ETHICS AND RESEARCH
Description of the Case-Study Containing an Ethical Dilemma
Mrs. K is a 37-year-old married woman who has four children. She has had irregular periods and decided to seek a consultation with her doctor to find the reason and intervention for the irregular periods. Mrs. K had been using a diaphragm as a form of contraception to prevent pregnancy, having stopped taking birth control pills because of their side effects. When she visits her doctor, the doctor tells her that she is pregnant. Mrs. K is in a dilemma because of the news of her pregnancy, yet she does not want another child. She says she already has as many children as she can cope with. The news of her pregnancy leads her into a depression because she does not know how to approach the issue of the pregnancy with regard to keeping it or aborting it. Her doctor considers her circumstances and suggests that the circumstance falls within the Abortion Act 1967. This means that the doctor has advised Mrs. K to seek an abortion because it is within the provided law and refers her to a clinic. Mr. K, a husband to Mrs. K is not of the same view with the doctor and disagrees with abortion.
Issues the Dilemma Raises
The ethical principle that guides this case study is that abortion is considered illegal and unwanted in the society unless it endangers the life of the mother. To understand the ethical issues brought about by this dilemma it would be essential to know the religion of Mrs. K, the period under which Mrs. K has been pregnant and her health status. The dilemma raises several ethical issues. First, the dilemma raises an ethical issue of whether to abort or not. The decision to abort the baby is an ethical issue because abortion is not an act agreeable to the society because of its controversies attached to killing. Secondly, Mrs. K had decided to use contraceptives to ensure that she would not get pregnant. However, as it has been found, she got pregnant accidentally and has to make an appropriate decision. Carrying out an abortion could be right because as the doctor puts it, it is allowed in the Abortion Act of 1967 while on the other hand it could be wrong judging from the circumstances that Mrs. K falls within, such as her religion, age and culture among others.
The second issue that the dilemma raises is whether the doctor is rightly placed to make a decision for Mrs. K. It is obvious that Mrs. K does not want to keep the pregnancy because of the fact that she has as many children as she can cope with. However, the doctor refers Mrs. K to a clinic without informing her about the consequences and maybe the requirements of the abortion. In fact, the doctor has only considered that her circumstances fall under the Abortion Act of 1967 but has not discussed with Mrs. K to see if she has another option out of the problem.
Another ethical problem that arises is that while Mrs. K does not want to keep the pregnancy, meaning that she is considering an abortion, Mr. K does not want the abortion. The ethical issue here is whether Mrs. K would be ethical to seek an abortion without putting into consideration the feelings and the reasons that Mr. K puts forth. Mr. K is an equal party in this issue because he is involved as Mrs. K’s spouse. Another issue is whether Mr. K is ethical in disagreeing with the abortion, yet he is not the one carrying the pregnancy. In addition, assuming that Mr. K is responsible for the pregnancy, would it be ethical for him to disagree with the abortion yet he does not use a form of contraception and put that responsibility on Mrs. K. Therefore, the above are the ethical issues that arise in the dilemma.
The Different People Involved
The ethical principle that guides different people in this scenario is their influence over Mrs. K and the consequences of their advice on Mrs. K and her family. Different people are involved in this dilemma. They include Mrs. K, Mr. K, Mrs. K’s doctor, professionals at the abortion Clinic, religious leaders and friends, family members of Mrs. K other than Mr. K, legal officers and health and social care assistants. Mrs. K is the first person in the dilemma for the fact that she is the one carrying the pregnancy. As has been revealed, she does not want to keep the pregnancy because she has enough children that she can support. Therefore, her view of getting out of this dilemma is to conduct an abortion and do away with the pregnancy and the complexity it seems to bring for her in the future. Therefore, for her abortion is the most appropriate solution to get out of that dilemma because of the constraints she is facing with her present conditions. The second person in this dilemma is Mr. K. In this situation, we cannot tell clearly whether Mr. K is responsible for the pregnancy or whether he declined to use contraceptive all together. However, it would be essential to assume that Mr. K did not want to use contraception and is responsible for the abortion. Nevertheless, Mr. K is opposed to the abortion. His position could be informed by the fact that he wants Mrs. K to keep the pregnancy because he wants the baby or he does not want to risk the life of Mrs. K by agreeing to support her in the process of abortion. Just like Mr. K, Mrs. K’s family may oppose the abortion because they would not like to put Mrs. K’s life in danger in making her take an abortion just because she has many children.
Another party in the dilemma would be religious people. Religious people are guided by the ethical principle of upholding spiritual values, one of which abortion is not. Here, it would be essential to assume that Mr. and Mrs. K are Christians because religion plays a morally significant role in determining the decision that Mr. and Mrs. K can make in this dilemma. Therefore, if we assume that Mr. and Mrs. K are Christians, their religion and religious leaders and friends will want Mrs. K to keep the pregnancy because Christianity does not allow abortion at any cost especially when the pregnancy does not affect the health of the unborn baby or the mother. Therefore, they could take this position because abortion because they consider abortion to be murder and a sin before God.
Mrs. K’s doctor is also involved in this dilemma importantly because he refers Mrs. K to take an abortion at a certain clinic, but should, at the same time, employ the ethical principle to protect life. The doctor helps in bringing another assumption about Mrs. K because of the doctor’s reference of the Abortion Act of 1967. Being 37 years old now, we assume that Mrs. K’s pregnancy is less than 28 weeks of gestation because the amendment made to the Act requires that a person be allowed to take an abortion before the lapse of 28 weeks of gestation unless the pregnancy is a risk to the life of the person. Mrs. K’s pregnancy does not put her life at risk, as the case does not show that. Therefore, the reason for the doctor’s advice could be justified by the observation that Mrs. K’s pregnancy is not more than 28 weeks old. Legal officers and health and social care assistants may support her in the decision to take an abortion first because it is within the law and secondly because it will be best for the wellbeing of her family. This view will be supported by the fact that social care assistants should help people live healthy and comfortable lives. In this view, it will be essential to assume that Mrs. K has resources only enough for the children she has judging from the fact that she says she has as many children as she can cope up with. Therefore, by allowing Mrs. K to take an abortion, they will be ensuring that the other children, that she has, get proper attention from her assuming that she only has the resources to support them and not any additional child.
Identify and Discuss Potential Conflict(s) and Points of Agreement in terms of Ethical Arguments
In discussing the potential conflicts and points of agreement in terms of ethical arguments, it is important to state that abortion is not acceptable in normal circumstances. It is also significant to bring in certain moral theories of ethics. In this dilemma, the potential conflicts arise on whether to keep the pregnancy or abort it and the consequences that will follow either action. Utilitarianism is a theory that is founded on the belief that right and wrong can be dealt with on the analysis of costs and benefits. The theory states that people must look at all the consequences when deciding whether an action is right or wrong (Sheng & Sheng, 1998, p. 1). Utilitarianism, therefore, is a theory that puts morality on the weight of reason based on good and bad. For utilitarians, an action is considered right when it brings good consequences compared to alternative actions. For instance, they state that it is wrong to harm others to benefit yourself because everyone is as important as one individual person. Using utilitarianism, the consideration of whether or not to take an abortion should be tied on the consequences of that action (Sheng & Sheng, 1998, p. 3). In addition, when considering abortion, it is imperative to point out that the right action and the right moral decision are two different issues. Therefore, if Mrs. K decides to take an abortion, it might be right if she does it to ensure that the other children she has do not suffer because of the new baby. On the other hand, it would be morally wrong to take an abortion considering that the abortion will be denying the unborn baby the right to life for the sake of the happiness of the other children and Mrs. K. in addition, it could be immoral because it will make Mr. K unhappy with that decision.
Another theory, categorical imperative, advises that people should act in a way that they will to be a universal law. The theory posits that people should behave and act in a rational way that would be rational to anyone. For instance, if it is right for one to defend himself when attacked, then it is similarly right for others to do so. This is moral. Robert Johnson created four steps that one can follow to find out whether an action is right and moral. The first step is to formulate a maxim that justifies a reason for acting in a particular way. The second is to put the maxim as a universal law of nature that should govern all rational beings. The third is to consider whether the maxim is plausible in a world governed by the maxim as a law of nature and fourth is to consider whether one can act on that maxim in such a world. If one can act on that maxim, then the action is morally plausible (Basford & Slevin, 2003, p. 225). Using the categorical imperative theory and assuming that abortion is allowable under the Abortion Act of 1967, it would be morally appropriate for Mrs. K to go on with the abortion because she can do and any other person can do it. However, a conflict would arise, if her husband’s objection were put into consideration. Despite the fact that, under the Abortion Act of 1967 one is allowed to conduct an abortion, the Act does no mandate people to carry out an abortion whenever they have pregnancies under 28 weeks of gestation (Latham, 2002, p. 104). Therefore, Mr. K is right in his own right for opposing the abortion since his maxim could also be used universally. Therefore, putting this scenario under this theory, it becomes difficult to tell whose choice is moral or not.
Another theory that can be used in this dilemma is Aristotelian Virtue Ethics. In this theory, Aristotle argues that person fulfilment and happiness is the utmost goal all persons should promote (Mizzoni, 2009, p. 34). He also argues that people should develop habits and behavior that helps in the realization of personal happiness. The Aristotelian Virtue Ethics Theory states that something is morally right if it is based on sensitivity to the existing situation and it leads to personal happiness (Mizzoni, 2009) (Mizzoni, 2009, p. 35). If we consider this theory, then all the parties involved in the dilemma are morally right even if they differ in their positions. Mrs. K is morally right to seek an abortion because it fulfils her personal happiness, Mr. K is morally right to oppose the abortion because it fulfils his personal happiness. This is also the same for all the other parties.
Therefore, potential points of conflict that arise in the dilemma are tied to the wellbeing of Mr. and Mrs. K and their children. While the abortion could be good for the wellbeing of the other children because of the available resources, it could be dangerous if it risks the life of Mrs. K as their mother. If the abortion can cause complications that could lead to her death, then the abortion becomes a bad option. On the religious point of view, the potential conflict originates from the fact that the abortion whether beneficial to Mrs. K or not is a sin because it is considered to be murder.
How Issues such as gender, ethnicity, religion, etc. might Influence How People Respond to the Ethical Dilemma.
Issues about gender, ethnicity, culture and age play a significant role in influencing how people respond to the ethical dilemma brought by the possibility of the abortion. First, religion plays a pivotal role. Most religions discourage abortion because conducting an abortion is considered a murder and a sin before God. Following the assumption made above, religion will not allow Mrs. K to conduct an abortion because it is not ethical under the Christian ethical codes. In Britain, for instance, she could belong to the catholic doctrine, which does not allow abortions. Ethnicity and culture could also play a significant role in influencing how people respond to the ethical dilemma. Ethnicity and cultures where one originates from have certain customs and taboos that should be respected. Obviously, Mrs. K belongs to a certain ethnic and cultural group. Despite the fact that she might make her own decision to conduct an abortion, the other people involved in the dilemma might use the customs and the taboo to either agree with her or disagree with her. Not any of communities in Britain condone abortion. However, it allowed by law for personal choice. Therefore, the ethnic group she might belong to be it Asian Britons or Black Britons, her choice of abortion might not be acceptable.
Gender may play a role in influencing how people respond to the dilemma. Despite the fact that gender issues have been streamlined in Britain, Mr. K may feel he has a right over Mrs. K because he is the head of their family. The gender of the Doctor could also come in handy. Women feel free to talk to their female counterparts especially on the issues of their sexuality. This is specifically on matters of abortion. Therefore, Mrs. K may feel safer to take the advice of the Doctor if she is a woman because she identifies with her in terms of gender. Issues of gender and sexuality mostly go hand-in-hand. Mrs. K may feel that she has the upper hand to decide on the best solution to the dilemma because she is the one carrying the pregnancy.
How Relevant Codes of Professional Conduct and Law, As Applied to the Dilemma, help with arriving at a Moral Solution.
Doctors have the moral responsibility to protect human life. This is their ethical principle. Relevant codes of conduct and law may or may not help in arriving at a moral solution, as applied to the dilemma. The law being applied in this scenario is the Abortion Act of 1967. Under this law and basing on the observations of the doctor, Mrs. K fits to seek an abortion legally (Latham, 2002, p. 104). However, this law does not state that if Mrs. K conducts an abortion she will be doing the right or moral thing. She might be doing an action agreeable by the law but may not be right considering other circumstances, such as Mr. K’s position. The law only sets a platform for the legality of the process. According to the law, Mrs. K would be right if she conducts an abortion because the law allows her to do it. However, when looking at a moral solution, the law does not help to arrive at it if it is looked at from the totalitarian point of view. However, if looked at through the Aristotelian Virtue Ethics, the law will be helping Mrs. K reach a moral solution through helping her find personal happiness. This applies similarly to the relevant codes of professional conduct. Considering the codes of professional conduct for health practitioners in Britain, the doctor helped Mrs. K arrive at a moral solution of personal happiness by considering her circumstances and referring her to the required clinic (Gaag, 2008, p. 3). This is a moral solution if looked at from the Aristotelian Virtue Ethics point of view. However, the doctor may not have helped Mrs. K reach a moral solution because the doctor was supposed to advice Mrs. K to discuss with her family before referring her to the clinic. This can be justified through the utilitarian theory because the doctor did the right thing but failed to consider the view of Mrs. K’s family in that dilemma.
A moral solution for Mrs. K would be to abort the baby. This is because, by aborting the baby, she will be doing something that will ensure her of her happiness and the happiness of the children she already has. One has the morality to ensure that those under his or her protection and dependence are well taken of. Using Aristotelian theory, she will be right and moral when she aborts the baby because considering a universal law would be difficult because every person has his or her own way of choosing what they consider to be universal. Therefore, Mrs. K should abort the pregnancy because by ensuring that her children are catered for, her happiness is assured.
In conclusion, the issue that makes the case a dilemma is whether Mrs. K should take an abortion. Various theories discussed above justify or fails to justify the morality of the positions that various people involved hold with regard to the dilemma. Therefore, considering the dilemma from different viewpoints, theories and the positions of the involved parties, the morality of the dilemma becomes a contentious issue.
Basford, L. & Slevin, O., 2003. Theory and Practice of Nursing 2nd Ed: An Integrated Approach to Caring Practice. 2 ed. New York: Nelson Thornes.
Gaag, A. v. d., 2008. Standards of Conduct, Performance and Ethics. Health Professions Council, pp. 3-8.
Latham, M., 2002. Regualing Reproduction: A Century of Conflict in Britain and France. Manchester: Manchester University Press.
Mizzoni, J., 2009. Ethics: The Basics. New York: John Wiley & Sons.
Sheng, C. L. & Sheng, Q., 1998. A Utilitarian General Theory of Value. London: Rodopi.