Batt,Nicole Midterm Assignment

To whom it may concern:

Before I begin, I would like to introduce myself and provide information about my background, both professionally and religiously. First of all, I am a doctor, a FEMALE doctor. I personally want what is best for my patients, and I want nothing more than to reduce a person’s discomfort in the safest way possible. Secondly, I identify as a Roman Catholic. While I do skip some Sundays and in no way claim to be the most “devout” Catholic in the Church, I do resonate with a majority of Catholic beliefs. That being said, after attending a college where the majority of my peers were Jewish and spending time over seas experiencing new cultures, I have become very open minded and accepting to other religious practices, and I have spent a lot of time observing their role in medicine. Due to the diversity in beliefs I have been exposed to, I have definitely struggled with addressing the ethical issues presented to me while being a part of this committee. This is mainly because I value practices and ideas in both Catholicism and other religions, such as Judaism and Hinduism. I hope that what I have to say next will be taken into consideration with respect and an open mind.

This hospital, which was initially under Catholic influence, now has the opportunity to introduce the procedure of abortion. While abortion is a very controversial topic, we—as a hospital—must respect all views and beliefs in the growing community and consider permitting the procedure in the hospital. I personally do not align with the pro-choice movement, as I am Catholic and this procedure goes against my moral belief of “right to life from the moment of conception.” I am also aware that other religions have similar moral beliefs as Catholics do, such as the Hindu belief that people should “do no harm” to other people (Bhattacharyya, 2006). However, abortions are in fact legal in the United States, and we should be providing the service to whoever may need it, regardless of their or our own religious practices. With that said, there are several religions that are more flexible with the idea of abortion and see it as permissible as long as it violates no other “moral code” in the religion.

I find it important to note that we are essentially the only hospital in this community, and it is necessary for us as humans to help the people within our diverse community. In order to do this, we must set aside our religious differences and embrace a utilitarian approach, where we put our community first and our beliefs second. We cannot expect our community to grow and prosper without being accepting and accommodating to others. Prohibiting the procedure of abortion may drive away many of the people in this community, as they may seek protection and help from a more cooperative hospital in another town if we do not.

Now, let us address the under-insured patients. My personal belief is that we should subsidize abortion; however, I can see the problem with providing funding for every abortion. Unfortunately, it is seen that one-third of abortions are repeat abortions. Therefore, my proposition is that we should not subsidize more than ONE abortion per patient. As a catholic and a mother, I would like to our community members to practice safe sex and/or abstinence until they are ready to bear and take care of the child. By subsidizing only one abortion, we will be able to avoid these repeat abortions as well as promote safer sexual habits in our community. After attending University and after I had finished my time abroad, I realized that a majority of people explained that life begins 40 days after conception, not at the start of conception. With this in mind and looking beyond the laws of Catholicism, we can allow for abortions to take place ONLY within a certain time frame. This guideline should accommodate most religious practices.

In regards to our doctors, we should NOT openly suggest abortion as an option to patients. While we should allow abortion to be an option, we should not necessarily advertise it. Advertising such a controversial procedure may drive away some patients that are pro-life, such as our large Catholic group. Our first goal is to respect the patient’s request, and if that request is abortion, then we must honor that request without judgment. However, our second goal is to minimize the number of abortion procedures we conduct. Our doctors should suggest alternative solutions, such as adoption or following through with the pregnancy. Perhaps introducing a policy that supports a pregnant woman considering adoption could aid in reducing the amount of abortions that occur.

As I mentioned, I struggle with the idea of abortion as a Catholic; however, I fully support prenatal testing, so long as it “respects the life and integrity of the embryo and the human fetus.” My belief is “directed toward safeguarding or healing,” and I do think prenatal testing can be extremely beneficial, as doctors can catch or be aware of disease before it becomes fatal (Shanon, 1988). This procedure, amniocentesis, can prove to be stressful for many women, so I suggest again that we do not advertise it. If a woman requests it, then we should perform the procedure; however, plenty of woman have gone through pregnancy without prenatal testing and have given birth to perfectly healthy babies. Thus, unless the woman expresses concern, our doctors should not promote it. With the integration of prenatal testing, we can appeal to our Jewish patients, who are typically concerned with “geneticism” and strongly favor genetic testing (Ivry, 2009). At the same time, we can appeal to our Japanese patients, who rarely request amniocentesis, by not promoting or suggesting the procedure to them. This creates a “no pressure” environment that patients can feel comfortable in, whether they favor genetic testing or not (Ivry, 2009). I’m sure the next concern with this is about how the results of the prenatal testing will affect the rate of abortion. While many people may argue that knowing test results will increase abortion rate, I believe that if we stay true to the idea of “limited advertisement” of abortion and prenatal testing, then there will not necessarily be a spike in abortion. The reverse situation may even occur, where a woman realizes her baby would be perfectly healthy, and then refrains from aborting it.

Another topic of concern is assisted reproductive technology, namely in-vitro fertilization. I typically diverge from the Catholic view towards IVF, as I support it while the Church does not. This is because I resonate with women and their desire to have children. I believe it is important that we, as doctors, give any woman the ability to have a child. The Church states that “it is a gift” to have a child, and if a woman is infertile then “God has a different plan” for her. However, being a mother has given me the opportunity to realize how important and special it is to bear a child, and I want to be able to help an infertile woman experience it. If this hospital allows IVF to occur, we can appeal to many members of our community. For example, Jewish women strongly support IVF because they feel that they need a child to be accepted into society (Kahn, 2000). Another example is in the Shi’ite community, where women are willing to break bonds with their own religion in order to have a child (Clarke, 2007). Therefore, I will make the point again that we should attempt to be more accommodating to other religions other than Catholicism. Permitting IVF can result in growth in the community in terms of population and diversity, not to mention many more women may be happy with families.

In order to support the women that desire IVF, we should encourage other women to donate embryos. I don’t see this as controversial of a topic as abortion, amniocentesis or genetic testing because there doesn’t seem to be any life-threatening consequences from it, and I don’t particularly see women being opposed to or offended by it. Therefore, I think it could be beneficial to promote embryo donations, which could not only provide another woman the chance to have a child, but could also allow for more research to be conducted within the hospital. Selfishly, I think this could also be a great opportunity for the hospital to gain recognition if we are able to produce new and exciting research from these embryos. Holistically, I do not necessarily see a down side to embryo donation and the advertisement of it, but if you feel that there is a problem with it then I would love to hear your opinion on it and see how we could work out a solution.

I am well aware that this hospital holds a strong tie to Catholicism, and moving away from Catholic views may upset staff and community members. Since I am Catholic myself, I would still love to incorporate the religion into the hospital in some way. I think the best way to do this is to keep the Catholic Clergy for counseling. I have learned that healing and religion go hand in hand, and while these patients are undergoing stressful procedures they need something to keep their mental health in tact. By having a patient meet with a religious counselor, they may gain new knowledge of their faith or of a new faith that can help them make their decision more confidently. Meeting with a religious counselor, either Catholic or non-Catholic, can also simply provide the patients with hope. As a doctor, I have come to realize that patients simply desire hope through a dark time, and to know they are in the hands of a non-judgmental and supportive system. I believe keeping counseling within the hospital will provide that support and guidance that is needed by many. This also allows the doctors to remain focused on just the procedure at hand, as the counselors can take on the more spiritual-support role.

If and when we allow all of these procedures to be available at this hospital, there follows a concern involving our staff and whether or not they agree with the decision. We are bound to have nurses and doctors that differ in opinion, and it is important that we address it. The only solution I have for this, given we have a limited budget, is to expose these nurses to new cultures and practices. I became open minded after being around people with different beliefs than myself, and if we can simulate that environment in this hospital then perhaps our staff will also become more secular. If you have suggestions of ways to do this, I would love to discuss them further with you. In the meantime, we would have to assign staff members that are able to put religious differences aside in order to perform the procedure at hand. As stated earlier, I do not think abortion/amniocentesis rates will increase much if we do not advertise them, and I do not think we would lose staff members to this switch.

Finally, I will reiterate the most important points I have made. We are a growing community that is becoming more and more culturally diverse. In order to provide proper care for all of our patients, we need to be aware of the differences in beliefs and acknowledge them. We are a hospital and our main purpose is to serve and heal any person that needs it, regardless of their upbringing, religion, culture, or social class. We should pressure no one into any procedure, and we should be sure to provide ALL information to patients about any procedure they wish to go through. The staff may practice their own beliefs freely, but may not force their beliefs on other staff or their patients. My hope is that allowing these procedures to be available will create an atmosphere of “culturally competent” staff and extremely hopeful patients (Bhattacharyya, 2006).