The topic of maternal and fetal rights is one of the most complicated ones in terms of ethics. Numerous dilemmas in this area are associated with the fact that the decisions of a mother impact the fetus, who is considered to have rights as well (Cosgrove & Vaswani, 2020). From the point of healthcare, it is critical to take into account both the mother and fetus and consider them from the points of law, freedom, morality, and ethics. The purpose of this paper is to critically analyze the case on the maternal versus fetal rights to identify the opposing sides and accompanying ethical theory and principles.
In the given case, a 29-year-old female, Janet, and Jack, her husband, got into the car accident. Jack died, but Janet received head injuries and fell into a vegetative state, while doctors stated that the prognosis is negative. It turned out that Janet was pregnant, and the fetus was alive. However, as a conscious nurse and person, she left the directives that her husband should decide on her care prolongation, and her parents were assigned the role of the second agents. On the one hand, parents agree with their daughter’s will to avoid artificial life continuation. On the other hand, the law of the State of Kansas states that withdrawal of life-sustaining procedures can be not legal if a woman is pregnant. The situation is complicated by the necessity for parents and doctors to decide whether to stop or prolong Janet’s life.
Analysis of Issue
In the described case, parents and doctors are the stakeholders that should decide on the future of Janet and her unborn baby. The parents, who also work in the healthcare area and value the will of their daughter, should make a decision to implement and oppose her wish. This is an ethical dilemma that requires parents to properly think not only about their daughter but also her baby. The doctors are also the stakeholders, who are engaged in Janet’s care and are expected to participate in the decision to be made. The ethical dilemma for these stakeholders is slightly different from that of parents.
A utilitarianism theory is one of the theoretical paradigms to consider the identified case. Wagner and Dahnke (2015) state that this theory implies determining what is wrong and what is right by paying attention to the outcomes. In other words, the choice that would produce the greatest benefit should be regarded as a correct one. For example, it is possible to suggest that if Janet’s life were interrupted, the parents would feel they are committed to the solution of their daughter. Accordingly, the satisfaction of their interests would be achieved, which ethical from the point of utilitarianism. At the same time, the preservation of the fetus’ life would enable a new person, who can potentially generate good to other people (Wagner & Dahnke, 2015). However, utilitarianism means that decisions should be made from an impartial position, which seems to be especially difficult since family relationships are involved in the dilemma.
A normative theory is another ethical perspective that integrates both facts and attitudes, which can be accompanied by including opinions, moral rules, and ethical principles. According to Arpaly (2015), this theory aims to establish the conceptual and interpret the dilemma from the point of what exactly works to achieve good. For example, the norms for the assessment of the case of Janet can be related to the law, nursing ethics, and opinions of parents. All of the mentioned components should be considered to find the best way of resolving the case.
Speaking of the ethical principles that take place in this case, it is important to focus on non-maleficence and beneficence as the core elements of medical ethics. Since following Janet’s wish would mean two deaths, this way seems to be unacceptable for doctors. As clarified by Butts and Rich (2019), the above principles require healthcare providers to avoid doing harm to patients and initiate only appropriate actions for their well-being. It should be stressed that doctors have a moral obligation to care about the fetus, doing all manipulations to support his or her life. In terms of the accountability principle, they should take responsibility for care decisions, which means that they cannot rely on the parents’ conclusions only (Butts & Rich, 2019). In addition, the law of Kansas states that the decisions of pregnant females to end their life may be illegal. Nevertheless, this law does not necessarily mean that Janet’s will should be opposed.
In healthcare, including a nursing profession, the appearance of ethical dilemmas is inevitable. Therefore, health care providers should be ready to synthesize a large volume of knowledge in ethics, laws, policies, and morality Grady, 2016). In this case, doctors and nurse who treated Janet after the accident are medical stakeholders. They are responsible for reporting about the consequences of both possible choices, as well as the state and potential of the fetus to inform parents. Janet’s mother and father are the agents who have the right to choose, and they should be provided with all related information, including medical risks and benefits. In terms of bioethics, a patient’s autonomy should be ensured by medical workers, and his or her decision should be accepted (Grady, 2016). Therefore, doctors should advice Janet’s parents, but they should also avoid any coercion and judgment, thus leaving the final solution at their discretion.
Resolution
Based on the above analysis of the given case, it is possible to suggest that the parents should partially go against the will of their daughter and prolong her life until the birth of the baby. Such a decision is consistent not only with the law but also the ethical principles of beneficence, non-maleficence, and fair in relation to the unborn baby, who have a right for life. However, this decision is opposed to the principles of fidelity and autonomy, which imply that a nurse should accept a unique opinion of the patient and keep his or her promises.
The ethical dilemma of the case makes it extremely difficult to resolve it, but one can assume that a life is the most valuable issue that everyone should protect and support. In this situation, it seems that the unborn baby should be given an opportunity to survive even though the mother provided clear instructions on her life prolongation. It should also be noted that Janet did not anticipate that she can be pregnant in such a situation, and probably her decision could be different. Nevertheless, parents and doctors cannot rely on guesses as only facts can serve as the source of reliable information.
Conclusion
To conclude, this paper examined the case of Janet, who fell into the vegetative state after the car accident. The ethical dilemma is associated with either supporting her life to until the birth of the baby or avoid prolonging her life, as she stated in her instructions for emergency cases. This situation was discussed from the point of utilitarianism and normative ethical theories, which provided the foundation for understanding what is right and wrong. Personally, I have learned that the topic of maternal and fetal rights is complicated as it involves not only laws but also ethics. Previously, I thought that women who are alcohol or drug addicts are a subject to such dilemmas. However, I understood that even the thought-out decisions of Janet to leave specific instructions cannot fully protect from ethical issues. This assignment helped to implement my theoretical knowledge in practice and interpret the case critically.
References
Arpaly, N. (2015). Moral worth and normative ethics. Oxford Studies in Normative Ethics, 5, 86-104.
Butts, J. B., & ich, K. L. (2019). Nursing ethics. Jones & Bartlett Learning.
Cosgrove, L., & Vaswani, A. (2020). Fetal rights, the policing of pregnancy, and meanings of the maternal in an age of neoliberalism. Journal of Theoretical and Philosophical Psychology, 40(1), 43-53.
Grady, C. (2016). Cultivating synergy in nursing, bioethics, and policy. Hastings Center Report, 46, 5-8.
Wagner, J. M., & Dahnke, M. D. (2015). Nursing ethics and disaster triage: Applying utilitarian ethical theory. Journal of Emergency Nursing, 41(4), 300-306.