Lecture sixteen: Ethics and the start of life

Question 1

What are some ethical topics about IN VITRO FERTILIZATION (IVF)

Answer 1

• the quality of consent obtained from the parties
• the motivation of the parents
• the uses and implications of preimplantation genetic diagnosis
• the permissibility of sex-selection (or the choice of embryos for other traits)
• the storage and fate of surplus embryos.

Question 2

What are ethical issues with IVF?

Answer 2

Savour siblings. Can do IVF to get siblings genetically similar and can be used to help for treatment for siblings.

Cons people can genetically alter genes.

Consent of the unborn child

Privatisation of care in an unfunded healthcare system.

Question 3

What are reasons that people freeze sperm/ eggs?

Answer 3

One reason is to preserve fertility until after cancer treatment or gender-affirming hormone treatment (GAHT)

and another is for people who think their fertility may decline before they are ready to have children

Question 4

What are ethical issues with sperm/ egg freezing?

Answer 4

Whos own them? Relationships breakup?

In nz postmorten sperm retrieval. Can get sperm from someone who has been deceased for less than 72 hours. Consent?

Consent? If someone dies with frozen sperm/ ovaries

What happens if a child is born and then the parents don’t want it- surrogacy

Question 5

What is the The Human Genome Project - Completed in April 2003

Answer 5

the Human Genome Project gave us the ability to read nature’s complete genetic blueprint for a human

The successful sequencing of the human genome could solve the mystery of many disorders in humans.

Question 6

What are some ethical issues with “The Human Genome Project”

Answer 6

Find out that someone will have a genetic illness- would we tell them?

Would they want to know? What about close relatives.

Want to keep confidentiality but we have duty of care for other people?

Question 7

What are the three kinds of abortion?

Answer 7

Abortion

Spontaneous abortion (Usually when a women miscarries before 20 weeks)

Induced abortion/ termination of pregnancy

Question 8

What kinds of abortion can you get?

Answer 8

An early medical abortion
A medical abortion
A surgical abortion

Question 9

Whats an early medical abortion

Answer 9

Morning after pill

Question 10

What is a medical abortion

Answer 10

Abortion without surgery.

Vacuum aspiration or dilation, curettage and medication

Question 11

WHAT LAWS REGULATE ABORTION IN AOTEAROA NEW ZEALAND?

Answer 11

Act 1977 as amended by the Abortion Legislation Act 2020.

Question 12

What were some key topic changes made from the 1977 abortion act to the 2020?

Answer 12

• LICENSED PREMISES
• HEALTH PRACTITIONERS
• ABORTION UP TO 20 WEEKS
• SELF-REFERRAL
• ABORTION POST 20 WEEKS
• COUNSELLING
• CONSCIENTIOUS OBJECTION

Question 13

What as the key change to the abortion law – LICENSED PREMISES?

Answer 13

There is no longer a requirement for abortions to be performed in licensed premises, making them accessible in the community and primary care settings

Question 14

What as the key change to the abortion law – HEALTH PRACTITIONERS?

Answer 14

A range of health practitioners
can now provide abortion –
this includes midwives and
nurses, not just medical
doctors.

Question 15

What as the key change to the abortion law – ABORTION UP TO 20 WEEKS

Answer 15

A qualified health practitioner may
provide abortion services to a pregnant person who is no more than 20 weeks gestation

A pregnant person does not have to fulfil any requirements in order to access abortion services

Abortions are no longer required to be authorized by certifying consultants

Question 16

What as the key change to the abortion law – SELF-REFERRAL

Answer 16

A pregnant person can self refer to a wider range of qualified health professionals for abortion services

Question 17

What as the key change to the abortion law – ABORTION POST 20 WEEKS

Answer 17

Just 0.9% of abortions were performed post 20 weeks gestation in 2020

Abortions that take place post 20 weeks are most commonly due to discovery of a fetal abnormality or a serious risk to a pregnant person’s life and or health

Health practitioners must:
 Consult at least one other qualified health practitioner
 Have regard to the gestational age of the fetus
 Have regard to all relevant legal, professional and ethical standards
 Have regard to the pregnant persons physical and mental health and overall wellbeing

Question 18

What as the key change to the abortion law – COUNSELLING

Answer 18

A pregnant person is no longer
required to attend counselling
before or after receiving
abortion services

Question 19

What as the key change to the abortion law – CONSCIENTIOUS OBJECTION

Answer 19

Disclosure to the patient

 A conscientious objection does not override Professional and legal duty to provide prompt and appropriate care

Question 20

What did the CONTRACEPTION, STERILISATION, AND ABORTION (SAFE AREAS) AMENDMENT ACT 2022 do?

Answer 20

protest-free ‘safe zones’ allowed outside abortion clinics

Question 21

What does the CARE OF CHILDREN ACT 2004 do?

Answer 21

Section 38 of the Care of Children Act 2004 makes explicit in law that a person under the age of 16 can consent to have or not have an abortion.

Question 22

What age does the Code of Health and Disability Services Consumers right say a person can CONSENT

Answer 22

They say there is no age to consent.

All consumers are presumed competent to make an informed choice and give informed consent

Question 23

What is the GILLICK’S COMPETENCE

Answer 23

Gillick v West Norfolk and Wisbech
Area Health Authority (1985)

 Minors may authorize medical treatment

 It would be arbitrary and unreal to
draw a line between childhood and
maturity at a certain number of years
(Keenan, 2010)

A child is said to be Gillick Competent regardless of their age if they can:

 Understanding relevant information given to them;

 Retain that information long enough to be able to make the decision;

 Weigh up the information to make the decision; and

 Communicate their decision.