Ethics at the beginning of life Flashcards
What are the methods of termination of pregnancy for less than 14 weeks?
- Surgical: Manual or electric vacuum aspiration
- Medical: Mifepristone followed by misoprostrol
What are the methods of termination of pregnancy for 14 weeks or more?
- Surgical: Vacuum aspiration or dilatation & evacuation (D&E)
- Medical: Mifepristone followed by misoprostrol
What were the abortion statistics for England & Wales in 2021?
- 214,256 abortions
- Rate of 18.6 per 1,000 women (aged 15-44)
- 89% under 10 weeks
- Medically induced: 87%
What percentage of abortions in Scotland in 2021 were medically induced?
99%
How many induced abortions occur worldwide each year?
73 million
What percentage of induced abortions worldwide are unsafe?
45%
True or False: Restrictive abortion laws are associated with fewer abortions.
False
What is the Offences against the Person Act 1861 related to?
Administering drugs or using instruments to procure abortion.
What does the Infant Life (Preservation) Act 1929 state about child destruction?
- Intent to destroy life of a child capable of being born alive results in felony
- Good faith for preserving mother’s life is a defense
What are the statutory defenses against the Offences against the Person Act 1861 as per the Abortion Act 1967?
- Social grounds (24 weeks)
- Grave permanent injury
- Risk to life
- Fetal abnormality
Fill in the blank: Females under the age of 16 may acquire a ToP without parental consent if they are _______.
[competent and able to understand risks and procedures involved]
What is the legal status of the fetus according to the Abortion Act?
The fetus has no legal right to life.
What are the four views about why an embryo might have moral status?
- Identity is important
- The embryo has the potential to be a person
- Moral value is accorded when the embryo has properties of a person
- The embryo has value given by others
What case ruled that a fetus cannot have rights until it is born?
Paton v BPAS (1978)
What is the GMC’s stance on personal beliefs and values in medical practice?
Personal beliefs and cultural practices are central to doctors and patients; doctors can practice according to their beliefs as long as they follow Good Medical Practice.
What is the significance of the case St George’s NHS Healthcare Trust v SR?
It confirmed that a patient’s wishes could not be overridden unless acting without capacity.
What is the range of maternal deaths worldwide due to unsafe abortion?
4.7-13.2% of maternal deaths.
What are the legal protections for conscientious objection in medical practice?
Conscientious objection exists for some grounds but not as a simple yes/no.
What are the obligations of a woman to a fetus as discussed in the ethical concerns?
Social expectation that women will modify behavior for the benefit of the fetus.
What is the role of personal beliefs and values in the practice of medicine according to the GMC?
Personal beliefs and cultural practices are central to the lives of doctors and patients. Doctors can practice in line with their beliefs, provided they follow Good Medical Practice.
What must doctors do when practicing medicine according to their beliefs?
- Act in accordance with relevant legislation
- Not treat patients unfairly
- Not deny patients access to appropriate services or care
- Not cause patients distress
Can doctors opt out of providing a procedure due to personal beliefs?
Yes, as long as it does not result in discrimination or harassment of patients.
What is conscientious objection?
It is the private, constant, ethically attuned part of the human character, where not acting in accordance with one’s conscience is seen as a betrayal of moral integrity.
What are the criteria for claiming conscientious objection?
The onus is on the objector to prove their claim is due to conscience, not self-protective reasons.
What does the Abortion Act, 1967 say about conscientious objection?
- No person is under duty to participate in treatment to which they have a conscientious objection
- Burden of proof rests on the individual claiming conscientious objection
What are the limitations on conscientious objection as per GMC guidance?
Doctors must not refuse to treat patients based on personal beliefs or lifestyle choices.
What was the outcome of the Janaway case?
The court held that ‘participate in’ means taking part in treatment for the purpose of termination.
What is Article 9 of the European Convention of Human Rights about?
It states the right to freedom of thought, conscience, and religion, including the right to manifest religion or belief.
What was the ruling in the Eweida & others v the UK case?
The ECHR found that the UK failed to protect Ms. Eweida’s right to manifest her religion, breaching Article 9.
What rights do medical students have regarding conscientious objection?
Medical students have the right to hold conscientious objections but must meet GMC’s outcomes for graduates.
What are the duties of a doctor according to the BMA?
A treating doctor’s primary obligation is to their patient.
What are the four arguments against the practice of conscientious objection?
- Inefficiency & inequity
- Inconsistency
- Commitments of a doctor
- Discrimination
What are the four key attributes of care that must be maintained by doctors?
- Respect for patient autonomy
- Beneficence
- Non-maleficence
- Justice
Fill in the blank: The GMC states that conscientious objection should not result in _______.
[direct or indirect discrimination]
What are the areas in which the BMA supports conscientious objection?
- Abortion
- Fertility treatment
- Withdrawal of life-sustaining treatment
What is a key outcome for medical students regarding their opinions on treatment?
Students must not let their opinions affect the way they treat patients.
True or False: A medical student can be exempted from GMC’s outcomes based on conscientious objection.
False
