The prevalence of infertility related to many couples in the United States and around the globe and the progress of medicine and technologies contribute to the development of the important ethical dilemma associated with the issue of surrogacy. Choosing to carry a pregnancy for a couple, a woman faces a lot of ethical and legal issues. Furthermore, surrogacy is the actively discussed question in relation to the aspects of nursing ethics because many physicians and nurses are inclined to reject the idea of surrogacy as immoral. Thus, surrogacy is a controversial ethical issue that is associated with the nursing practice and requires further detailed discussion to determine the ethical and legal implications because the question of surrogacy refers to the commercial component, nurses’ ethical norms, and important aspects of culture and religion.
The Legal Precedents and Aspects
It is important to distinguish between commercial surrogacy and other types of surrogacy without the mentioned fees. Surrogacy as a commercial activity is prohibited in many countries and in the majority of the states in the USA. Moreover, according to Pozgar, “the surrogate contract is perceived to be illegal when a fee is involved because it is compared with baby selling, which is illegal in all states” (Pozgar, 2013, p. 112). That is why many operations associated with the case of surrogacy cannot be discussed as legal because they are too controversial and violate different legal norms. Referring to the cases presented in Saxena, Mishra, and Malik’s research, it is necessary to note that the problem of the fee and act of ‘baby selling’ is not the main legal problem connected with surrogacy. Thus, there are many cases when children’s nationality and legal status are not approved according to the laws of definite states, and this situation results in “either a long legal battle like in case of the German couple with twin surrogate children or the Israeli gay couple who had to undergo DNA testing to establish parentage or have a bleak future in an orphanage for the child” (Saxena, Mishra, & Malik, 2012, p. 211-212). From this point, the policies and laws in many countries are not developed to respond to the issue of surrogacy.
Ethical Viewpoints on the Issue
There are a lot of ethical questions which nurses ask while discussing the issue of surrogacy. The main ethical question can be formulated the following way: Is it right “to enter a contract with a woman, taking advantage of her circumstance by offering her money in exchange for bearing a child and then transferring all parental rights and physical custody of the child to the ‘commissioning couple’?” (Pozgar, 2013, p. 111-112). The role of the gestational mother in the case is also one of the most discussed issues because there are various opinions on the possibility of contact between gestational mothers and children. Surrogacy is a challenge for the gestational mother and for the parents who can experience such problems as the Israeli gay couple in the future (Islam & Nordin, 2013). Moreover, it is impossible to conclude strictly about the effect of surrogacy on the child and on his or her physical and psychological health. On the other hand, many people support surrogacy because this approach provides many couples with a chance to build a healthy family.
Arguments to Support Surrogacy
In spite of the fact that there are many legal and ethical issues associated with the question of surrogacy, this practice can be supported in medicine because many people receive the opportunity to overcome their health problems and infertility with the help of surrogacy. Following the American Nurses Association’s Code of Ethics, it is important to note that nurses should focus on the primacy of the patients’ interests and address the professional boundaries (American Nurses Association, 2001; American Nurses Association, 2010; American Psychological Association, 2010). Furthermore, the actions of nurses should respond to the patients’ needs and demands. Thus, infertility makes many people suffer from psychological problems. Surrogacy is a chance to satisfy the people’s needs of different levels. Thus, surrogacy is the appropriate approach to overcome the issue of infertility, if the legal questions are addressed accordingly.
Conclusion
Although surrogacy provokes a number of legal and ethical threats to the relationships between the parents and a child, surrogacy should be also discussed as the chance and credit for many couples. Like any other opportunity that exists within the realm of the legally approved procedures, the procedure associated with surrogacy should be improved and used more. Those people who have few chances to have a child should be given the right to try surrogacy.
E-Folio: Essential V and the Scenario
Essential V: Healthcare Policy, Finance, and Regulatory Environments focuses on the importance of learning definite policies related to the questions of quality and safety in relation to the nursing practice. Thus, according to the Essential V, healthcare policy shapes “the nature, quality, and safety of the practice environment and all professional nurses have the responsibility to participate in the political process and advocate for patients, families, communities, the nursing profession” (American Association of Colleges of Nursing. 2008, p. 20). It is important for the baccalaureate to discuss the nursing practice within the larger context while following the Essential V statements (Bell, 2001).
Exemplar
To illustrate the role of the Essential V for the nursing practice, I have selected the cases related directly to the survival after plane crashing and the moon equipment failure case. The cases provide the list of a nursing practitioner’s responsibilities which should be followed according to the definite regulatory policies and with references to the role of the nurse in designing the guidelines for emergencies. The case regarding plane crush survival offers a very complicated moral dilemma concerning the choice of the people who should have the right to use the equipment (a life raft) in order to survive. The situation demands the focus on the almost impossible choice which should be made, thus, the case helps choose the strategy to act reasonably in case when the supplies are limited and will not suffice for the entire team of survivors with references to the regulatory policies and issues of safety. The given cases, especially the one concerning the problem with moon equipment, might seem unrealistic to an average person; however, the key specifics of the nursing practice in relation to the healthcare policies are introduced.
Reflection
Therefore, the given cases contribute to the better understanding of the work of a nursing practitioner. The given cases show that a good nurse must not only be an expert in his or her field of nursing but also specialize in a number of other issues which are associated with the necessity to respond to the regulatory policies (Meister et al., 2002; Oermann, 2002). I have realized with references to the cases that following the set lists of guidelines and policies, a nurse should design the best suitable model for action, even if the action means survival. Nurses have to deal with very complex and often controversial dilemmas and should act appropriately according to the Essential V.
References
American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Web.
Bell, S. (2001). Professional nurse’s portfolio. Nursing Administration Quarterly, 25(2), 69-73.
Meister, L., Heath, J., Andrews, J., & Tingen, M. (2002). Professional nursing portfolios: A globalperspective. MEDSURG Nursing, 11(4), 177-182.
Oermann, M. (2002).Developing a professional portfolio in nursing. Orthopaedic Nursing, 21(2), 73-78.
American Psychological Association. (2010). Publication manual of the American Psychological Association. Washington, DC: Author.
American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Web.
American Nurses Association. (2010). Guide to the Code of Ethics for Nurses. Washington, DC: Author.
Islam, S., & Nordin, R. (2013). Ethics of surrogacy: a comparative study of Western secular and Islamic bioethics. JIMA, 44(1), 15-27.
Pozgar, G. D. (2013). Legal and ethical issues for health professionals. Sudbury, MA: Jones and Bartlett.
Saxena, P., Mishra, A., & Malik, S. (2012). Surrogacy: Ethical and legal issues. Indian Journal of Community Medicine, 37(4), 211–213.