Genetic decided to open up the issue

Genetic
Mutation (Tay-Sachs Disease)

Janet was married to Carlos duke for five years;
they had three kids, 2 boys, and a girl.
Janet and Carlos both planned to have five kids in a perfect world of theirs.
Just around the time when Janet had her fourth pregnancy and decided to start
her antenatal clinic checkups, she was told by her doctor at the 13th
week of her pregnancy that her fetus had a mutation on the HEXA gene causing Tay-Sachs diseases. The diagnosis was done by
means of Chorionic villus sampling, where samples of cells were taken from the
placenta to be tested. Janet’s doctor insisted that another diagnosis be
carried out around the 15 – 20th week of her pregnancy in other to
confirm the condition. At the 18th week of Janet’s pregnancy, an amniocentesis was carried out on
her, where a needle was used to remove amniotic fluid by guide of an
ultra-sound for testing. Few days after the test was performed, Janet’s doctor
confirmed to her that her fetus had Tay-Sachs
disease.

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Janet and Carlos were both carriers of the
genetic disease due to the fact that Tay-Sachs
disease is an autosomal recessive disorder; both parents did not manifest the
disease condition because they were only carriers of the disease and could only
express it when two recessive alleles were inherited from both parents.

After having a series of communications
with her doctor, Janet decided to open up the issue to her husband. Both Janet
and Carlos discussed over it, considering the options that were presented by
her doctor, both parties decided that Janet will terminate the pregnancy. Janet
had three carriers of the disease; it was unfortunate that her fourth pregnancy
resulted in a sufferer of the disease trait.

At the end of it all, Janet’s doctor
aborted her pregnancy at the 20th week by means of dilation and
evacuation.

Tay-sach’s disease causes progressive deterioration
of nerve cells resulting in mental and physical disabilities that begins around
seven months of age and usually results in death by the age of four.

 

 

Case
Study: Abortion

Introduction

There exist several definitions of
abortion these definitions can differ from each other in ways due to contentious
nature abortion, lawmakers and other
stakeholders often face controversy in defining it (Arzuaga et al., 2011)

Abortion is the spontaneous or induced
termination of pregnancy before fetal viability. In most occasions popular use
of the word abortion implies a deliberate pregnancy termination, some prefer
the word miscarriage to refer to spontaneous fetal loss before viability.
Induced abortion is that which is carried out in the medical setting via
methods of suction aspiration, dilation and curettage (D and C), dilation and evacuation
(D and E),saline injection, hysterotomy ,prostaglandin chemical and partial
birth  abortion. The National Centre for
Health Statistics, the centers of Disease Control
and Prevention (CDC), and the World Health Organization (WHO) defines
abortion as pregnancy termination prior to 20 weeks gestation or a fetus born
weighing less than 500g. Despite this definition, the term varies widely
according to state laws (Schorge et al., 2008).

According to the “UK
abortion law”, abortion is regulated by the Abortion Act of 1967, which
permits a doctor to perform an abortion if two doctors agree that there are
medical grounds for it. This Act has rules about the premises where abortions
may be conducted and about certifying and registering abortions. The Abortion
Act does not apply in Northern Ireland but pro-abortion groups like Amnesty and
Marie Stopes are working strenuously to extend it. The law of abortion in
Northern Ireland is based on the Offenses
Against the Person Act of 1867 which makes it an offense to “procure a miscarriage…unlawfully” (Lee, 1995). It is
known that abortions are carried out in Northern Ireland but under lawful
circumstances. In practice the department of health allows doctors to sanction
abortions without genuine medical grounds and seeks to ensure that abortions in
England, Wales and Scotland are typically funded by NHS finances and takes
place in NHS hospitals. (National Health Services).

The abortion Act 1967 is an Act of
parliament of the United Kingdom legalizing abortions by registered
practitioners and regulating the tax paid provision of such medical practices
through the NHS. This Act was introduced by David Steel on the 27th
of October1967 and came into effect on 27th April 1968(Sir John peel, 2012).

 

 

 

 

Case
study on Ethical Dilemmas in Health Care

Case
study: Infectious agent (Toxoplasma-gondii)

On
returning from her engagement party, Clara realized that she’s been
experiencing flu-like symptoms of headache, weakness, nausea, and fatigue. Maybe it’s just the psychological syndrome
surrounding the first trimester of her pregnancy she exclaimed! Clara then
decided to visit her doctor because the symptoms had been ongoing for days. Her
doctor then decides to give her a series of physical, medical and laboratory
examinations.

After
all the findings, Clara’s doctor realized that she was diagnosed of Toxoplasma gondii (IgM) positive. Clara was two months
pregnant when her doctor broke the news to her, she did not know how to take
it. She might have gotten infected with the parasite (Toxoplasma Gondi) through fecal-oral
means (i.e. by consuming undercooked meat containing tissue cyst of the parasite
or by ingesting unpasteurized milk, water or vegetables contaminated with oocysts shed in feces of an infected animal (cat).
After listening to the doctor’s lecture on the effect of the parasite on the
fetus, she was advised by her doctor to do a fetal test (cordocentesis),
involving the removal of the baby’s blood from the umbilical cord, which was
carried out at the 16th week of her pregnancy.

Day’s
after the laboratory diagnosis, the result came out positive, proceeding with
an ultrasound; her doctor discovered the fetus had developed congenital
malformations of hydrocephalus, intracranial calcification, and ventriculomegaly.
At that stage having (keeping), the
pregnancy is equal to giving birth to an “incomplete retarded and physically
deteriorated individual”.

Following
a battery of choices and outcomes thrown to Clara by her doctor, Clara decided
to go for a D and C (dilation and curettage) without informing her fiancé. She
intends to tell her boyfriend that she accidentally had a miscarriage. Finally, Clara aborted her pregnancy, following
the affirmation of her doctor.

 

Discussion of Balanced Ethical Arguments

Is
it ever right to commit an abortion? What does it mean to have an abortion? Well, abortion is legal in England under the Abortion
Act of 1967, which permits a doctor to perform an abortion if two doctors agree
that there are medical grounds for it. As concerns Clara’s case, she was
diagnosed with an infectious parasite at the 8th week of her
pregnancy which was later confirmed by her doctor at 17 weeks that her fetus
had been infected with the parasite (Toxoplasma-gondii).
The act of Clara committing abortion was justified by law (legal justice) under
the Abortion Act of 1967, due to the fact that there was substantial risk that
if the child were born it would suffer serious physical and mental abnormalities
(Dr. Gavin, 2009). This is true because the fetus had developed congenital
malformations of ventriculomegaly,
hydrocephalus (water in the brain) and intracranial calcification. At this
stage keeping the fetus is equal to giving birth to”nonsense”. What is the
essence of bringing forth life, when life and the value of life cannot be lived
to its fullness? The concept of rights-based
justice was also scrupulously employed by Clara, which was based on the respect
of her own rights after a cocktail of explanations, information’s and options
were disposed by her doctor concerning the condition.

Spontaneous
miscarriage was one of  the effects of
the parasite on her fetus, due to the fact that she caught the infection at her
first trimester, and continuance of the pregnancy would involve risk to her life
greater than if the pregnancy were terminated and the termination was necessary
to prevent grave permanent injury to the physical or mental health of the woman
involved (Joan, 2001). In addition, the
benefits and the balanced benefits of the outcome (abortion) was high against
the risks involved (not aborting). This is the ethical principle of beneficence
which was concisely employed by the parties involved to generate the best
outcome. In this case, the fetus involved
had already been malformed and the mother in question was at risk of spontaneous
miscarriage which was detrimental to her physical and psychological well-being. What she c decided to keep the
pregnancy and later suffers a spontaneous miscarriage which will lead to the
evacuation of her womb? That would have been insensible and stupid.

Furthermore,
the greatest happiness (good) was obtained for the greatest number and was used
as a measure of right, taking into consideration the circumstances surrounding Clara’s
pregnancy. At the end of it all, she did
what was good for the majority and that is the principle of utilitarianism. The
mental and physical trauma that comes with caring for a baby with a severe
defect was eliminated, which at the end of it all the prognosis of the
condition is futile. A condition characterized by severe organ damage to the
brain, heart, and eye which leads to a
limitation in the performance of basic human activities like  respiration, reasoning, locomotion, and sight. Imagine the social and psychological
stigma that would be inflicted not only on the child but on the mother as well
and the overwhelming stress that comes from managing such baby’s which will eventually
end in the death of the child. Even though the primary action of abortion may be
bad, the end results was good considering the choices involved. The consequence
of the action was assessed in relation to the overall good. Some researchers
will argue that the fetus has a right to life. Even if the fetus possesses a
right to live, it is not entitled to the
use of the mother’s body because her right to control her own body is paramount
(Mathew Lu, 2011). Don’t women have the right to do what they want with their
own bodies? Are they not autonomous about what happens to their bodies? What happens
when the fetus is a threat to the mothers own life? In such particular
instances abortion is legal, not all dead’s are alike and not all deads are
involved in evident destruction. Since the fetus is not yet a person or an
independent entity, abortion is not considered murder because the fetus is a
part of the mother as it, not a person until
it comes into the world.

To
continue, deontologist will highlight to act only on the maxim, through which
an individual can at the same time will
so that it should become a