Abstract
Abortion is the process of fetus or embryo removal that results in pregnancy termination. New Jersey Bill A495 requires physicians to offer pregnant women who request abortion to undergo obstetrical ultrasound or sonogram within 48 hours after the referral. The State and Assembly versions of the Bill and the New Jersey legislation are very similar, although the former contains more provisions. The primary benefit and the intent of the New Jersey Bill A495 are in providing women with ultrasound images that can impact their decision regarding pregnancy termination.
Introduction
There are two leading positions regarding abortions that prevail in the United States and affect the legislations – pro-life and pro-choice. New Jersey Bill A495 makes it mandatory for medical professionals to offer patients who choose to have an abortion undergo an ultrasound or sonogram. This paper aims to review the New Jersey Bill A495, the differences in the legislation process between New Jersey and other states, provide a personal position on the issue of abortion, and discuss the impact that this Bill will have on the stakeholders and nurses.
New Jersey Legislative Process
Unarguably, medical termination of pregnancy is a complex ethical problem that is connected to the right of patients to choose and the viability of the fetus. According to Pozgar (2019), “an abortion is the termination of pregnancy by removal or expulsion from the uterus of a fetus or embryo before it is viable” (p. 63). The focus of the New Jersey Bill A495 is on obstetrical ultrasound or sonogram that patients can request in the timeframe of 48 hours after the abortion referral. The intent of this legislation is to provide patients with a chance to view images of the embryo or fetus that can affect their decision. Therefore, the aim is to help women make informed decisions. Since the New Jersey Bill A495 outlines new practices of managing patients referred for abortions, this section of the paper will focus on the legislative process and prior regulations connected to abortions.
Currently, the regulations in New Jersey allow women to be referred for abortion procedures, with specific legal acts outlining the gestational age and other implications for the pregnancy termination. The first laws connected to abortion were drafted by the council in the late 1900s. Since 2017, New Jersey, together with other states, permitted qualified non-doctors to write a prescription for drugs that can be used to perform medical abortions (Beckman, 2017). In this regard, it is necessary to define the concept of non-doctors to understand the scope of the regulation. Under New Jersey laws, non-doctors are nurses, behavior, and physical therapists, as well as related health professionals such as medical laboratory scientists, phlebotomists, dietitians, and social workers. Other laws existed in New Jersey that enabled women to leave babies at certain assigned areas without giving their contact data and without confronting lawful ramifications.
The critical decision on abortion, which the Supreme Court made on January 22, 1973, is known in the United States as Roe vs. Wade case. Under the pseudonym, Jay Row was a Texas resident Norma McCorvey, who later became a pro-life supporter and opponent of abortion (Coleman, 2017). Her opponent was Dallas, Texas County Attorney Henry Wade, who advocated strict restrictions on abortion. Prior to Row vs. Wade, abortion was banned in several states of the country, while in others, it was limited by a number of restrictions (Beckman, 2017). Explicitly, the United States Supreme Court acknowledged that within the first three months of pregnancy, a woman or her doctor could decide to have an abortion without any legal restrictions.
In March 2018, the Bill A495 of New Jersey has introduced New Jersey. The difference between the state and assembly versions of the Bill is only in the presence of a few more provisions in an assembly version. Thus, basic the two versions are almost identical, and these legislatures oblige a medical establishment to provide a patient with a chance to undertake an ultrasound or sonogram to see the developing embryo within 48 hours of referral for fetus removal. It can also be performed 48 hours preceding a premature birth technique being performed. Any well-being inconsistency that may affect the health of the patient revealed by the ultrasound or sonogram must be communicated to the patient.
The rationale for Choosing This Legislation
The Bill A495 of New Jersey is an essential addition to the existing regulations on abortion because it helps patients receive additional information, in the form of fetus or embryo images. Hence, this policy was chosen because it supports the right of patients to consider abortion, while obliging the medical establishments to have the equipment necessary to provide patients with additional information, relevant to this decision. The regulations in New Jersey use gestational age as the basis for determining the timeframe during which the patient can choose to terminate the pregnancy. Gestational age is the terminology used to describe the pregnancy timeframe in weeks, which is often used in legal policies to set a limitation on when abortions can be performed.
Currently, patients can terminate pregnancies until the gestational age of the fetus is twelve weeks, even if no medical emergency or concern is present. Throughout the twelfth and twenty-first week, the medical recommendations or certain social factors can be used to advocate for medical termination of the pregnancy. Medical indications for abortion in New Jersey include rubella, HIV, acute form of tuberculosis, fetal malformations incompatible with life, or those that can lead to disability in the future. Additionally, severe types of endocrine diseases that the patient may have, somatic and mental illness, and any conditions in the stage of decompensation are a valid reason for termination (Beckman, 2017). There are also several social reasons, such as the age of the patient that is less than 15 years or more than 45 years and pregnancy because of disability.
According to Bill A495 of New Jersey, physicians are required to provide patients the opportunity to undertake a sonogram or obstetrical ultrasound 48 hours after performing an abortion. In compliance with Article II of the Bill, all institutions where abortion procedures take place must have either sonogram or functional ultrasound equipment or must have access to this equipment via other medical institutions (New Jersey Bill, 2019). Article III of the Bill emphasizes that any well-being anomaly revealed by the ultrasound or sonogram that may affect the health or security of the patient must be disclosed (New Jersey Bill, 2019). This can be connected to the fetus removal or another medical issue that may exist, and the patient must be notified at least 48 hours after the scheduled abortion operation. This Bill has a significant impact on the overall health and welfare of the population in New Jersey. There is no financial impact statement attached to the Bill. The benefits of this legislation are connected with the additional medical support of women prior to an abortion, while limitations will be discussed in the next section of this paper.
The problem of the legitimacy of medical termination of pregnancy, along with transplantation, psychiatry, genetics, and cloning, is an indicator of legal support for medical activities. It is important to note that abortion problems are complex, as evidenced by the international level work on this issue by the UN Committee on Economic, Social, and Cultural Rights (Coleman, 2017). The problem of abortion affects the interests and fate of at least two people – a woman who has decided to terminate her pregnancy and an embryo or fetus in her womb.
Statistics showing a significant number of abortions in New Jersey demonstrate the need for a comprehensive analysis, considering the theoretical and legal implications of the current situation (Jones & Jerman, 2017). Indeed, the primary task of lawmakers is to work out universal legal principles and, on their basis, to adopt legislation that would regulate all aspects of such an essential issue as abortion. Undoubtedly, such decisions should be made only on the basis of preliminary theoretical and legal research, comprehensive discussion with the involvement of doctors, philosophers, representatives of religious and public organizations, as well as other stakeholders.
Personal Position
Although abortion is a complex ethical issue, I support it in cases when the pregnancy threatens the life of the patient or fetus. In addition, I think that women who were raped and impregnated during the incident should have the right to choose whether they want to proceed with the pregnancy or terminate it. In both cases, I think that abortion is ethically justified and should be supported through appropriate legal acts.
In my opinion, there are two main elements that should be considered when evaluating the policies that either support or oppose abortions – the women’s right to choose and the medical implications of the procedure. The latter element refers to both health impairments that can affect the fetus leading to its inadequate development and the safety of the abortion procedure as well as its consequences for a woman. As was previously mentioned, a diagnosis such as tuberculosis, rubella, HIV, as well as fetus malformations, can serve as a basis for recommending medical abortion. In these cases, the fetus is endangered by the disease or abnormality, which can lead to complications in the future. Moreover, in some cases, medical professionals can recommend abortion if the pregnancy endangers the health and well-being of the patient. From a professional and ethical perspective, I think that denying the fact that abortion can be the only valid medical recommendation is incorrect.
Additionally, I do understand the need to provide women with all the information necessary to make the decision regarding abortion. One such aspect is Bill A495 of New Jersey that allows them to see a sonogram or obstetrical ultrasound of the fetus. The main benefit of this requirement is the fact that women will be able to receive more information about the fetus, which can affect their decision. However, in cases of medical concerns described above, I would argue that requiring physicians to offer this choice to women might be ethically incorrect since the decision to not perform a medical abortion would result in possible health impairments. The main limitation of the Bill is that although it outlines the need to ignore the requirement for offering ultrasound or sonogram in cases of a medical emergency, it fails to address the problem of rape. Hence, this legislation can provide additional pressure to these patients, making it more difficult for them to decide.
As a medical professional, I am well aware of the issues associated with pregnancy and the difficulties connected to the desire to make a choice regarding pregnancy termination. In general, I would argue that the basis of my opinion regarding abortion is the implications of free decisions when planning a pregnancy and medical concerns regarding the well-being of the patient and the fetus. Moreover, it is evident that in cases of rape, the victim has no choice over the consequences, and denying these patients the ability to make a choice is incorrect.
Position of Healthcare Stakeholders and Impact on the Nursing Profession
Currently, there is no prevailing model of legal regulation of abortion. For example, in the United States, which is famous for its democratic principles, the issues of regulating artificial abortion are characterized by certain peculiarities. The problem of a woman’s right to an abortion, in the form of a medical one, has acquired a pronounced socio-political angle, with pro-life and pro-choice activists providing different outlooks on the issue. When considering the lawfulness of abortion, the United States Supreme Court concluded that the right to a person’s autonomy is quite broad and includes a woman’s right to decide to terminate an unwanted, for one reason or another, pregnancy (Jones & Jerman, 2017). However, in the case of abortion, the right to individual autonomy is not unconditional. A woman cannot terminate her pregnancy, at whatever stage she wants, in whatever way she wants, and for whatever motive she wants (Jones & Jerman, 2017). The court agreed that within three months of pregnancy, women are free to make decisions on abortion. However, from the moment when the embryo is considered a viable fetus, the artificial termination of pregnancy is prohibited, except if the threat to the health or life of the patient exists.
The American Nurses Association supported Bill A495 on abortion, claiming that it will clearly outline the timeframe needed to stabilize patients after the abortion procedure. In the United States, stricter abortion standards have been introduced over the past ten years – while in 2006 there were restrictions in two states, in 2017, twenty-nine states had regulations on abortion (Beckman, 2017). Donald Trump, President of the United States, limited funding for international organizations related to abortion. The stakeholders of New Jersey Bill A495 include New Jersey senator, Jeff Van Drew, congressman, Kevin Drennan, and assembly representatives Anthony Cimino and Mark Duffy.
Conclusion
Overall, this paper reviewed the New Jersey legislation concerning abortions, which is the New Jersey Bill A495. The requirement of this policy is to ensure that all medical establishments that perform pregnancy termination procedures should have equipment for performing ultrasound or sonogram and offer such options to patients. The history of the legislative process concerning abortion in New Jersey is complex, with several Bills regulating specifics of the procedure, while New Jersey Bill A495 is similar to the assembly version of the legislation. My opinion on the issue of abortions is that that pregnancy termination should be allowed if there are medical concerns or if the patient was raped and does not proceed with the pregnancy.
References
Beckman, L. J. (2017). Abortion in the United States: The continuing controversy. Feminism and Psychology, 27(1), 101-113.
Coleman, S. (2017). The ethics of artificial uteruses: Implications for reproduction and abortion. New York, NY: Routledge.
Jones, R. K., & Jerman, J. (2017). Abortion incidence and service availability in the United States. Perspectives on Sexual and Reproductive Health, 49(1), 17-27.
New Jersey Bill A495. (2019). Web.
Pozgar, G. D. (2019). Legal and ethical issues for health professionals. Boston, MA: Jones & Bartlett Learning.