Analysis of an Ethical Dilemma Part Two NRS-437V Ethical Decision Making in Health Care Grand Canyon University

Today’s world is filled with endless controversial arguments, ethical debates, and a constant clashing of varying perspectives and outlooks. This is especially relevant to posthumous reproduction, which has sparked many disputes in the global world. Even in our own social circles, the viewpoints on posthumous reproduction tend to be varied. Additionally, posthumous production raises many moral, legal, and ethical concerns. Currently, hospitals do not have a strong ethical stand on posthumous reproduction, but recently they have been forced to develop policies regarding consent, and other legal practices. The following are four interviews done by the writers’ involved four different individuals, a hospital administrator, spiritual leader, healthcare colleague, and a friend. The writers also came to a resolution of dilemma based on research. The information presented is based on the ethical dilemma of a child dying, the parents desire to harvest the child’s eggs for the opportunity to conceive another child or treat any potential genetic anomalies. One of the researchers interviewed the hospital administer where she works. Regarding "posthumous reproduction", the administrator stated that the hospital offers this advanced technology to spouses of patients who meet criteria. The administrator agreed that there is a lack of guidelines and policies related to posthumous reproduction. Answering to the researcher’s question on personal bias, her reply was she does not allow her personal opinion to interfere with her responsibilities. She stated she is dedicated to her job and that her responsibility is to act in the best interest of the patient and the hospital in general. The administrator described the difficulty and ethical dilemma in dealing with patients and family members connected with posthumous reproduction. The next interview was with a female minister from a full gospel evangelist church who has a Roman Catholicism background. She believes in the Biblical principle that God created man and woman and gave us the ability to be fruitful and multiple in childbearing. New technology has brought us into new era where couples having a difficult time getting pregnant can have in vitro fertilization and embryos implantation. It is important that the couples are provided all necessary information, guidelines, policies & procedure, financial responsibility, and psychological counseling. Additionally, informed consent must be obtained prior to the procedure being performed. The health care colleague is a nurse believes that as long as the harvesting is not harmful to the remaining parent or the child, there is no ethical dilemma with in vitro fertilization. People often become desperate and sometimes are willing to sacrifice one for another when faced with a life or death situation. She thinks that God has given us the ability to create and think for ourselves. Medical advancements have proven that. The important question is does that end justify the means? It is important to weight the sacrifices. If the sacrifice improves someone’s life and does not harm another’s life, what is the issue? As long as the action does not endanger or diminish the life of another person, this health care professional has no problem with posthumous reproduction. A friend of the researcher, who also happens to be a nurse, agrees with the new technology to a certain extent, but mainly she disagrees because of the negative effects of posthumous reproduction. She is a believer in Christ and says she cannot stand the misuse of this technology, which is against the Bible. With the increasing number of unmarried parents, conception without sex but with the involvement of multiple adults, gay marriages, etc., the traditional model of childbearing has changed. This new assistive reproductive technology gives men and women who receive chemo, the option of storing gametes for use later in life. In addition, the surviving husband or wife has the option to create offspring after their significant other’s death. This potentially places women and children at risk of physical and psychological harm. In this given dilemma, the child is dying and the parent wants to harvest the child's egg. According to the writer’s friend, this is unethical as the child is unaware of the situation. It is ethical because the wish of the parents is to have a healthy child. Some problems might arise in the family regarding the actual relationships. Post-mortem retrieval, storage and insemination would be permitted only with valid written consent, proper counseling, and education of the persons involved. According to the administrator, posthumous reproduction should be achieved within the proper guidelines and with legal and procedural clarification to everyone involved. The administrator agrees that if the family or persons involved understand the pros and cons, they should have the freedom to make use of this technology. The spiritual leader who strictly believes in biblical principle thoroughly opposes embryo freezing and harvesting or genetic manipulation and posthumous conception. The other two were nurses and they have similar opinions. If it is not harmful to anyone or helps to improve someone's life, embryo harvesting or posthumous conception is an agreeable option. Out of the four interviews, three people were fine with the new technology if it is used in an appropriate way. Developing legal guidelines and sound policies to prevent abuse of the procedure and at the same time ensuring fair access when it is appropriate can be challenging (Hans, 2008). However, legalities may raise issues to the adults involved in the procedure and even for the child created with this technique (Knapp, Quinn, Bower, & Zoloth, 2011). Embryo donation/adoption is a complex issue that has medical, legal and ethical dimensions. Allowing for embryo donation/adoption is the only viable option that protects and preserves their human life. The other viable options: being discarded, destroyed for research, abandoned or kept in “suspended animation” indefinitely, are unacceptable because they have the potential of harming or intentionally killing these embryos that deserve special respect. (Clark, 2009). Today, the death of a husband or partner before procreation is less devastating for a wife or significant other because it is possible to procure sperm posthumously (stanford.edu, n.d.). A relationship can be deepened and enriched by this sort of affirmation; moreover, such affirmation can exist when the procreation is planned to occur after the death of one member of the couple. For example, in the Hecht case it was reported that the plan to attempt post-mortem reproduction had this sort of special meaning for the couple (Hecht v. Superior Court, 1993). Informed consent and full disclosure of all information is the key to ensuring that all parties are not endangered or harmed concerning PAR. The researchers came conclude that post-mortem retrieval and storage of gametes would be permitted only with valid written consent, proper counseling and education to the persons involved.

This topic is so sensitive and challenging to the healthcare field because of its complexity, moral and ethical values which should be handled carefully. In sensitive situations, such as this, careful consideration needs to be given to the wishes of dead and living. The clear understanding of the motivating factors behind genetic manipulation will help to resolve the dilemma behind it.

References
Hans, J. (2008). Attitudes toward posthumous harvesting and reproduction. Death Studies, 32(9), 837-869
Bahadur, G. (2002). Death And Conception. Human Reproduction 17 (10), 2769-2775. Retrieved February 8, 2013, from http://humrep.oxfordjournals.org/content/17/10/2769.full
Clark, P.A. (2009). Embryo Donation/Adoption: Medical, Legal and Ethical Perspectives. The Internet Journal of Law, Healthcare And Ethics. Volume 5 Number 2. DOI: 10.5580/22df Retrieved February 10, 2013, from http://www.ispub.com/journal/the-internet-journal-of-law-healthcare-and-ethics/volume-5-number-2/embryo-donation-adoption-medical-legal-and-ethical-perspectives.html#sthash.pZPZqQ5b.dpbs
Knapp, C., Quinn, G., Bower, B., & Zoloth, L (2011). Posthumous Reproduction and Palliative Care.Journal Of Palliative Medicine, 14(8), 895-898. doi:http://dx.doi.org.library.gcu.edu:2048/10.1089/jpm.2011.0102
Kohlenberger, J. (2010). The Holy Bible, New King James Version (3rd ed.) Peabody, MA.
Rosoff, M., P & Katsur, M. (2003). Preserving Fertility in Young Cancer Patients, Medical, Ethical And Legal Challenges. Retrieved February 6, 2013, from www.psljournal.com/archives/papers/preservingFert.cfm
Stanford University. (N.D.). New Ways of Making Babies. What Are The Implications of All of This? Retrieved February 8, 2013, from http://www.stanford.edu/class/siw198q/websites/reprotech/New%20Ways%20of%20Making%20Babies/referen.htm