Ethical Issues within Healthcare Provisions
Nursing & Midwifery
Abortion ——————————————————————————— pg.3-4
Medicinal Marijuana ————————————————————— pg. 5-6
Moral philosophies dealing with moral dilemmas in healthcare
Pragmatism ———————————————————————————pg. 7
Utilitarianism ——————————————————————————— pg.8
Consequentialism ——————————————————————— pg. 9
Deontological ethics or deontology ———————————————pg. 9-10
Post-modernism ———————————————————————— pg. 11
Bibliography ————————————————————————— pg. 12-15
Abortion is “when a pregnancy is ended so that it doesn’t result in the birth of a child, also known as ‘termination of pregnancy'” (BPAS, 2015). Abortion has been around for thousands of years and is still a controversial issue today. There are pro-life campaigners that are against abortion who puts the life of the foetus as the most important factor in the choice to have an abortion or not. There are pro-choice campaigners that puts the woman’s right to choose what to do with her own body as the most important factor. Being pro-choice doesn’t mean you are pro-abortion, it’s supporting women making their own choices over their bodies (Reddit, 2016).
Pro-life supporters campaign that abortion is murder and “that the killing of an innocent human being is wrong, even if that human being has yet to be born. Pro- life supporters also campaign that life begins at conception, so unborn babies are human beings with a right to life. Another argument pro-life supporters campaign is that foetuses feel pain during the abortion procedure because “almost 54% of abortions occur from 7-12 weeks, when a baby already has a developing nose, mouth, ears, bran waves, touch response and hiccups” (Mullins, 2016). Pro-life campaigners also argue that abortion is the killing of a human being, which defies the word of God” (ProCon, 2017). More arguments that pro-life campaigners use are that “abortion should not be used as another form of contraception and that an abortion can result in medical complications later in life; the risk of ectopic pregnancies double and the chance of a miscarriage and pelvic inflammatory disease also increases” (Lowen, 2018).
Pro-choice supporters campaign that “abortion is a safe medical procedure because medical abortions have less than 0.5 percent risk of serious complications and do not affect a women’s health or future ability to become pregnant or give birth. Pro choice supporters also campaign that in the case of rape or incest, forcing a women made pregnant by this violent act would cause further psychological harm to the victim. Another argument that pro- choice campaigners argue is that the ability of a woman to have control of her body is critical to civil rights and that abortion is not used as a form of conception, because pregnancy can occur even with responsible contraceptive use. Only 8 percent of women who have abortions do not use any form of birth control ” (Lowen, 2018).
The term medicinal marijuana “refers to using the whole, unprocessed marijuana plant or its basic extracts to treat symptoms of illness and other conditions” (National Institute on Drug Abuse, 2017). Marijuana is not recognised as having “any therapeutic value under the law in England and Wales, and a person can commit any of the range of offences including possession and supply” (Release, 2018). However, there is a cannabis-based product called Sativex. Sativex can be legally purchased and supplied in limited circumstances. Sativex is common amongst patients suffering from Multiple Sclerosis (MS) (Release, 2018).
People are either against or for the legalisation of marijuana for medical use. Campaigners against the legalisation argue that “frequent marijuana use can seriously affect your short-term memory, frequent use can impair your cognitive ability, smoking can seriously damage your lung tissue, smoked marijuana contains cancer-causing compounds and that marijuana has been implicated in a high percentage of car crashes and workplace accidents” (Morrow, 2018).
Campaigners for the legalisation of medicinal marijuana argue that “marijuana is
effective in relieving nausea and vomiting. Studies have shown that pharmaceutical cannabis can decrease nausea caused by chemotherapy used to treat cancer and almost completely eliminate vomiting. Campaigners also argue that marijuana can relieve the spasticity of the muscles that is sometimes associated with multiple sclerosis and paralysis. Marijuana can also help treat appetite loss associated with conditions such as HIV/AIDS and certain types of cancers. Campaigners also argue that marijuana can relieve certain types of chronic pain, including neuropathic pain and that studies show that smoking marijuana alone (without the concurrent use of tobacco) does not increase the risk of lung disease. Campaigners argue that marijuana does not need to be smoked to be medically beneficial. Products such as cannabidiol (CBD) oils, topical pain relief treatments and edibles are available” (Morrow, 2018).
Moral philosophies dealing with moral dilemmas in health care.
Pragmatism is “a philosophical movement that includes those who claim that an ideology or proposition is true if it work satisfactorily, that the meaning of a proposition is to be found in the practical consequences of accepting it, and that unpractical ideas are to be rejected” (Internet Encyclopaedia of Philosophy, 2018). Pragmatism is an unemotional approach to what is right or wrong. “For pragmatists the matter of ethics is approached practically” (O Sullivan, 2002). Pragmatists would answer the question whether an action is moral or not by looking at statistics and the maths of various health practices and seeing if the results are satisfactory or not.
John Dewey was an “American philosopher and educator who was a founder of the philosophical movement known as pragmatism. Dewey proposed that all things are subject to change and do change and the the challenge to human life, therefore, is to determine how to live well with processes of change, not somehow to transcend them” (Gouinlock, 2018).
Examples of health care practices that have been influenced by this idea is abortion. Pragmatists regulate abortion through laws such as safe abortions. Since the “1967 Abortion Act was introduced abortion deaths in Britain have fallen to almost zero” (Saunders, 2012). Pragmatists also remove the need for abortions in the first place as much as possible. For example, providing medical care for couples who want to have children (IVF treatment), having options like adoption, family planning services and for women not interested in having children access to education and birth control to prevent pregnancies (Reddit, 2013).
Utilitarianism “is the idea that the moral worth of an action is solely determined by its contribution to overall utility in maximising happiness or pleasure as summed among all people. The total utility of individuals which is important here, the greatest happiness for the greatest number of people. Utilitarianism is all about what is for the greater good” (Philosophy Basics, 2008). Utilitarians would answer the question whether an action is moral or not by looking at what is for the greater good. For example, forced sterilisation. In Britain, forced sterilisation upon an individual is decided in court (Erler, 2011). A case where authorities want to make an action for the greater good is “a mother of six with learning difficulties who will be lawfully forced to be sterilised by authorities to prevent further pregnancies. The mother lacked the mental capacity to make decisions on birth control, a spokesperson said that the reasoning behind the forced sterilisation are in favour for the woman’s own personal autonomy and for the safety of her children” (Sabin, 2015).
Jeremy Bentham was a famous utilitarian. He is most famous for producing the first utilitarian justification for democracy.(University College London, 2018).
Consequentialism is based on “two principles: whether an act is right or wrong depends only on the results of that act and the more good consequences an act produces, the better or more right that act” (BBC, 2014). Consequentialists would answer the question whether an action is moral or not by not looking at the action but the consequences, if they are good it is a moral action and if they are bad it is an immoral action. For instance, “most people would agree that lying is wrong. But if telling a lie would help save a persons life, consequentialism says it’s the right thing to do” (Ethics Unwrapped, 2018).
Consequentialism applies to health care practices in terms of forced sterilisation because if the consequences of forced sterilisation are stopping a child from being abandoned, unloved or abused, the consequences are good and therefore a good moral action. Consequentialism can also apply to health care practices in terms of abortion for the same consequences of forced sterilisation.
Deontological ethics or deontology
Deontological ethics biggest concern is what an individual does and not the consequences of their actions. For example, doing the right thing, because it’s the right thing to do. For example, don’t do anything wrong, avoid doing wrong things because they are wrong. Under deontology you can’t justify an action by showing that it produced good consequences. Deontologists live by a set of moral rules, such as: it is wrong to kill innocent people, it is wrong to steal, it is wrong to tell lie, it is right to keep promises (BBC, 2014).
This idea has been applied in health care through codes of practice and job descriptions. For example, “The Code: Professional standards of practice and behaviour for nurses and midwives” by the Nursing and Midwifery Council (NMC)” (NMC, 2008). There are cases where nurses have been fired for not following their code of conduct and going out of line with their job description. For example, Sister Sarah Kuteh. Kuteh had fifteen years experience being a nurse, but was dismissed from her job after offering to pray with her patients. Chiefs working at her hospital had said that her actions were unwanted conversations and were out of line and had offended patients (Turill, 2016).
Immanuel Kant was a deontologist well known for his famous moral theory. Immanuel Kant believed “that human inclinations, emotions and consequences should play no role in moral action; therefore, the motivation behind an action must be based on obligation and well thought out before the action takes places” (Seven Pillars Institute, 2013).
Postmodernists believe that truth is up to each and every individual to determine for themselves. Postmodernists do not think about what is right or wrong, true or false, good or evil. They only believe that there is no thing as absolute truth. A postmodernist views the outside world as being in error. (Philosophy, 2018). The post-modernism movement developed in the mid-to late- 20th century, during this era the Human Rights our freedom and basic rights that belong to every person in the world, from birth to death, were also created to prevent atrocities, like World War One and Two to happen again (Equality and Human Rights, 2018). Within health care, the NHS was developed to protect peoples rights. We allow our patients to practice their own believes and patients have the freedom to refuse treatments and have living wills. For example, Jehovahs Witnesses and blood transfusions.
Bauman joined the Communist Youth Association and started studying at the University in Gorki (Adam Mickiewicz Insititute, 2018).