The relevance of the problem of abortion today can hardly be overestimated. It is surrounded by various moral and ethical issues a woman faces deciding to have a procedure. Allowing abortion should be born in mind that it is a serious moral and physical trauma for a woman. Since this medical intervention involves interrupting the life of an unborn person that has already begun, this issue is very acute. The controversy on this topic has continued for centuries, and it seems the problem will never lose its relevance.
Moral Problems Surrounding Abortion
In recent decades, abortion has become one of the most intensely and widely discussed problems in the theory of morality. However, the philosophical and scientific sophistication of this discussion does not mean that the problem of artificial termination of pregnancy is becoming clearer. The problem is usually associated with questions about the beginning of human life, the rights of the fetus, the woman’s right to self-determination (Muldoon, 2021). The debate over the problem of abortion in many countries is at the level of public policy. Opponents of abortion are fighting to adopt, maintain and expand restrictions or prohibitions on abortion, while advocates of the right to abortion are fighting to repeal or soften such laws. Abortion advocates and their opponents disagree in the terminology of the controversy. Opponents argue that the problem is whether embryos should have the right not to be killed, like other human beings. Defenders consider the central question of whether it is possible to force a woman to bear an unwanted fetus even at the cost of her own health and life.
Ethical Principles of Abortion
The most recognized bioethical principles are the principle of non-maleficence, autonomy, and justice. However, in practice, their use often leads to contradictions, when in specific situations, individual principles collide with each other, giving rise to bioethics dilemmas. The problem of abortion is a striking example of such bioethical dilemmas. The semantic center of this problem is in the space of life and death of a potential mother and a person in the development process – an embryo and a fetus. Discussions on abortion include the following issues: defining the criteria for life; the status and rights of the embryo and fetus; whether abortion is a murder and whether it can be considered justified. This problem concerns the ethical status of the embryo, on which the solution of the moral and ethical problem of artificial termination of pregnancy or abortion depends.
Non-maleficence
With the principle of non-maleficence, harm is done not only to the fetus but also to the woman’s health, who may lose the opportunity to become a mother in the future. In addition, the question of the need for anesthesia of the fetus is raised, although advocates of abortion have expressed doubts about its ability to experience pain in early pregnancy. Meanwhile, it is difficult to doubt that the fetus is in a state of severe discomfort during manipulation.
Autonomy
According to the principle of autonomy, which gives a person the full right to dispose of his or her body, a woman has the right to independently decide whether to preserve or interrupt it. However, this woman’s right conflicts with the rights of a child who has not yet been born (Greasley, 2017). This issue is one of the most discussed and controversial in modern bioethics.
Justice
The issue of the permissibility of abortion underlines the importance of discussing the principle of justice. It raises the question of how appropriate the choice in favor of the rationally understood benefit of a woman’s autonomous personality is. Within this principle, ethics touches upon whether it is fair to neglect the possibility of a new person emerging. Whether it is fair to involve medical specialists in an operation to destroy a living creature is also a matter of concern. There are no unambiguous answers to all the questions that arise, which complicates the global solution of the problem.
Literature Review
The presented research literature on the topic confirms the contradictory nature of the issue; everything also comes down to medical debt or immoral choice on which a new life depends. In his work, Dr. George disputes the nature of planned abortion as a medical service based on the implicit judgment that unwanted pregnancy is not a disease. The author notes the philosophical nature of the issue, which scientific research methods cannot resolve (George, 2019). That is why there is no reason to force doctors to violate their beliefs and go against their conscience, who disagree with the abortion procedure. The doctor defends medical professionals who disagree with abortion and are forced to violate their principles to not lose their jobs. Attention is drawn to the right of physicians to follow their ethical considerations in the situation of the need to provide a service. Analyzing the article, the need to consider the opinions and moral convictions of specialists can be noted. The service delivery system should be transformed in such a way as to create comfortable conditions for both patients and medical personnel with the anxious abortion procedure.
Another article, in contrast to the above, focuses on access to abortion in different countries. This compares regulatory, policy, and programmatic barriers that prevent access and timely provision of medical care for safe abortion. The importance of removing various barriers and opportunities for women to receive medical services is emphasized. The data for analysis is based on the Global Abortion Policy Database, taking into account countries where abortion is legal. The results demonstrate the differences in regulatory requirements. Analyzing the information presented, it is essential to note the global trend of legislation liberalization since most countries’ experience shows that restrictive legislation does not reduce the number of abortions. The main findings are the ideas presented that the accessibility of abortion should be seen in the broader context of reproductive health. Abortion policies can be supportive or restrictive; however, regulatory, policy, and programmatic barriers to access must be removed.
Resolution
Taking care of life and health is one of the main concerns of the state. In the modern world, state policy and legislation in abortion vary significantly from a complete ban to a permit with various kinds of restrictions. The legalization of abortion is also necessary because, in this case, the state takes responsibility for ensuring safe abortion and its prevention. The leading international organizations prefer to refer the issue of the starting point of personal life to the competence of the member states (Lavelanet et al., 2020). It is recommended only to maintain a balance between protecting the interests of the unborn, the mother, and society.
Legal, social, medical, spiritual, moral, organizational, and other aspects form the problem, complicating its resolution. Correlating this problem with realizing the right to live in different states of the world, one can come to a disappointing conclusion. Humanity is not yet ready to make a clear choice in favor of one of two fundamental rights – the right to life and the private side of its manifestation. However, it is necessary to ensure equal access to medical services, including abortion, for all segments of the population; attempts to implement this can be considered the only correct one.
Healthy People 2030
The Healthy People 2030 Program for Health Promotion and Disease Prevention has an area dedicated to reproductive and sexual health. The related goals and targets cover many vital aspects, including access to sexual and reproductive health services, the ability to make decisions about one’s health, and comprehensive sexuality education. To protect women’s health and lives, it is imperative to promote access to safe abortion and reduce the incidence and complications of unsafe abortion (Office of Disease Prevention and Health Promotion, 2017). In this area, more effective data collection is needed to improve the medical and legal environment to ensure safe abortion care and reduce the stigma associated with the procedure. The current program aims to facilitate access to abortion in line with best clinical practice in full national legislation and to ensure quality post-abortion care.
Role of the Advanced Practice Nurse
With the necessary qualifications, a nurse must provide a service and respect choices, judge the situation with an open mind, and express support and empathy to the patient. Women seeking an abortion can have complex and conflicting feelings, and the advanced practice nurse should be aware of and respectful of the patient’s emotions and feelings. The professional should assess the situation and choose the correct tactics of behavior; in this case, the medical worker’s experience and necessary competencies are essential. The patient should feel empathized; while getting safe and competent help. A respectful attitude should come from the specialist throughout the service. In all this, a person’s competence and humanity are important; therefore, the advanced practice nurse plays a crucial role in the process.
References
George, R. P. (2019). A defense of conscience in healthcare. Ethics, Medicine and Public Health, 11, 16-20.
Greasley, K. (2017). Arguments about abortion: Personhood, morality, and law. Oxford University Press.
Lavelanet, A. F., Johnson Jr, B. R., & Ganatra, B. (2020). Global abortion policies database: a descriptive analysis of the regulatory and policy environment related to abortion. Best Practice & Research Clinical Obstetrics & Gynaecology, 62, 25-35.
Muldoon, M. (2021). The abortion debate in the United States and Canada: A source book. Routledge.
Office of Disease Prevention and Health Promotion. (2017). Healthy People 2030 [PDF document].