Question

O.P., an unmarried 15-year-old high school student, finds herself pregnant by her 17-year-old boyfriend of several months. She estimates she is 10 weeks pregnant and visits a doctor to ask for an abortion.

O.P.’s parents have made it very clear that they would no longer allow her to live at home and would withdraw all financial support were she to become pregnant before marriage. O.P. has always aspired to attend college and graduate school. Her family knows about her relationship with the young man but they are unaware of its sexual nature. In her country, the law requires parental consent in all health care services for minors under the age of 16 years. It also provides for abortion for any woman upon request, up to 12 weeks of pregnancy. However, the doctor refuses to perform an abortion for O.P. unless one of her parents provides consent for the procedure.

Questions for discussion

What are the medical issues in this case? Specifically:

What are the health risks and benefits of a termination procedure at 10 weeks’ gestation?

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How do these risks change if the procedure is delayed for a further 4–6 weeks?

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What are the health risks if this girl undergoes an unsafe abortion?

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What are the likely health and social outcomes of a pregnancy for this 15-year old?

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How does the law in the United States recognize the principles of evolving capacity or best interest of the child as it applies to medical care?

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How do your responses to the above questions guide your support of O.P.’s decision-making authority free from parental consent?

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What is autonomy?

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What are ethics?

Answer 1

In this Scenario, 15 year girl is pregnant and now she is in her 10th weeks of pregnancy. Now she presented in the clinic for the termination of Pregnancy.

Medical issues related to the Teenage Pregnancy include:

· If the pregnancy is continuing , then there is a risk for premature birth or low birth weight

· Risk for Anemia

· Risk for developing Pregnancy induced Hypertension

· There will be high rate of Infant Mortality

· There is a chance of developing Nutritional problems

· Risk for Mental health disorders

· Risk for developing breast cancer

Health risks and benefits of a termination procedure at 10 weeks’ gestation

Health Risks of the termination of the pregnancy includes:

· Risk for developing Infection of the uterus after the termination

· Risk for Heavy bleeding

· Risk for Incomplete Abortion means some of the pregnancy tissues will remain in the uterus.

· Risk for developing Anesthesia related complications

Benefits of termination procedure at 10 weeks’ gestation include:

· Access for the safe Abortions

· Less risk for developing Infection

· Lower risk for developing complications in abortion

· Less chance for death in abortion when compare to childbirth

· Abortion will reduce both Physical and Mental health risks

Risks for the delayed termination of Pregnancy

· Risk for the retained tissue of the pregnancy including the placenta in the uterus

· Risk for uterine perforation that will cause severe blood loss and pain

· Risk for developing Cervical perforation and heavy bleeding

· Chance for getting Infection

Health risks of an unsafe abortion

· Abnormal vaginal bleeding

· Vaginal Infection

· Abdominal pain

· Shock

· Hemorrhage

Health and social outcomes of a teenage pregnancy

Health outcomes of the teenage pregnancy include:

· High risk for Pre-eclampsia

· Urinary tract Infection

· Low birth weight

· Acute Pyelonephritis

Social outcomes of a teenage pregnancy include:

· Family conflict and breakdown

· Violence

· Lack of relevance

· Difficulty to make friends

· Frustration

· Feeling difficulties in school and Home

· Desire to leave school

· Poor housing

Law in the United States

         A teenager who is under the age of 18 years, who is in the pregnancy stage can have the right for undergoing abortion. In US, some states need the parental consent for undergoing abortion and some states does not need this consent. Instead of Parental consent judicial bypass from court can also take as consent for the termination of pregnancy. By taking the judicial bypass, there is no need of consent from parents for the abortion. In this case, may be parents were not known regarding the pregnancy of their minor daughters.

Measure to support O.P to free from parental consent

  O.P can perform the abortion of her teenage pregnancy by taking a judicial bypass instead of parental consent. For taking the judicial bypass she should reach the court and to get a judicial bypass from the judge. This will make her the free from parental consent.

Autonomy

Autonomy is defined as the independence of one’s thoughts and actions.

Ethics

Ethics is defined as a system of moral principles that affects the human’s concepts of right and wrong conduct.