Midterm – Lina Du

Policy Proposal Regarding Reproductive Technologies and Prenatal Testing in Sasquatch Community Hospital

 

Proposer Background: I am a 50-year-old Protestant Japanese American who immigrated to the U.S. at the age of 22. During my years in the U.S., I have become a proud mother of two children and have worked as a nurse practitioner. Having watched Sasquatch Community Hospital (SCH) grow from a small clinic to a major hospital in the State and from Catholic affiliation to non-denominational during my fifteen years of working here, I truly regard SCH as my second home.

 

Over the last few decades, Sasquatch County Hospital (SCH) has committed to a professional and national system of healthcare. The mission of the hospital is to serve and provide equal access to all people despite religion, race, and class in the name of the Father. Adhering to our original purposes greatly, we have seen the transition of SCH to a non-denominational hospital subsidizing medical care to under-insured patients. With continuation to thrive for inclusive service, I therefore propose subsidies on abortion services, IVF treatments, prenatal testing for under-insured patients. Spiritual counseling should continue to be offered with Catholic clergy. In addition, literacy courses in pregnancy and pre-natal testing for patients and training on cultural competency for staff members ought to be offered.

 

Informing and providing abortion services and prenatal testing to under-insured patients will reduce stratified reproduction. Reproduction builds on one’s existing notions of “contingency” in contemporary America but it is stratified due to the variance in cultural, religious, and socioeconomic pressures on individuals. Consonant with the views from much scholarly research and models espoused by health professionals, the locus of control does not lie so exclusively in individual pregnant women; it is rather shaped by much larger socio-cultural forces. Implied by Tsipy Ivery in her research of pregnancy experiences in Israel and Japan, the power structures of the respective countries shape the schemes of “contingency” thinking upon individuals; with the “Gamburu”, or “make an effort” ideology embedded in the image of ethical self, Japanese women often bear the responsibilities of the babies’ nurturance to themselves. In contrast, the notion of selfhood and disabilities in the Israeli culture have led to their intimidation of reproductive catastrophe (Ivry 243). Similarly shaped by the socio-cultural hierarchies, the majority of women in U.S. described by Rapp are usually informed by biomedical statistics and utilize biomedical technologies to evaluate their risks (Rapp 317). However, the under-insured patients in Sasquatch county may not be well-informed of all the possibilities and risks pertaining to pregnancy due to their socioeconomic backgrounds. Although the hierarchy of information may vary across cultures in regards to pregnancy, we as a nationally renounced hospital ought to provide the patients with universally competent prenatal care in order to reduce the noted stratified reproduction based on socioeconomic backgrounds. A crucial step to reduce stratified reproduction is to offer information as well as access to pre-natal testing to the entire community, allowing them to gain a scientific perspective on pre-natal testing and equal access to abortion services just as women who are insured do. Weekly pre-natal and IVF testing literacy classes could help women acquire equal access to reproductive information. Therefore, subsidies on abortion services as well as pre-natal testing, and inclusion of relevant classes for the under-insured will help them gain equal access to reproductive information and make the most informed choices despite their financial situation.

 

In-vitro fertilization (IVF) should also be provided for under-insured female patients. Despite the diverse religious and cultural notions in Sasquatch county, the choice for women to bear children is shared among different backgrounds. If physical conditions prohibit women from bearing children, IVF could provide them with the opportunity of motherhood. The population in Sasquatch county consists of an Irish, Jewish, a mixed white and African American population, with growing influx of Lebanese Shitte and Japnaese immigrants. According to the Protestant and Catholic understanding of the Genesis, the purpose of women is to “reduce and multiply.” Similarly, reproduction is viewed as a “imperative religious duty” and even “honor and prestige of the family” in the Jewish view (Kahn 4 & 44). The African American cultures tend to view pregnancy as a blessing (Seeman 36) and in the Japanese culture, women highly pride themselves for nurturance of children. Besides, the varying political views of pro-life and pro-choice activists even consent upon the manifestation of feminist power in pregnancy. As pro-choice activists view pregnancy as a right for women, pro-life activists view pregnancy as an indispensable responsibility differentiating women from men (Ginsburg 216). No cultural forces and political structures oppose or limit the natural desire of women to bear children, so nor should socioeconomic status. Equal access to IVF is necessary as it will largely benefit Sasquatch county’s under-insured population. Therefore, subsidies on IVF treatments to the under-insured should be offered as well.

 

Nevertheless, the encouragement of embryonic donation for scientific research should be prohibited. The choice of pregnancy, IVF treatments, prenatal testing, and abortion concerns the mother of the child greatly. In these cases, the mother bears the responsibilities for reproduction as well as the quality of life the child would have; therefore, they have the right to make choices in terms of their and the child’s interests. However, the decision of donating the embryo to research does not pertain to the interest of the mother at all. Instead, only the rights of the embryo ought to be considered in this case. According to Donum Vitae and other Christian scriptures, “the moment of life begins upon conception.” There is no justification for encouraging one to make the decision for another person on terminating their life. In the book A Defense on Abortion, Thomson uses the analogy of one sustaining the life of a violinist by letting him use one’s kidney as a description of mother bearing a child. He argues that not providing the violinist with the kidneys is self-centered but not unjust as the violinist originally does not have the right to use it (Thomson 61). Similarly, if you decide to no longer sustain the life of the violinist, you do not have the right to determine how he ends his life either. The child has the right to her or his own life; when their lives no longer pertains to the mother’s interest, the mother does not have the right to choose for them. Therefore, encouraging embryonic donation is unjust and should be prohibited.

 

In order to reflect the Catholic Origin of Sasquatch Community Hospital, spiritual counseling should be continued but reduced to one Catholic clergyman. No additional counseling of other religions should be allowed since it is necessary to reduce reproduction stratification in the hospital through limitation of religious factors. As mentioned previously, our job as the hospital is to provide patients with equal information and access of reproduction strategies and technologies despite the other sociocultural contingencies that may be imposed upon the women. Thus, classes on assisted reproductive technologies and late term genetic testing will be offered freely to all patients once a week. The two-hour-course would not only improve the understandings of patients towards their potential reproductive options, but also equip them with the resources to make more informed reproductive decisions. Not only so, as some medical staff have and will continue to complain about the Catholic Clergy interfering with their work by opposing assisted reproductive technologies, the classes will allow the medical staff to express their professional opinion. As long as both sides have equal opportunities to express their views, the woman will be more empowered with her decision, no matter what she will choose. The class material, however, should be reviewed by the committee every month in order to prevent the transmission of biased statistical information or inappropriate messages.

 

Due to their Catholic affiliation, some nursing staff would likely be unwilling to perform the procedures of abortion and reproductive services. It is thus crucial to provide the nursing staff with necessary training to develop their cultural competency and reinforce their jobs as healthcare providers acting only on behalf of patients instead of personal beliefs. Therefore, training to improve the understandings of different local cultures and religions ought to be provided for the staff every month. With more appreciation of the distinctive socio-cultural forces effecting pregnancy, nursing staff may become more open-minded to the local population they are serving. If one insists upon no provision of abortion and reproductive services, she or he may choose to leave the obstetrics – gynecology department or leave the hospital. Other nursing staff from other departments of the hospital could replace the leaving staff member. Further hiring or replacement of staff members ought to reflect the mission of equal service and the commitment to Sasquatch county’s diverse population.

 

Dedication to reduce socioeconomically stratified healthcare, protection to the right of women and children, and commitment to serve our culturally diverse population have been reflected in Sasquatch Community Hospital’s past. With thoughtful consideration and careful implementation of the the above proposed actions, I believe that Sasquatch Community Hospital will continue to thrive on the path of serving the local population. Continuation of excellent service will thus attract an increasing number of potential donors from other religious and cultural backgrounds and more funding from local agencies and state government may be granted in the future.

 

Work Cited

1. 1. Book of Genesis, chapters 1-2
   2. 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).
   3. Don Seeman, Iman Roushdy-Hammady Annie Hardison-Moody. “Blessing Unplanned Pregnancy: Religion and the Discourse of Women’s Agency in Public Health.” Medicine, Anthropology, Theory3 (2016): 29-54.
   4. Faye Ginsburg, Contested Lives: The Abortion Debate in an American Community(University of California Press, 1989).
   5. Judith Jarvis Thompson, “A Defense of Abortion.” Philosophy and Public Affairs1 (1971): 47-66. Tsipy Ivry, Embodying Culture: Pregnancy in Japan and Israel(Rutgers University Press, 2009).
   6. Rayna Rapp, Testing Women, Testing the Fetus(Routledge, 2000).
   7. Susan Martha Kahn, Reproducing Jews: A Cultural Account of Assisted Conception in Israel(Duke University Press, 2000).