrison, 2009).According to the element of confidentiality, it is ethically inappropriate for medical professional to disclose a patient’s information to other people. There are however some cases where patients have to give up some of their rights to confidentiality so as to receive particular benefits.
For example, signing insurance forms permits all clinical information and diagnoses to be shred with managed care organizations, insurers, employers and even the government. It is essential for any organization receiving information about an individual’s health to maintain the element of confidentiality so that only the justified members have knowledge of the information (Nickel, 2007).Fidelity is an element that entails respect for persons and is closely linked to keeping one’s word. Medical professionals are expected to stick to what they say regarding therapeutic measures accorded to patients.
This is an implication that medial practitioners ought to stand by their promises. Other additional principles that apply to health care profession are the principles of integrity and competency. Under competency, it is expected fro heath professionals to take continuing education in order to enable license renewal. The principle of integrity on the other hand requires health professionals to mitigate conflicts of interest (Roberts, 2008).There are several legal rights pertaining to individuals as they interact with the health care services.
One of the individual rights recognized in the ANA code for nurses is the right of individuals to make choices concerning what is to be down with their bodies. The code further postulate that individuals have a right to be given information that is required prior to informed consent or decision-making. The potential effects associated with a given therapeutic measure should also be clearly communicated to a patient (Morrison, 2009).A partial challenge of referring to individual rights is the various differing views regarding the true constitution of a right.
It is essential to differentiate rights from privileges. Privileges refer to advantages or benefits given by someone else such as in an organization (Schwab, 2005).Legal rights are created by the law or enacted by the legislatures and courts. A simple claim of a right does not necessarily mean that the right exists in the legal perspective. This becomes a major issue when it comes to claims concerning the rights to access healthcare services. Constitutional changes provide citizens with a wide spectrum of rights but fail to provide amendments that are specifically related to health care or health as a legal right to everyone.
One has to demonstrate that an individual person or property is endangered in order to claim a legal right (Nickel, 2007).An adversarial confrontation instead of conflict resolution occurs due to framing an issue solely in terms of rights, without specifying the type of rights violated. Legal rights usually identify institutions or individuals that have corresponding duties. There are some states that have the Patient’s Bill of Rights as a legal standing.
In these states, health care institutions may be charged with the responsibility of upholding and respecting the legal rights of patients (Miller, 2006).Most health care institutions require patients to maintain all the civil and legal rights I the course of receiving healthcare services. Moreover, patients have a right to receive fair and unbiased treatment without regarding to religion, sex, ethnic background, religion, nationality disability or financial standing. Patients have a right to be free from neglect or abuse.
They have a right to humane and adequate healthcare services in an environment that is least restrictive. Finally, patients have a right to confidentiality while receiving healthcare devices. Their personal information should not be shared with other people without a legal consent (Roberts, 2008).In conclusion, there are various ethical and legal issues pertaining to the healthcare profession. Wrong conception is one of the issues that have led to substantial debates and controversies. Some of the principles that should be upheld by healthcare professional include autonomy, fidelity, confidentiality, non-malfeasance and beneficence.
References
Ashcroft, R. E., Dawson, A., & Draper, H. (2007). Principles of health care ethics (2nd Ed). John Wiley and Sons
Kuhse, H., & Singer, P. (2009). A Companion to Bioethics (2nd Ed). John Wiley and Sons
Miller, R. D. (2006). Problems in health care law (9th Ed). Jones & Bartlett Learning
Morrison, E. E., & Monaqle, J. F. (2009). Health care ethics; critical issues for the 21st century (2nd Ed). Jones & Bartlett Learning
Nickel, J. W. (2007). Making sense of human rights (2nd Ed). Wiley-Blackwell
Pozqar, G. D. (2005). Legal and ethical issues for health professionals. Jones & Bartlett Learning
Roberts, L. W., & Hoop, J. G. (2008). Professionalism and ethics; Q & A self-study guide for mental health professionals. American Psychiatric Pub
Schwab, N., & Gelfman, M. H. (2005). Legal Issues in School Health Services: A resource for School Administrators, School Attorneys and School Nurses. iUniverse pg 88-89
