what are some examples of issues r/t reproductive ethics (7)
- abortion
- surrogacy
- reproductive technologies
- genetics/genomics
- equity of access to reproductive technologies
- implications for offspring
- financial incentives
describe the laws regarding abortion in Canada
- there is no law in Canada governing termination of pregnancy
- termination can be done at any stage of pregnancy
what does abortion require
- fully informed consent
abortion is a safe medical or surgical procedure in..
- the first trimester
describe the ethical principle “respect for autonomy” (4)
- recognizes right to self-determination
- emphasis on making choices consistent w values
- permits choice among medically indicated options
- requires: info & equitable access
what is gene therapy
- experimental therapy that makes it possible to cure or prevent certain congential conditions
what are some cons of gene therapy (3)
- may have unexpected/unintended effects
- may affect all future generations/evolution (germline editing)
- future generations cannot consent
describe routine screening r/t genetic conditions
- can identify anomalies –> helps parents prepare for the birth or inform decision-making process
ex. termination of pregnancy
what is the right to try
- argues for access to experimental drugs as a last resort
- includes unproven or unapproved treatments
who is the “right to try” considered for
- people whose condition is terminal anyways –> they have “nothing to lose”
what is a benefit of the “right to try”? con?
- benefit: encourages hope & empowerment, taking control of one’s response to a health condition
- con: trades on vulnerability & lack of info about the efficacy & safety of the drug
describe the Charlie Gard case
- parents wanted to access experimental/unproven therapy
- hospital felt palliative care was in his best interests
the right to an open future doctrine suggests that (2)
- parents should not make choices that restrict future rights
- this means erring on the side of providing lifesaving measures so that a child can reach a developmental stage where they can make their own choices
provide an example r/t “right to an open future”
- for a child born w genetic condition such as CF, parents generally consent to medical intervention in infancy so that the child has the opportunity to grow to an age where they can decide if they want continued or more invasive treatments
define: futility
- intervention which will not produce a significant benefit
what is quantitative or medical futility
- likelihood of benefit is poor
- desired outcome is not likely or possible
what is qualitative futility
- quality of benefit produced is poor
- desired outcome is not worth pursuing
what are our obligations when a pt wants something that is futile? (2)
- there is no obligation to provide treatments known to be ineffective (ex. antibiotics for a virus)
- there is a continued obligation to provide what is indicated (ex. empathy, communication, comfort care)
babies born less than… are considered premature
36 weeks
what is generally considered to be the limit of extrauterine viability?
- 23-24 weeks
decision-making around what kind of interventions to provide an extremely premature infant includes (4)
- informed consent
- autonomy
- best interests
- QOL
what is the purpose of Informed consent (5)
- demonstrates respect for the dignity & inherent worth of each person
- promote pt autonomy, do good, and prevent/avoid harm
- ensures treatment plans are aligned w their values
- providers an opportunity to prepare for risks & minimize harms
- actions may be well-meaning but are not necessarily risk free
what are the 3 elements of consent for health care intervention
- capacity
- voluntary
- understanding
describe capacity r/t informed consent
- the person must have the legal & mental capacity to make a decision about the treatment
