Skip to main content Accessibility help
×
Hostname: page-component-7c8c6479df-nwzlb Total loading time: 0 Render date: 2024-03-29T10:42:07.742Z Has data issue: false hasContentIssue false

13 - Ethical issues in reproduction

Published online by Cambridge University Press:  05 August 2012

D. Micah Hester
Affiliation:
Division of Medical Humanities, University of Arkansas
Toby Schonfeld
Affiliation:
Emory University, Atlanta
Get access

Summary

Objectives

  1. Identify and explain the major ethical considerations speciic to reproductive decision-making, including the moral status of the fetus, the status of the pregnant woman, and the maternal–fetal relationship.

  2. Describe ethical challenges associated with contraception and pregnancy termination, including the legal and cultural context surrounding conscientious refusal.

  3. Describe the ethical challenges associated with conception and loss, including management decisions in the context of significant fetal anomalies.

  4. Describe the ethical challenges involved in the management of pregnancy, including potential conlicts between maternal health needs or behaviors and fetal well-being, and decisions about mode of delivery.

Case 1

T.D. is a 22-year-old woman who presented to the emergency room after being raped by a coworker. She underwent a full rape work-up; although standard procedure is to offer her emergency contraception, the emergency room physician felt that doing so would be a conflict of conscience for him, so he refused to write the order. The nursing staff raised concerns that the physician was putting his own interests before those of his patient and failing to provide standard care. The physician countered that it is his right – even his obligation – to act in accordance with his conscience.

Case 2

L.G. is a 28-year-old with a history of multiple miscarriages. In her last pregnancy, a cerclage (a stitch around the cervix) was placed; she carried the pregnancy to term and delivered a healthy child. Now pregnant at 14 weeks, she had planned cerclage placement again; however, an ultrasound revealed an anencephalic fetus. The patient declined abortion and requested the cerclage be placed, but her doctor refused, arguing the risks of cerclage placement (anesthesia, infection) were not justified absent the possibility of meaningful life for her child.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Academy of Pediatrics (AAP) 2009 Policy Statement – Physician refusal to provide information or treatment on the basis of claims of consciencePediatrics 124 1689CrossRefGoogle Scholar
American Congress of Obstetricians and Gynecologists Committee on Ethics 2005 ACOG Committee Opinion #321: Maternal decision-making, ethics and the lawObstetrics and Gynecology 106 1127CrossRefGoogle Scholar
Dresser, RS 1994 Freedom of conscience, professional responsibility, and access to abortionJournal of Law Medicine and Ethics 22 280CrossRefGoogle Scholar
Faden, RRKass, NMcGraw, D 1996 Women as vessels and vectors: Lessons from the HIV epidemicWolf, SFeminism and Bioethics: Beyond ReproductionNew YorkOxford252Google Scholar
Layne, L 2003 Motherhood Lost: A Feminist Account of Pregnancy Loss in AmericaNew YorkRoutledgeGoogle Scholar
Little, MO 2008 Abortion and the margins of personhoodRutgers Law Journal 39 331Google Scholar
Little, MOLyerly, ADMitchell, LM 2008 Mode of delivery: Toward responsible inclusion of patient preferencesObstetrics and Gynecology 112 913CrossRefGoogle ScholarPubMed
Lyerly, ADGates, ECefalo, RCSugarman, J 2001 Toward the ethical evaluation and use of maternal-fetal surgeryObstetrics and Gynecology 98 689Google ScholarPubMed
Mahowald, MB 1995 As if there were fetuses without women: A remedial essayCallahan, JReproduction, Ethics and the Law: Feminist PerspectivesBloomingtonIndiana University Press199Google Scholar
Sonfield, A 2008 Provider refusal and access to reproductive health services: Approaching a new balanceGuttmacher Policy Review 11 2Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×