MED-105 Reproduction Ethics 2024 Notes PDF

REPRODUCTION & ETHICS Abortion; ethical & legal issues MD6 Y1 2023-2024 Dr Eirini Kampriani Assistant Professor of Medical Anthropology & Medical Ethics [email protected] LOBs Discuss ethical approaches to reproductive choice Describe the different country perspectives on abortion Outline the l...

REPRODUCTION & ETHICS Abortion; ethical & legal issues MD6 Y1 2023-2024 Dr Eirini Kampriani Assistant Professor of Medical Anthropology & Medical Ethics [email protected] LOBs Discuss ethical approaches to reproductive choice Describe the different country perspectives on abortion Outline the legal/professional guidance in relation to termination of pregnancy in one country & discuss the ethical implications Describe the ethical issues and positions on the topic of abortion Explain the concept of personhood and why it is important in the abortion debate Outline 1. Intro to Reproductive ethics ▪ Topics ▪ Reproductive freedom and rights ▪ Abortion; terminology 2. Abortion; comparative country perspectives Global legal perspective UK legal framework Northern Ireland & USA 3. Ethical debate on abortion ▪ Views on personhood ▪ Views on the moral status of the embryo ▪ Ethical Positions in the abortion debate 4. Professional practice ▪ Professional vs personal ethics ▪ Conscientious objection 1. INTRO TO REPRODUCTIVE ETHICS Beginnings of Life; Reproduction Contraception Conception Pregnancy Termination of pregnancy Childbirth Assisted reproduction Reproduction ethics Do people have reproductive freedom? Should there be any regulation of reproduction? natural reproduction? assisted reproduction? Is there a right to reproduce? The right to reproduce can be: Negative (freedom to decide whether to reproduce or not) Positive (active assistance by states) WHAT IS ABORTION from the Latin abortio, "miscarriage, premature, untimely birth“ In medicine abortion means ending a pregnancy prematurely. Also 'termination of pregnancy’ – ToP Is it ethical? Is it legal? Consider: 1. Do you believe abortion is morally justifiable? YES/NO 2. Should a woman who has got pregnant as a result of rape be allowed to terminate her pregnancy? YES/NO 3. Is it justifiable for an unmarried 19-year-old university student who works night shifts for a living to seek termination of pregnancy on the grounds that it does not fit into her current life situations? YES/NO 4. Should the fetus be protected by law? YES/NO 9 2. COMPARATIVE COUNTRY PERSPECTIVES ON ABORTION 11 A Global Legal Perspective WHO; access to safe abortion, as an important challenge in decreasing maternal mortality globally. UK country example; Law in England and Wales Abortion is illegal [under the Offences Against the Persons Act 1861] The Abortion Act 1967 permits doctors to perform abortions under certain circumstances; It does not decriminalize abortion in general Few amendments via the Human Embryology and Fertilisation Act 1990 [changes to gestational stages at which abortions can be performed] Summary of legal aspects Under current legislation in England and Wales ❑an abortion can be lawfully carried out if certain criteria are met: it is carried out on approved premises; ie a hospital or licenced clinic It is performed by a registered doctor approved by two Doctors [in an emergency, abortion can be certified by the operating practitioner only] On what grounds? ❑Prior to 24 weeks; abortion may be allowed on the grounds of a risk to woman’s mental or physical health and/or existing children ❑In rare situations, an abortion may also be allowed to be carried out after 24 weeks Where there is a severe disability of the fetus OR to save the life of a pregnant woman or prevent grave permanent injury to the woman’s physical or mental health, abortions can be performed up to 40 weeks Additional points In the UK; A woman has a legal right to refuse an abortion; but A woman does not have the right to demand an abortion The father of a fetus has no legal right to prevent a woman from having an abortion The fetus has no legal right; its status is determined by birth UK Statistics Abortions on the grounds of risk that the child would be born ‘seriously handicapped’; Approx. 2% What does severe abnormality or handicap include? ❑Rev Joanna Jepson (2001) sought judicial review of decision by police not to prosecute doctors in West Mercia who had conducted a 28-week ToP using disability criteria for a cleft lip palate Ruling (2005); What constitutes a "severe abnormality” is not fully defined under the Abortion Act; doctors can apply a degree of discretion when taking the mother's wishes into consideration. Notification of abortions Abortions must be notified to CMO (within 14 days); statistical data recorded/analysed Abortion law in Northern Ireland Until recently, abortion was illegal in Northern Ireland Seen as tantamount to murder unless the woman’s life was at risk. Rape, incest and fatal fetal abnormalities were not grounds for legal abortion. A number of women moved to other countries (mainly UK) to have an abortion In 2018, Northern Ireland voted in a referendum to make abortion legal (66.4% in support) In October 2019, abortion was decriminalised. New legal framework - Abortion Regulations 2020; Abortions on request up