Zhang, Final (draft)

The Policy Proposal of Sasquatch Hospital

Introduction

As a member of the ethics committee at Sasquatch hospital, I intend to propose several new policies regarding the use of abortion services, assisted reproductive technologies, prenatal testing, the donation of unused embryos to research, the implementation of religious counselings, and the relocation the nursing staff. I am a 28 years-old Chinese woman who grows up in Virginia. Although I am an atheist physician who believes in the power of the modern medicine, I respect all religions and their practice. Our hospital was run for many years under Catholic auspices and supported by Catholic donors. These auspices influenced the provision of reproductive services because of the belief by the Catholic Church that “from the time that the ovum is fertilized, a new life begins” (Cahill et al 145). According to Catholic doctrine, the fetus is a human being from the moment of conception. Therefore, it is also Catholic belief that abortion is equivalent to murdering a new life. As a result, our hospital has never previously provided abortion services.

Abortion services

Although abortion is legal today under federal law, the prohibition of abortion by the Catholic Church has prevented our hospital from providing the procedure to our patients. Although there might be a religious backlash to the provision of abortion services, our goal as the largest hospital in the area should be to provide better and more comprehensive health care services to our patients. The religious beliefs of our patients “should not be seen as passive, as anti-science, or as constraints to medical treatment” (Hamdy 156), but rather as individual qualities that can be overcome through innovative treatments and convincing results. Due to our hospital’s recent religious transition to one of non-denominational practicing, the hospital is no longer subjected to the rules of the Catholic Church. Although the hospital would like to maintain its religious patients and donors, the hospital should begin to provide abortion services to patients who choose to use them. As supported in Thompson’s “A Defense of Abortion,” the hospital should support the right of choice for a woman going through a pregnancy and potentially an abortion. In his book, Thompson proposed a thought experiment involving an unconscious, famous violinist to explain her point (Thomson 48). The scenario is presented as such: you are the only person that can cure a famous violinist of his fatal kidney ailment, and because of that, the Society of Music Lovers kidnaps you and “plugs” you into the violinist. If you unplug yourself, the violinist will die. He uses this analogy as a description of the 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). I agree with him that mother has the right to have the abortion just as “unplugs” you from the violinist because essentially mother and fetus are different individuals. The mother has the right to carry the fetus to term and build a mother-child relationship. However, she also has the right to have the abortion and choose to not start the relationship.

To placate our Catholic patients and donors, our hospital will not provide subsidized abortion services for underinsured patients at present.  This decision is influenced not only by the fact that we are a private hospital with limited resources, but also are heavily reliant on our Catholic donors. The hospital will ensure donor relationships remain strong by accepting both blanket donations and donations towards specific treatments. This is to avoid tension over some donations paying towards abortion services. The controversial nature of abortion holds true for Islamic patients and donors as well.  If in the future, the hospital has new donors from other cultural and religious backgrounds which are more accepting of abortion, we can start to subsidize treatments for underinsured patients. The bottom line is that the hospital should provide subsidized abortion services based on the financial grounds of the hospital rather than the religious preferences of the patients.

IVF treatments and Prenatal Testing

Although at present the hospital cannot provide subsidized abortion services, the government is going to provide our hospital-specific funding for In Vitro Fertilization (IVF) treatments and prenatal testing including amniocentesis for the next five years. Although the Catholic Church and donors believe that any intention “to request [amniocentesis] with the deliberate intention of having an abortion” (Cahill et al 152) is unethical, and some Catholic donors may not support these treatments, the use of government funding allows the hospital to make this decision detached from donor preferences. Also, there are more and more Japanese, Jewish and Lebanese Shiite immigrants population nearby our Hospital so we should make accommodations to well serve our patients.

Other than the Catholic Church, the local Japanese population is similarly resistant to the use of IVF treatments.  Although there is widespread access to modern and advanced medical technologies in Japan, prenatal care still focuses on “Gamburu,” or to “make an effort” (Ivry 134) Ob-gyns are viewed as coaches to guide women spiritually during the pregnancy rather than a physician who interprets pregnancies in a genetic manner. For example, the focus of Japanese culture is to nurture the child with environmental care from the mother as mothers are viewed as “ohukuro,” or respectable bag of the children(Ivry 156). It will be beneficial to offer cultural training for Ob-gyns when they treat Japanese patients and offer more spiritual guidance.

Not only does the hospital serve a Catholic and Japanese population, but also a vibrant Jewish community who is eager to try IVF treatments. In Jewish culture, “Reproductive technologies are allowed and even encouraged as a means of furthering the Jewish bloodline and realizing God’s command to multiply (Kahn 5). Reproduction is an ‘imperative religious duty’ sanctioned by the very specific economic, political, social, and historical contexts that have given rise to the use of new reproductive technologies as a way to satisfy that duty” (Kahn 3). Paradoxically, it seems that the traditional notions of the Jewish family are separate from those of increasing the Jewish population.  Furthermore, to avoid religious conflict and show our respect to the Lebanese Shiite immigrants, our hospital will only “authorize the insemination of the woman’s egg with the donor’s sperm in a lab dish, and then implantation of the fertilized egg into the wife’s uterus” (Marcia C. 165). According to Marcia C., this procedure circumvents adultery, as “the definition of incest in Shia thought and practice does not depend on the transfer or contact of bodily substances. Rather, it depends on the illegitimate physical act of illicit sexual intercourse, and not on the act of conception itself.” We want to be able to provide IVF treatments while also taking in the consideration of Islamic patient’s religious belief.

Furthermore, Jewish pregnant mothers are more willing to use prenatal testing because Jewish pregnancy culture tends to focus on geneticism more than environmentalism (Ivry 250). This focus derives from the belief that if a Jewish woman experiences premature birth and miscarriage, the cause is viewed as a genetic defect of the fetus. As a result, the mother has the choice to terminate the pregnancy, which may reduce the mother’s likelihood of physical and mental harm (Ivry 263). It is the duty of our hospital to provide care and provide prenatal testing to all the women in the community.  The decision rests on the mother on whether to use this service. It is important to understand that a variety of factors play into a patient’s decision on whether or not to undergo medical treatment; therefore, it is necessary that the hospital provide prenatal testing. According to Hamdy, the decision to receive treatments is “extremely complex and highly variable, depending on the patient’s changing circumstances” (Hamdy 156). Nonetheless, we know that “middle-class patients (disproportionately white) usually accept the test while poorer women (disproportionately from ethnic-racial minorities) are more likely to refuse it” (Rapp 168). Since government funding is available, we can reduce the price of prenatal testing, which may encourage more women of lower socioeconomic status, including ethnic minorities, to receive treatments without making it appear as the hospital is subsidizing such procedures.

Donation of Unused Embryos to Research

If our hospital begins to provide IVF treatment, the hospital should also encourage families to allow their unused embryos to be donated towards potentially life-saving research. This decision is due to the fact that “more embryos or fertilized eggs are created than are usually needed for a single treatment. Those extra embryos are frozen and can be kept over a period of several years for later use without significantly losing their potential develop successfully into human beings through pregnancy” ( Eich 64 ).  Once a couple is satisfied with their number of kids, they should be encouraged to sign an agreement to donate their frozen embryos. These extra embryos could be used for research purposes so that their inevitable destruction would serve some benefit to science. Circumventing much ethical debate, “a fertilized egg before nidation differed significantly from an embryo after nidation and therefore did not have the same human rights, the rights of bodily integrity”( Eich 66). If the fertilized egg was not implanted, they are simply cells and can be used to study stem cell regeneration. The Catholic Church has argued against the use of fertilized eggs due to concerns over their use for cloning, but our hospital will set specific regulations banning the use of these fertilized eggs for cloning research.

Onsite Religious Counseling

In addition to providing new treatments, the hospital will attempt to consider the needs of individual patients from various religious backgrounds. To pursue this goal, the hospital will provide religious counseling by clergies of all religions because these counselings can be therapeutic during the process of undergoing medical treatment (Ginsburg, 37). However, The clergymen will not be allowed to discuss their view towards any specific medical procedure such as abortion and prenatal testing. As stated in Testing Women, Testing the Fetus, “A counselor should, as a matter of principle, support whatever decision regarding testing and pregnancy outcome that a woman or a couple makes” (Rapp, 58). Distinct from an advisory role, clergymen would serve to ensure a deity is with the patient through illness and hardship.  Furthermore, every week Clergyman and doctors will have weekly meetings to share their opinions on specific patient cases and suggestions for providing better patients service in the future. I believe if we keep the communication open, the tension between doctors and clergymen can be gradually solved. If the hospital still receives complaints from doctors of interference, the hospital will arrange one to one meeting between the doctor and the clergymen to reconcile the issue together.

Relocation of the Nursing Staff

Last but not the least, the hospital will relocate the historically Catholic nursing staff who are unwilling to perform abortion and reproductive services to other wards within the hospital. Since we have a limited budget, we will hire a nursing professor who specializes in teaching abortion care and reproductive services rather than hiring new, specialized nurses. Education will be available to all nurses who are willing to perform abortion and reproductive services. At the same time, the hospital will also welcome nursing school students to volunteer in the hospital for one or two semesters. If they perform well, our hospital will potentially provide them part-time positions after training.

In conclusion, I propose that our hospital start to provide abortion services, IVF treatments, prenatal testing, and religious counseling services to accommodate the increased diversity of the local community. Donors and nurses who are resistant to the new changes can be accommodated through changes to the hospital financing structure and assignment allocations as explained above.

Works Cited

Don Seeman, Iman Roushdy-Hammady Annie Hardison-Moody. “Blessing Unplanned Pregnancy: Religion and the Discourse of Women’s Agency in Public Health.” Medicine, Anthropology, Theory 3 (2016): 29-54.

Donum Vitae In Shanon, Thomas A. and Lisa Sowle Cahill, Religion and Artificial Reproduction: An Inquiry 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

Inhorn, Marcia C., and Soraya Tremayne, editors. Islam and Assisted Reproductive Technologies:  Sunni and Shia Perspectives. 1st ed., Berghahn Books, 2012. JSTOR,

Judith Jarvis Thompson, “A Defense of Abortion.” Philosophy and Public Affairs 1 (1971): 47-66.

Rayna Rapp, Testing Women, Testing the Fetus (Routledge, 2000).

Sherine F. Hamdy, “Does Submission to God’s Will Prevent Biotechnological Intervention?” In Jeremy Stolow editor, Deus In Machina: Religion, Technology and the Things In-between (Fordham University Press, 2013), 143-57.

Susan Martha Kahn, Reproducing Jews: A Cultural Account of Assisted Conception in Israel (Duke University Press, 2000).

Thomas Eich, “Decision-Making Processes among Contemporary ‘Ulama’: Islamic Embryology and the Discussion of Frozen Embryos.” In Jonathan E. Brockopp and Thomas Eich, Muslim Medical Ethics From Theory to Practice (University of South Carolina, 2008), 61-77.

Tsipy Ivry, Embodying Culture: Pregnancy in Japan and Israel (Rutgers University Press, 2009).Community (University of California Press, 1989).