Ethics in OB/GYN

 Obstetric and gynaecology are unique specialties, characterized by rapidly evolving

clinical situation and full of ethical dilemmas, from genetic diagnosis to fetal therapy.
 Ethical Principles in Obstetrics and Gynaecology as in any
other branch of medicine include:
1. Make the care of your patient your first concern.
2. Treat every patient politely and with consideration.
3. Respect patients dignity and privacy.
4. Listen to patients and respect their views.
5. Give patients information in a way they can understand.
6. Respect the right of patients to be fully involved in decisions about their care.
7. Keep your professional knowledge and skills up to date.
8. Recognize the limits of your professional competence.
9. Be honest and trustworthy.
10. Respect and protect confidential information.
11. Make sure that your personal beliefs do not prejudice your patients care.
12. Act quickly to protect patients from risk if you have good reason to believe that you or
a colleague may not be fit to practice.
 Ethics is the science of morals , the branch of philosophy that is
concerned with human character and conduct.
 We all need to consider ethics for several reasons :
1. To guide us in the future when a dilemma occurs.
2. To decide if an action is right or wrong.
3. .To know the extent of our professional obligations.
4. For society to set boundaries of unacceptable behaviour through guidelines or laws.
 Some Ehical Dilemmas in Obstetric and Gynaecology
1. Abortion.
2. Antenatal screening.
3. Termination for congenital anomalies.
4. Genital surgery on infants to 'correct' intersex condition .
5. Underage sex and contraceptive advice .
6. Adolescent confidentiality .
7. Screening for viral infection in pregnancy .
8. Pre-implantaion diagnosis.
9. Fertility treatment at increasing age .
10. Multiple embryo transfer .
11. Assisted conception for same sex couples
12. Female genital mutilation .
13. Cosmetic requested surgery.
 Ethics of Counseling
 Genetic counseling is the process of conveying risk information about genes.
 Consent For every medical procedure the patient should be offered an explanation
of the problem and possible solutions, and then their consent should be obtained.
This is called informed consent. The information includes at least the following, which
must of course, be presented in language the patient can understand :
 Information of the consent
1. A description of the recommended treatment or procedure.
2. A description of the risks and benefits of the recommended procedure, with special emphasis
on risks of death or serious bodily disability.
3. A description of the alternatives, including other treatments or procedures, along with the
risks and benefits of these alternatives.
4. The likely results of no treatment
5. The probability of success, and what the physician means by success
6. The major problems anticipated in recuperation, and the time period during which the patient
will not be able to resume his or her normal activities
7. Any other information generally provided to patients in this situation by other qualified
physicians
 Decision Making
1. Health care workers should be decision facilitators, the patients should make the
decisions.
2. Ethics deals with decision-making, about making good choices, and choices that we
can live with, improving our life and society.
3. The timing of reproduction, contraception, marriage choice, or euthanasia are not
new choices, but are always difficult.
 The ethical principles decision-making, and making ethical judgments are:
1. Beneficence: Using medical skills to do good , to put your patient's interests first'
2. Non-maleficence: From the Hippocratic tradition of 'first of all, do not harm'.
3. RESPECT for autonomy: Autonomy means 'self-rule' .There is a basic human right to bodily
integrity that underpins consent. Doctors promise to respect confidentiality .
4. Justice : To do with fameless, payment systems , universal access
 Genetic Counseling is defined as
1. advising adults preconception, of the probability of their conceiving a child who will suffer
from a genetic disorder and
2. advising adults, post-conception, by the use of some method for fetal screening, as to
whether or not a fetus is suffering from a genetic disorder and
3. alerting adults to their options. This is what we could call non-directive counseling.
 In Islamic/Arab communities, the counselor should have full awareness of the
beliefs, traditions and values of the community and take special care in avoiding any
confrontation. due to their strong religious beliefs, social reservations and the high
significance of customs and traditions.
 Prenatal diagnosis as a procedure, is allowed in Islam, as long as it does not
unnecessarily increase risk for the mother and the fetus, and leads to
abortion that is not in line with Islamic Shareah.
 ABORTION Regulations for termination of pregnancy.
 Abortion is always morally wrong because life starts at conception and no human being has
right to take life (even in the case of rape or self-defence), abortion is not allowed even if the
medical diagnosis proved that the fetus is malformed, except only if it is proved by report from
a committee formed of competent trustworthy physicians that continuance of the pregnancy
has a confirmed risk to the mother’s life.
 ART In Islam
 Regarding assisted reproduction, Islamic teaching does not prohibit in vitro fertilization (IVF),
provided that the ova, sperm and uterus are from husband and wife during the existence of
the matrimonial bond. If divorce or death of a spouse occurs then no procreation is allowed.
Hence all forms of artificial insemination by a donor or egg donation are completely outlawed
in Islam
 The cloning of humans is not allowed in Islam, as this process does not follow the
“Fitrah of Allah” i.e. sexual reproduction.