Ethics (Reproduction)

Question 1

What aspect of a situation is crucial to ALL forms of sex?

Answer 1

Consent

Question 2

When is consent invalidated?

Answer 2

When:

1. Individual is intoxicated (drugs/alcohol)
2. Individual is pressured into sex
3. Violence/threat of violence involved

Question 3

What are the ethics involving those under 13 years and sex?

Answer 3

Illegal by law as a <13 year old CANNOT consent to sex.

As a doctor, you must inform social services

Question 4

What are the ethics involving 13-15 year olds and sex?

Answer 4

Cannot consent to sex

Can legally participate in kissing, sexual touching and conversations.

Question 5

How can doctors help those <16 years with regards to sex?

Answer 5

Can provide relevant advice and contraception SO LONG AS the individual has been assessed as competent and that the advice given is enough for them to give informed consent to sex

Question 6

What guidelines are used to assess competence in children and young adults?

Answer 6

Fraser Guidelines

Question 7

List the criteria of the Fraser guidelines

Answer 7

1. Individual has sufficient maturity and intelligence to understand the nature and implications of the proposed treatment
2. Individual refuses to tell their parents/allow the clinician to tell their parents
3. Treatment proposed is in the best interest of the patient
4. Physical/mental health could suffer if the proposed treatment is not given
5. Likely to start/continue having sex with/without contraception

Question 8

Those over 16 years are assumed to be competent enough to consent to sex. What are the exceptional circumstances?

Answer 8

1. Individual has a mental disorder

2. Other party involved is in a position of power

Question 9

What are 3 things clinicians must remember with regards to reproductive ethics in everyday clinical scenarios?

Answer 9

1. ALWAYS get informed consent and have a chaperone for all intimate examinations performed on patients
2. Look after own wellbeing, especially for cases that strike close to home
3. Do NOT breach confidentiality in cases of sexual assault where the patient has decided not to take the case further

Question 10

What 3 things clinicians must remember with regards to conscientious objection in everyday clinical scenarios?

Answer 10

1. Ensure the MDT are aware of your views
2. Ensure that your views do not influence the patient’s choice of care
3. Ensure that your views do not delay/hassle the patient’s access to their chosen treatment/care

Question 11

Which body regulates all assisted conception therapies?

Answer 11

Human Embryo and Fertilisation Authority (HEFA)

Question 12

What are some ethical considerations in assisted conception therapy that are worth remembering?

Answer 12

1. It is possible to choose the sex of the embryo in cases where a serious medical condition is related to sex
2. It is possible to create an embryo with 2 mothers involved if there is mitochondrial disease
3. Preimplantation tissue typing is available for an existing child who is affected by a life-threatening condition
4. Embryos that are not developing properly can be used for testing but research is only permitted for 14 days