Ethical Issue in Health: Absolute Uterine Factor Infertility - Essay Example

Ethical Issue in Health about Baby Born From Transplanted Uterus Ethical Issue in Health about Baby Born From Transplanted Uterus Introduction Uterus transplantation has emerged in the past decade as one of the most probable solutions to the issues of infertility or Absolute Uterine Factor Infertility (AUFI) in women (Ozkan, et al., 2013). For several years, doctors have been researching on the possibility of a successful uterus transplantation, results of which culminated in a successful transplantation processes in Sweden. The successful transplantation has opened up a new approach in treating infertility in women by using the latest technologies in biomedicine. Nevertheless, the progress made in this aspect of medical treatment has also been met with huge amounts of criticism over the ethical issues involved. For instance, there are several ethical challenges and dilemmas concerning the babies born form such transplantation processes (Ozkan,et al., 2013). The main dilemma, however, is based on a conflict of two major ethical principles in medicine, the principle of autonomy and non-maleficence. The principle of autonomy states that people are free to make their choices regarding their health and lifestyles. As such, this principle supports uterus transplantation if and when a woman feels it is right for her to go through the process. On the contrary, the principle of non-maleficence requires that doctors and other medical practitioners do no harm to their clients. In this regard, whenever health workers are faced with a complex medical problem, in certain cases it is better to avoid doing anything, than engaging in a process that will ultimately affect the patient negatively. The conflict arising from these two ethical principles makes it quite difficult for the doctors to make a sound decision over whether to progress with uterus transplantation or not. Furthermore, there is the challenge related to the nature of the baby born from such a process (Ozkan, et al., 2013). There are many issues that may affect the ethics of uterus transplantation as relates to the nature of the baby. For instance, the relationship between the child, the parents and the donor, personal identity of the baby, as well as the uncertainty surrounding the future of a baby born from uterus transplantation. These issues can make it difficult for one to make a strong decision concerning transplantation, thus making it a very risky process. Furthermore, other questions about the costs and technology involved in such a process make the dilemma more complicated. For instance, if indeed the process is successful, it will not be affordable to the majority of the people who need it. Therefore, what is the need of investing in a risk of such a magnitude is it will not benefit the people it targets? History of the Dilemma The issues of uterus transplant emerged as early as the 19th century with the works of Emil Knauer, who documented a transplantation process in a rabbit in 1896 (Jauniaux & Rizk, 2012). Ever since, there have been numerous efforts in the field of fertility medicine with successful processes conducted in animals such as dogs and rats that resulted in successful processes with fertile offsprings. However, it wasn’t until the latter parts of the 20th century the issue became contentious. This was after the processes started taking place in human beings in various parts of the world, including Denmark and Sweden. In 1931, a transgender woman died a few weeks after a transplant process that culminated in organ rejection in one of the earliest uterine transplants in the world (Jauniaux & Rizk, 2012). Questions began to emerge in bioethics concerning the process of uterus transplant in humans. Nevertheless, research in the area continued to expand with newer technologies coming in place. In the year 2000, a Saudi Arabian doctor transplanted a uterus from a 46-year old woman suffering from hysterectomy into a 26-year-old woman. However, the transplant lasted for 99 days only, after which complications such as blood clotting came about. This prompted a removal of the uterus from the woman. Turkish doctors also conducted a surgical operating in 2011 that led to a successful uterine transplant. The transplant resulted in a long-term functional womb in a 21-year old woman, who eventually became pregnant in 2013 (Jauniaux & Rizk, 2012). However, the pregnancy was terminated at 32 weeks after the doctors failed to identify a heartbeat in the fetus. The most successful uterine transplant process occurred in Sweden in 2014 after it was reported that it had resulted in the birth of a healthy baby. However, due to the stigma that might be associated with the family, the location and identity of the participants in the study was not revealed to the public. However, this case was particularly contentious as it involved donation from a live person, a woman aged 61 years. Several ethical concerns have since emerged following the progress of the uterine transplantation process. For instance, questions regarding the need of the surgical procedure, since it is not a lifesaving medical procedure. Furthermore, the procedure consumes a lot of money, which would otherwise have been used in promoting other lifesaving causes such as cancer treatment (Jauniaux & Rizk, 2012). Similarly, since most of the transplantations involve living people, the question of the intrinsic value of humans comes up, given that the procedure amounts to using people as means to achieve some ends contrary to Kantian ethics. Nevertheless, the underlying moral question is the dilemma surrounding the babies born from such processes. Current Literature on the Topic Given the significance of the topic in contemporary health research, several scholars have researched and documented the topic from different perspectives. Current literature on the topic covers many different issues and themes, including the history of uterine transplant, the challenges involved in the process, the technology and costs associated with the procedure, the future of uterus transplant, and the ethical issues involved in the whole process. Among the ethical concerns discussed in available literature, most scholars relater the process of uterus transplant with the ethical principles of medical practice in bioethics as well as major decision-making theories in situations of ethical dilemmas. According to McCulloch, et al., (2009), considerations of uterine transplantations are very complicated since the matter involves a wide range of interconnected issues such as parenthood, procreation, ethical, and financial priorities in delivery of healthcare outcomes. Nevertheless, the perceptions in terms of the complexity, costs, and the ethical nature of the process differ from one community to the other around the globe (McCulloch, et al., 2009). Mostly, the issues depend on one’s moral, ethical, religious, or even legal perspective. In analyzing the ethical dilemma involved in uterine transplantation and the resulting birth of a baby, one needs to assess each of the issues involved based on four major principles of ethics; beneficence, non-maleficence, justice, and dignity. This also has to be done within the view that the principle of beneficence supersedes that of non-maleficence. Therefore, in assessing a risk-benefit analysis of the procedure, the interests of several key stakeholders in n the process have to be taken into account. These include the live donor, the recipient, the recipient’s partner, and most significantly, the baby that will result from the successful completion of the process. Like in all other kinds of organ transplants involving fertile women of a childbearing age, the future of the child is often a major issue of concern. In uterine transplants, it may be difficult to point out the benefits of the process to an unborn child, similar to any other techniques of treating infertility in women. Nevertheless, most scholars indicate that the risk involved has to be assessed with the benefits of adopting another child. However, there are several risks and complications that the unborn baby may be exposed to either before or after the surgical process. For instance, the unborn child may be exposed to immunosuppressive treatment, which can affect the child’s development before and after birth (Olausson, 2014). In other cases, reported incidences of background diseases from the donor are also likely to affect the child’s development in terms of low weight at birth and other issues such as preterm delivery, and pre-eclampsia. Given the adverse effects that the unborn child is likely to be exposed to and the fact that the child is not involved in the decision making process is a major ethical concern (Olausson, 2014). Furthermore, the process is very costly, risky, and unreliable. It is not possible to predict the outcome of the transplantation process with certainty. While the transplant may be successful, whether the woman will be able to carry a pregnancy successfully and give birth to a healthy baby are only matters of speculation. As such, many scholars question the need and significance of this risky procedure that seems to have unpredictable benefits. This is mainly because this is not a lifesaving procedure aimed at prolonging the life of the patient. On the contrary, this procedure is only aimed at improving the patient’s life rather than prolonging it. Nevertheless, the experimental nature of uterine transplant demands that both the recipient and the donor have to make their own decisions before engaging in the process. The question of the patient’s informed consent is a significant component or ethical dimension in resolving the ethical dilemma involved in uterine transplantations. Prior to making a decision on whether to proceed with the procedure, a patient must be fully aware of the various options available for treating uterine complications such as AUFI. For instance adoption and gestational surrogacy can also be used in jurisdictions that have related provisions. Conclusion Given the complicated nature of the morality of uterine transplantations on those involved, including the unborn baby, it is quite difficult to recommend the procedure as the solution for AUFI or other infertility issues in women. Furthermore, despite the huge amounts of research conducted in this area, it is still quite a new field that cannot be reliably used as a treatment method. The reflection in the ethical issues and dilemmas involved in the process of uterus transplantation is aimed at bringing out the key moral issues involved in the process in order to facilitate decision-making. The unborn child suffers the greatest risk since it is not involved in the process, but its future largely depends on the success of the procedure. Among the risks the child is likely to face include low birth weight, preterm delivery, and other complications resulting from immunosuppressive treatment. References Jauniaux, E., & Rizk, B. (2012). Pregnancy after assisted reproductive technology. Cambridge, UK: Cambridge University Press. McCulloch, P. Altman D. G., Campbell, W. B., Flum, D. R., Glaziou, P., Marshall, J. C. (2009). No surgical innovation without evaluation: The IDEAL recommendations. 374, 1105-1112. Olausson, M. (2014). Ethics of uterus transplantation with live donors. Fertility and Sterility,102(1),40-43. Ozkan, O., Akar, M. E., Ozkan, O., Erdogan O, Hadimioglu N, Yilmaz M. (2013). Preliminary results of the first human uterus transplantation from a multiorgan donor. Fertile Sterile, 99(1) 470-476. Read More