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Conceptual and Practical Challenges to the Ethics of Women's Health Care and Medical Research

Conceptual and Practical Challenges to the Ethics of Women's Health Care and Medical Research. UNESCO Regional Conference on Ethics of Women's Health Care and Research (Cairo University, Dec. 8, 2011). Ghaiath M. A. Hussein Assistant Professor of Bioethics

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Conceptual and Practical Challenges to the Ethics of Women's Health Care and Medical Research

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  1. Conceptual and Practical Challenges to the Ethics of Women's Health Care and Medical Research • UNESCO Regional Conference on Ethics of Women's Health Care and Research • (Cairo University, Dec. 8, 2011) Ghaiath M. A. Hussein Assistant Professor of Bioethics Faulty of medicine, King Fahad Medical City Riyadh, Saudi Arabia Email: ghaiathme@gmail.com Phone: 00966566511653

  2. Outline • 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

  4. What makes healthcare/research to women ethically sensitive?

  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, treatmentalternatives, 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. Challenges related to research

  9. How to approach these challenges? How our network can help in resolving conceptual and practical challenges to women’s health & research?

  10. 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

  11. 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

  12. 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

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