The Ethics of Reproduction

Assessment of the Health Care EnvironmentFailure of the fertility doctors to regulate themselvesCouples only have one thing on their minds, having a babyDoctors give into the parents wishes even though there could be severe consequencesFertility clinics give statistics of how many live births they have achieved but that doesnt include how many preterm births or deaths after birth due to prematurity(Van Voorhis, 2007)(Paul-Simon, 2011)

Inferences & ImplicationsFertility clinics need regulations on how many embryos can be transferred in one cycle of IVFPre genetic screening needs to also be regulated and used to look for fatal genetic disorders not just gender selectionFertilizing more eggs than a couple plans on using. Each harvest egg has a 60-70% chance of being fertilized (Goldworth, 1999)What to do with the extra embryosTalk with couples about selective reduction in the case of multiples beyond twins.

American society of reproduction medicine There are guidelines for embryo transfer for physicians but they are only guidelines not regulationsA limit of 2 embryos implanted for women aged 40 years.

(American Society of Reproductive Medicine, 2009)

Points of view-patientsCouples just want to have a baby.They will do anything to get pregnant.Couples dont believe that anything bad will happen, they will have a healthy, perfect baby.

Points of view-nursesCouples may make decisions that the nurse does not agree with on a personal level.Nurse may feel the couple is playing God when dealing with pre-genetic screening.Nurse may feel that the couple does not totally understand what they are consenting to.

Quality & Safety Assess level of patient's decisional conflict and provide access to resources Describe strategies to empower patients or families in all aspects of the health care processValue seeing health care situations through patients' eyes(QSEN, 2012)

ANA StandardsStandard 5a- Coordination of CareProvides leadership in the coordination of multidisciplinary health care.Standard 6-EvaluationSynthesizes the results of the evaluation to determine the impact of the plan on the patient and family. Standard 12 EthicsInforms patient of the risks, benefits, and outcomes of healthcare regimens.Standard 13ResearchFormally disseminates research findings.(ANA, 2004)

Nursing ConsiderationsKnowledge of current practices and researchKnowledge of additional resources for couples and families going through IVFAdvocate for familiesThere is a need for families to understand the underlying condition when there is a pre-genetic diagnosis.

(Gallo, Knafl, & Angst, 2009)

ConclusionIVF is a very common procedure but needs to be better regulated to keep both the woman and the unborn baby(ies) safe. As nurses we need to be knowledgeable and compassionate with couples going through IVF.

Thank you for watching and I hope you enjoyed my presentation.

ReferencesAmerican Society of Reproductive Medicine. (2009). Guidelines on number of embryos transferred. Fertility and Sterility. 92(5):1518-1519. doi:10.1016/j.fertnstert.2009.08.059

American Nurses Association. (2004). Nursing scope and standards of practice. Silver Springs, MD: Nursebooks.org.

Baruch, S., Kaufman, D., Hudson, K. (2008). Genetic testing of embryos: Practices and perspectives of US in vitro fertilization clinics. Fertility and Sterility. 89(5):1053-1058. doi: 10.1016/j.fertnstert.2007.05.048

Gallo, A., Knafl, K., Angst, D. (2009). Information management in families who have a child with a genetic condition. Journal of Pediatric Nursing. 24(3):194-204 doi: 10.1016/j.pedn.2008.07.010

Goldworth, A. (1999). The ethics of in vitro fertilization. Pediatrics in Review. (20)28-31. doi:10.1542/pir.20-8-e28

Lachman, V. (2006). Applied ethics in nursing. New York, NY: Springer Publishing Companies, Inc.

Medicine Net. (2012).Infertility. Retrieved October 3, 2012 fromhttp://www.medicinenet.com/infertility/page7.htm

References Cont.Moyers, S. (2012). ART and embryo donation: A short story. Retrieved October 3, 2012 from http://www.fertilityauthority.com/blogger/swmoyers/2012/4/05/art-and-embryo-donation-short-history

Nursing Theories. (2012). Jean Watsons philosophy of nursing. Retrieved October 6, 2012 from http://currentnursing.com/nursing_theory/Watson.html

Paul-Simon, A. (2011). Infertility and multiples. Newborn & Infant Nursing Reviews. 11(4):180-184. doi: 10.1053/j.nainr.2011.09.007

Peach, E., Hopkin, R. (2007). Advances in prenatal genetic testing: Current options, benefits, and limitations. Newborn & Infant Nursing Reviews. 7(4):205-210. doi: 10.1053/j.nainr.2007.09.012

Pfister, H., Bohm, G. (2008). The multiplicity of emotions: A framework of emotions in decision making. Judgment and Decision Making. 3(1):5-17.

QSEN. (2012). Competency KSAs. Retrieved from http://www.qsen.org/ksas_prelicensure.php

Van Voorhis, B. (2007). In vitro fertilization. The New England Journal of Medicine. 356:379-386. doi:10.1056/NEJMcp065743