Terminating an Unplanned Pregnancy - Essay Example

Terminating an Unplanned Pregnancy I. Introduction: The purpose of this paper is to undertake the analysis of a medical case of Sara who is opting to terminate an unplanned pregnancy. The midwife needs to take legal and ethical obligations into account before any decision-making process working in national health services (NHS) hospitals. The purpose of evaluation of the case study and analyzing variety of legal and ethical consideration is to differentiate between ethical and legal grounds in England and Wales. This will allow midwifery students to understand the significance of undertaking legal and ethical grounds as a base of decision-making process. This paper shall present the case chosen along with in-depth analysis of the case. The analysis will be followed by the legal and ethical considerations that are applicable on health care services in England and Wales. Also, there will be inclusion of other cases which is relevant to the laws and chosen case of termination of pregnancy. II. Case Presentation: Sara presented at antenatal clinic, pregnant at 22 weeks gestation with her fifth baby. Two days earlier during a scan performed to investigate irregular menstruation Sara had been informed that she was pregnant. The ultrasound scan suggested a 21+ weeks, singleton with no abnormalities detected. The midwife working in the community had provided maternity care throughout Sara’s four previous pregnancies, all of which had been straightforward births resulting in four healthy children. Sara has identified to the midwife that this pregnancy is unplanned and unwanted by both her and her husband. She feels that it would put a strain on her and her family, physically, emotionally and financially. Sara discloses that she is going to terminate this pregnancy. III. Analysis: Considering the case of Sara opting for the termination of pregnancy, there are two main areas to be taken into account by the health practitioners. These areas are rather in terms of legal and ethical grounds. With due consideration to the case of Sara, it can be said that her case has both moral and legal grounds of analysis. The distinction can also be noted in her case in terms of ethical and legal grounds mainly because of the debated issue of abortion (Beauchamp and Childress 2008). The analysis of the case of Sara is being conducted under the legal statuses of abortion and similar cases are also important base of analysis. Following are the two distinctive grounds that need to be focused by midwife responsible for the termination of pregnancy case of Sara. The case of Sara should not be considered as overly debated case because of the adherence to Abortion Act. However, there is a significant difference between the legal and ethical grounds of the case (Harris 2002). IV. Legal Considerations: Legal Status for Abortion: The appeal of Sara for terminating the unplanned pregnancy can be taken into consideration because as per the abortion principle of England and Wales, it is as per the law. The principles as governed by the Abortion Act 1967 defenses the appeal for pregnancy termination of Sara because it states that abortion can be done if the pregnancy has not passed its twenty four weeks. The principles has further been amended by the Human Fertilization and Embryology Act of 1990 that if the pregnancy is probable to cause injury to physical or mental health of woman or any existing children of her family then medical practitioners must terminate the fetus (Pattinson 2009). It should be noted that cases like Sara being noted in other states of UK are not being consulted as in Wales and England because the abortion act in Ireland are being addressed by the Offences Against The Person Act 1861. As per the Offences Against The Person Act 1861, it has been marked that abortions can only be undertaken if a woman has been raped. This also comes under the act of Sexual Offences Act of 1956. This is the basic postulate that is being focused by the health practitioner in Ireland. In case of Sara’s appeal of termination of pregnancy, these postulates can be considered moral and absence as Sara is a mother and has been able to produce the fetus with his husband (Beauchamp and Childress 2008). As per Abortion Act, there are some of the cases and situations under which a patient is eligible for terminating her pregnancy. In order to terminate the pregnancy of Sara, following clauses of the act can be taken into focus by the midwife (Buka 2008) (a) The first section of the act attempts to clarify any sort of ambiguity with respect to the gestation size of the embryo. This means that a woman can appeal for termination of her pregnancy before the 24th week. This notes that in case termination of pregnancy is undertaken after the 24th week of the fetus growth will be risky and illegal. This clause also notes that the termination of pregnancy can be undertaken when physical and mental health of family members is at risk (Nursing and Midwifery Council 2008). (b) Termination of a pregnancy is allowed or made legal in case the mental or physical health of mother is in danger. The pregnant woman should be able to present consent to and decide after carefully looking into the matter. (c) The third clause of the act approves termination of pregnancy because growth of the fetus may endanger the life of the mother. Medical practitioners can take the decision of aborting the fetus as the mother’s health is endangered due to the process of pregnancy (Mason and McCall Smith 2006). (d) Abortion is also legal in case if a child diagnosed to have any sort of abnormality. In a case where the fetus is more likely to develop as an abnormal child, it is suggested that the embryo is removed. This is to save the existent family members and child from any sort of mental injury. This clause is backed up with a claim that a child should be free from a painful life and the family must be competent enough to handle a child with any abnormality. Looking at the consequences of a family where the child cannot be treated soundly in terms of finance, the act states that the pregnancy must be terminated (Dimond 2008). A midwife also needs to make undergo consultation with a second registered medical professional. This is in favor of taking a decision in a good will to save the patient from any sort of mental and physical injury. The significance of this clause is higher because it stresses on the registration of the medical professional (Hope, Savulescu and Hendrick 2008). The laws concerning the abortion of abnormal fetus remains absent from the legislation because it is the medical professional who is responsible to note the severity of the abnormality for which the child is being aborted (Health Professions Council 2009). In the case of Sara’s pregnancy, it is obvious that that the pregnancy can be undertaken mainly because this is meeting the criterion of Abortion Act’s section 1(a). This is in accordance to the inability of the family to financial support the new baby. Sara already has four children who may be at risk of financial aid in case this fifth child is born. This notes that Sara eligible to appeal for the termination of pregnancy. Also to note is the fact that Sara’s unplanned pregnancy process is now in 21st week which enables her to easily get the attempt of aborting the fetus. An opposing viewpoint on the case of termination of Sara’s pregnancy is that she can ask aid from the England local authorities of childcare under the Childcare Act 2006. In this way, the fetus can still be born and be taken care of. But seemingly, Sara does not seem to act to it because she has already appealed for the termination of her pregnancy and has claimed that the pregnancy is unplanned (Hendrick 2004). More recently, it has been noted that the England Parliament has passed a regulation regarding underprivileged lifestyle of children under the Child Poverty Act (2010). According to the Act, parents must be able to plan before aiming for another child. It is because the existent children are expected to be on risk with a new member in the family. In this regard, the decision of Sara will be beneficial for the family and the fetus itself (Beauchamp and Childress 2008). However, other clauses in the section 1 of the Abortion Act are not meeting the case pointers of Sara. For instance, there is no indication of abnormality of Sara’s fifth pregnancy process as noted in the section 1(d). This means that the child can still be born if the family is able to meet the financial needs of the family. This also notes that the existent children of Sara should not be put on any type of harm (Hope, Savulescu and Hendrick 2008). It should be noted that the previous pregnancy history of Sara has proven that she has given birth to healthy children straightforwardly without any abnormality. This means that the prediction can be passed that Sara will not be in any harm or physical injury. Thus, section 1(c) cannot be added as the pointer file of Sara’s case study (Buka 2008). Furthermore, the third imperative pointer of the Abortion act noted that the abortion is legal in Wales and England if the process of pregnancy is going to be difficult to conduct and endanger the life of mother and child. It is that very point that the fetus needs to be aborted as soon as it can (Nursing and Midwifery Council 2008). It should be noted that the case of Sara does not include the section 1(b) pointer of the act because her pregnancy seems to be normal and without any risk. This is why the midwife will not have much complication in making the case filed. In addition the Abortion act and the amendments made to the Act, it can also be noted that there were some of the legal justifications and legislations posed to address abortion and fetal sex consideration. This means that there were a number of cases that were posed to abortion due to the fetal sex (Griffiths and Tenagh 2008). There are many countries in the world where preference is given to girl and boy being different sex. As soon as the mother or father gets to know the fetal sex, they may undertake the decision of aborting fetus. This has been the case which has gained a great deal of address by UK legislation (Nursing and Midwifery Council 2008). The legislation marked against the fetus sex as the basis of abortion is strict and does not allow the parents to abort the fetus on the basis of fetal sex. There should be an accurate reasoning provided for the appeal of abortion. In the case of Sara, it has been noted that she does not have any issue with the preference of fetal sex. Thus, this legislation can easily be related to the case (Buka 2008). Conscientious Objection Clause in English Law: English law with the in-charge of the abortion Act provides a right namely conscientious objection that allows medical professionals to object or refuse to conduct pregnancy termination. But the necessary aspect of the clause is that it makes the medical professionals obliged for provision of treatment to the pregnant woman in a state of physical complication (Griffiths and Tenagh 2008). V. Ethical Consideration: The ethical grounds must be taken into account because a birth of a new child should not in any way harm the lives of other existent babies in the family. Also, in the case of faulty appeal of a woman for abortion due to unsafe sexual intercourse should not be terminated because the Abortion act has been passed just to safeguard the mental; and physical health of mother and family. This means that it is the right of the women to terminate the pregnancy by deciding whether she can take care of the baby or not in case where her life is in danger or other children of the family may suffer. However, in England and Wales, it has been noted that the number of cases of abortion has become increasingly filed (Dimond 2008). It is merely because women who are still able to give birth to baby and are sound financially are asking for termination of fetus which is against the law and ethical grounds of medical procedures associated with pregnancy. By taking the case of Sara under review, following are some of the ethical considerations that the midwife have to note. The following section provides medical practitioners with three main stances that are taken for abortion (Gordon 2004). Abortion Support: The supporting mindsets of people consider that abortion should be made available to all. The supporting view of people also shows that abortion availability is not an incorrect practice. Such a view is merely based upon non-recognition to the rights of fetus. Supporting views tend to describe a woman to be the significant subject of abortion and fetus is considered as secondary subject. In other words, it can be said that it is the right of a woman to undergo abortion as she is independent in terms of her body. In English law, it is quite to evident to note that a woman is able to excerice her right of rejecting the consent to medical law because she might consider that it will affect the child. The law case of St George's Healthcare NHS Trust v S; R v Collins clearly notes that the woman rejected the choice of treatment because of consideration to pregnancy as a natural process1. A woman is responsible for her pregnancy and the actions that need to be taken for fetus. Another argument that has been posed in this case is the availability of the contraceptives. The moralists claim that with the increased availability of contraceptives to the common people, abortion should be made available and easy to access by the women (Health Professions Council 2009). The application of such a thought becomes easily to observe in actual practice. The case of Roe v. Wade is an example of a case that clearly states women to be responsible for her body and termination of practice2. In reply of the charge of rights of a fetus being a person and a life, there is a very solid reason that is posed by the moralist. It has been claimed that a fetus may also have a right to born but the rights are comparatively lesser in strength to be undertaken for consideration than those who already exist. In other words, it could be said that the women can easily terminate the pregnancy if in any case there is a possibility of violation of rights of the existing babies. This clarifies that the choice of terminating the pregnancy is a legal and ethical choice of a woman making it clear that there need to be no debate in this regard (Hope, Savulescu and Hendrick 2008). In the view of supporting comments regarding of abortion, it can be said that Sara is responsible for her body and she should be the one who can make a decision as to what she really wants to decide for the family and herself. The responsibility of a mother does not halt as soon as the fetus is fully grown in a baby. A mother has to breastfeed the baby and takes care of the infant throughout the growing experience of the baby. It can be said that it is the sole right of the woman to decide whether she wants to keep the baby or not. When the rights of mother as a woman are raised then the rights of the fetus comparatively become less-weighing. Sara is also responsible for her body and she can decide for the birth of her baby (Gordon 2004). Against Abortion: The ethical considerations in the case of termination of pregnancy becomes debated when the viewpoint against the termination is observed. Notably, a number of people who are against the abortion or termination of pregnancy has claimed that abortion is basically sanctity of humanity. Also, the termination of the growth of fetus is totally against the rights of unborn child. These claims against the abortion have caused a severe debate in the medical field mainly because the medical professionals are put under critical reasoning. This has been noted in almost every country of the world. Talking in terms of Wales and England, it can be said that some of the people consider abortion as an immoral act because they are of the view that fetus is a person. The beginning of the pregnancy process is a very important time of a woman’s life and it should not be removed (Nursing and Midwifery Council 2008). Another reason that has been forwarded by this school of thought states that the abortion spreads a sense of disrespect among people regarding human behavior. It is for this reason that these people state that women should go through legal statuses in order to terminate their pregnancy because abortion is a moral sin and will reflect a negative behavior among the society. The debate has been noted to mark a considerable difference in the viewpoints among people. People with a negative viewpoint against abortion have claimed that as per the Criminal Justice Act of 1945, it can be said that killing of a breathing human is a crime. Within the context of this legal postulate, Paton v. UK case is a very famous yet relevant case (Hendrick 2004). As per the case proceedings, it was noted that husband of the mother was against the ideal of abortion. However, the judges made use of the legislation of UK Parliament (ART 2 of the Abortion Act)3. Following the claims against the abortion being undertaken in England and Wales freely, people with an opponent view of abortion also state that every human has a value. Every life has the right to live and survival. The moment when fetus starts to grow in a woman’s body, it holds all its rights which cannot be violated by mother. These views can also be referred to as moral and religious views (Pattinson 2009). Another very important aspect of the debate regarding abortion in England and Wales has been made on the basis of abortion’s impact on the special and handicapped people. In many cases and legal ob ligations, it has been noted that a fetus can be aborted in case of any abnormality (Nursing and Midwifery Council 2008). Mothers have also been noted to show interest on aborting babies who are predicted to have any sort of abnormality. The viewpoints against the abortion claim that aborting abnormal fetus spread the air of confusion among special and handicapped people. In other words, it could be said people who have some sort of abnormality consider themselves as unwanted and devalued humans because children like them are aborted and unwanted. This claim has been noted to be very powerful in terms of its effect on the handicapped people (Health Professions Council 2009). The negative comments regarding the abortion can also become centre of focus in the case of Sara’s appeal of termination of pregnancy. It is because religiously and socially, she will be teaching a lesson to her existent children in later life that one should get rid of the consequences. In other words, it can be said that Sara was unable to take care of the baby because she is not sound in terms of finance. The comments against the abortion make it evident that many people still believe that aborting fetus will not be a solution to a problem. It is the authorities who should provide food, shelter and wearables to the needy (Dimond 2008). Ethical Decision-making and Consent Provision: The medical practitioners need to understand the significance of consent and decision-making process that a patient must consider. As per the Mental Capacity Act 2005, it has been stated that there are four steps that are needed to be taken before undergoing abortion (Gordon 2004). 1. There should be collection of relevant information regarding the basis of decision (in case of financial disability leading to risk of mental health of existing children as a reasons behind abortion, relevant information could be collected through the earring data). 2. To retain the collected data relevant to the decision for any futuristic requirements. 3. To associate the collected information. 4. To eventually communicate the decision with the practitioners (Hendrick 2004). The above noted steps are needed to be undertaken by the decision-maker (patients) to show the capacity to consent. The case of Sara is somewhat similar. It is for this reason that Sara is obliged to undergo the above noted four steps so that the consent can easily be posed (Harris 2002). This is essential to note that case of Sara comes under the moral obligation as it is a matter of parents claiming that they are not able to take care of the bay. Thus this decision needs to be clearly noted as consent from the patient. This needs to be done by collecting the relevant information of the case and decision being undertaken by the midwife (Buka 2008). The above noted ethical postulates and opposing views stimulate a debate in the case of Sara. But the legal considerations make it easier for the midwife to prepare the case and file it for termination of pregnancy. In the case of legal grounds for abortion in Wales and England, the freedom for a woman to appeal for abortion is higher than other countries which have allowed woman to take care of their health. Thus, it can be said that midwifes can easily assist a patient in making a decision by considering the legal and ethical considerations. References List Beauchamp, T. & Childress, J., 2008. Principles of Biomedical Ethics. Oxford: Oxford University Press. Buka, P., 2008. Patient’s Rights, law and Ethics for Nurses. A practical guide. London: Hodder  Arnold. Dimond, B., 2008. Legal aspects of Nursing. New York: Pearson Education. Gordon, G., 2004. Eight Theories of Ethics. London: Routledge. Griffiths, R. & Tenagh, C., 2008. Law and professional issues in nursing. London: Learning Matters. Harris, J., 2002. The Value of Life. An Introduction to Medical Ethics. London: Routledge. Health Professions Council , 2009. Guidance on conduct and ethics for students. London: HPC. Health Professions Council, 2008. Confidentiality – guidance  for registrants. London: HPC. Hendrick, J., 2004. Law and Ethics in Nursing and Healthcare. London: Nelson Thornes. Hope, T., Savulescu, J. & Hendrick, J., 2008. Medical Ethics and Law. The Core Curriculum. London: Churchill Livingstone. Mason and McCall Smith, 2006. Law and Medical Ethics. New York: Butterworths. Nursing and Midwifery Council, 2008. The Code: Standards of conduct, performance and ethics for nurses and midwives. London: NMC. Pattinson, S.D., 2009. Medical law and ethics. London: Sweet and Maxwell. Table of Statuses Abortion Act 1967 http://www.legislation.gov.uk/ukpga Abortion Amendment Act 1990 http://www.legislation.gov.uk/ukpga/1967/87/section/7 Childcare Act 2006 http://www.legislation.gov.uk/ukpga/2006/21/contents Offences Against The Person Act 1861 http://www.legislation.gov.uk/ukpga/Vict/24-25/100/contents Criminal Justice Act 1945 http://www.legislation.gov.uk/ukpga/1988/33/contents Child Poverty Act 2010 http://www.education.gov.uk/childrenandyoungpeople/families/childpoverty/a0066302/the-child-poverty-act FHuman fertilization and Embryology Act 1990  http://www.legislation.gov.uk/ukpga/1990/37/contents Mental Capacity Act 2005 http://www.direct.gov.uk/en/Governmentcitizensandrights/Mentalcapacityandthelaw/Makingdecisionsforsomeoneelse/DG_186479 Sexual Offences Act (re underage sex) 1956 http://ministryofethics.co.uk/index.php?p=7&q=3 Table of Cases Case Year Location Paton v. UK [1980] EHRR 408 Roe v. Wade [1973] 410 U.S. 113 St George's Healthcare NHS Trust v S; R v Collins and others [1998] 3 All ER 673,S  Read More