Fetal Abnormality Case Study: Moral Status Essay HLT310V
Fetal Abnormality Case Study: Moral Status Essay
Background: Advances in genetic screening can identify patients at high risk for common genetic conditions early in pregnancy and can facilitate early diagnosis and early abortion. Less common abnormalities might only be diagnosed with invasive testing is performed after structural abnormalities are identified.
Objective: Our objective was to compare gestational age (GA) at diagnosis and abortion for genetic abnormalities identified based on screening with abnormalities that were not discovered after screening.
Study Design: All prenatal diagnostic procedures from 2012 to 2017 were reviewed, and singleton pregnancies terminated following diagnosis of genetic abnormalities were identified. Cases diagnosed as the result of screening tests were compared with remaining cases. Conditions were considered “screened for” if they can be suspected by cell-free DNA testing, biochemistry, carrier screening, or if the patient was a known carrier of a single-gene disorder. When abnormal karyotype, microarray, or Noonan’s syndrome was associated with abnormal NT, these cases were considered “screened for.” GA at abortion was the primary outcome. Fisher’s exact test and Mann–Whitney’s U test were used for statistical comparison.
Results: In this study, 268 cases were included. A total of 227 (85%) of abortions were performed for “screened for” disorders, with 210 (93%) of these for karyotype abnormalities, 5 (2%) for microarray abnormalities, and 12 (5%) for single-gene disorders. Forty-one (15%) of abortions were performed for conditions not included in screening, with 8 (19%) of those for karyotype abnormalities, 25 (61%) for microarray abnormalities, and 8 (19%) for single-gene disorders. Invasive testing and abortion occurred at earlier median GA for those with conditions that were screened for: 122/7 versus 155/7 weeks, p ≤0.001 and 135/7 versus 200/7 weeks; p ≤0.001.
Conclusion: Most abortions were for abnormalities that can be suspected early in pregnancy. As many structural abnormalities associated with rare conditions are not identifiable until the mid-trimester, prenatal diagnosis and abortion occurred significantly later. Physicians and patients should be aware of the limitations of genetic screening.
Based on “Case Study: Fetal Abnormality\” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:
What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected? Case Study: Fetal Abnormality (Moral Status Essay).
How does the theory determine or influence each of their recommendations for action?
What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?
Remember to support your responses with the topic study materials.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Case Study: Fetal Abnormality
Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.
Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.
Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud. Case Study: Fetal Abnormality (Moral Status Essay).
Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears.
Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother.
Case Study for Moral Status
In the “Case Study: Fetal Abnormality” four individuals that are able to make their feelings about aborting a fetus are presented. They include Jessica, Marco, Maria, and Dr. Wilson. In this scenario, Jessica is pregnant with a fetus that has a 25% chance of Down Syndrome and currently does not have any arms with a low probability they will develop. Marco is Jessica’s husband who will support her decision. Maria is the religious aunt that pleads with Jessica about her obligation to God and this unborn child. Dr. Wilson is supportive of aborting the fetus. These individuals pose various theories in determining the moral status of a fetus.
Dr. Wilson has provided the family with all the possible options, but shows the greatest support of abortion based on his medical knowledge of the disabilities. Dr. Wilson is utilizing the theory of cognitive properties, which states in order to have moral status one needs to be able to demonstrate a level of awareness and rationality, which fetus’s do not posses (“Theological anthropology,” 2015). Under this theory the fetus has no moral status so it is acceptable to abort it.
Maria pleads with Jessica to think about her obligations as a mother to this child, as well as respecting God’s intent. This would fall under the theory based on relationship. Jessica has a relationship to this fetus as its mother and a relationship to God, these relationships provide the fetus with moral status making abortion wrong. This also demonstrates the divine command theory, which is based on God being the creator and decides morality (Dunstan, 2012).
Jessica is in confict because of the financial burden this child poses and her religious beliefs that oppose abortion. Jessica is acting as the moral agent, a person acting for herself to make the most appropriate decision (Purtilo &Doherty, 2011). This represents the theory of moral agency, because Jessica will decide the moral status of the child. Marco is concerned about the burden of a disabled child but is willing to support Jessica. This demonstrates the theory based on relationship, because the moral status of the child may change, depending on Jessica (“Theological anthropology,” 2015).
This Authors Opinion
This author believes in the theory of sentience and relationship. Sentient beings have moral status and relationships that determine moral status (“Theological anthropology,” 2015). This will influence the decision of abortion because the author believes that a fetus can feel pain and that the mother has an obligation to the fetus, as its mother to protect it as well as an obligation to God not destroy one of his creations.
The four individuals in this case study, as well as the author had different values when it comes to human life. As a Christian this author believes that abortion is immoral and goes against God’s plan. However, as a Nurse my opinion should not influence the decision of a patient. A decision regarding abortion is a difficult choice to make, and is a decision that a patient will need to live with for the rest of their lives. As a medical professional we have a responsibility to provide all of the options in an unbiased manner.
Fetal Abnormality Case Study: Moral Status Essay References
Dunstan, A. (2012, February 16). The Divine Command Theory Supports That Abortion is Morally Wrong. In Hubpages. Retrieved from http://hubpages.com/education/ divinecommandtheoryabortion
Purtilo, R. B., & Doherty, R. F. (2011). Ethical Dimensions in the Health Professions (5th ed.). St. Louis, MO: Elsevier Saunders.
Theological Anthropology and the Phenomenology of Disease and Illness (2015). In Grand Canyon University lecture notes. Retrieved March 17, 2016, from
Moral Positions on a Fetal Abnormality Case Study
Every person has their own set of values, ethics, and morals that they have developed over their lifetime and has been shaped by their life experiences, the relationships in their lives and their own personal worldview and moral compass. A person’s moral compass guides them in the decisions they make daily both in their personal lives and their professional careers, helps individuals determine what is right and wrong, and helps guide them during situations in which there are many different paths they can choose from that are each morally correct but have completely different resolutions and outcomes. Case Study: Fetal Abnormality (Moral Status Essay).
This paper will identify and explore the different worldview theories that the characters Doctor Wilson, Aunt Maria, Marco and Jessica identify with and use to influence and determine the moral status and recommendation for the fetus in a case study from Grand Canyon University, “Case Study: Fetal Abnormality” (n.d.). Using this case study, this author will explore and discuss which theory this author identifies with and how this theory will influence and determine the action this author would take in a situation such as presented in the case study.
Worldview Theories and Influences
The decisions and paths that one choses and follows all stem from our own moral compasses and personal worldviews which are shaped by our culture, religion, spirituality, ethics, values, personal relationships and life experiences just to name a few influences. When given a similar situation, individuals will respond and react differently depending on their moral compass and worldview. In health care, it is important to not only be able to identify and understand your own moral compass and personal worldview, but to be able to identify and understand those of other’s around you. They allow health care professionals to understand and respect the wishes of others even if the worldviews are different, remain non-judgmental and unbiased, and provide high quality care that is both caring and compassionate.
Doctor Wilson and Scientism
The author of this paper believes that Doctor Wilson’s personal worldview is influenced by scientism. In “Case Study: Fetal Abnormality” (n.d.), Doctor Wilson uses facts that the test results were positive for the rare condition and the chance that the fetus could have Down syndrome also to deliver the news to Jessica and Marco and the available options. Case Study: Fetal Abnormality (Moral Status Essay). Doctor Wilson delivered the news without interjecting religion or spirituality into his discussion; however, he did provide his own view that abortion was medically and scientifically a good choice in this situation, and a responsible medical alternative. (HLT 310V Case Study: Fetal Abnormality, n.d.)
According to Burnett (n.d.), scientism explains reality and events in a material or physical manner. Scientism removes all spiritual, cultural and religious aspects in examining, explaining and rationalizing reality and does not account for what happens after death. Science is viewed as the only real source of knowledge and ignores other branches of learning and knowledge. Scientism can influences and determine the actions of individuals by the use of scientific facts, studies and knowledge gained from science alone, and by explaining situations in a physical or material manner. (Burnett, n.d.)
Using the concepts listed one can see scientism in the actions of Doctor Wilson: providing facts on the abnormalities and quality of life for the child, abortion as a medical alternative, different options available but also makes it known his opinion that abortion is medically and scientifically a good choice. As stated, scientism removes all spiritual, cultural and religious aspects which we can see Doctor Wilson did not address while giving his recommendations. (HLT 310V Case Study: Fetal Abnormality, n.d.)
Aunt Maria and Christianity
The author of this paper believes that Aunt Maria’s worldview is Christianity. In the case study, Aunt Maria prays for her family and is seen phoning their priest. Aunt Maria also interjects her opinion that Jessica should not abort the fetus, asks Jessica to think of her responsibilities to the growing fetus inside of her as the fetus’s mother and that they should follow God’s plan.
According to Shelly and Miller (2006), a Christian worldview looks to God and the importance of prayer, faith and a personal approach to health care, and that science and technology are gifts from God to help benefit creation. The Christian worldview also encompasses taking care of the sick, indigent and to provide aid and comfort to those in need. Another Christian concept is imago Dei which is a term with many dimensions: we are all created in the image of God, we have a duty and responsibility to ourselves, others and to God, we have a place in God’s plan, and we all must find a purpose and meaning to fulfill in life. (Shelly & Miller, 2006)
Using the concepts listed one can see Aunt Maria’s Christian worldview through the use of prayer, and the belief in God’s plan. The Christian worldview looks at the fetus as a living human being that has a place in God’s plan, and that Jessica and Marco have a duty and responsibility to the fetus as the fetus’s parents to nurture, care and to love the fetus no matter what abnormalities the fetus may have. The fetus was created through love and in the image of God, and as such, the fetus has the right to live, the right to grow and the right to follow in God’s plan. Though through the advances in science and technology one can see that the fetus will have some abnormalities; however, only God can determine the path of the fetus and what abnormalities the fetus will actually be born with, and the fetus may be able to benefit from the advances in science, health care services and technology through the use of prosthetics and different therapies. (Shelly & Miller, 2006).
Marco and Materialism
The author of this paper believes that Marco has a Materialistic worldview. In the case study, Marco is portrayed as being concerned about his wife Jessica and will support her in any decision that she makes, in regards to the growing fetus. Marco also is concerned about the economic security and plans for his wife and himself, and sees the pregnancy and possibility of having a disabled child not only as a burden but also a barrier to their future.
Materialism is a worldview with several definitions that encompass views that all objects are material and that only matter exists, material progress and material well-being are the purpose and highest value in life, and that there is importance in material things or object. Materialism ignores spirituality, religion, and what happens to humans beyond death, and relates events, life experiences and reality to matter within the laws of nature. (Materialism, n.d.)
Using the concepts above in influencing and determining the moral status of the fetus and recommendation of action would mean that the fetus is just matter, no consciousness, no spirit, and possibly a barrier in Jessica and Marco obtaining economic security and future plans. Since materialism places more emphasis on material objects and the need for material for growth and changes in economic and social status, the fetus would hinder Jessica and Marco’s progress in life. Also under materialism there is no consideration or regard to the future of the fetus itself, or thoughts of what would happen to the fetus upon termination, the fetus would simply just cease to exist.
Jessica, Blended Theories and Modern Western Worldview
The author of this paper believes that Jessica has a blended worldview on the moral status of the fetus. In one aspect Jessica appears to have similar thoughts to Marco on how the fetus would hinder their progress on the socioeconomic ladder and hinder their independence, which aligns with the materialism worldview which puts more emphasis on matter and material objects than with religion, spirituality, intelligence, or value in the fetus that has abnormalities. On the other hand Jessica has a belief that all life is sacred which aligns with the Christian worldview.
As these two concepts create conflict, one could also argue that Jessica’s worldview is modern Western as it is influenced by dualism, biblical values and a scientific perspective (the quality of life of her child). Shelly and Miller (2006), describe the modern Western worldview as being influenced by dualism which dualism is a division between two entities that will always have conflict and can be seen as matter (evil) having conflict with the spirit (good). Case Study: Fetal Abnormality (Moral Status Essay). This worldview is also influenced by success-failure, truth-falsehood, scientific perspectives and biblical values of justice and love. Overtime in this worldview God has become distant and people believe their paths and destiny in life are their own, emphasizing the value of people as individuals. (Shelly & Miller, 2006)
Each of these worldviews play a role in determining Jessica’s path that she will chose in regards to the fetus. Materialism would call for Jessica to go through an abortion, Christianity and a modern Western worldview would influence Jessica to carry on with the pregnancy and fulfill her role in caring, loving and nurturing the fetus. (Shelly & Miller, 2006)
Author’s Blended Theory
This author believes in a blended worldview and a blended theory approach to the different situations and dilemmas that are presented in one’s lifetime. This author finds that a blended approach is best to determine which path to follow as there is not just only one correct theory or path in life. This author believes that each person is a unique individual who is valuable and has a purpose, everyone is entitle to a life that has meaning and quality, not one of pain and suffering. As a nurse this author feels that we must do everything in our power to care for each other physically, emotionally and spiritually and keep an open mind when presented with life’s difficulties. This author also believes in science and knowing the logical facts of situations; however, even science and the facts can be wrong or misinterpreted at times.
Christianity is just one piece that makes up this author’s worldview; however, it is this worldview that would influence this author the most if presented with this case or in this situation. Christianity would influence this author to have faith in God, or a higher power, to do what is right and what is best for the child. If the child survives birth, it is our duty as Christians to help take care of this child, to nurture and to love. Case Study: Fetal Abnormality (Moral Status Essay). Science and advances in health care and technology are also available to make sure that the child has additional resources to find and have quality in life.
As humans are unique individuals, each one has their own philosophies, theories and worldviews on life. Until one is presented with such a dilemma or situation, one is unable to exactly say what they would say, do or believe in when in such a situation. As everyone as a unique perspective on life and the way they perceive reality, it is important for one to be able to identify the worldviews of others around them. With an open mind and a greater understanding of the views around us, in our personal and professional lives we are able to be unbiased, caring and compassionate, find our purpose and meaning in life and develop our own moral compass to help guide us in today’s world. Case Study: Fetal Abnormality (Moral Status Essay).
Burnett, T. (n.d.). What is Scientism? Retrieved from www.aaas.org/page/what-scientism
HLT 310V Case Study: Fetal Abnormality. (n.d.). Grand Canyon University, Phoenix, AZ.
Materialism. (n.d.). In Merriam-Webster online. Retrieved from
Shelly, J.A., & Miller, A.B. (2006). Called to Care: A Christian Worldview for Nursing (2nd ed.). Downers Grove, IL: IVP Academic/InterVarsity Press Case Study: Fetal Abnormality (Moral Status Essay).
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