Biotechnology and Reproductive Rights

Case Assignment - Biotechnology and Reproductive Rights

Trident University

BHS365 - Ethics in Health Care

Dr. Beverly Fierro

December 24, 2012

Biotechnology and Reproductive Rights In the case of Nadya Suleman, the doctor should not have agreed to implant the embryos.

If the doctor had declined to implant the embryos, the two ethical issues would involve the conflicting values between the ethical responsibility of the doctor to bring no harm to his patient, potential babies, and the respect for the autonomy of Ms. Suleman to make her own choices. She has the right to make reproductive options (Gender and Justice, 2007, p. 3).

The doctor would engage in an ethical decision making process, considering the potential result of implanting vs. not implanting the embryo. He would need to consider the worst-case scenario that all the embryos growing to term or that the mother might be harmed. Beyond the economic issue of being able to provide sustenance for the babies after birth, the doctor should have also considered the potential physical harm or even death to Ms. Suleman and the babies. One principle of American Medical Association (AMA) is that "a physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law (Principles of Medical Ethics 1995-2012).

From the utilitarian perspective, the decision that provides the most good to the greatest number of people or the least harm to the least number of people would be the right decision. In this sense, the best decision would probably sustain this position; the doctor should not have agreed to implant the embryos. This would provide the greater good to the greatest number of people. It would be better for Ms. Suleman, who would not have the stress, health risk, or even death, because of carrying eight babies. She could have finished her education and tended to her other six children. It would be better for her family, as it would free up her mother from caring for the children in a house that was too small and on an insufficient income. It would also be better for society, because she would not have to rely on public assistance to provide for some or all of these children. It prevents possible risks of having multiple births with potential learning and developmental problems. This should have overridden the right to autonomy. The principle is "A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights" (Principles of Medical Ethics 1995-2012). However, the need for medical care in a way to do no harm would override autonomy in this case, as Ms. Suleman already had her hands full with caring for six children without a husband's help, attending college, and she did not have a job or a way to provide for them. Therefore, the greater good to the greater number of people would be to refuse to implant the embryos.

Does this mean removal of the children from her home after delivery or from her womb before birth? To remove the fetuses, would bring up a completely different set of ethical issues, especially for those who believe that life begins at conception, such as Ms. Suleman and for the doctor who needs to do no harm, which means aborting the fetuses is doing harm. Ms. Suleman would not agree to this, which challenges autonomy again. From her religious and pro-life, the perspective to remove the fetuses would be murder, as abortion is from the perspective of pro-life and many religious institutions, such as the Roman Catholic Church. For the doctor, the greatest good for the greater number of people could mean different things for different people. However, the doctor would need to consider the eight babies and the mother is her or his decision. For a doctor who was pro-life, the right decision would be that all babies should have an equal chance for life, as well as Ms. Suleman.

If this statement implies to take away the children at birth, this again challenges the principle of autonomy, as Ms. Suleman has a right to make choice for her own children, even

though 14 children seem surreal and nearly impossible for one person to care for. However, ethically, Ms. Suleman would need to be given a reasonable chance to show that she could care for her children as she made claim. This is fair treatment. However, if she proves to be unable to provide the essential care and/or food for the children, then the right decision would be to remove the children based on the fact that it would be doing