Central Lee Hospital Ethics Committee Policy Proposal on Assisted Reproductive Technologies
Introduction
For many years, Central Lee Hospital has been a cornerstone of wellness in the community of Sasquatch Connecticut, providing high-quality, comprehensive healthcare to those in need regardless to race, color, national origin or citizenship status, sex, gender identity or expression, pregnancy, sexual orientation, age, disability or military status. Even though we were under Catholic auspices for many years, we have decided to allow the hospital to become non-denominational, and subsidize medical care for under-insured patients.
With the increase in the population and diversity in our community in addition to the fast advancement in new technologies, we felt that there is a need to form a new policy regarding the use of assisted reproductive technologies in our hospital. As a member of the ethics committee at the Central Lee Hospital, I, Saeyoung Lee, was assigned to introduce a new policy proposal that addresses the use of assisted reproductive technologies. Before I begin, I want to emphasize that this is a proposal that makes the hospital as helpful as possible to all of our patients, regardless of my race or religious belief. However, in order keep what is the best for the hospital, we must not forget our Catholic origins.
Abortion Policy
First, our hospital should NOT provide any abortion services. Due to our Catholic origins and many of our important donors being Catholics, our ethics committee agrees that “the human being must be respected, as a person, from the very first instant of his existence” (Vitae). In addition, we must note that human life must be absolutely respected and protected from the moment of conception (Vitae). Therefore, I wish to share the goal of recriminalizing abortion, but also sees abortion as symptomatic of other social problems. In particular, I am concerned that materialism and narcissism are displacing nurturant ties of kin and community (Ginsburg, 1989). Thus, the Donum Vitaedoctrinal reminder provides the fundamental criterion for the solution of abortion, thus we should not promote nor provide any abortion services.
However, we understand that there are many patients who request abortions for valid reasons. Therefore, we will be implementing a special referral services for those who desperately desire abortions. In order to get a special referral, patient will only have to inform her OB-GYN. Then, the specialist will send a referral to the closest hospital (Hope Connecticut Hospital) that performs many different assisted reproductive technologies including abortions for the patient to be seen. Please note that this alternative hospital is within two hour drive from our community of Sasquatch Connecticut.
IVF Treatments and Prenatal Testing Policies
Even though our hospital ought to reflect its Catholic origins, we understand that there has been many advanced technology and cultural shifts worldwide, including in our community. For example, most recently, we have seen some population diversities in our community. In addition to the dominant Irish Catholic population, the local area is also home to a small but vibrant Jewish community, a mixed white and African American (non-Irish Catholic) community, and a growing influx of Lebanese Shiite and Japanese immigrants. In order to cope with these changes, our hospital needs to open its doors to different religious perspectives slowly, but step-by-step. Therefore, in addition to becoming non-denominational, we should accommodate to services such as IVF treatments, and prenatal testing including amniocentesis to those in the unity of marriage and for a reason. However, we must make it clear that these services will only be provided after cautious evaluations from our reproductive health professionals with clinical disciplinary perspectives.
Development of the practice of in vitro fertilization has required innumerable fertilizations and destructions of human embryos. Even though our Catholic church still thinks the embryos obtained in vitro are human beings and we should not cause harm to life or integrity of the unborn child, through a careful consideration, I want to put more weight on the fact that every married couple has a right to become a father and a mother. Therefore, a child is a gift and blessing of God, and a confirmation and completion of their reciprocal self-giving. Unused embryos collected from IVF treatments should not be donated or used as scientific materials for any type of research because such experiment will cause harm or death without a potential of becoming the fruit of marriage.
Next, Prenatal testing including amniocentesis should be provided only if prenatal diagnosis respects the life and integrity of the embryo and the human fetus and is directed toward its safeguarding or healing as an individual (Vitae). With that said, this testing should not be performed when it is done with the thought of possibly inducing an abortion depending upon the results such as malformation or a hereditary illness which are not equivalent of a death sentence. Such diagnosis is only to know the condition of the embryo and the fetus, and to make it possible to anticipate earlier and more effective medical and surgical procedures for better outcome of birth.
Spiritual Counseling Policy
Patients consider spiritual and physical health to be of equal importance and recognize that spiritual needs may increase during illness. With the increase in population and diversity around our community, we decided to provide clergies of other religious communities such as Jewish, Shia Islamic, and Buddhist clergies in addition to social workers and genetic counselors. Furthermore, we should hire new reproductive health professionals including doctors and nurses with different religious perspectives to limit any religious interferences conflicting patients and medical staff’s decision making. These new additions to our hospital will make sure that all of our patients are receiving the best medical care regardless of their status. However, our staff and new hires should agree upon our policies of assisted reproductive technologies during the contract renewals and hiring processes. Those who make accommodations outside of our policy will be terminated.
Conclusion
As we all know, due to our Catholic origins, we still are predominantly funded and run by Catholics. The possibility that the hospital will now provide reproductive services has alarmed some of the hospital’s funders and its historically Catholic nursing staff. As a member of ethics committee, I strongly oppose against forcing anyone to perform any tasks against their religious beliefs. Therefore, I think our Catholic nurses should not have to perform any procedures related to assisted reproductive technologies. Some of our Catholic nurses should be able to transfer to other departments such as Cardiology and Endocrinology. In order to fill in the gap, we should ask if any nurses from other department to voluntarily transfer over to the Reproductive Health Department.
Hopefully these new changes in policies will expose individuals to different cultural and religious beliefs and practices. In addition, we will have the opportunity to broaden our own perspectives, thus enriching our stock of conceptual and axiological resources from which to draw when making difficult decisions for ourselves (Bhattacharya, 2006).
Works Cited:
Donum Vitae In Shanon, Thomas A. and Lisa Sowle Cahill, Religion and Artificial Reproduction: AnInquiry into the Vatican “Instruction on Respect for Human Life in its Origin and on the Dignity of Reproduction.”(Crossroad, 1988).
Faye Ginsburg, Contested Lives: The Abortion Debate in an American Community(University of California Press, 1989).
Swasti Bhattacharya, Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology(Suny University Press, 2006).
I will comment.
Hello Saeyoung,
Great work with your proposal! Your writing style is clear, concise, and direct. I appreciate the way you divided your proposal into various subheadings; this truly helps the reader follow your direction and train of thought.
In your introduction, you establish right away the vantage point of your proposal: clearly, your approach to addressing the concerns at Central Lee Hospital involves an air of inclusivity and openness to people of all faiths and walks of life in the community. The hospital’s decision to become non-denominational was interwoven quite nicely in the proposal, as these could very well be examples of how the hospital has already taken steps towards inclusivity in Sasquatch’s community. But, I did notice some inconsistencies in where you have chosen to be inclusive and where you have not. Of course, it is perfectly acceptable to have varying stances on these serious issues. However, it is important to adequately flesh out why you have reasoned this way
In your second paragraph, you mention that you want to emphasize inclusivity regardless of “race of religious belief”, however in the subsequent sentence you mention that you also do not want to disregard the hospital’s Catholic origins. To this, I ask: how can Central Lee Hospital honor its Catholic religious values while still being inclusive of new faiths and Sasquatch’s newly diversifying population? I personally see the hospital’s move to become nondenominational as a way to move away from the antiquated traditions that have held our community stagnant in the way of progress in the modern world.
I see this conflict between progress and tradition as particularly evident in your section regarding abortion. You mention wanting to be inclusive but then proceed to place a stamp on disapproval on abortion, yet you are willing to send patients to undergo abortions- only if it isn’t on your property. The referral service may not work for all patients needing to end their pregnancy- how will insurance cover the costs of the procedure if you are sending patients away to a hospital that is nearly a two-hour drive away from Sasquatch? Most people who need affordable care are on health plans that are very limited in their choice of in-network doctors. I cannot speak for all people, but most other citizens of sasquatch have voiced that they would not be able to make that two-hour drive, let alone miss work to account for the four hours of driving. Having to undergo this procedure is tough as it is and physically taxing on the body. Additionally, the drive may not even be physically possible for those who have just undergone the procedure.
As a matter of fine tuning your proposal in order to gain more credibility and establish yourself as an effective arguer, please make sure to be careful of how you refer back to certain sources. For instance, in your section on abortion policy you cite Donum Vitae as “(Vitae).” My understanding is that Donum Vitae is a very important, and honored decree of Catholic ethics and morality. Your proposal would gain persuasive strength by highlighting and playing up the source to which you refer here in your proposal. Maybe explain a bit on what this document is and what it means for devout Catholics like yourself? Your reasoning for not allowing abortion as Central Lee may also be strengthened by mirroring the same logic presented in Donum Vitae. In other words, you should go in to a little bit more as to why abortion should not be permitted; why should the fetus be respected? From what I recall, Donum Vitae states that the embryo is afforded the status of personhood on the basis that because the human embryo will become human, and human alone, it must be treated with the utmost respect, just as any person would be treated (Donum Vitae 147).
In the section on IVF treatments I would change your wording a bit to make it sound more direct: perhaps change “…our Catholic church still thinks…” to “the Catholic church states…” or “the Catholic church stands by its decision to…” or even “the Catholic church still stands in opposition to…” It would also be helpful to include more citations to support your assertions in the IVF section of your proposal. Is your decision to allow only married couples the privilege of using IVF a choice based on Donum Vitae? If so, please include a reference here. Here are two great quotes for this: “Respect for the unity of marriage and for conjugal fidelity demands that the child be conceived in marriage; the bond existing between husband and wife accords the spouses, in an objective and inalienable manner, the exclusive right to become father and mother solely through each other,” and “… from the moral point of view a truly responsible procreation vis-à-vis the unborn child must be the fruit of marriage” (Donum vitae 157). Fertility treatments may only be used in the context of a married couple; using IVF in any other context would, according to the Catholic church, deprive “him [the fetus/embryo] of his filial relationship with his parental origins and can hinder the maturing of his personal identity” (Donum Vitae 157-159).
With these points said, I would like to thank you for your proposal, Saeyoung. Although our views may not align entirely, I believe your words have sparked a significant conversation that is crucial to the advancement of our great town of Sasquatch, Connecticut.
Sincerely,
Anonymous concerned (and very liberal) citizen of Sasquatch
Dear Saeyoung amd Ibel,
Thanks to you both. Let me start with Saeyoung.
This is a very well-written statement and I appreciate the care you have taken. The only obvious language problem that jumped out at me was your statement near the end that you “oppose against forcing anybody…”. You can be opposed to or you can be against, but I do not think you can oppose against. Please reword this.
I agree with Ibel that you need to cite more of the readings and in greater detail to support your claim. Donum Vitae is one example, but I also think you need to relate to our other readings on assisted reproductive technologies and the nature of bioethics. What you have here is good, but insufficient.
Finally and most substantially, I notice some inconsistency in your approach that needs to be accounted for. Thus, you say that you have chosen to become non-denominational in order to provide service to a wide variety of people, but if your policies adhere closely to Catholic Church policy, what have you accomplished? Presumably the hospital was also happy to treat people of all persuasions when it was under Catholic auspices. Aren’t you trying to have it both ways at once?
It was courageous for you to suggest that your hospital will not perform abortions, given your beliefs. But then how do you reconcile IVF treatments, which certainly create embryos that will not be used or implanted? You mention that you are against using them for experimental purposes but then what should become of them? And if they are discarded, no matter how respectfully, doesn’t think indeed amount to abortion of those embryos? A non-Catholic position might have an answer to that question, but I think this puts you at odds with Donum Vitae despite your stated effort to respect the teachings of the Church. This is something you will need to address more directly in the final.
I thought the idea of a referral service is intriguing. People like your respondent may object, but it does show a good faith attempt to help people get the services they desire even if you will not provide them. This will still leave you a target of anti-abortion advocates however. Also, I’d like you to consider what you would say if federal funding to your hospital were at risk because of your refusal to provide all standard contemporary reproductive services?
This is in any case a very good start– you have some work to do in expanding it for the final, so it may be worthwhile to start thinking about it now. This is the first paper I have read, and I want to read a few more before assigning it a grade.
Finally Ibel, I found your [anonymous response] well-written and effective. All of your points are well-taken. But do you really think that an anonymous, very liberal citizen of Saskwatch would be so calm and welcoming to a decision to remove the local hospital from abortion provisions? This seems a little far-fetched to me. Still, full credit for your response.
best,
Don Seeman
Oh Saeyoung, one more thing I forgot to point out. You mention that you are in favor of re-criminalizing abortion, yet you are willing to provide referrals and even conduct IVF treatments that will lead to the destruction of embryos? This feels like another logical contradiction you need to address.
It will be helpful if, in addition to stating your opinions, you also imagine what some objections to your position will be and try to address them.