Critical issues for individuals

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a break down of critical issues for individuals in health care and ethical principles

Question 1

If you were faced with infertility but desperately wanted a child, would you consider ART? Why, or why not?

Your journal entry must be at least 200 words in length. No references or citations are necessary.


Part 2



instructions




Blog

Have you ever known someone who has dealt with a potentially ethical issue in health care such as end-of-life decision-making, in vitro fertilization, religion, long-term care decisions, or other issues? Did it cause you to want to conduct further research on how to help him or her or to better understand his or her situation? Maybe you have personally experienced such a condition.

Begin to research articles in the CSU Online Library that might help you better understand the condition of this individual, or research an ethical medical dilemma of your choice. Research articles that may help explain some insight into the issue. Locate at least three articles that are no more than 10 pages in length that might arm you with information to help this individual.

Now, imagine that you are the author of a blog. You do not want to identify your friend, but you know he or she reads your blog, so you begin to write a special entry for your friend without identifying him or her. In the blog, address each of the prompts below.

· Summarize the ethical issue.

· What is the impact of the ethical issue in health care?

· What social factors influence the issue and decision?

· Pick one side of the issue’s argument, and defend it.

· Include a discussion about the impact of the research on ethical questions surrounding the issue.

· What additional resources can you offer/mention in the blog?

Note: Keep in mind that you will want to keep the name of the individual confidential. If you would like to use this person in your blog, please use an alias (fake name) for this individual.

Your blog post must be at least 500 words in length. Remember that the blog should be in a conversational format but still include supporting evidence and references to clarify ideas and your thoughts. Be sure to explain any technical terms, as this would be for the whole community to view, including those unfamiliar with your chosen topic.

HCA 3302, Critical Issues in Health Care 1

Course Learning Outcomes for Unit II

Upon completion of this unit, students should be able to:

1. Critique arguments related to the impact of social factors that influence the U.S. health care system.
1.1 Determine the social factors impacting a current health care issue.

2. Defend an opinion on critical issues facing the U.S. health care system in the 21st century.

2.1 Summarize a current critical issue in health care.
2.2 Defend an opinion on a critical issue in health care from a research-based point-of-view.

7. Discuss common ethical principles applied to critical bioethical issues.

7.1 Recall common principles and theories of health care ethics.

Course/Unit
Learning Outcomes

Learning Activity

1.1

Unit Lesson
Chapter 3
Chapter 4
Unit II Scholarly Activity

2.1, 2.2

Unit Lesson
Chapter 3
Chapter 4
Unit II Scholarly Activity

7.1

Unit Lesson
Chapter 3
Chapter 4
Unit II Scholarly Activity

Required Unit Resources

Chapter 3: The Moral Status of Gametes and Embryos: Storage and Surrogacy

Chapter 4: The Ethical Challenges of the New Reproductive Technologies

Unit Lesson

In this unit, we will discuss critical issues for individuals. Particularly, we will learn about the moral status and
ethical decisions surrounding gametes and embryos, the ethical challenges of new reproductive technologies,
and spirituality in health care. Currently and in the future, this part of reproduction and prenatal care will
continue to present critical concerns for health care providers who wish to be ethical and honor patient
wishes. Ethical issues such as assisted conception, spirituality, and abortion, all related to health care, will
continue to influence professional decision-making in health care in the future (Morrison & Furlong, 2019).

Infertility and the use of reproductive technology is a growing trend. Currently, reproductive technology is not
regulated by the government, but it is still a highly profitable endeavor because of the demand for it. It has
been a trying task for health care decision-makers to ethically assess reproductive technologies (Morrison &
Furlong, 2014).

Key Terms

UNIT II STUDY GUIDE
Critical Issues for Individuals

HCA 3302, Critical Issues in Health Care 2

UNIT x STUDY GUIDE
Title

These terms are used throughout this unit and you should familiarize yourself with their definitions:

• Embryo: the early stages of animal differentiation and growth;
• Gametes: usually possessing haploid chromosomes, a mature female or male germ cell can initiate

formation of a new diploid through fusion with a gamete of the opposite gender;
• Surrogacy: the action of being a surrogate mother;
• Infertile: the inability to reproduce; and
• Oocyte: an egg that has not matured, also known as a female gametocyte.

The Moral Status of Gametes and Embryos

Compared to other human body cells, human gametes have a unique status because only gametes have the
reproductive ability to produce a new human life. They also carry an individual’s heritage. The earliest
developmental stage of human life is the embryo. Embryos are created upon the union of the sperm and egg,
which form a genetically unique individual. A common controversial issue is when an embryo is considered a
human being and when it acquires moral status (Adelaide Centre for Bioethics and Culture, n.d.-a).

Due to modern technologies, human embryos can be developed outside of the human body. This opens the
possibilities of screening for genetic conditions as well as a number of ethical issues and decisions. Human
embryos can now be screened, discarded, frozen, stored, and used for research and training (Adelaide Centre
for Bioethics and Culture, n.d.-a). The moral questions arise from what should and should not be done with
human embryos.

Reproductive Technologies

Twelve months of actively trying to conceive and being unable to conceive is clinically accepted as infertility.
When a couple is infertile and wants a child, often they will devote a large amount of resources and effort to
have a biological child. Assisted reproductive technologies (ART) are medical interventions to help improve
the chances of human conception for an infertile couple (Adelaide Centre for Bioethics and Culture, n.d.-b).
According to the Centers for Disease Control and Prevention (n.d.), ART includes fertility treatments where
eggs and embryos are used. This typically involves surgical procedures that remove oocytes (eggs) from a
woman’s ovaries and combine them with sperm in a laboratory, then return the fertilized egg or eggs to a
women’s body. ART also enables children to be conceived who may not have any genetic relationship to one
or both of their parents (Adelaide Centre for Bioethics and Culture, n.d.-b).

The terms associated with ART that you should be familiar with are the following.

• Artificial insemination: the unnatural insertion of semen into the oviduct or uterus;
• In vitro fertilization (IVF): using a test tube or laboratory dish to fertilize an egg;
• Gamete intra-fallopian transfer: by the means of laparoscope, an egg is obtained from an ovary,

combined with sperm, and inserted into a fallopian tube (Merriam-Webster, n.d.);
• Gestational surrogacy: the action of a woman being a surrogate mother;
• Gamete donation: the donation of sperm or eggs for others to use (American Medical Association,

n.d.);
• Sex selection: the selection of the gender of a future child using preimplantation technologies (Ethics

Committee of the American Society for Reproductive Medicine, 2015);
• Pre-implantation genetic diagnosis: a procedure conducted prior to implantation that can identify

genetic defects in embryos (American Pregnancy Association, 2012).

Reproductive technologies can create ambiguity about how a person sees the nature of an embryo. If an ART
involves a donor (see text below), then the donor abdicates their future responsibilities for their reproductive
acts that enable the birth of their own biological children (Morrison & Furlong, 2019).

Other reproductive ethical issues include the proper use of genetic diagnostic screening that is done pre-
implantation into the women; storage, use, and destruction of unused IVF embryos; and research that
includes the involvement of embryos. A main issue in ART surrounds the creation and destruction of embryos
for research purposes. Bioethicists contribute to evaluations and ethical and moral guidelines of new
techniques and technologies that involve ART (Adelaide Centre for Bioethics and Culture, n.d.-b).

HCA 3302, Critical Issues in Health Care 3

UNIT x STUDY GUIDE
Title

From the ethical principles discussed in Unit I, the ethical principles of justice and fairness are ones to
consider in regard to reproductive technologies. Additional ethical concerns regarding reproductive
technology are justice, fairness, and the exposure of risks to the fetus. Additionally, many people believe that
the use of reproductive technology is an individual choice that should not be regulated by the government.

Surrogacy

Surrogacy may be an option for infertile couples who want to have a child. In the mid-1970s, the first legal
surrogacy agreement was passed, and in the United States in 1980, the first paid traditional surrogacy was
done. The first successful egg donation pregnancy occurred in Australia in 1983, and the first gestational
surrogacy occurred in the United States in 1985 (Barry, 2011; Modern Family Surrogacy Center, n.d.).

Surrogacy contracts should be used and developed with caution. A surrogate mother has the obligation to
protect the life that may result from the surrogate pregnancy as well as fiduciary duties. However, if the
surrogate mother’s life is in jeopardy, she may retain the legal right to elect abortion. Several court cases
have dealt with surrogate contract disagreements as well as with surrogate mothers who do not cut ties with
the child after birth.

Donors

Individuals can donate sperm, embryos, eggs, or gestation wombs as part of collaborative reproduction.
There is a market for each of these items as brokers, clinics, and individuals advertise and sell these in a very
competitive market (Morrison & Furlong, 2019). Brokers have physical catalogs of donor profiles that
individuals can read to select a donor. As infertility has increased, the use of infertility clinics and ARTs has
grown to a multibillion-dollar business. A moral issue arises when an individual chooses to donate an egg,
sperm, and other biological matter, so the individual is not merely a donor but is selling genetic and bodily
resources. There has been little analysis as to the psychology and morality of the donors and what he or she
is doing (Morrison & Furlong, 2019).

Storage

Used in livestock industries, laboratory animal breeding, the conservation of endangered species, genetic
conservation, and now for human medical practice, sperm and embryos can be frozen for later use (Trounson
& Dawson, 1996). The freezing of sperm is a safe and effective way to use sperm for later insemination. The
freezing of sperm for conception at a later time is an option for male individuals who may have to undergo a
medical treatment that may make them infertile. For women, embryos can be frozen and used for in vitro
fertilization to help improve the chances of conception or to conceive at a later time. The freezing of human
embryos has brought about new ethical dilemmas regarding use or misuse. Individuals who participate in the
freezing of sperm or embryos may forget about, ignore, or not care about the frozen specimens, which leave
medical teams in a legal predicament as to what to do with the specimens. Sperm, oocytes (eggs), and
embryos can be donated for use by other human beings, destroyed by choice of the donor, or donated to
research. Further, legal disputes can develop in cases of divorce, separation, or death (Trounson & Dawson,
1996).

Conclusion

Along with natural conception, assisted reproductive technologies are part of the landscape of the creation of
human beings in this century. Assisted reproductive technologies and each component that goes along with
the technology (embryo, gametes, sperm, etc.) complicate the moral community as the reproductive
technologies call for moral and ethical decisions to be made. Scientific knowledge has bought about new
techniques and technologies to assist with infertility dysfunctions, but along with these techniques and
technologies, also comes an ethical assessment (Morrison & Furlong, 2019).

References

Adelaide Centre for Bioethics and Culture. (n.d.-a). Human embryos and gametes.
http://www.bioethics.org.au/Resources/Resource%20Topics/Human%20Embryos%20and%20Gamet
es.html

HCA 3302, Critical Issues in Health Care 4

UNIT x STUDY GUIDE
Title

Adelaide Centre for Bioethics and Culture. (n.d.-b). Reproductive technology.

http://www.bioethics.org.au/Resources/Resource%20Topics/Reproductive%20Technology.html

American Medical Association. (n.d.). Gamete donation. https://www.ama-assn.org/delivering-

care/ethics/gamete-donation

American Pregnancy Association. (2012). Preimplantation genetic diagnosis: PGD.

https://americanpregnancy.org/infertility/preimplantation-genetic-diagnosis/

Barry, V. (2011). Bioethics in a cultural context: Philosophy, religion, history, politics. Cengage.

Centers for Disease Control and Prevention. (n.d.). What is assisted reproductive technology?

https://www.cdc.gov/art/whatis.html

Ethics Committee of the American Society for Reproductive Medicine. (2015). Use of reproductive technology

for sex selection for nonmedical reasons. Fertility and Sterility, 103(6), 1418–1422.

Merriam-Webster. (n.d.). Merriam-Webster.com dictionary. https://www.merriam-

webster.com/dictionary/gamete%20intrafallopian%20transfer

Modern Family Surrogacy Center. (n.d.). The history of surrogacy.

https://www.modernfamilysurrogacy.com/the-history-of-surrogacy

Morrison, E. E., & Furlong, B. (Eds.). (2014). Health care ethics: Critical issues for the 21st century (3rd ed.).

Jones & Bartlett Learning.

Morrison, E. E., & Furlong, B. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (4th ed.).

Jones & Bartlett Learning.

Trounson, A., & Dawson, K. (1996). Storage and disposal of embryos and gametes. British Medical Journal,

313(7048), 1–2.

  • Course Learning Outcomes for Unit II
  • Required Unit Resources
  • Unit Lesson
    • Key Terms
    • The Moral Status of Gametes and Embryos
    • Reproductive Technologies
    • Surrogacy
    • Donors
    • Storage
    • Conclusion
    • References

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