This helped to guide me
as a student and even after I graduate to handle scenarios professionally as a
healthcare worker and to have a basis for my critical thinking. I learned how I
can analyze and examine situations with use of research to decide which best
serves patient interest and at the same time ethically perform that duty. In this
topic of abortion, I realized that it has its own advantages to it and that it
may not always be wrong depending on the situation. Unwanted pregnancy has much
more to it than I thought.
Through this assignment,
I get to evaluate and exercise decision making process about challenges I may
face in the future as a Nurse. I also get to examine dilemmas in an ethical
way, like in this scenario about abortion. At first, I thought that if
something isn’t accepted culturally, the answer would always be no to abortion.
But as I look at this situation, involving the ethical principle we learned,
the answer depends on what really is best for the patient even if this means
breaching one or two ethics.
Having mentioned this,
still foster care and parenthood have advantages of learning responsibility at
a young age and have a sense purpose of having a child. Girls would also be
more mature in a sense that they have experience
and be wise in decisions. The study by Seamark & Lings (2004) proved
how being a young parent can benefit the teenager, choosing to not let go of
the child. This is supported by value statement 7 of being an advocate for the
client and ensure that early decision making help her adjust better and get the
resources she needs.
On the contrary, looking
at the short-term effects of keeping the child may seem ethical, in the long-term,
it may affect her health; physical and mental well-being. She may not be ready
to be a mother and handle this responsibility. Thus, I would say that value
statement 5 is breached as we can’t guarantee a safe and effective approach.
Parenthood is a
transition that needs much support. She has the right to know about
organizations like ‘Babes’ which especially provide support for pregnant teenagers.
Babes has helped a lot of youths about being a young mother. By giving her this
information, I’m applying Value statement 2 of assisting her to have
information she needs.
Foster care provides the
clients address their economic status if they are financially strained and
unable to care for the child. By not having an abortion, the client’s value is
still exercised while at the same time addressing their need of financial support.
This is in accordance to value statement 1.
Two solutions are chosen
as together, these choices can help provide alternative solution for the
family. Example is they can first place the child in foster care then after she
finish studying and when she finds a job, she can go on to carry her duties as the
Looking through the
different possible solutions, parenthood and foster care seem to offer the best
solution. Foster care gives her the time of seeing her child and allow for time
to recover from pregnancy. Compared to adoption, foster care gives her more
flexibility and support to raise the child. Parenthood allows for maturity and
personal growth. Dealing with the problem
itself would help her realize better the value of life. In Singapore, there is
an organization called “Babes” which help to support teens facing teenage
pregnancies (Babes: A helping hands for pregnant teens PDF, n.d). They help youths find the most suitable options for
their situation and approach to deal with their pregnancy. In 2016, the pregnancy
outcome for teenage pregnancy is 81% chose parenthood, 12% went for abortion and
2% opted for adoption. This is suggestive of girls under the guidance of Babes
choose to parent their child.
(Code of ethics and professional conduct –
Singapore Nursing Board PDF, 1999)
Last but not the least
is parenthood. This is when the mother continue with her pregnancy and take
responsibility and take care of the child.
Parenthood involves a lot of support and time especially for a young lady transitioning
from a teenager to teenage mother. Being a teenager mother both have its pain
and joy. A research on teenage pregnancy found that teenage mothers, aged 15 to
19, are twice more at risk of suffering from postpartum depression compared to
women above 25 years. They are also likely to have increases suicidal thoughts
compared to their non-pregnant peers (“Effects of Teenage Pregnancy:
Mental Health”, n.d.). A different study talks about the good side of teenage
pregnancy. The qualitative study by Seamark & Lings (2004) showed how
these mothers found new purpose in their lives and having children made them
realize more realistic dreams and goals. Teenage motherhood also involves
strong social and emotional support for better outcomes.
Foster care is another option.
Foster care provides children below 18 years of age with a caring and safe
environment when their family is unable to support them. Unlike adoption,
foster care is a temporary where the child can still be reunited with their
biological parents. In Singapore, one of the reason for foster care is that the
family has financial difficulties and unable to support the child (Fostering,
n.d.). The foster family will
be the one who will provide safe, caring environment for the child and when
their biological family is ready, they can take the child back. This option would
be beneficial for my friend and her child especially if they are having
financial difficulties and this allows her time to finish her studies. The limitation
to this is the family have to first meet certain criteria one of them being the
family being really financially drained.
A benefit of adoption is
that the child can become the son/daughter of a couple who can’t have children.
At the same time, this also increases the number of children feeling rejected
by his/her biological family.
In Singapore, there
were 387 adoptions in 2016 (Adoption, n.d.) and among teenage pregnancies, 2%
decided to give their child for adoption (Babes:
A helping hands for pregnant teens PDF,
n.d ). Adopting requires a lot of
paperwork to ensure the parents are suitable to raise a child. She can choose
adoption as with this her baby will still be alive despite she cannot take care
of him/her. She would be also doing good, beneficence, for the baby by keeping
her alive however, this approach would also conflict with ethical principle of
fidelity. This is because as the child’s mother, she has the commitment to take
care of him/her, which she can’t fulfill if she chooses adoption.
One example is
adoption. According to section 7(i) of Adoption of Children Act(ACA), Adoption
is when the biological parents put to an end to their legal responsibilities or
their child and in turn, the adoptive parents will be responsible for the
child’s holistic care.
Having discussed about
abortion and the various conflicts of ethical principles it has, it is not the
only option to deal with unwanted pregnancy. There are other choices, choices
which has benefits and limitations of their own.
This shows how no
matter how much we reason about whether she should have an abortion or not,
there will still be conflict between ethical principles.
Suppose she decided to
abort the baby, being a concerned friend, I would inform her parents about her
situation which is veracity. But this action would be deemed as me not
respecting her right to whether she want to tell her parents or not.
As her friend, telling
her about how abortion is like ending a life and that it may be against our
values, that she shouldn’t be forced to listen to her boyfriend is to do her
good. It is exercising beneficence as I would be able to give her my ethical
opinions and make her think about whether she really want to abort. However, I
won’t be doing her justice as i’m only enforcing on her my point of view of how
wrong abortion is without even fully understanding her situation.
For my friend’s case, if
she chooses abortion because her boyfriend says so, this would mean that her
autonomy is not exercised. This is because the decision is forced on her and
she may not want to do so because she still value the baby’s life. On the other
hand, if she choose not to have an abortion, her boyfriend might be upset as
she didn’t listen to him and she might end up feeling guilty. This is
non-maleficence where while it is good that she chose to make her own decision
but in the end, hurt her boyfriend’s feelings.
Having mentioned about
some advantages of abortion over keeping the pregnancy, abortion is still
highly debatable. It may be legal, but ethically, abortion may contradict with
one’s values and beliefs.
Abortion may be frowned
upon and considered ethically immoral, but for teenagers who did so, they still
reaped benefits compared to those who kept their pregnancy. In an article be Fergusson,
Boden, & Horwood (2007), they found that women who had an abortion has
significantly better outcomes in terms of education, income, work life, etc.
Furthermore, I would
also encourage her to inform her parents that she’ll have an abortion. Though
parental consent is not required for minors under 21, she still has to tell her
parents about what is happening to her (Abortion In Singapore: What
You Need To Know, 2018). However,
in an article by The Straits Times, social workers stated that this is one
issue which girls would be scared to tell their parents (Big
drop in number of teen pregnancies ,2016).
In terms of the impact
of abortion on her body, the risk for complication is low(<1%) and its effects, such as future fertility, will be minimal since abortion is generally a safe procedure if done by a trained professional (Abortion | AWARE Singapore, 2017). Back to the case, suppose she is above 16 and decided to go with abortion, she has to be less than 24 weeks pregnant and her decision must be hers not because she is forced into doing so according to the Termination of Pregnancy act (Termination of Pregnancy Act (CHAPTER 324), n.d.). Abortion is when a pregnancy is terminated by the means of either by force or spontaneously. In Singapore, abortion is legal and is guided under Termination of Pregnancy Act. For girls under 16, they will be referred to Health Promotion Board(HPB) for pre-abortion counselling This could be so as girls may see abortion as the way out of their 'problem'. In Singapore, the trend for teenage pregnancy have declined over the years, but there are still girls who have to face this stressful and painful situation. For girls under 19 years, about 359 births were reported in 2015. Along with the declining trend of teen pregnancy is the decreasing number of abortion carried out in girls below 20 years old. Tracing back from 2004, there were 781 babies born to these girls, while the number of abortion is 1,341. A decade later, there were 406 births and 449 abortions reported. These statistics show an overall decline in teenage pregnancy and this also shows that more girls choose to go for abortion over keeping their pregnancy. (Big drop in number of teen pregnancies ,2016) In a recent survey by the National Youth Council(NYC) in 2016, youths aged between 15 to 34 found that they are not that confident to face the life issues (Chua, 2017). Youths are already having difficulties about facing life challenges how much more deciding what to do on a life. An ethical dilemma is a situation which involves professional decision making process in accordance to the standards set by the profession as the right action (What Is an Ethical Dilemma?, 2013). For this case, the issue is whether she should get an abortion or not. This is an ethical dilemma as firstly, a decision has to be made and even after a decision is made, there will still be implications to whether she choose to abort or no. Example, as a student nurse, I would advise her not to abort as we learn that abortion is not right. The consequence may be that this would jeopardize her relationship with her boyfriend. On the other hand, if she aborts because her boyfriend says so, she may feel bad in the end as this may not be what she wants. Either way, there will be no perfect solution and one or two ethical principles will be compromised.