Ethics: the agonizing decisions in mental retardation

Many decisions which were once outside our control are now becoming matters of choice. Amniocentesis can detect severe birth defects and severely defective or crippled persons can be kept alive for long periods of time. Most people believe in adequate medical care and education for those born with physical and/or mental handicaps; the problems arise when the attempt to attain 1 valued goal conflicts with attaining others. There are insufficient resources to attain all goals. Physicians and nurses traditionally value individual human life while ignoring the family and broader society. The question raised now concerns the allocation of resources to individuals with terminal illness or life of limited quality vs. spending on public health measures that might preserve more lives. What part should societal coercion or societal persuasion play in handling cases of pregnancy at high risk of a deformed or retarded fetus, or extraordinary care of a severely deformed child? It is imperative for nurses to take an informed stand on such ethical issues. Many of the decisions to be made have greater bearing on the lives of women, those who will have to undergo the amniocentesis or abortion or raise the retarded child.