Ethical Considerations for Sickle Cell Disease Paper
Ethical Considerations for Sickle Cell Disease Paper
Ethical Considerations for Sickle Cell Disease Paper
Discuss any ethical considerations for sickle cell disease.
2. Compare how genetics can improve care and health outcomes while reducing cost to usual practices.
3. Discuss the changes in approaches to care when new evidence warrants evaluation of other options for improving outcomes or decreasing adverse events.
4. Create a plan for how you might educate colleagues and/or patients on this genetic disorder.
Original work, proper English, include subheadings and and a introduction with a thesis statement. Also add a conclusion
Complete a paper with 1,000-1,250 words.
The issue of safety of the procedures used for PND is worth mentioning first. Though they are found to be relatively safe, there is still a chance of a miscarriage following chorionic villus sampling and amniocentesis (worse with CVS and usually multi-factorial) 9, 10. Abortion of the affected fetus is regarded as a component of PND in most cases. In the case of the fetus having the SS genotype, the ethical question arises whether to have an abortion or to keep the pregnancy. The decision whether to terminate a pregnancy based on a positive result is usually a difficult one that involves religious, psychosocial and cultural considerations1.
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Another reason why the abortion of an affected fetus may not be accepted is because of the risk of complications mainly due to lack of reliable and safe health care practices in developing countries. Even when abortion is legal in the local context, the question whether it is right to terminate an innocent life is still a much debated issue. If on the other hand, a decision is made to keep the pregnancy, the question whether it is right or not to bring a child with a disease condition that causes so much suffering to the world. Utilitarians would argue that it is more cost effective to abort the affected fetuses as this will reduce on the long run the socio-economic and
emotional consequences of the disease. Bringing up the question of cost-effectiveness and life of patients would be looked at in many developing countries like Nigeria as being cold and inhuman, but the reality of scarcity of resources and rationing of health care resources is there for all to see. The introduction of pre-implantation genetic diagnosis (PGD) in developed countries would seem to have put the controversial issue of termination of affected pregnancy at rest as only “genetically healthy” embryos will be transferred to the uterus. The practice itself is laden with its’ own ethical dilemmas relating to: the moral status and destruction of embryos, tendencies for eugenic practices (selection of particular traits in the embryo), the possibility of long term complications from the procedure and distributive justice issues11. Opponents of these prenatal or preimplantation tests would also argue that SCA is now becoming a chronically manageable disease with increase in life expectancy and quality of life of patients hence there is no reason for these investigations.
Some people would argue that using a prenatal diagnosis for SCA would lead to a systematic elimination of the genetic mutation from the population. Could this be called a form of eugenics? The author definitely does not think so as the choice here is not about specific traits that are desired in a child but having a child free of a particular genetic disorder. The right to know is a fundamental right of the couple hence carrying out a PND for SCA actually empowers the couple to plan for the new child (if they decide to keep the pregnancy – if SS genotype) and gives them peace of mind (if AS or AA genotype). This is the autonomous choice of the couple, a right to decide what is acceptable to them. There is also the risk of pressure being put on the couple directly or indirectly by the society to have prenatal diagnosis done because of the availability of the tests (the so called technological imperative). This could lead to affected couples being blamed for not making use of the tests to avoid having children with sickle cell disease.
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