abortion,
Biomedical Ethics: Induced Abortion
Abortion is the expulsion of a living fetus from the mother’s womb before it is
viable.
Abortion is the termination of pregnancy spontaneously or by induction prior to
viability. Thereafter, termination of pregnancy is called delivery.
Types of Abortion
•Spontaneous Abortion
•Induced Abortion
Induced Abortion
•Occurs as a result of artificial or
mechanical interruption or due to voluntary and effective human intervention
•It may be sought as an end or as a
mean
As
an end: get rid of the baby
As
a mean: therapeutic abortion wherein the health of the mother is concerned.
•Induced abortion is intrinsically
evil and must be qualified as homicide.
Types of Induced Abortion
•Abortion by D and C (Dilatation and Curettage)
•Abortion by Caesarian Section or by Abdominal Hystoroctomy
•Abortion by Suction
•Abortion via Intra-Amniotic Infiltration
•Abortion via IV infection of Prostaglandin
Abortion by D and C
•Accomplished in the periods between
7 to 12 weeks gestation
•Under general anesthesia
•Scraping of endometrium until all
embryonic or fetal matters and surrounding placental tissues are removed
Abortion by D and E
Dilation and evacuation (D and E) This is the most common procedure for ending a pregnancy between
14 and 21 weeks. It is similar to a suction D and C but with larger
instruments. The cervix has to be dilated or stretched open to a size larger
than required for a D and C. Suction is used along with forceps or other
special instruments to ensure all the pregnancy tissue is removed.
Abortion by CS or by Hysterotomy
•Carried out in similar fashion as
the procedure but after the umbilical cord is cut, the neonate is left to die
without resuscitation
•Done during the last trimester
since no other technique is available at this stage.
Abortion by Suction
Done during the first trimester
Abortion via Intra-Amniotic
Infiltration
•Done by first extracting about 10
to 300cc of amniotic fluid through an abdominal puncture. This is followed by
infiltration of a 20% hypertonic saline solution or 50% dextrose of water into
the amniotic sac. This causes necrosis of the placenta and saline intoxication
of the fetus. The fetus eventually dies within an hour.
•Abortion is completed with the
expulsion of the fetus at about 36 hours after the infiltration of hypertonic
solution. This technique carries a certain risk of uterine perforation, not
excluding the death of the abortant mother on account of the passage of the
saline solution into the blood.
Abortion via IV Infection of
Prostaglandin
•When one considers the ideal period
when to perform abortion by suction of by intra-amniotic infiltration, one
observes brief internal period from 12 weeks to 16 weeks AOG, during which it
is difficult to abort.
•During this period, the tiny human
being has acquired sufficient mass, making it difficult to suction, as the
mangled parts may not easily pass through the tubing. Neither can one abort by
infiltrating hypertonic solution because there is not enough amniotic fluid. Therefore, slow intravenous
infusion of prostaglandin is used by those bent on getting rid of the unborn
baby at this time.
•Recently, a new contraceptive pill,
RU 486 (Mifepristone) has been launched in the market. It is a progesterone
antagonist which opposes its action to sustain pregnancy. RU 486 is associated
with prostaglandin which provokes uterine contraction and expels the embryo
from the womb.
Legal, Moral, and Ethical
Considerations
•Article II, Section 12 of the 1986 Philippine Constitution provides that “The
state recognizes the sanctity of life and shall protect and strengthen the
family as a basic autonomous social institution. It shall equally protect the
life of the mother and the life of the unborn from conception.”
•The direct and voluntary killing of
an innocent human being is always gravely immoral, even when it is performed as
a means to a good end.
•Respect for human life and the
radical condemnation of abortion as intrinsically evil is not an exclusive
position of Catholics. All men of upright judgment share this view, which is
based on what a person is and should be.
•Abortion destroys life and violates
the right to life. As such it is morally evil and it should not be in any way
legalized and liberally permitted in the laws and constitution of a nation.
Effects of Abortion
•Abortion could have varied physical and psychological effects on the
woman concerned.
•On the physical aspect, the woman may suffer habitual miscarriage,
ectopic pregnancies, menstrual disturbances or discomfort, still births,
bleeding, shock, insomnia, loss of appetite, coma, fever and cold sweat,
intense pain, weight loss, frigidity.
•Psychologically, a woman may
manifest guilt, suicidal tendency, loss of sense of fulfillment, loss of
confidence, thwarted maternal instinct, self-destructive behavior, anger, rage,
helplessness, loss of interest in sex, inability to forgive herself, and
intense interest in babies.
Abortion Under the Law
•Criminal abortion is a grave crime in penal codes. Today, with the
legislation and positive authorization of abortion in some cases, things have
changed. A review of the legal proceedings of those countries which have
legalized abortion show some differences in modalities, which can be observed
upon reading the World Health Organization chronicle of 1976.
•The chronicle summarizes the
conditions or situations in which the legislation of different countries
authorize the practice of abortion.
•Such situations are:
–When the mother is authorized to safeguard her physical and mental
health
–When pregnancy is the consequence of rape or incest, or when it occurs
in minors
–When the mother contracts sub-cola during a critical stage of gestation
(which consequent risk of congenital malformations of the baby) or has been
exposed to other risks (e.g. certain drugs or ionizing radiations) which can
lead to defective fetal development
–When Down’s syndrome or other chromosomal abnormalities are diagnosed
through amniocentesis
–When the parents are mentally deficient and considered incapable of
adequately rearing a child.
References
Abortion (Termination Of Pregnancy)
- How It's Done | SparkPeople. (n.d.). Retrieved from
http://www.sparkpeople.com/resource/health_a-z_detail.asp?AZ=513&Page=4
Ciabal, L. P. (2003). Ethics
for Health Professionals. Quezon: C&E.
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