Saeyoung Lee- Final

Central Lee Hospital Ethics Committee Policy Proposal on Assisted Reproductive Technologies

                              by Saeyoung Lee

Introduction

For many years, Central Lee Hospital has been a cornerstone of wellness in the community of Sasquatch Connecticut, providing high-quality healthcare to those in need. Even though we were under Catholic auspices for many years, recently 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 with an ultimate goal of providing the best medical care to our diverse population needs as much as possible. However, it is very recent that our hospital became non-denominational, which is a huge policy change for us. Therefore, it is impractical to accept all of the assisted reproductive technologies at once due to still prevalent religious practices in our community. As of now, we are not a catholic institution anymore, and we shouldn’t feel obligated to adhere strictly to the Catholic policies. However, I want to emphasize that I am broadly pro-life. This means that I do not support abortions, but I am pro-life in a sense that I am in favor of helping people exercise their right to procreate and not to terminate.

 

Abortion Policy

First, our hospital should NOT provide any abortion services. Due to our strong Catholic background and support from many Catholics, the majority of people in our ethics committee agrees “that the human being must be respected, as a person, from the very first instant of his existence” and “that human life must be absolutely respected and protected from the moment of conception” (Vitae). In this view, the first moment of existence is considered to be the moment the zygote is formed, meaning that from the time that the ovum is fertilized, a new life has begun which is independent from his or her mother or father. Therefore, it is the life of a new human being with his or her own growth. While I do not quite agree that life begins at conception or the formation of zygote is equivalent to a human life, I do agree that human life must be respected and protected. Therefore, I wish to continue discouraging abortion in our facilities.

Furthermore, I see abortion as symptomatic of other social problems. In particular, I am concerned that materialism and narcissism are affecting communities and the ways we view kinship. In other words, discouraging abortions could be interpreted as a desire to reform the more dehumanizing aspect of contemporary capitalist culture (Ginsburg, 1989). The reason that I think this way is because abortion can lead to additional concern with the social and cultural devaluation of dependent people such as the “unborn child,” the elderly, the unwed mother, and the handicapped.

However, it is important to recognize that some patients who request abortions for a valid reason such as medical emergencies when the life of the mother is at stake. Because the life of the mother is equally as important as that of the fetus, I believe there is no other option but abortion to save her life if the mother has contributed anyhow at least a little to the present society who is in front of our eyes. Even though I think this would be the only legitimate reason to request an abortion, I understand that many people have different perspective towards who is allowed for an abortion or not. Therefore, we should implement a special referral services for those who desperately request abortions with different reasons to be seen in another hospital. Although our hospital should not perform any abortion services to any patients, we should be nonjudgmental about the choices they make. In order to get a special referral, a patient will have to inform her OB-GYN although patient does not necessarily have to explain her reasoning. 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, and it will be the patient’s responsibility to get to the Hope Connecticut Hospital.

 

IVF Treatments and Prenatal Testing Policies

Even though our hospital ought to reflect its Catholic origins to some extent, we must recognize technological advancement and cultural shifts worldwide, including those 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 slowly start welcoming different religious perspectives. 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 heterosexual marriage. However, we must make it clear that these services will only be provided after careful evaluations from our reproductive health professionals with clinical disciplinary perspectives.

Before I go into more detail, I would like to present a counterargument to for those who think that allowing IVF treatments indirectly leads to more abortion. I do not want to affiliate with Catholic, but I am pro-life in a different way. Development of the practice of in vitro fertilization has required innumerable fertilizations and destructions of human embryos. Even though the 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, I am not necessarily against the termination of all embryos. Through a careful consideration, I want to put more emphasis 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. Therefore, by accommodating to IVF treatments, I am in favor of creating more life at the end rather than less.

Furthermore, unused or frozen embryos collected from IVF treatments should not be donated or used as scientific materials for life-saving research because such experiment will cause harm leading to death without a potential of becoming the fruit of marriage. However, I understand that since we would be performing IVF treatments, we would have unused embryos that expire anyways. Therefore, we should encourage the donation of extra gametes to other heterologous married couples that are infertile. This alternative can lead to family formation as ways to preserve their loving marriage, satisfy their fatherhood desires, and challenge religious dictates for those who argue that such a child “won’t be my son” (Inhorn 94). The reason some of Muslims are against gamete donation is due to the importance of purity of lineage. Islam privileges or even mandates the biological descent and inheritance. Therefore, the origin of a child is thought to be very important and morally imperative. However, many men including the male religious leaders that are Muslim recently have allowed adoptions and gamete donation practices in their community to achieve fatherhood and happiness in their marriages in addition to solving the problem of infertility. With many advantages, we have seen multiple cases of Islamic and Jewish couples accepting the donation of gametes, so I am sure that those patients in our community can benefit from this provision in addition to reducing the wasting of unused embryos.

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). This means that prenatal testing is only allowed to make and to anticipate earlier and more effective therapeutic, medical or surgical procedures for a better outcome of birth and life. 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 will be only permissible with the consent of the parents after they have been adequately informed of our policy that it would be opposed to the moral law when the diagnosis is done with the possibility of abortion. However, if the diagnosis suggests death risk of the mother, further consulting should be done with the medical professionals to weigh the risk and benefits. If the result confirms more than 50% death risk for the mother, special referral request will be sent to another hospital for consideration of abortion. In this case, transportation fee will be paid by our hospital.

 

Spiritual Counseling Policy

Patients consider spiritual and physical health to be of equal importance, and our hospital recognizes that managing spiritual health may be difficult during illness. With the increase in population and diversity around our community, we should provide clergies of other religious communities such as Jewish, Shia Islamic, and Buddhist clergies in addition to social workers and genetic counselors in order to fully support our non-denominational policy. 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. Nonetheless, it is impossible to please everyone in our quest to set regulations on healthcare. As a member of ethics committee, I strongly oppose forcing anyone to perform any medical procedures against their religious beliefs. Therefore, our Catholic nurses should not have to perform any procedures related to assisted reproductive technologies. In addition, eligible Catholic nurses should have the option 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.

Even though my proposal does not have all the answers to the questions we may have, I have proposed a plan that constructs a moral vision informed by several different perspectives. Although these proposed policy changes may not be suitable for some people, we must remember that changes in our society and technological advancement have altered what is considered to be the norm. I hope that these new policy changes 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).

Marcia Inhorn, He Won’t Be My Son: Middle Eastern Men’s Discourses of Gamete Donation.” Medical Anthropology Quarterly20 (2006): 94-120.

Swasti Bhattacharya, Magical Progeny, Modern Technology: A Hindu Bioethics of Reproductive Technology(Suny University Press, 2006).