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  • Title: Childbearing, reproductive control, aging women, and health care: the projected ethical debates.
    Author: Freda MC.
    Journal: J Obstet Gynecol Neonatal Nurs; 1994 Feb; 23(2):144-52. PubMed ID: 8201457.
    Abstract:
    Of the many social trends that will have an impact on the ethical debates surrounding women's health in the 21st century, three are discussed: the shifting demographics of age and race in the United States; the fundamental change in the health care system to a community-based, preventive model; and the equal voice of women in the government. Using these trends as a framework, this article hypothesizes the ethical debates that will occur in the 21st century concerning such issues as fetal viability, abortion, contraception, infertility, genetic engineering, aggressive versus nonaggressive treatment of aging women, scarce resources, menopause, organ transplants, sexism in biomedical research, fertility in postmenopausal women, birthing centers, fetal surgery, and fetal therapy. In the 21st century, 3 pivotal social trends will have an impact on women's health and on women's health nursing. 1) The inclusion of women in ever-increasing numbers in the decision-making roles in government. The long lasting effect of the 1991 Senate hearings on the appointment of Clarence Thomas to the Supreme Court is that large numbers of women choose politics and government service as their career. Early in the 21st century this will produce the first woman US president, equal numbers of women and men in the Congress, and substantial numbers of women governors. 2) Another social trend is the changing demographics of race and age in the United States. A historic transition is moving the United States from a predominantly white culture to an ethnically diverse culture. By 2001 African-Americans, Hispanics, Asians, and Native Americans will be one-half of the population. This will force nurses and health care to become ethnically sensitive, shifting from the Caucasian European-American model of the 20th century. By 2050 life expectancy in the United States will be 82.1 years. By 2002, it is estimated that 40-50 million women 45-64 years old will be menopausal. By 2010, the senior citizen Baby Boom generation will migrate to the South and to the West, altering the health care there. 3) The reform of health care. The Clinton administration's health care reform plan includes universal coverage; cost controls with voluntary restraints; rules for insurance companies; and a standard package of benefits for all, emphasizing preventive care in community settings. Ethical debates in the 21st century will concern fetal viability, abortion, contraception, infertility, genetic engineering, aggressive versus nonaggressive treatment of aging women, scarce resources, menopause, organ transplants, sexism in biomedical research, fertility in postmenopausal women, birthing centers, fetal surgery, and fetal therapy.
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