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Presentation at the session on
‘Principles and practice of bioethics’ in the IIIT European Summer School held
in Kirklareli, Turkey 8th August 2015 by Professor Omar
Hasan Kasule Sr. MB ChB (MUK). MPH (Harvard), DrPH (Harvard) Chairman of the
Ethics Committee King Fahad Medical City.
INSTRUCTIONS
·
Read the scenario carefully
·
Identify the ethical issue
·
Provide your solution to the
ethical issue relying on maqasid and qawaid
REPRODUCTIVE
ISSUES
Case scenario #1
An infertile
couple was in the midst of a ‘test tube baby’ or in vitro fertilization (IVF)
procedure when the husband died soon after his semen was frozen. The wife
wanted to obtain the semen and have a baby by a surrogate mother. A former wife
also wanted the semen because she had a girl with leukemia who needed a
compatible bone marrow donor, preferably a sister.
Case scenario #2
A recently
married woman continued taking oral contraceptives prescribed for menstrual
irregularities. Her husband wanted her to discontinue the contraception because
he wanted to start a family immediately, but the wife refused.
Case scenario #3
A 14 year-old girl was admitted to hospital
for an abortion. She was two months pregnant from what she claimed was rape.
The family was distraught and wanted the doctors to carry out the abortion
immediately. The physicians were reluctant because there was no medical
reason.
Case scenario #4
A couple who had
eight girls in successive pregnancies desperately wished a boy. They decided to
try IVF with selection of male gametes. The obstetricians refused because there
was no medical reason since the couple had no problem in conceiving.
Case scenario #5
A child whose
external appearance was female and had been brought up as a girl was taken to
the hospital at 14 years of age because of delayed menstruation. The internal
gonads and chromosomal patterns were male. The parents wanted a gender
reassignment operation to conform to the genetic profile. The child refused to
change from her familiar female identity.
Case scenario #6
A middle-aged
woman without any medical condition asked her physician for hormonal treatment
to appear younger. The physician refused because he judged the risk of heart,
blood vessel, and cancer complications to be more than the benefits.
Case scenario #7
A 14 year-old
girl with cancer requiring chemotherapy was advised to have her ova removed and
put in cold storage for the duration of the treatment. Her parents refused the
procedure because they did not believe in IVF and she was not yet married.
CONFIDENTIALITY
ISSUES IN TEENAGERS
Case scenario #8
A 14-year old
school girl with painful and irregular menstrual periods saw a school physician
who prescribed oral contraceptives to regularize the period. She refused saying
that if her parents found out they would suspect that she was engaged in
illicit sexual relations. She only agreed to take the treatment when the
physician promised that he would not disclose the information to school
authorities or parents without the patient's permission.
Case scenario #9
A 15-year old
girl asked a private gynecologist for an abortion after missing her period
following a rape by a person close to her family. She asked the gynecologist to
keep it a secret from the parents because if they knew they could kill her or
kill the rapist.
Case scenario
#10
A 13-year old
teenager with a foul smelling vaginal discharge went for treatment at the
school clinic and asked the nurses not to disclose the condition to her parents
because they would suspect her of having sexually transmitted infections.