nicoledurrance.weebly.com€¦ · Web viewJared and Ellie tried to conceive a child for two and a half years. They became frequent patients at a fertility treatment center where Ellie

Running head ETHICS ON THE START OF LIFE 1

Ethical Discussion on When Human Life Starts

Nicole Durrance

Azusa Pacific University School of Nursing

ELM Program

December 8 2013

ETHICS ON THE START OF LIFE 2


Jared and Ellie tried to conceive a child for two and a half years They became frequent

patients at a fertility treatment center where Ellie was prescribed Femara to help level out her

thyroid levels in hopes that she will become pregnant After doing blood work on her seventh

fertility appointment Ellie received a voicemail saying ldquoWe got your lab results back and they

are positive Congratulationsrdquo Hearing the news Jared yelled out ldquoWersquore pregnantrdquo and Ellie

responded ldquoIrsquom gonna be a momrdquo To this couple a lsquopositive testrsquo means that ldquo[they are] going

to have a babyrdquo (Mecham E amp Mecham J 2013)

Every year there are millions of babies born in the United States In 2012 there were a

total of 3952937 births in the United States (Hamilton Martin amp Ventura 2013) The number

of births in 2012 essentially did not change from the 2011 number of 3953590 (Martin et al

2013) thus establishing a baseline and revealing a consistent birth rate These births are a

combination of many different circumstances whether it is a teen pregnancy or a couple like

Ellie and Jared who used fertility treatment The thing they all have in common is the birth of a

new life into this world The ethical question is when is this new life considered an individual

who can receive their rights Furthermore is the timing of those received rights adhering to the

ethics of today

Dimensions Science of Life

Defining Life

In order to answer the question lsquoat what point do babies receive rightsrsquo a person must

first define when babies are determined to be a living human The Merriam-Webster (2013)

online dictionary describes life as a noun and adjective When used as a noun life can mean any

of these explanations ldquothe ability to grow change etc that separates plants and animals from


things like water or rocks the period of time when a person is alive [and] the experience of

being aliverdquo (Merriam-Webster 2013 ldquoliferdquo para 1) In comparison when used as an adjective

life means ldquoof or relating to liferdquo (Merriam-Webster 2013 ldquoliferdquo para 2) Life is further

expanded upon in the medical sections of the Merriam-Webster (2013) dictionary as ldquoa state of

living characterized by capacity for metabolism growth reaction to stimuli and reproductionrdquo

(Merriam-Webster 2013 ldquoliferdquo para 4) It also says life is the ldquoquality that distinguishes a vital

and functional plant or animal from a dead bodyrdquo (Merriam-Webster 2013 ldquoliferdquo para 5)

Notice here the use of the word dead which according to the medical Merriam-Webster (2013)

dictionary means ldquothe irreversible cessation of all vital functions especially as indicated by

permanent stoppage of the heart respiration and brain activity the end of liferdquo (Merriam-

Webster 2013 ldquodeathrdquo para 2) These definitions demonstrate that there are many different

descriptions an individual can use to interpret the word life This causes disputes over when

babies or fetuses should be declared living and receives human rights To discern the time of

when life starts it is imperative to understand the lsquolife cyclersquo a baby goes through in the motherrsquos

womb

The Infants Life Cycle

Reproduction

Reproduction is the joining of male and female gametes each containing 23

chromosomes to form a new life or individual A woman produces her gametes known as ova

(eggs) in her ovaries Similarly a man produces his gametes known as spermatozoa (sperm) in

his testes The chromosomes in these gametes contain DNA that when combined will form a full

unique set of 46 chromosomes This complete set is the blueprint needed to start the development

of a fetus (Sherwood 2011)


The process of this union starts separately in each sex In men the production of sperm is

termed spermatogenesis This is a complex process by which relatively undifferentiated germ

cells (spermatogonia) of 46 chromosomes proliferates and converts into motile spermatozoa

(sperm) of 23 chromosomes (Sherwood 2011) Correspondingly the process in which women

create eggs is called oogenesis It also is a complex process where an undifferentiated germ cell

(oogonium) of 46 chromosomes proliferates into primary oocytes Every month one oocyte

enlarges and is released to divide into a secondary oocyte of 23 chromosomes and a polar body

(nutritional cell) The secondary oocyte divides a second time resulting in a mature ovum of 23

chromosomes which is released into the fallopian tube ready for fertilization (Sherwood 2011)

Fertilization

Fertilization is the union of a sperm and egg to create a zygote which normally occurs in

the oviduct (fallopian tube) of a woman The merging of these cells occurs after intercourse

between two sexual people When the man ejaculates he releases approximately 250 million

sperm from his penis into the vagina The sperm are surrounded with protective lubrication from

the man so that they can survive in the acidic pH environment of the womenrsquos vagina The sperm

have also been converted into motile cells which enable them to lsquoswimrsquo up the uterus and into

the fallopian tube where they will meet with the mature egg When the sperm has reaches and

fuses with the egg a protective shield covers it so that no other sperm can combine This marks

the completion of fertilization (Sherwood 2011)

Gastrulation to implantation

The fertilized egg undergoes cleavage (division) multiple times until it becomes a

blastocyst This process is called gastrulation The new cellular make-up of a blastocyst consists

of a single-layer of hollow ball of about 50 cells encircling a fluid-filled cavity with a dense


mass of cells grouped together at one side (Sherwood 2011) The inner cellular mass becomes

the embryo and develops into the fetus The thin outer layer of cells trophoblast will implant

onto the uterine wall Once implantation is completed the placenta forms from the trophoblast

and decidua (cells of the uterus at the site of implantation) This placenta is a key organ to

sustain the development of the embryo into a fetus It is the soul organ where maternal and fetal

blood can rapidly exchange nutrients oxygen and other materials the fetus needs to thrive

(Sherwood 2011)

Developmental stages of fetus

In nine months (36 weeks) the embryo grows and develops into a fetus Most women do

not realize they are pregnant until they are about three to four weeks pregnant Development of

the embryo is divided into the embryonic and fetal periods The embryonic period is during

weeks four through eight The fetal period follows beginning at week nine and continuing until

birth

The most vulnerable and important period of development is week four because the

organs are starting to develop In the fifth week the embryo has already developed three

important layers of cells The ectoderm is the top layer where the neural tube is starting to

develop This will eventually form the brain spinal cord nerves backbone skin hair nails

sweat and mammary glands and tooth enamel The mesoderm is the middle layer where at this

point the heart is already dividing into four chambers This will form the circulatory system

muscles cartilage bones and subcutaneous tissues The endoderm is the inner layer which will

form the lungs intestines urinary system liver pancreas and thyroid (McKinney et al 2013)

Rapid growth begins in the sixth week with the neural tube closing and the heart pumping

blood The basic facial features begin to appear along with small buds that will become the


limbs In week seven the brain and face are quickly developing forming eyelids and the nose

(Mayo Clinical Staff 2012) The buds are forming paddles to become hands and the liver and

pancreas are formed In the eighth week fingers ears and eyes are forming and visible The

lungs are developing and the lsquotailrsquo is almost gone

The beginning of the fetal period starts the ninth week All the essential body parts are

accounted for and under continued development including the external genitals which cannot be

determined yet (BabyCenter Medical Advisory Board 2013) The embryorsquos heart is completely

developed and the organs muscles and nerves are starting to function (Mayo Clinical Staff

2012) At this point in the pregnancy small details are developing like peach fuzzed hair

(BabyCenter Medical Advisory Board 2013) The baby is officially called a fetus by week

eleven (Mayo Clinical Staff 2012) is almost fully formed and is starting to do simple

movements (BabyCenter Medical Advisory Board 2013) In week 12 the fetus is developing

reflexes and has a human face profile In week 13 the baby is forming fingerprints (Mayo

Clinical Staff 2012) and in weeks 14 and 15 the sex is able to be determined (BabyCenter

Medical Advisory Board 2013) The baby continues to develop and mature By 24 weeks the

embryo is seen as a viable meaning it can survive outside of the uterus however mortality is

high (Breborowicz 2001) because the lungs are immature In week 28 the lungs are producing

surfactant which increases the survival rate of a preterm infant born before 37 weeks (Sherwood

2011)

An infant is considered full term at 37-40 weeks and post-term when more than 41

weeks Most arguments on when life begins lie between in-utero development and the moment

of birth while others debate between the stages of in-utero development Now that the science

and stages of reproduction and development has been explored an individual can apply it to


understanding the arguments The different perceptions on the beginning of life can be rooted in

scientific thought cultural and religious thought and ethical viewpoints

Cultural Dynamics

To understand an individual and how they perceive when life starts it is critical to

explore the influence of culture and religion The scientific viewpoint and religion are the two

biggest contributors to how a person will perceive the start of life

Scientific Culture

Metabolic genetic and embryological scientists share different viewpoints on the

beginning of life On the metabolic level scientists do not recognize new life because the egg

and sperm are seen as units of life before they combine together Also the process by which a

new child is formed is a continuous and smooth process making the beginning of human life not

important (Gilbert 2006) The genetic viewpoint sees the creation of a genetic individual being

the process of fertilization deeming that the creation of the zygote is an individual or the

beginning of life (Gilbert 2006) However arguments against this do arise because the zygote

does have the possibility of lsquotwinningrsquo splitting its genetic makeup to form another zygote This

supports the view that a zygote is not lsquogenetic uniquenessrsquo because it can be multiplied into two

or more individuals (Shannon amp Wolter 1990)

In disagreement to the genetic viewpoint the embryological stance on the beginning of

human life is not at fertilization but at the gastrulation point of the embryo This stance is

supported by many scientists like Renfree Grobstein and McLaren because it is at this stage of

development that individuality is possible This is also the most popular scenario for the

beginning of life among many philosophers (Gilbert 2006) These philosophers however do not

see a zygote as an individual ldquoAn individual is not an individual and therefore not a person


until the process of restriction is complete and determination of particular cells has occurred

Then and only then it is clear that another individual cannot come from the cells of this

embryordquo stated by Catholic scholars Shannon and Wolter (Gilbert 2006 64) It is evident that it

can be difficult to clearly state when a life starts especially when there are differing viewpoints

among top scientists

Religious Viewpoints

The religious view of when life began varies differently amongst Jews Christians Islam

and many others The Jewish believed that life does not begin in the fetal stage of development

but after birth This can be explained by looking at Exodus 2122-23

ldquoIf men strive and hurt a woman with child so that her fruit depart from her and yet no mischief follow he shall be surely punished according as the womans husband will lay upon him and he shall pay as the judges determine And if any mischief follow then thou shalt give life for liferdquo

and Exodus 2112 He that smiteth a man so that he die shall surely be put to death (Holy

Bible KJV) These verses are in the context of when the law is being given to the judges The

study of these two verses reveals that capital punishment for murder should only be given when a

woman is killed not when her fetus is killed Thus giving the conclusion that a fetus does not

have the same status as a human being does (Jakobovits 1973)

Christians in contrast look at a different translation of the verse and interpret the verse to

read that the woman actually ldquogives birth prematurelyrdquo instead of just believing that the lsquofruit

depart from her (Holy Bible NKJV) Thereby Christians see the beginning of life as occurring

when the fetus is fully formed and viable Therefore killing the fetus would be equivalent to

murder (Gilbert 2006) This interpretation however has to questions if the biblical writers were

aware of the different developmental states of embryos To some theologians the recognition of a

formed or unformed fetus in determining the beginning of life does not matter because


embryonic development should not be interrupted by humans because it is a divine process

(Gilbert 2006)

This divine process is discussed all throughout Scripture with God talking about us as

individuals that he knew before he made us in the womb One verse clearly states that God is all-

powerful and all-knowing by saying ldquoyou knit me together in my motherrsquos wombrdquo (Psalm 139

13b Holy Bible NIV) It also shows that od views people as individuals before they are even

born ldquoyour eyes saw my unformed bodyrdquo (Psalm 13916 NIV) This verse relates back to the

beginning of life before a person was formed in the womb Jeremiah 14-5 also supports this

view of individuals and life before birth with saying ldquobefore I formed you in the womb I knew

you before you were born I set you apart I appointed you as a prophet to the nationsrdquo (Holy

Bible NIV) God uses words like lsquoknewrsquo and lsquobeforersquo to demonstrate that he planned an

individual before they were made in the womb therefore giving them an individual identity

before being physically created In addition Christianity and Islam religions both agree that all

humans including fetuses have the same value and stance in life meaning that there is a right to

equal distribution of resources and rights (Bonner 1985)

Ethical Theories

Plato in the ancient Roman society was one of the first theorists who formulated the first

concepts of when a human life is viable Plato theorized that the human soul does not enter the

individualrsquos body until birth (Buss 1967) The viewpoint of ensoulment the fetus being a part

of the woman until birth became a widely accepted belief of Stoics (Tribe 1990) On the

opposite spectrum the Pythagoreans believed that the human soul was made part of the

individual at the time of conception (Gilbert 2006) However the most widely and

acknowledged view on the beginning of human life came from Aristotle His belief was that in


early stages of pregnancy there was no sensation and development of life in the embryo (Bonner

1985) making the beginning of life at birth

Laws

Regardless of all the viewpoints on the beginning of life and the moment rights should be

granted the government has put laws into place to help facilitate any debate The first and most

famous Supreme Court case on life was Roe v Wade in 1973 This case ruled that woman have a

right to privacy and are allowed to terminate their pregnancy up to 24 weeks the lowest point of

viability (Cornell University 2013) In 1992 the court case of Planned Parenthood v Casey

Standard dropped the viability age from 24 to 22 weeks (Cornell University 2013) These two

cases and many since have put a time stamp on when the state sees life as beginning (22 weeks)

With this development of establishing life politically there are now fetal homicide state

laws As of today 38 states have these laws in affect and at least 23 of these states apply this law

to the earliest stages of pregnancy including conception fertilization post-fertilization and any

state of gestation (State Laws 2013) These laws state that if a fetus dies in a victimized woman

against her will the criminal will be charged with murder One of the cases that put this into

effect was in 1996 when William Dunson in an angry rage beat his 13 year old daughter She

was seven months pregnant and the fetus was pronounced dead the day after He was charged

with second-degree fetal murder (Tsao 1998)

The law attempts to mandate the start of an individualrsquos life however like the scientific

views the law is flawed On one hand you are allowing mothers to terminate their pregnancy

during the first trimester Controversy a person is charged with second-degree murder if a fetus

dies during the earliest stages of pregnancy after an attack These laws were made in the attempt

to provide justice and autonomy The mother receives autonomy by being granted to right to


terminate her pregnancy The fetus receives justice if killed without the motherrsquos desire

However what about the fetusrsquos right when the mother wants to terminate is there no justice

then This is a debate that has been in courts countless times with no real conclusion because

everyone sees ethics and rights differently

Nursersquos Position

As nurses a personal view on when life begins and the rights a fetus should receive does

not matter The primary patient is the mother and what her wishes for care are In the medical

world the issue of when life begins primarily affects professionals who are caring for pregnant

women This can happen on any unit in a hospital and usually involves when a women is going

to have an abortion or has had an abortion These abortions can be spontaneous or intentional

either way it is a traumatic experience for any woman to go through

There have been many cases when nurses will refuse to participate in an abortion making

the access to having an abortion difficult for women (Kade et al 2004) If a nurse does not

desire to care for a patient pre or post abortion then they have the right to formally write to their

employers letting them know If a nurse does not wish to help counsel a patient on abortion they

have the right to refer that patient to an agency or provider (NYSNA 2013) Nurses also have

the ldquoright to refuse to participate in a voluntary termination of pregnancy except in an

emergency situation where the patientrsquos needs do not allow for substitution (ANA 2001

Provision 1)rdquo (NYSNA 2013 p1) There have been many changes allowing for the personal

belief of nurses on life and abortion to be protected as they are no longer forced to care for a

patient who wishes to terminate fetal life


Personal Stance

As a Christian I believe that we have all be made and planned by God before conception

Just as Jeremiah 14-5 says above God knew us before we were even created in the womb Our

physical life begins as soon as the sperm merges with the egg However I could rational to

myself that it begins even before with the creation of the specific sperm and egg that merges

together In the professional sense I would reason the start of life to be at fertilization I believe

that when a woman is pregnant that it is her responsibility to nurture and protect the fetus I

know that some women do not want a child and that is why they choose abortion To them I

would recommend that they should care for that life and then after the birth give that baby up for

adoption There are many couples that cannot conceive and would love to adopt a baby I

personally see an embryo fetus or infant as a blessing and they should be given rights the same

as any individual For the professional medical world my only recommendation would be to

continue to respect the ethical beliefs of their employees to ensure the patients the best of care

Conclusion

It is clear that determining the start of life may never conclude to a single universal

answer The start of life is disputed among scientist religions and individuals across the world

It is the basis for when ethical and individual rights shall be granted to a fetus With such dispute

on the start of life it can be guaranteed that the argument on the moment an embryo or fetus

receives rights will also never cease to a final answer The law has done its best in trying to

mandate this quarrel however it comes down to individual belief A person has to look at what

they think is ethical and draw their own conclusion on life and the rights to be given


References

BabyCenter Medical Advisory Board (2013)What your baby looks like this week babycenter

Retrieved from httpwwwbabycentercomfetal-development-week-by-week

Bonner G (1985) Abortion and Early Christian Thought In Channer JH (Ed) Abortion and

the Sanctity of Human Life (pp 93-122) Milton Keynes United Kingdom The

Paternoster Press

Breborowicz G (2001) Limits of fetal viability and its enhancement PubMed 5(1) 49-50

Retrieved from httpwwwncbinlmnihgovpubmed11753511

Buss M (1967) The beginning of human life as an ethical problem Journal of Religion 47

244-255

Cornell University (2013) Roe v Wade Cornell University Law School Retrieved from

httpwwwlawcornelledusupcthtmlhistoricsUSSC_CR_0410_0113_ZShtml

Gilbert Scott (2006) Developmental Biology A Companion to Developmental Biology Eighth

Edition Sunderland MA Sinauer Associates

Hamilton B E Martin J A amp Ventura S J (2013) Births Preliminary Data for 2012

National Vital Statistics Reports 62(3) 1-33 Retrieved from

httpwwwcdcgovnchsdatanvsrnvsr62nvsr62_03pdf

Jakobovits I (1973) Jewish Views on Abortion In Walbert D and Butler J (Eds) Abortion

Society and the Law (pp 103-121) Cleveland London The Press of Case Western

Reserve University

Kade K Kumar D Polis C amp Schaffer K (2004) Effect of nursesrsquo attitudes on hospital-

based procedures in Massachusetts Contraception 69(1) 59-62

doi101016jcontraception200308009


Life (2013) Marriam-Webstercom Retrieved from

httpwwwmerriam-

webstercomdictionarylife

Martin J A Hamilton B E Ventura S J Osterman M J amp Mathews T J (2013) Births

Final data for 2011 National Vital Statistics Reports 62(1) 1-70 Retrieved from

httpwwwcdcgovnchsdatanvsrnvsr62nvsr62_01pdftable01

Mayo Clinical Staff (2012) Pregnancy week by week Mayo Clinic Retrieved from

httpwwwmayocliniccomhealthprenatal-carePR00112

McKinney E James S Murray S Nelson K amp Ashwill J (2013) Maternal-Child Nursing

Edition St Louis MO Elsevier

Mecham E amp Mecham J [Ellie and Jared] (2013 June 17) The moment wersquove been waiting

for [Video file] Retrieved from httpwwwyoutubecomwatchv=ytwu8pwB_2Q

NYSNA (2013) Position Statement on the role and responsibility of the registered professional

nurse in abortion New York State Nurses Association Retrieved from

httpwwwnysnaorgpracticepositionsabortionhtm

Shannon T A amp Wolter A B (1990) Reflections on the Moral Status of the Pre-Embryo

Theological Studies 51 603-626 Retrieved from

httpwwwtsmuedureaderscontentpdf515145142pdf

Sherwood L (2011) The Reproductive System In Cossio Y Alexander S Glubka A amp

Brady A (Eds) Fundamentals of human Physiology 4th Edition (pp 544-588) Belmont

CA BrooksCole

State Laws (2013) Fetal Homicide Laws National Conference of State Legislatures Retrieved

from httpwwwncslorgresearchhealthfetal-homicide-state-lawsaspx


Tribe L (1990) Abortion The Clash of Absolutes New York NY Norton

Tsao A (1998) Fetal homicide laws shield against domestic violence or sword to pierce

abortion rights Hastings Constitutional Law Quarterly 25 457-482 Retrieved from

httpwwwhastingsconlawquarterlyorgarchivesV25I3Tsaopdf



Jared and Ellie tried to conceive a child for two and a half years They became frequent

patients at a fertility treatment center where Ellie was prescribed Femara to help level out her

thyroid levels in hopes that she will become pregnant After doing blood work on her seventh

fertility appointment Ellie received a voicemail saying ldquoWe got your lab results back and they

are positive Congratulationsrdquo Hearing the news Jared yelled out ldquoWersquore pregnantrdquo and Ellie

responded ldquoIrsquom gonna be a momrdquo To this couple a lsquopositive testrsquo means that ldquo[they are] going

to have a babyrdquo (Mecham E amp Mecham J 2013)

Every year there are millions of babies born in the United States In 2012 there were a

total of 3952937 births in the United States (Hamilton Martin amp Ventura 2013) The number

of births in 2012 essentially did not change from the 2011 number of 3953590 (Martin et al

2013) thus establishing a baseline and revealing a consistent birth rate These births are a

combination of many different circumstances whether it is a teen pregnancy or a couple like

Ellie and Jared who used fertility treatment The thing they all have in common is the birth of a

new life into this world The ethical question is when is this new life considered an individual

who can receive their rights Furthermore is the timing of those received rights adhering to the

ethics of today

Dimensions Science of Life

Defining Life

In order to answer the question lsquoat what point do babies receive rightsrsquo a person must

first define when babies are determined to be a living human The Merriam-Webster (2013)

online dictionary describes life as a noun and adjective When used as a noun life can mean any

of these explanations ldquothe ability to grow change etc that separates plants and animals from
















womb


Reproduction

















Fertilization





















(Sherwood 2011)






birth






























2011)








Cultural Dynamics




Scientific Culture










































(Gilbert 2006)














Ethical Theories











Laws












































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole























womb


Reproduction

















Fertilization





















(Sherwood 2011)






birth






























2011)








Cultural Dynamics




Scientific Culture










































(Gilbert 2006)














Ethical Theories











Laws












































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole


















Fertilization





















(Sherwood 2011)






birth






























2011)








Cultural Dynamics




Scientific Culture










































(Gilbert 2006)














Ethical Theories











Laws












































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole















(Sherwood 2011)






birth






























2011)








Cultural Dynamics




Scientific Culture










































(Gilbert 2006)














Ethical Theories











Laws












































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole



























2011)








Cultural Dynamics




Scientific Culture










































(Gilbert 2006)














Ethical Theories











Laws












































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole











Cultural Dynamics




Scientific Culture










































(Gilbert 2006)














Ethical Theories











Laws












































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole

































(Gilbert 2006)














Ethical Theories











Laws












































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole










(Gilbert 2006)














Ethical Theories











Laws












































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole











Laws












































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole































Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole









Personal Stance













Conclusion









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole









References





Paternoster Press




244-255










Reserve University






httpwwwmerriam-



















CA BrooksCole










httpwwwmerriam-



















CA BrooksCole













Documents

nicoledurrance.weebly.com€¦ · Web viewJared and Ellie tried to conceive a child for two and a half years. They became frequent patients at a fertility treatment center where Ellie