Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Conceptual and practical challenges to the ethics of women's health care and medical research ghaiath-dec8.2011
1. Assistant Professor of Bioethics
Faulty of medicine, King Fahad Medical City
Riyadh, Saudi Arabia
Email: ghaiathme@gmail.com
Phone: 00966566511653
2. • Basic definitions
• What are the sources of ethical concerns in
healthcare for and research on/for women?
• Conceptual challenges related to care for
women
• Ethical challenges to healthcare for women
• Examples of the ethical issues that arise
during provision of care to women
• Ethical challenges to research on/for women
• Recommendations for future steps
3. What do we mean by
Ethics Conceptual Practical
To what do we refer in
Morality: the beliefs and deciding what is How are we going to so
standards of good and bad, right/wrong? what we decided as right
right and wrong, in healthcare, research?
Philosophy? Utlitarian,
Ethics is defined as the deontology, feminisme, virtue,
systematic study of morality. rights-based, principle-based?
How are we going to
manage situations when
Bioethics: is normative ethics ethical guidance is
applied to decision-making and violated?
Religion? Islam? Which
public policy in the domains of interpretations? Christianity?
biology, health care and Which church?
research.
4. What makes healthcare/research to
women ethically sensitive?
Status Ethical implications
•Diminished physical diminished decision-making capacity
power Prone to coercion, abuse, exploitation
•Less educational levels Absent or inefficient contribution to care/research
(bear more burden, e.g. contraceptives)
•Less involvement in Less representation in ethics committees (policy,
ethics research, clinical)
•Economic dependence Diminished access to care
•Diminished political Laws/regulations/guidelines that protect woman
empowerment are either absent, irrelevant, or not affective
Lack of gender-sensitive healthcare (research
agenda)
Diminished representativeness in research
oversight mechanisms
•As a child-bearer Restricted personal rights (vs. rights of the fetus
&/or the father?)
5. Conceptual Challenges
• Lack of guidance (moral status of fetus,
surrogacy, new RH technologies)
• Contradicting guidance (national vs. int’l)
• Different interpretations of notions in
guidance (int’l declarations)
• De-alignment of legal and ethical guidance
• Dominance of community values over
religious guidance (female circumcision)
• Abuse of variation in religious interpretations
▫ catholic church and pro-life groups
▫ irrational jurisprudence rulings (Fawtas)
6. Practical challenges in care provision
• Lack of gender-sensitive healthcare
▫ Waiting areas
▫ Privacy
▫ Confidentiality (e.g. husband access to the wife’s
medical information)
• Gender insensitive policies (e.g. consent)
• Male-led management
• Gender insensitive (discriminative) practices
(e.g. C-sections)
7. Examples of gender imbalanced care
• Men’s interference (marital authorization) in the women’s RH
decisions (contraception, abortion, protected sex);
• Diminished freedom of consent (in non-RH issues)
• Woman’s right to know (her spouse’s STD status, treatment
alternatives, etc.)
• STDs protection (and contraception) is more woman-dependant
(pills, IUCDs, hormonal therapy, etc.)
• Women with HIV/AIDS: right to treatment, stigmatization,
confidentiality, counseling strategies on pregnancy continuation/
termination, future child bearing, and use of contraception
• Breach of woman’s confidentiality by male family members
• Women get tested in ANC visits, while men are discovered only
on voluntary basis (except for visa purposes?)
• Women’s dependence on men to get access to care
• Undue denial of safe abortion, even when religiously allowed
8.
9. Challenges related to research
Research Research
Research topics
methodologies oversight
•Clinically-focused • Inclusion/exclusion • Women’s issues
topics biases (risks) are not well
•Lack of gender- • Facility-based acknowledged
related studies on studies (access) • Ethical guidelines
determinants of • Consent are developed
• ‘don’t get pregnant mostly by ‘white
health
during trial’ men’
•Lack of studies on
• Inadequate • Gender-
vulnerable groups Imbalanced REC
among women (age, Compensation
memberships
sexual-orientation,
disability)
10. How our network can help in
resolving conceptual and
practical challenges to women’s
health & research?
11. Approach to ethical challenges in healthcare
• Individual level
▫ Raise awareness about patients right, in general, and women’s
right in particular
▫ Positive involvement of men in advocacy for women
▫ Assist in minimizing the women’s illiteracy and financial
dependence
• Organizational/Institutional level
▫ Provide gender-sensitive care (waiting areas, examination
rooms ,etc.)
▫ Train providers on ethics (FAB)
▫ Balanced gender management
• Policy-making level
▫ Develop gender-sensitive policies
▫ Encourage women involvement in policy-setting
▫ Continuous communication with Ulama (scholars) regarding
women health
▫ Advocate for women’s health issues among politicians and
policy makers
12. Approach to ethical challenges in
research
• Train researchers in research ethics, especially vulnerability
• Improve gender balance in REC structures
• Educate ethics committees members on women’s health
research, gender analysis, and participatory action
methodologies, and to ensure gender issues and analysis are
part of funding criteria
• Train more female researchers on research methods and
ethics
• Encourage/Adopt community-based methodologies
• Review the current guidelines to makes them more gender-
sensitive
• Funding agencies should encourage research with members
reflecting the diversity of the population;
• North-South exchange of experience and head for sustainable
development, guided by the MDGs related to maternal health
13. Questions and
Discussion
Please feel free to contact me:
Ghaiath M. A. Hussein
Email: ghaiathme@gmail.com
Phone: 00966566511653
Website:
https://sites.google.com/site/medicalethicscourse