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080809L - CASE ANALYSIS: DYSFUNCTIONAL UTERINE BLEEDING

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Case by Professor Omar Hasan Kasule Sr. for discussion at Year 3 Semester 1 medical PPSD session of 09th August 2008

Background
X’s husband had sought divorce from the civil court on grounds of mental and physical abuse. His lawyers presented details of the marital relation in the past 5 years. X had on turning 40 changed her behavior. She became moody and quarrelsome. She started attacking her husband verbally at the beginning and physically as time went on. Being a tall and big women she inflicted injury on her thin and physically weak husband. The husband dared not complain because it would socially be embarrassing to be beaten and injured by the wife. She also refused him sexual favors. She claimed that she was in prolonged menstruation all the time and it was against religious teachings to engage in sexual activities during menstruation. Once in a while she consented to sexual intercourse but then complained that the husband had infected her because she had pain during intercourse and for 3-4 days later. Douching had become very painful. She accused him of having affairs with other women from who he had contracted STD. The husband denied all this and had more beatings. Meanwhile prolonged and irregular bleeding made X’s life very miserable. A friend advised her to ask her gynecologist for hysterectomy since it was the uterus that was the source of all the problems. She subsequently had the hysterectomy done but was not put on any hormonal treatment because the surgeon took care to preserve the ovaries. One day while running after the husband fleeing from her beating, she fell suddenly. She experienced much pain and could not stand up. The husband called for an ambulance that took her to hospital where a hip fracture was diagnosed. Hip replacement surgery was carried out and she was started on hormonal replacement treatment and calcium supplements. Two years later she developed pain in the right groin and examination revealed cancer of the ovary. The cancer was too advanced for surgery and she was put on palliative radiotherapy and chemotherapy. She decided to take the hospital and all doctors who had treated her to court for medical malpractice.

Discussion:
1. List and explain all ethico-legal issues in this case.
2. Imagine you are the judge in the divorce court, what would your ruling be regarding the divorce request.