Ethical Implications of Reproductive Technologies and Patient Rights in Healthcare

Outcomes

Overview

As Keatings and Adams note, “[s]cience and technology has advanced to the extent that we can now extend life, overcome infertility, eliminate genetic anomalies, manipulate and control the characteristics of potential human beings, predict the risk of future diseases, find their cures and identify strategies for their prevention” (Keatings and Adams, 2019). “Nurses who work in settings where these technologies are used”, particularly those who work as genetic counselors, “face profound social, psychological, and emotional issues, and are confronted by questions about their own values and beliefs about life and its potential” (Keatings and Adams, 2019).

Among the questions associated with the increasing use and sophistication of reproductive technologies are the following:

• Is it the right of every human being to have a child?
• Do we have a right to control the genetic attributes of our children?
• Is it right to use technology to sustain life at all costs regardless of the quality of that life? (Keatings and Adams, 2019).

Outcomes

By the end of this lesson students should have a firm understanding of:

• The scope and ethical implications of the Human Genome Project
• Legislation regulating the use of stem cells
• Ethical issues involving the use of stem cells
• Reproductive technologies, including artificial insemination, in vitro fertilization and surrogacy
• The ethical implications of these technologies
• The provisions of the Assisted Human Reproduction Act of 2004
• The distinction between rights and obligations in health care
• Confidentiality and the right to privacy
• Ethical challenges associated with the duty to disclose health information

Guide

The following lesson examines an array of complex technologies that have been developed in the recent past and include reproductive technologies, genetic testing and gene therapy. This lesson also examines the rights of patients in the healthcare setting and the obligations of nurses to ensure that patients’ rights are respected.

Discussion Forum

Please take the time to reflect on and discuss the three assigned articles with your fellow group members and respond to one of the following questions. Please post your response as well as your reply to one of your fellow group member’s posts online via Moodle.

1. Do you agree or disagree with Savulescu’s suggestion that we should use PreImplantation Genetic Diagnosis (PGD) to select the best possible child for our own good and for the good of society? Is Savulescu’s suggestion inherently paternalistic? Is it inherently wrong?

2. Now that we have the ability to sequence our own genomes and thereby obtain vital information about our genetic heritage (e.g., predisposition to certain diseases) is there any compelling reason why adopted children should have the right to know their biological parents’ identity?

Guide

Assignments

Individual Case Analysis

Once you have read the materials for the lesson please complete the following case analysis and post it online for review and grading by your fellow group members. Analyses must not exceed 3 double-spaced pages. Each analysis is worth 5 points and will be graded by your fellow group members, who must assign a grade from 0 to 5, based on the thoroughness of the response. You should cite relevant material in the assigned course readings as appropriate. You are also welcome to consult external sources but must provide proper references for any quotation or citation from external sources. Once you have completed grading the assignments please have one group member email the grades to me. Each individual case analysis will be worth 5 points.

Case

 
Gail is driving home after a very busy 12-hour shift in the cardiovascular intensive care unit. She is 5 minutes from home and is looking forward to spending the evening with friends. As she rounds a corner, she sees a multivehicle accident. She slows her car and observes a number of people rushing to help. Reassured that appropriate assistance will be provided, Gail continues home.

The next day, she arrives at work to discover that she is assigned to care for one of the accident victims, a 20-year-old man who sustained serious chest trauma resulting in a tear to his aorta. Delays in the arrival of paramedics resulted in problems with early management of his airway. Now, although surgery has corrected the tear, it is unclear whether inadequate oxygenation to his brain will result in permanent brain damage. Gail feels responsible and wishes she had stopped to help.

Questions

1. Has the nurse in this scenario violated any ethical or legal standards?
2. Is there a risk of any civil or criminal liability?
3. Did Gail have any ethical or legal responsibility to provide assistance to the victims of this accident? Is there a difference between her legal and moral responsibilities?
4. What choice would you have made?

Group Case Analysis

Please read Case 1: Margot Bentley and Advanced Care Planning found on pp. 404-416 in Yeo and colleagues’ Concepts and Cases in Nursing Ethics and answer the related questions. Your analysis should take the form of an essay in which you devote 5 double-spaced pages to answering the questions. As there are 4 case analyses you are expected to rotate authorship of the case (i.e., you should take turns coordinating the group discussion and writing up the case analysis). You will submit each group case analysis online via Moodle and will receive a common grade. You should cite relevant material in the assigned course readings as appropriate. You are also welcome to consult external sources but must provide proper references for any quotation or citation from these sources. Each group case analysis will be worth 10 points.