Medical Ethics of Fertility Counselor - Assignment Example

Medical Ethics

2. Fertility counselor

Ms Quick, the client that came to me for the advice concerning her pregnancy is facing a difficult situation. She has to make a very important decision, and she has little time to make a choice. The ultrasound diagnostics has revealed that she has three fetuses when the term of pregnancy was nine weeks. The Abortion Act allows termination of pregnancy if the term is less than 24 weeks, but, as the British Medical Association states, the sooner the abortion is made, the better it is for the women’s physical and psychological well-being.

The situation is that Ms Quick, a thirty-year-old woman, who has been treated from infertility by clomiphene citrate. She was aware that this drug increased the incidence of multiple births. When the client conceived she was happy, but when the ultrasound diagnostics revealed she had three fetuses growing inside her, she decided she didn’t want to give birth to triplets. The client motivates her decision saying she would not be able “to be a good mother” for more than one child. The client’s husband supports this opinion. Thus she requested her physician to terminate the gestation of two of three fetuses, even being aware that this procedure seriously increases the risk of miscarriage. Moreover, the patient states she would rather terminate pregnancy than give birth to triplets. Dr. Green, her physician, doesn’t approve her decision, and he is thinking about transferring her to the other doctor in case she would make a final decision about terminating the pregnancy or selectively terminate the gestation of two of the triplets.

After talking with the patient I found out that the woman is scared by the possibility to have three children instead of one kid she always dreamed about. She wants to be a good mother very much, for her maternity is a very serious task. She is pregnant for the first time, and has never had an opportunity to take care of the newborn kid. She feels that raising a child takes lots of time, effort and resources. In her opinion three children is too much for her family, she isn’t sure they would be able to give them decent upbringing and education. She has always planned to have one, maximum two kids, and three, all the more so, at a time, is too much for her.

The type of the problem we have her is Ethical Dilemma – a situation when there is more than one right course of action, but we can’t follow both of them (Darwal et al, 1997).

The patient has the right to choose not to give birth to more children than she wants, and she has the legal right to terminate her pregnancy before twenty-four weeks term. Nevertheless, the fetuses also have the right to live. Dr Green has the right to refuse to terminate pregnancy, if this is unethical from his viewpoint, and recommend the patient to turn to other doctor who would be willing to terminate the pregnancy.

To solve this problem we could use the cost-benefit approach, under which the costs and benefits of taking versus not taking a particular action are balanced (Darwal et al, 1997).

In case the patient would decide to selectively terminate the gestation of two of the triplets, the risk of miscarriage is becoming greater. In the same time, the patient gets the chance to have the child she dreams about, and be delivered of the problems connected to raising three children. Nevertheless, for those, who support the pro-life abortion position this decision would be unethical, and the patient may suffer from moral problems and public condemnation (Baird, 2001). In addition, even the selective termination of two fetuses would create other health risks except for miscarriage.

The decision to terminate the pregnancy rather than giving birth to triplets would result in having no problems with the newborn kid Ms Quick is so afraid of. It would give her time to think over her position concerning maternity, and to decide whether she needs children at all. In the same time, it is likely that the client will end up having no possibility to have a child at all, considering the fact that abortion increases the risk of infertility greatly (McNamee et al, 1993), and the fact that she was treated for infertility when she conceived.

Another option exists in this situation, which is giving birth to all the three children, and given two of them for adoption. The diagnostics shows the fetuses are healthy, thus there should not be many problems finding new families to the newborns. It would allow saving the lives of the unborn kids, without creating the risks for the life and health of their mother, and increase the chances that she would have a healthy child she dreamed about. Also a variant exists that during pregnancy the client would change her mind considering the number of kids she is ready to raise, and this situation would be solved by itself.

In the same time, the risks exist that this decision would lead to psychological problems for the patient, to the problems with her husband and family. In addition, public opinion is disapproving to women, who give the kids up for adoption, especially when those women are married, as Stephen Fitzpatrick, who researches the question of adoption, noted in his article Choice (2005). For Ms Quick the fetuses are something abstract, she does not see them as live children, which is proved by the fact that she is ready to get rid of two of them for her convenience. But newborn kids cannot be an abstraction. They cry, and want to eat, and you may touch them.

Giving her kids up for adoption may be traumatic for the patient. She may decide not togive them up under the pressure of the society, her family, or because of her own reasons, but she could still be unhappy, feeling that she doesn’t want to raise three children, that she is unable to do it. Both the client and the kids would suffer in this situation, together with her family.

Nevertheless, as I, as a fertility counselor, hold to the pro-life position, giving birth to the triplets and than giving them for adoption is the best choice in my opinion. Of course it may cause numerous problems to the client, and to the kids, but this children would still be given the chance to live, their lives would be saved. That is why I would advice my client to keep the pregnancy, considering the option of giving the kids for adoption, and leaving herself the time to decide about her course of actions after giving birth to her kids.