A licensed practical/vocational nurse was caring for a pregnant client who underwent genetic testing and was positive for being a carrier of Huntington's disease (HD)
She has a 50% chance of delivering an infant who will have HD. Symptoms of HD usually don't develop until the person is 35 years or older. The woman wanted help reaching a decision. Her religious beliefs forbid abortion. She also knew that her child could suffer a debilitating neurological disease and die from it. The nurse wishes to use the process of ethical decision making. Based upon the client's view, which step should the nurse take first?
A) Is it right to end an unborn life because of 50% chance to develop a debilitating disease and die early in life? Is it wrong to end an unborn life because of the risk for HD when the person will have up to 35 years or more of quality life before developing symptoms of HD? Is it wrong to end the unborn life because 50% will not have HD?
B) Action A: End the pregnancy. Advantages: Help prevent potential suffering. Disadvantage: Not allow the person to enjoy several decades of life, or abort an unaffected fetus. Action B: Don't end the pregnancy. Advantage: Provide life to unaffected fetus, or up to several decades of life for the affected fetus and potential for a cure to stop the disease.
C) Religious beliefs: sanctity of life; no abortion; personal values—follow teachings of the church and provide the best quality of life for an individual; personal moral principles—it is not right to take a life of an unborn child; laws: not illegal for abortion; society's beliefs—both right to life and right to choose.
D) The situation is genetic testing is not 100% accurate and provided that the mother is positive as a carrier, but the father is not a carrier and does not have HD. The mother has firm beliefs in not aborting the fetus, but also wants what is best for her unborn child's future. The mother could receive additional fetus testing to determine if the fetus actually has HD or not to help her make the decision, if she wants.
Ans: C
Feedback:
The first step of the ethical decision-making process is understanding the components involved to make the decision, which is included in answer C. Answer A is the description of the dilemma, the third step. Answer B is possible courses of action, the fifth step. Answer D is the description of the situation, the second step.
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