Policy Proposals of Sasquatch Hospital
I am a 28-year-old Chinese woman raised in Virginia. Although I am an atheist physician who believes in the power of the modern medicine, I respect all religions and their practice. As a member of the ethics committee at Sasquatch hospital, I intend to propose several new policies regarding the use of abortion services, reproductive technology, embryo donation, and religious counseling.
Sasquatch hospital was run for many years under Catholic auspices and continues to be 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. Although abortion is legal under federal law, the prohibition of abortion by the Catholic Church has prevented our hospital from providing the procedure to our patients. Despite the possibility of the 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 non-denominational practice, the hospital is no longer subject to the rules of the Catholic Church. Although the hospital would like to maintain its religious donors, the hospital should begin to provide abortion services to patients who choose to use them. As supported in Thompson’s book “A Defense of Abortion,” the hospital should support the right of choice for a woman going through a pregnancy and potentially an abortion. Thompson proposes a thought experiment involving an unconscious, famous violinist to explain her point: you are the only person that can cure a famous violinist of his fatal kidney ailment, so the Society of Music Lovers kidnaps you and “plugs” you into the violinist. If you unplug yourself, the violinist will die (Thomson 60). He uses this analogy as a description of the mother bearing a child. He argues that choosing to unplug from the violinist is self-centered but not unjust as the violinist originally does not have the right to use it (Thomson 61). I agree with Thompson’s thesis that mother has the right to have the abortion, just as one has the right to “unplug” themselves 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. On the other hand, the mother also has the right to have the abortion. Our hospital will not force anyone to accept abortion but if patients need the abortion, we will provide the services to them.
Although our hospital should provide optional abortion services, our hospital should not subsidize these 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 that our hospital is reliant on Catholic donors. The hospital must ensure donor relationships remain strong by accepting both blanket donations and donations that exclude abortion services. This donation procedure will avoid tension over certain donations paying towards abortion services. The controversial nature of abortion holds true for donors of other religions, such as adherents to Islam as well. If the hospital begins to accrue a donor base of more accepting religious and cultural backgrounds, we can start to subsidize treatments for underinsured patients in the future. 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 beginning to provide our hospital-specific funding for In Vitro Fertilization (IVF) treatments and prenatal testing including amniocentesis. According to the Protestant and Catholic understanding of the Genesis, women regard one of their missions in life as to “reproduce and multiply.” Therefore, this funding for IVF treatments and prenatal testing is to help more women in the area to give birth to healthy children. It will cover the general service fee and post-surgical care. 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. Furthermore, there is an increasing number of Japanese, Jewish and Lebanese Shiite immigrants population nearby who require greater reproductive service accommodation based on their religious and cultural preferences.
In addition to Catholic Church, the local Japanese population is less willing to use IVF treatments and prenatal testing. The Japanese often express discomfort and distrust with prenatal testing(Ivry 2009, 11). Although there is widespread access to modern and advanced medical technologies in Japan, prenatal care still focuses on the notion of “Gamburu,” or to “make an effort” (Ivry 134). Ob-gyns are viewed as coaches to guide women spiritually during the pregnancy rather than as a physician who interprets pregnancies in a genetic manner. The focus of Japanese culture is to nurture the child with environmental care. The goal of our hospital is also to create a “no pressure” environment that patients can feel comfortable in. We want to grant our patients the choice of whether they would like to use prenatal testing. Therefore, the hospital should offer cultural training to Ob-gyns, such as those who treat Japanese patients, to better offer spiritual guidance.
Not only does our hospital serve a Catholic and Japanese population, but our hospital also serves a vibrant Jewish community that tends to be comfortable with the idea of using IVF treatments. Under Judaism, “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). As the result, Jewish women strongly support IVF treatments because they feel the need to have a child to be fully accepted into society.
Furthermore, to avoid religious conflict and show our respect to the Lebanese Shia 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 the concerns of 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”(Marcia C. 170). Our hospital would like to provide IVF treatments while also taking in the consideration of Islamic patient’s religious belief.
With regards to prenatal testing, Jewish pregnant mothers are more willing to use prenatal testing because Jewish pregnancy culture tends to focus on geneticism rather than environmentalism (Ivry 250). This different 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 needs the choice to terminate a pregnancy to reduce the likelihood of physical and mental harm to the mother (Ivry 263). As a result, the duty of our hospital is to provide care and prenatal testing to all the women in the community, but the final decision should still rest 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 rests on 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. I am aware that the Catholic Church teaches that all life is sacred from the moment of conception until death (Cahill et al 180). Circumventing this ethical debate, a strong case can be made that, “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, our hospital also wants to consider the needs of individual patients from various religious backgrounds. To pursue this goal, the hospital should provide religious counseling by clergies of all religions because of the sometimes therapeutic benefit they provide (Ginsburg, 37). However, 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 should serve to ensure a deity is with the patient through illness and hardship. Every week Clergyman and doctors will have a one-hour meeting to share their opinions and suggestion on specific patient cases for providing better patients services in the future. I believe if we keep the communication open, the tension between doctors and clergymen can be gradually resolved. If the hospital still receives multiple complaints from doctors about interference, the ethics committee will start to investigate the case. If clergymen are found to be interfering with the doctor-patient relationship, the clergymen will be given warnings or a temporary suspension.
Relocation of the Nursing Staff
Last but not the least, the hospital should relocate historically Catholic nursing staff unwilling to perform abortion and reproductive services to other wards within the hospital. Since the hospital has 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 welcome nursing school students to volunteer in the hospital for one or two semesters. If the volunteers perform well, the hospital could potentially provide them part-time positions after training.
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. I am confident that this proposal will allow us to move towards a brighter future for our hospital and the local community.
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