Leadership refers not to the position or power of a person; it is a particular person’s relationship with his or her followers/community. Ethics is not focused on the individual; it is about an individual’s relationship with the people around him or her. Therefore, leadership ethics relies on the web of relationships within the community. Workers or followers will conduct their behavior based on what the leader shows them. The leader is the one who sets the standards in an organization, and his actions directly impact all those around him or her, creating the mood set in the community. The Dalai Lama has brought attention to the need for a revision on ethics. There are a number of new medical technologies that can be said to improve the lives of people. However, there are questions of ethics that plague these scientific discoveries. The issues on euphemism, sex or gender change, assisted reproduction and other things possible in the medical field all have their issues on ethics. This paper discusses the ethics on assisted reproduction with the morality views of the Dalai Lama.
Assisted reproduction is something made possible through today’s advancements in technology. It is the process where a woman bears a child for someone else (Bavister, 2002). This was also seen in the past – where a woman could not bear a child for her husband – the couple would find a woman which the husband would impregnate and bear child. However, today modern technology enables a couple to have a child through another woman without going through this unusual process. This can be done through vitro fertilization (IVF). IVF is a scientific procedure which enables couples who are unable to have a child the baby which they desire without having to adopt. Even though this process is quite common nowadays, it still goes through very common complaints in regards to its ethics.
IVF is where a surrogate mother is provided a fertilized egg – the sperm and the egg can be either donated by a third party or provided by the couple – and the surrogate mother is to bear the child in her womb (Bavister, 2002). Simply put, surrogacy is the arrangement in which a woman carries and delivers a child for another person and/or couple. Genetically, the woman can be the child’s mother, or she may be carrying the embryo transferred to her uterus from another woman. Surrogacy involves a lot of people. This includes the parents, or the couple desiring the child, the surrogate mother, and sometimes even fertility specialists, lawyers and surrogacy agencies.
There have been issues in the past which have created this surrogacy to be a highly controversial issue. Like the famous issue of Baby M (Bavister, 2002). With the baby M case, the biological mother of the baby, Mary Beth Whitehead, whom provided both the egg and the womb for a couple desiring a child, at the end of the pregnancy decided to keep the child. This devastated the couple awaiting the child and left court decisions in a tangled mess. Due to the legal and ethical complications of this rare situation, surrogacy cases now require a contract for the woman bearing the child and/or donating the egg.
Along with complications such as this, it is not surprising that surrogacy has many moral concerns as well. The first example of surrogacy can be traced back to the time of Abraham as recorded in the Bible. This is where Sarah, Abraham’s wife decided that Abraham should impregnate their servant, Hagar so that Sarah may have a child. This sort of surrogacy can be seen and criticized as adultery. However, because of the advancements of technology, this type of surrogacy is no more needed, and babies can be created in test tubes and Petri dishes. Now, the thought of this scientific procedure in creating life may conjure up ideas of science-fiction or even horror movies to mind. Also bringing up the fear that the woman you entrust to bear your child is a complete stranger whom you really know nothing of. The thought of surrogacy has many ethical issues coming from left and right. Surrogacy helps both parties who are in need.
The use of selective abortion is discussed when one of three situations occur: testing positive for the possibility of a genetic disease, gender preference, and reduction of multiple fetuses usually due to fertility treatments (Asch, 1999). Many issues arise because of this because it is still seen as taking an innocent baby’s life. Some who stick to traditional ways of thinking and completely close off science as an alternative to reproduction and starting families believe that life is something which should be left totally to God or nature.
Before a child is born, a mother who is undergoing pre-natal care will be tested for any diseases the unborn child could have. Any findings which can pose as possible threats to the mother bearing the child are reported, and abortion is opened up as an option (Asch, 1999). The tests which detect any defects, diseases or serious illnesses are designed to reduce any types of complications, and this is to ensure the complete health of the baby as well as the mother. However, there are many who still believe that a child should be loved and nurtured no matter what ailment or disease he or she may have – that children who may have special needs and the like still deserve to live and have equal opportunities. Opposing that point of view, many believe that it is a reality that bringing a child with special needs into the world makes it difficult for both the child and the parents – that the child cannot have a normal life (Fauser, Devroey & Macklon, 2005). The sex-selective abortion brings up a similar concern where parents can choose if they would like a male or a female child.
The importance of maintaining patient privacy is unquestionable. Patients belief that health care professionals will handle their personal information with respect, dignity and maintain their confidentiality not only illustrates the ethical and legal responsibilities of health care providers, but correlates positively with the formation of trust between patient and nurse. According to Stein-Parbury (2005 p.42), “ without trust, there is minimal self-disclosure and little chance that patients will share their experiences with nurses or that nurses will come to understand patients’ experiences.” Therefore, through the maintenance of patient privacy and confidentiality, the element of trust, which forms the basis of all nurse-patient relationships, is strengthened. Crisp and Taylor (2005), illustrated the importance of patient privacy and confidentiality as without these two essential components patients would not feel able to tell health care professionals their most intimate and private details. This potential hesitation to share personal information with health providers can have a negative impact on the provision of care and can ultimately lead to treatment that does not take into consideration essential aspects of patient’s health.
The maintenance of patient’s privacy is essential in both building trust between nurse and patient and providing holistic nursing care. As stated previously, the maintenance of patient privacy has implications in both legal and ethical spheres and is paramount to the formation of the nurse-patient relationship. Student nurses must therefore gain an understanding of the importance of maintaining patient privacy to ensure that once qualified as a registered nurse, one will understand the reasons why legally and ethically we must adhere to the guidelines. In today’s health care setting, the emphasis of patient’s rights and understanding these rights is paramount if one wishes to practice safe appropriate care for all peoples. It is for these reasons that the central issue of patient privacy was selected for consideration.
Although the importance of maintaining patient privacy is unquestionable, there are certain situations that warrant the sharing of patient information. As observed by the student nurse, health care professionals continuously share patient information between themselves in attempts to allow allied health professionals to provide appropriate holistic patient care. In today’s hospitals, with shift work and the increasing specialization of various allied health workers, it is essential that patient information is shared to improve patients care and outcome. In order to achieve appropriate care for patients, this is a requirement and will not be considered as a breach of patient privacy. This team work approach to health care is viewed as of benefit to the patient and is absolutely essential is today’s health care facilities where health care professionals are increasingly working in more specialized fields.
Informing patients of various treatment options and encouraging patients to take an active role in decisions about their health are fundamental components of informed voluntary consent. Informed voluntary consent may be implied, written or verbally given. The student nurse observed various nurses obtaining implied consent from patients when performing routine procedures such as taking a blood pressure reading. The student also viewed health providers obtaining verbal consent from patients when preforming procedures such as showering and mobilizing patients. The health providers adhered to the legal requirements which state that consent must be voluntarily given and informed (Forrester & Griffiths, 2005). It is essential that student nurses have an understanding of their moral and legal requirements surrounding patients consent. If a health provider performs a procedure without acquiring consent, there is a possibility that their actions legally may amount to assault or battery. According to Forrester and Griffiths (2005), battery involves the unlawful touching of a person without his or her consent. In charges of battery, there is no requirement that the patient sustains any injuries as a result of health professionals unlawful touching. Health providers must therefore have an understanding of the legal ramifications surrounding consent to ensure that they provide safe nursing care based on respecting patient’s legal rights. It is for this reason that the issue of patient’s consent was included for discussion in this paper.
It is becoming increasingly important for health professionals to have an understanding of their legal and ethical responsibility for the maintenance of patient privacy and obtaining informed voluntary consent prior to performing any procedure with patients. With the emphasis on patients rights becoming more prevalent in the health care setting, it is essential that health care workers respect patient’s rights which include, but are not limited to, maintaining patient privacy and obtaining informed voluntary consent.
In particular, those aspects observed by the student relating to patients privacy and confidentiality were described and discussed with reference to incidences where nurses may be involved in fostering these basic patient rights. Situations in the hospital setting where the student nurse viewed health professionals informing patients about treatment options, encouraging patients to take action in decisions about their health, and gaining informed, voluntary consent prior to procedures was examined. The importance for selecting consent and privacy was illustrated in terms of nurse’s ethical and legal responsibility to promote and respect patient’s rights.
Works Cited
Asch, A. (1999). Prenatal Diagnosis and Selective Abortion. In Alper, J.S., C. Ard, A. Asch, J. Beckwith, P. Conrad, and L. N. Geller (Eds.), The Double – Edged Helix. Baltimore: John Hopkins University Press.
Bavister, B. D. (2002). Early history of in vitro fertilization. Reproduction, 124, 181-196.
Crisp, J., Taylor, C. (2005). Potter & Perry’s fundamentals of nursing. (2nd ed.). Marrickville (NSW): Elsevier.
Forrester, & Griffiths. (2005). Essentials of law for health professionals (2nd ed.). Marrickville ( NSW): Elsevier.
Fauser, B., and P. Devroey, and N. S. Macklon. (2005). Multiple birth resulting from ovarian stimulation for subfertility treatment. The Lancet, 365, 1807-1816
Stein-Parbury, J. (2005). Patient & person: Interpersonal skills in nursing. (3rd ed.).
Tanner. L, (2007), "Boom Times in Denton County", Dallas Business Journal, Retrieved from: http://www.bizjournals.com/dallas/stories/2007/06/11/focus2.html on June 12, 2008.
