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Expectant Mothers Who Misuse Alcohol And/or Illicit Drugs

The maternal alcohol and drug consumption pattern directly impact the growth of the fetus and for better health, it needs to be checked upon. Alcohol and drug consumption of pregnant women disrupt normal growth pattern and can have a teratogenic effect over the baby (Sebastiani et al., 2017). Medical and ethics are two aspects that that work simultaneously to maintain quality of care for better patient experience. The four ethical principles that are used to work ethically that include beneficence, non-maleficence, autonomy and justice (Lulé et al., 2019). Expectant mothers should consider being extra careful regarding their diet and habits as it directly impacts the baby (Kaye, 2019). The essay will present the argument concerning expectant mothers who misuse alcohol and/or illicit drugs by considering the ethical principle. The argument will be presented to correlate the ethical principle in the situation which helps to understand the ethically right and wrong situation. The essay will be in favour of the mandatory reporting for child abuse concerning the misuse of alcohol by the expectant mother.

The substance abuse in pregnant women is due to the prior habit of alcohol and drug that is difficult to change. The data presented in the research indicate that 5.9% of the pregnant women use illicit drug and 8.5% drink alcohol that increase the risk for the greater exposure of the offspring with substances abuse (Forray, 2016). The habit of substance abuse during the pregnancy not able to affect the baby but it also has a deleterious effect over the mother like miscarriage or preterm labour. The use of the different drugs and alcohol also increases the chances of disorder in the foetus which has impact lifetime (Forray, 2016). World Health Organization (2020) states that substance abuse during pregnancy leads to health and social issue that will directly impact both. Several impairments are faced by the child due to substance abuse habit of the mother like physical malformation or neurological damage. The mother should take the pregnancy as a chance to stop the substance abuse by realising about the health of the baby as it will directly impact the health of the baby.

The use of alcohol and drug during pregnancy can be ethically right as it maintains the autonomy of the mother. The mother has maintained her wish to use all these substances during pregnancy that helped her to maintain autonomy. One of the articles presented by Murgic et al. (2015) discussed that autonomy is important to improve the individual identifies to do the things corresponding to their wish. Autonomy improves the perspective to be consumer-centric that will improve individual satisfaction. The autonomy helps to improve the individual decision-making skills concerning their life that help them to have the power to decide right and wrong as per their preferences. Moreover, another side was presented by Dove et al. (2017) by adding that individual autonomy is good up until it does not harm any other individual. Negative autonomy can directly harm the individual over the other individual that considered being unethical. The negative autonomy frees the individual from the external constraint which directly frees the individual to perform anything without understanding about consequences. The mother decided to use alcohol and drug is considered to be the negative side of the autonomy in which her decision is respected but it will negatively impact the health of the baby. The baby autonomy is not considered as the baby is not able to convey about is he/she want to be effected from the substance abuse of the mother or not that is again a breach of the ethical principle.

The mother consuming alcohol and drug during pregnancy which will directly cause harm to the offspring and it comes under the maleficence that is considered to be unethical concerning the harm to the other individual. One of the studies presented by Casey et al. (2015) discussed that maleficence is considered to be the intentional act of harming that will negatively impact the individual. The maleficence behaviour is considered to be negative as it harms other individuals without any reason thus it comes under the breach of the ethical principle. The maleficence covers the entire acts that are performed to cause harm to the other individual without thinking about the consequences. On the hand, the article presented by Girdler et al. (2018) ethically individual should work as per non-maleficence to safe the ham that negatively impacts the other individual. The act of non-maleficence is considered to evaluate all the risk and benefit of the act to reduce the chances of harm caused due to the act. The mother alcohol and drug consumption will directly negatively affect the individual that comes under maleficence which is unethical. 

The substance abuse of the mother will don’t benefit the child but it will directly harm the child that will increase complication after the birth like cognitive impairment or issue with the organ functioning. The study presented by Singh & Ivory (2015) discussed that breach of the beneficence will directly harm the other individual that is unethical. The breaches of the beneficence lead to the promotion of the harm that will negatively impact the other individual. The breaches of the beneficence occur when the balance of the benefit and harm become misbalanced those lead to harm of the other individual. The individual not following the beneficence in the working will eventually end up harming the other individual that will violate the human right as well as ethics. The findings are supported by Clark & Weaver (2015) by adding that beneficence helps the individual to increase the rate of benefit associated with their action. The beneficence indicates that individual action should be is such a way that it will benefit the other individual. Beneficence helps to perform the action that will eventually benefit the other individual that is ethically right. Beneficence is considered to be one of the most important ethical principles that aim to benefit the other individual by improving the action. The mother breached the beneficence principle as her action will directly reduce the benefit to the child which is unethical.

The extra negative behaviour of the mother due to the substance abuse will decrease the healthy growth of the baby which will comes under the unethical injustice. The study presented by Krau, (2015) discussed that the unfair action of the one individual that will directly affect the other individual negatively comes under the injustice practice. The injustice practises directly increases the chances of harm that can increase the issue for the other individual that is considered to be unethical. The breach of the justice principle directly increases the chances of disparity of the resources and care that is required for the welfare of the other individual. The injustices increase the chances of discrimination and the absence of equity of which will directly increase the chances of the other individual to utile the right resources to flourish. Moreover, the article presented by Brännmark, J. (2019) discussed that justice in the action is important to improve the equality and equity which will decrease chances of discrimination. The justice will help the individual to provide equal opportunity to others that are important to increase the welfare of the other individual. There are different ways in which justice in the action can be improved which are improving practise, reframing values and understanding other perspectives. The justices help the individual to follow the fairness in every action that only aim to benefit the other individual by equally providing the opportunity to grow. The substances use of the mother will lead to a discriminated environment for the baby in which all the negative factor will coordinate to decrease the growth and increase the chances of impairment. This situation is considered to be discrimination of the right resources that are necessary for the growth of the baby.

The findings reveal that there is the more supportive argument that is the support for the mandatory reporting of the maternal misuse of the alcohol and drug should for the child abuse is necessary as it is directly decreasing health status of the baby

The essay can be concluded that ethical principles are framed to improve the practices that promote the welfare of mankind. The mother habit of the substance abuse will directly impact the child negatively which is considered to be unethical. The autonomy of the patient is respected in the scenario but it has directly increased health-related complication for the baby. The lack of beneficence from mother side can decrease the chances of benefit for the unethical children. The maleficence behaviour of the mother has increased harm for the children which will deteriorate the health of the patient. The injustice created by the action of the mother due to substance abuse increased the chances of discriminated environment for the baby that will deteriorate health. So this can be concluded misuse of the alcohol and drug by the expectant mother should be considered as mandatory reporting for child abuse as it is directly deteriorating the health of the baby. The mother carelessness can impact the child health that is unethical and should be considered under child abuse.

References for Beneficence and Non-Maleficence

Brännmark, J. (2019). Principles of justice and the idea of practice-dependence. Ethics & Global Politics, 12(3), 1-16, DOI: 10.1080/16544951.2019.1667132

Casey, P. (2015). Beneficence and non-maleficence: Confidentiality and carers in psychiatry. Irish Journal of Psychological Medicine, 33(04), 203–206. DOI: 10.1017/ipm.2015.58 

Clark, C. D. & Weaver, M. F. (2015). Balancing beneficence and autonomy. The American Journal of Bioethics, 15(7), 62–63. DOI:10.1080/15265161.2015.1042717 

Dove, E. S., Kelly, S. E., Lucivero, F., Machirori, M., Dheensa, S. & Prainsack, B. (2017). Beyond individualism: Is there a place for relational autonomy in clinical practice and research? Clinical Ethics12(3), 150–165. DOI: 10.1177/1477750917704156

Forray A. (2016). Substance use during pregnancy. F1000Research, 1-9. DOI: 10.12688/f1000research.7645.1

Girdler, S., Girdler, J., Tarpada, S. & Morris, M. (2018). Nonmaleficence in medical training: Balancing patient care and efficient education. Indian Journal of Medical Ethics, 4(2). DOI: 10.20529/IJME.2018.100.

Kaye, D. K. (2019). The moral imperative to approve pregnant women’s participation in randomized clinical trials for pregnancy and newborn complications. Philosophy, Ethics, and Humanities in Medicine, 14(11), 1-11. DOI: 10.1186/s13010-019-0081-8 

Krau, S. D. (2015). Social justice: A basis for health care delivery. Nursing Clinics of North America, 50(3), xiii–xv. DOI: 10.1016/j.cnur.2015.07.002

Lulé, D., Kübler, A. & Ludolph, A. C. (2019). Ethical principles in patient-centered medical care to support quality of life in amyotrophic lateral sclerosis. Frontiers in Neurology, 10. DOI: 10.3389/fneur.2019.00259 

Murgic, L., Hébert, P. C., Sovic, S. & Pavlekovic, G. (2015). Paternalism and autonomy: Views of patients and providers in a transitional (post-communist) country. BMC Medical Ethics, 16(1). DOI: 10.1186/s12910-015-0059-z 

Sebastiani, G., Borrás-Novell, C., Casanova, M. A., Pascual Tutusaus, M., Ferrero Martínez, S., Gómez Roig, M. D. & García-Algar, O. (2018). The effects of alcohol and drugs of abuse on maternal nutritional profile during pregnancy. Nutrients10(1008), 1-7. DOI: 10.3390/nu10081008

Singh, J. P. & Ivory, M. (2015). Beneficence/nonmaleficence. The Encyclopedia of Clinical Psychology, 1–3. DOI: 10.1002/9781118625392.wbecp016 

World Health Organization. (2020). Substance use in pregnancy. Retrieved from: https://www.who.int/substance_abuse/activities/pregnancy_substance_use/en/

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