Ethical Issues in Health Essay

Abortion is one of the most polarising moral issues in today’s society. It presents an ethical dilemma for many people and especially all healthcare professionals involved. Firstly, this essay will begin by briefly outlining the highly controversial issue of abortion, discuss why this topic draws fierce debate, for and against, and explain the current legal standing in the UK today.

It will then move on to explain how different ethical models can be used in relation to ethical dilemmas, in particular Thiroux’s Five Principles of Ethic’s.Using this model to discuss how each principle individually applies to this contested issue it will then conclude by summarising and highlighting the main conflicts regarding abortion. The oxford dictionary defines abortion as ‘the expulsion of a foetus from the womb before it is able to survive independently and the deliberate termination of a human pregnancy’ (www. oxforddictionaries.

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com). This can be a very painful topic with many issues causing debate.Answering all of the surrounding issues can be extremely complex, with many factors having to be taken into account as each person has their own individual and personal reasons for abortion. Currently in the UK abortion is legal and, in accordance with The Abortion Act 1967, must be carried out before 24 weeks of pregnancy, although there are certain exceptions when the law states that an abortion may be carried out later.The Act also states certain criteria that must be met which includes: – two doctors must agree that an abortion would cause less damage to a woman’s physical or mental health than continuing with the pregnancy and abortions must be carried out in a hospital or a specialised licensed clinic (Jackson, 2001). There are different methods of abortion, depending on the length of pregnancy, which include the abortion pill for pregnancies up to 9 weeks and surgical methods for further progressed pregnancies which involve the use of local or general anaesthetic.From 7-15 weeks of pregnancy suction termination is a procedure that uses gentle suction to remove the foetus from the womb.

From 15 weeks onwards surgical dilation and evacuation (D;E) is a procedure where the cervix is gently stretched and dilated and forceps and a suction tube are used to remove the foetus. Pregnancies between 20-24 weeks use a combination of the previous methods and involve an overnight stay in hospital with either general anaesthetic used or early labour induced (Francome, 2004).When dealing with topics such as abortion conflicting moral principles and rules may create dramatic dilemmas and the use of ethical models help to analyse these dilemmas. Although there is no single or universal theory of ethics, each model is the starting point of a framework that offers solutions to ethical dilemmas. Thiroux’s Five Principles of Ethics is one model that identifies five clear principles which, although there are many commonly held values in our society, he describes as near absolutes or enduring ethical values. These include: – 1.

The principle of the value of life – humans should value and respect life. This also implies the acceptance of death as the ethics of consequence apply when further treatment may be judged to cause more harm than good. 2. ) The principle of Individual freedom – Individuals must have the freedom to choose their own way of being moral within the framework of the other four basic principles. This principle considers an individual’s right to autonomy and where complete autonomy may not be possible, every effort should be made to maximise the opportunity for all to implement their choices. . ) The principle of goodness or righteousness (encompasses beneficence and non-maleficence) – we should strive to do good and avoid the bad.

When situations arise where there are no good decisions left a choice between the lesser of the two evils may be inevitable. 4. ) The principle of justice or fairness – the distribution of good and bad on a just and fair basis. 5. ) The principle of truth telling or honesty – necessary for meaningful communication (Edwards, 2008).When implementing this model within the topic of abortion the first and, for some, the uppermost principle of the value of life creates possibly one of the most relevant debates surrounding this issue. The organisation Pro-Life state that absolute respect for human life is the keystone of justice and the right to life is the most important right from which all others flow.

The movement argues that even non-viable, undeveloped human life, is sacred and must be protected. Pro-Life members are diverse in economic status, race, religion, and education.They are unified by the concept that all humans, especially the innocent unborn, have an inherent right to life. One of the main reasons against abortion given by Pro-Life advocates is that life begins at conception and that, by terminating the pregnancy, causes the foetus to die. They point out that during the first 8 weeks of pregnancy, when most abortions take place, a baby develops a heartbeat and elementary brain activity. It is believed that, by terminating a pregnancy, this seriously violates the human rights of the foetus and discriminates the fundamental principle of the value and right of life.This termination results in the foetus becoming a ‘silent’ victim of murder (www.

prolife. org. uk). Many people and particularly those from religious backgrounds believe that nobody has the right to kill or take a life that god has created.

Others argue that if the mother does not wish to keep the child then she should continue the pregnancy to term, thus allowing the child the right to live, and be adopted once born. With regards to pregnancy resulting from rape or incest, however unplanned by the mother, the conceived foetus still has the right to life.This concept similarly applies to foetus’ found to have disabilities or impairments (Kaczor, 2011). The organisation, Abortion Rights, is the national Pro-Choice campaign that argues extensively with regards to Thiroux’s second principle of an individual’s right to autonomy. Pro-Choice campaigners believe that individuals have unlimited autonomy with respect to their own reproductive systems. The organisation argues that, in cases where human personhood cannot be proven, e. g. in pregnancies prior to the point of viability, nobody has the right to impede a woman’s right to decide whether or not to continue a pregnancy.

The health and lives of the women involved is something that should not be overlooked. Abortion Pro-Choice advocates often cite rape and incest as legitimate reasons for a woman to abort a pregnancy and, by ignoring arguments in these cases, opponents argue against justice for the female victims of these crimes. To force any woman to endure a pregnancy brought about by rape is to force her to recall the rape each and every day of her pregnant life.

There is nothing moral about forcing a woman to carry that embryo to term. In fact, it is one of the most immoral things that society could do.Adoption is not considered to be an alternative to abortion because it is the woman’s choice to choose and each choice has a different psychological effect on the mother. (www. prochoicemajority. org. uk). Others argue that every child should be a wanted child and aborting unwanted children reduces the number of abused children.

The continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family (www. bortionrights. org. uk). The principle of beneficence and non-maleficence also creates controversial viewpoints as, combining the first 2 principles together, causes conflicting issues with regards to the mother and unborn child.

Firstly it is any healthcare professional’s duty to do the utmost best for the patient in their charge, but this also includes the foetus the mother is carrying. As a result of performing a termination at the mothers request this respects the patients right to autonomy and therefore ensures goodness on her behalf.Consequently beneficent acts can sometimes produce, or involve, maleficent results and, in the case of abortion, this particularly applies to the foetus being aborted (Levine, 2004). As this is a highly sensitive topic for many people the Abortion Act 1967 afforded permission for a ‘conscience clause’. This deems the right for any healthcare professional to conscientiously object to perform any duties in relation to abortion if they regard it as being morally impermissible (Legge, 1985). Thiroux’s fourth principle details that the distribution of good and bad should be fair and just.Whilst this includes both the mother and child, justice and fairness should also be extended to the father of the unborn child.

Although the issue of abortion is largely devoted to the rights of the foetus and the mother, the rights and concerns of the father also have to be considered. In the case of the father wanting to have the child and the mother wanting an abortion the question arises, is the principle of justice being fulfilled as it transgresses the father’s rights? (www. bbc.

co. uk). Other issues of adoption are placed under scrutiny when examining justice.

It can be questioned that, if the adoption process was made easier and more accessible, then this might persuade more expectant mothers to allow their child to go for adoption rather than to have the worry of the child being simply abandoned. Is justice being done to the mother and child by making the adoption process difficult? (Weiss, 2001). An imperative part of any health professional’s duties is Thiroux’s principle of honesty.

This principle can often prove to be the most difficult to maintain with startling ethical dilemmas as a result.Abortion is no exception to this and it is the healthcare professional’s duty to ensure that the essential component of truth telling allows effective communication to take place. All aspects of the abortion process should be conveyed honestly to the mother in order for her to make a correct, well informed decision. This includes areas of both good and bad consequence for both mother and child. Examples of this would be discussing the mother’s options both at present and in the future, informing of any disabilities the unborn child may present and risks involved (French, 2009).Issues surrounding abortion counselling that is often offered to the mother have criticized that it could be perceived as biased instead of being impartial and honest (www. guardian.

co. uk). In conclusion, it would seem apparent that abortion is a highly regarded controversial and sensitive ethical dilemma. When applying Thiroux’s Five Principles of Ethics to this issue two main areas of conflict are clearly established. The principle of the value of life and the principle of individual freedom both provide convincing arguments at either end of the spectrum.

The remaining principles address concerns that may not initially be recognised but are of equal importance. Questions otherwise not thought of, but with equivalent significance, are encountered as a result of applying this model. Although each principle can be assessed individually, issues arising from the dilemma of abortion can encounter more than one principle at a time and they all need to be addressed.ReferencesEdwards, M, 2008, The Informed Practice Nurse, West Sussex, John Wiley ; Sons Ltd.

Francome, C, 2004, Abortion in the USA and the UK, Hants, Ashgate Publishing Limited. French, K, 2009, Sexual Health – Essential clinical skills for nurses, West Sussex, Blackwell Publishing Ltd. Jackson, E, 2001, Regulating Reproduction – Law, Technology and Reproduction, Oxford, Hart Publishing Ltd.

Kaczor, C, 2011, The ethics of abortion- Women’s rights, human life, and the question of justice, Oxon, Routledge. Legge, J, S, 1985, Abortion policy – An evaluation of the consequences for maternal and infant health, Albany, State University of New York Press. Levine, P, B, 2004, Sex and Consequences- Abortion, public policy and the economics of fertility, Oxfordshire, Princeton University Press.Weiss, A, E, 2001, Adoptions Today-Questions and controversies, Connecticut, Twenty-First Century Books. Electronic references http://oxforddictionaries. com/definition/abortion? q=abortion- (Date accessed – 10-02-12) http://prolife. org.

uk/category/abortion/ – (Date accessed – 09-02-12) http://www. prochoicemajority. org.

uk/ – (Date accessed – 09-02-12) http://www. abortionrights. org. uk/ – (Date accessed – 11-02-12) http://www. bbc. co. uk/ethics/abortion/legal/fathers. shtml – (Date accessed – 15-02-12) http://www.

guardian. co. uk/commentisfree/2012/jan/27/abortion-counselling-consultation – (Date accessed – 19-02-12)


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