The ethical concerns

The respectable concerns that I realise related to this dilemma be many. What is the readys responsibility to try to stop the mothers contractions? What are the limits of the attempts that should be made to save the barbarian? Should the mother be intromited to danger her own manners to attempt to save the spiritedness of a claw that is believably not operable outside the uterus? Should the doctor plan a cesarean separate despite the fact that the infant volition probably die as soon as it is take from the mothers womb? I bottomt imagine making this decision soulally, exclusively many mothers are forced to soak up it all(prenominal) day. Here is the situation that lead to my ethical quandary.I have a patient who is 3 week punt partum and has had premature rupture of membranes. This condition could cause hemorrhaging for her and death of the infant in uterus. In laymans terms, both she and the infant are at risk of death. She is starting to contract and the phys ician will not do anything since the fetus is not considered viable. The physician has described the issues of having a vaginal birth versus a cesarean section with this patient because the fetus is breech. The patient wants everything to be done to save this baby. As described above, the issues are exceedingly complex. The physician appears to have charmd that the child is a lost cause and is sound offing further of the health of the mother, but this is opposed to her wishes. Should the mothers desire to save her child be allowed to turn back her own survival instincts? And, what role, if any, should the childs father have in decision-making process?My literature play along for this situation was amazingly frustrating. I expected there to be a great deal of plain materials available regarding this topic. It is, in essence, the quintessential ethical debate do you save the breeding of the mother or the life of the child? And, there is the question of the doctors ethics. Shou ld he be able to contain the best medical course of action if it is contrary to the mothers wishes? And, who fancys when a fetus is viable? Can we allow it to be based on an arbitrary date?I found a lot of older research regarding the ethics of abortion and approaching the discussion of fetal viability from that point of view, but there was nothing recent and nothing than dealt with miscarriages as opposed to abortion. And, there was nothing that talked about the discussion of the life of the mother versus the life of the child. I think this would clearly be a great do for additional study. I think specifically the ethical question of whether medical decisions should be made contrary to the patients wishes should also be considered.Right now, as a society, we allow a person to make their own decisions about their health care even though we do not allow them to determine when or how they die. What I did find were several articles regarding the mental trauma that miscarriage and s tillbirth inflict on the mother and an interesting article promoting the development of advanced leadings regarding pregnancy health care. Of all the articles, this is the one that I found most interesting and directly applicable to the situation at hand.In this article, Anita Caitlin proposes that obstetricians think outside the calamity and promote the development of advanced directives for prenatal and delivery care. The proposal is simple, just as a person can create a living will for care during a terminal illness or traumatic injury, a pregnant adult female would in her early weeks of pregnancy discuss in information with her doctor the potential things that could go wrong and develop a plan of action. For instance, a woman would try at the very beginning of the pregnancy what circumstances would lead to her decision for a cesarean section (Caitlin, 2005).This would eliminate the need to make the decision during a high stress time, since we can assume that such decision would cause stress, and at a time that the mothers mental and emotional area is impacted by the high levels of hormones associated with pregnancy. I understand that being able to hold a woman to the advanced directives would be impossible, but a woman could elect to rely on the already issued directive and not add the trauma of making a decision to an already stressful time. This would also allow the person to discuss the eventualities with those whom she believes have a right to have a say in her life instead of just those that the laws say have a right to assist with her decision-making (next of kin, when the patient is incapacitated).Another article that move my attention that I found in my literature review was a discussion about the ethical concerns some doctors have about making medical recommendations that are contrary to their own moral and ethical beliefs.A bring uping number of doctors, nurses, and pharmacies are refusing to take into account, refer, or even tell their patients about care options that they obtain are not in keeping with their own personal religious beliefs, stated Barbara Kavadias, Director of flying field Services at the Religious fusion and leader of the three-year project that created In Good Conscience. Institutions are refusing to provide essential care, citing their religious commitments. (Bioweek, 2007)This is a growing ethical panache in medical care that I have some major concerns with. Take, for instance, the case of my current patient. If she were (or is) being treated by a doctor who believes all life is sacred, he king be willing to risk the life of the mother in an hunting expedition to try to save the child. In this case, it is difficult to determine how a person with these moral concerns might treat the patient. Taking the child via c-section is probably the best for option to preserve the mothers life. It may result in the immediate death of the fetus. Waiting and trying to abate the mothers contractions ma y provide the child with a greater chance of survival, but also puts extra risk on the mothers life. At that point, what are the criteria used by those with this moral outlook to determine the proper course of action?These questions are likely to grow in controversy as technology increases and the fetus is increasingly viable outside of the womb. The more that society becomes able to keep a child alive without the benefit of the mother, the more questions regarding the ethics of doing so or not doing so will grow in prominence. It is absolutely possible that with increasing medical technology and the ability to prolong life we will have additional debates regarding who gets to determine what lives are worth saving and what lives are lost.I believe that a trend toward making informed decisions is a good one and a move in the right direction, taking people forward from having to make a decision in a crisis situation. I also think that it is worthwhile to discuss the role of the fat her in the decision-making process. Because of the trend toward increasing womens rights and in an effort to prevent a return to the days of the complete male dominance, society appears to be moving away from the rights of a souse to have a say in decisions that affect them.For example, the birth of a child is an 18-year (minimum) commitment for men as well and in an effort to secure the rights of women, we have completely removed the father from the decision-making process. As a human, I believe that ultimate control of a persons body should be his or her own, but it is also reasonable to believe that a spouse (or life partner) should have some say in the decision. In the case of m patient, I cannot believe that a loving partner would encourage her to risk her own life for the tiny chance to save a child which would already have been lost if not for technology.Works CitedCaitlin, Anita. Thinking Outside the Box Prenatal tutorship and the Call for a Prenatal Advance DirectiveJourna l of Perinatal & Neonatal Nursing. Frederick Apr-Jun 2005. Vol. 19, Iss. 2 pg. 169.Geller, Pamela A. judgement distress in the aftermath of miscarriage Network News. Washington Sep/Oct 2002. Vol. 27, Iss. 5 pg. 4.Klier, C. M. , P. A. Geller, J. B. Ritsher. Affective disorders in the aftermath of miscarriage A comprehensive review,Archives of Womens Mental Health. Wien Dec 2002. Vol. 5, Iss. 4 p. 129.Religious Coalition for Reproductive Choice Religious Leaders Call for New Efforts to Reverse Growing Imposition of sectarian Religious Beliefs on Reproductive and End-of-Life Care Biotech Week. Atlanta May 9, 2007. pg. 973