Case Study on Moral Status: Fetal Abnormality – Nursing Ethics Assignment Brief

Course: PHI-413V Ethical and Spiritual Decision Making in Health Care
Assignment: Moral Status Case Analysis
Word Count: 750–1,000 words
Format: APA 7th Edition (no abstract required)
Submission: Turnitin via LMS

This assignment requires students to analyse the Case Study: Fetal Abnormality through the lens of moral status theories. Students must identify which theories each character applies, explain how those theories shape their recommendations, and articulate their own position with supporting rationale. The task develops ethical reasoning skills essential for nursing practice in prenatal and perinatal care settings.

Assignment Overview

Based on the Case Study: Fetal Abnormality and the required topic study materials, write a 750–1,000-word reflection that addresses the following questions:

1. What is the Christian view of the nature of human persons, and which theory of moral status is it compatible with? How is this related to the intrinsic human value and dignity?
2. Which theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson to determine the moral status of the fetus? What from the case study specifically leads you to believe that they hold the theory you selected?
3. How does the theory determine or influence each of their recommendations for action?
4. What theory do you agree with? Why? How would that theory determine or influence the recommendation for action?

Remember to support your responses with the topic study materials. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines.

Case Study: Fetal Abnormality

Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.

Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears.

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother.

Scoring Rubric

Total Points: 200

Sample Answer Excerpt: Moral Status Analysis

Jessica’s position reflects the theory of moral status based on the inherent value of life itself. She holds a conviction that all life is sacred, which aligns with the view that moral status derives from simply being alive, regardless of cognitive capacity or social utility. This perspective is consistent with the Christian worldview that human persons are created in the image of God and therefore possess intrinsic dignity from conception. Marco, by contrast, appears to apply a combination of the consciousness and sentience theories, as he views the fetus through the lens of potential burden rather than inherent worth. His concern about economic security and the challenges of raising a child with disabilities suggests he does not attribute full moral status to the fetus at this gestational stage. Research indicates that social support and partner involvement significantly influence how individuals process traumatic prenatal diagnoses, with strong partnership bonds often mediating the emotional impact of such news (Barrera, 1986).

Dr. Wilson’s Professional Obligations and Ethical Tensions

Dr. Wilson operates from a biomedical ethics framework that prioritises patient autonomy and informed consent, yet his approach reveals a tension between professional obligation and relational care. His insistence on disclosing the diagnosis directly to Jessica, despite Marco’s request, demonstrates adherence to the principle that patients have a right to know their health status. However, his clear recommendation for abortion as the “scientifically” wise choice introduces a directive element that some ethicists argue may undermine truly informed decision-making. The concept of the fetus as a patient, particularly in cases of severe anomaly, requires careful balancing of beneficence-based obligations to the fetus with respect for maternal autonomy (Chervenak & McCullough, 2021). Dr. Wilson’s position aligns with the human properties theory, which attributes moral status based on characteristics such as genetic heritage or physical human features. His recommendation for action stems from his assessment that the fetus lacks certain human properties, namely fully developed limbs and, potentially, typical cognitive function, thereby reducing its moral status in his professional judgment.

Aunt Maria’s Relational and Religious Framework

Aunt Maria’s response exemplifies the relationship theory of moral status, which holds that moral obligations arise from existing relationships and the roles individuals occupy within those relationships. Her plea for Jessica to “think of her responsibility as a mother” directly invokes the maternal-fetal relationship as the basis for moral consideration. Additionally, her religious conviction that abortion is morally impermissible reflects the Christian view that human life possesses intrinsic value from conception, a perspective that the Christian tradition grounds in the doctrine of imago Dei (Shelly & Miller, 2009). Maria’s recommendation to continue the pregnancy flows directly from this relational and theological framework, as she sees Jessica’s duty as inseparable from her identity as a mother.

Christian Anthropology and the Foundation of Moral Status

The Christian view of human persons centres on the belief that each individual is created in the image of God and therefore possesses inherent dignity and worth that is not contingent on developmental stage, ability, or social contribution. This theological anthropology is most compatible with the theory of moral status based on human properties, specifically the possession of a human genetic code and the potential for relationship with God. The intrinsic value and dignity of human persons in Christian thought derives from their status as bearers of the divine image, a status that applies from conception to natural death. This understanding has profound implications for nursing practice, particularly in perinatal and palliative care contexts, where decisions about life and death must be made with reverence for the sacredness of each human life. As Mack and Camosy (2023) argue, the Christian nurse is called to be the hands and feet of Jesus, offering care that reflects the inherent worth of every patient, including the unborn.

Ethical Decision-Making in Perinatal Nursing Practice

The case study highlights the complex interplay of ethical principles, professional obligations, and personal values that nurses and healthcare providers navigate when caring for families facing fetal anomalies. Research demonstrates that the decision-making process for families offered termination of pregnancy for serious congenital abnormalities is influenced by multiple factors, including religious beliefs, socioeconomic considerations, and the quality of support from healthcare providers and family members (Malope et al., 2023). Nurses play a critical role in this process by providing accurate information, facilitating communication between patients and providers, and offering emotional support that respects the diverse moral frameworks patients bring to these difficult decisions. The ethical dilemmas inherent in fetal abnormality cases require nurses to develop competence in moral reasoning and to maintain awareness of their own biases and values.

Answer-First Summary

This assignment examines the moral status of a fetus with severe abnormalities through the lens of four characters: Jessica, Marco, Maria, and Dr. Wilson. Students analyse which moral status theories each character applies, how those theories shape their recommendations, and articulate their own position with supporting rationale from Christian ethics and professional nursing standards.

Why This Matters in Practice

Nurses frequently encounter ethical dilemmas involving fetal anomalies, termination decisions, and end-of-life care. Understanding moral status theories equips nurses to navigate these situations with sensitivity, respect patient autonomy, and provide compassionate care that honours diverse belief systems while maintaining professional ethical standards.

Frequently Asked Questions

What are the main theories of moral status relevant to this case study?
The primary theories include: human properties theory (moral status based on genetic or physical human characteristics), consciousness theory (moral status based on awareness or sentience), moral agency theory (moral status based on capacity for moral reasoning), and relationship theory (moral status based on relational connections and roles).

How does the Christian worldview inform the moral status of the fetus?
The Christian worldview holds that human persons are created in the image of God (imago Dei) and therefore possess intrinsic dignity and worth from conception, which is most compatible with the human properties theory of moral status.

What ethical obligations do nurses have when caring for families facing fetal abnormalities?
Nurses have obligations to provide accurate information, support informed decision-making, respect patient autonomy and diverse values, offer emotional and spiritual support, and advocate for compassionate care that honours the dignity of both the pregnant person and the fetus.

How should healthcare providers balance professional obligations with patient preferences in fetal abnormality cases?
Providers must respect patient autonomy while fulfilling their duty to disclose relevant medical information, offer evidence-based options, and provide non-directive counselling that supports patients in making decisions aligned with their values.

References

Barrera, M., Jr. (1986). Distinctions between social support concepts, measures, and models. American Journal of Community Psychology, 14(4), 413–445. https://doi.org/10.1007/BF00922627

Chervenak, F. A., & McCullough, L. B. (2021). The professional responsibility model of obstetric ethics. Clinical Obstetrics and Gynecology, 64(3), 526–535. https://doi.org/10.1097/GRF.0000000000000631

Mack, A. N., & Camosy, C. C. (2023). Bioethics for nurses: A Christian moral vision. William B. Eerdmans Publishing Company.

Malope, M. F., Stewart, C., Fieggen, K. J., & Wessels, T. M. (2023). The decision-making process of pregnant individuals offered termination of pregnancy for serious congenital abnormalities. Patient Education and Counseling, 112, 107745. https://doi.org/10.1016/j.pec.2023.107745

Shelly, J. A., & Miller, A. B. (2009). Called to care: A Christian worldview for nursing. InterVarsity Press.

Write a 750-1000-word reflection analysing the Fetal Abnormality case study through moral status theories, Christian ethics, and nursing practice implications.

Complete a 3-4 page APA-formatted case study analysis examining moral status theories applied by Jessica, Marco, Maria, and Dr. Wilson in a fetal abnormality ethical dilemma.

Week 3 Discussion Post

Course: PHI-413V Ethical and Spiritual Decision Making in Health Care
Assignment: Week 3 Discussion Post – Spiritual Assessment in Clinical Practice

After completing the Moral Status Case Analysis, students will engage in a discussion post exploring the role of spiritual assessment in nursing practice. The initial post requires students to describe a spiritual assessment tool (such as HOPE, FICA, or SPIRITual) and apply it to a clinical scenario involving a patient facing a life-limiting diagnosis. Students must discuss how spiritual beliefs influence health decisions and identify strategies for providing culturally competent spiritual care. Responses to peers should include constructive feedback and additional perspectives on integrating spiritual assessment into nursing practice. The discussion aims to develop skills in holistic patient assessment and interprofessional collaboration.