RELIGIONS/ BIOETHIC/ CULTURAL CONTEXT ON REPRODUCTIVE ISSUES, FERTILITY AND ABORTION (ISLAM & CHRISTIAN)

SEMINAR GROUP 17 pis2 no war ~(fatzni & lily)~

CROSS-CULTURAL COMMUNICATION
DOCTORS AND PATIENTS MIGHT HAVE DIFFERENT WORLDVIEWS OR ATTITUDES ON:SPIRITUAL

BELIEFS AND PRACTICES SOCIO-CULTURAL IDEAS FAMILIAL EXPERIENCES AND VALUES BELIEF ABOUT HEALTH, ILLNESS AND TREATMENT BELIEF AND STEREOTYPES ABOUT THE MINORITY CULTURE

BARRIERS
MAINLY CULTURAL VALUES

DIFFERS IN ATTITUDES TO FAMILY STRUCTURE, MARRIAGE OR PARTNERSHIP, CHILDBEARING AND CHILDREARING ASSUMPTION ON OTHER CULTURAL VALUES SHOLUD BE AVOIDED EXAMPLE:

Muslim Chinese, Chinese Buddhist and Modern Chinese- although they share some basic ideas differ in their attitude to how the body of a deceased person should be treated.

ADVICES

BE AWARE OF OWN VALUES LEARN ABOUT CULTURAL BACKGROUND OF PATIENT SHOW RESPECT FIND OUT SIMILARITIES IN IDEAS AND EXPECTATIONS BE OPEN-MINDED ACCOMMODATE CULTURAL IDEAS IN TREATMENT

DO Use open questions Explore racial and cultural background only if necessary Be honest on anything that is unclear to you Show respect DONT Pretend to understand cultural patterns Be judgmental about cultural patterns Make assumptions Assume that cultural issues are unimportant if they dont appear in the initial interview

Dos and donts

DIFFICULTY FOR DOCTORS TO RAISE CROSSCULTURAL ISSUES

FEAR OF BEING RACIST FEELING INADEQUATE AND INEXPERIENCED WHEN DISCUSSING SUCH ISSUES NOT KNOWING ENOUGH MISUNDERSTANDINGS FEAR OF REJECTION UNCERTAINTY ABOUT PATIENTS PARTICULAR BACKGROUND

IN SHORT,

Allow patients to explain their cultural backgrounds, values, beliefs and expectations. Awareness of cultural issues helps to improve therapeutic relationship and to enhance treatment. Doctors need to accept others cultural and racial ideas as different, but equally important. Appropriate assessment of each patients individual and cultural needs is required before deciding on subsequent treatment.

ISLAM

ISLAMIC MEDICAL ETHICS

Islam considers acces to health care as a fundamental right of individual Muslim physician derives his/her conclusion from rules of Islamic laws (Shari`ah) and Islamic Medical Ethics. Main principle of Islamic Medicine 1) emphasis on sanctity of human life which derives from alQuran. 2) emphasis on seeking cure 3) protection of property and religion

REPRODUCTIVE ISSUES & FERTILITY

(A)Assisted Reproductive Technologies & Surrogacy

1. All forms of assisted reproductive technologies (ART) are permissible between husband and wife during the span of their marriage using the husbands sperm and the wifes ovaries and uterus. No third party involvement is allowed.We believe in the sanctity of marriage and that the death of the husband terminates the marriage contract on earth, thus frozen sperm from a deceased husband can not be used to impregnate his widow. 2. Sperm, ova and embryo donation are not permitted. 3. Additional embryos produced by IVF between husband and wife can be discarded or given for genetic research, if not to be used by the same couple for a future attempt.

4. Surrogacy involving a third person is not permissible, as we believe that it exceeds the boundaries of the marriage contract and lineage.
5. Use of fertility drugs is permissible.An infertile couple, if they can not find a permissible cure, can care for an orphan or someone elses child as their own within the Islamic guidelines of adoption.

(B)Contraception

For married couples, contraception for several reasons, including health of the mother, social or economic reasons etc, is permitted, provided that it is practiced by mutual agreement of the husband and wife
the method used is reversible and not harmful. Withdrawal, prophylactics,birth control pills and other hormonal methods are allowed.

Contraceptive methods which can lead to abortion are not allowed.

(C)Sterilization

Sterilization, whether by vasectomy or tubal ligation, as a national policy for family planning or population control, is unlawful and should not be allowed. On an individual level it is permissible provided that both husband and wife want it and: 1. When there is a significant medical contraindication to the pregnancy, for example,if there is a significant risk to the wife's health if she conceives. 2. When other methods of birth control have failed or are causing significant side effects. 3. When a genetic disease of the husband or wife or both poses a high risk of being transmitted to the fetus e.g. autosomal dominant or autosaul recessive conditions when both husband and wife are carriers. 4. When it is done for family planning, i.e., the husband and wife are satisfied with the number of children they have, some scholars will permit it but it is makrouh (hated)

ABORTION

ABORTION

= expulsion from the uterus of products of

conception before uterus viable But is the fetus a human being? Is it part of the woman's body and she is free to do what she likes with it. This is the logic of modern materialistic way of life. Islam has something else to offer. It is completely different from all other concepts or religions.

As a comprehensive and unique way of life, Islam does not at all agree with those who say that a woman has full control over her body. This does not mean that Islam subjugates woman and puts them under men's control.

Islam :
- considers our bodies as a trust, which we have to preserve and maintain - fetus is the creation of Allah S.W.T. No one, not even the mother, has the right to get rid of it

- unless its presence threatens the life of the mother.For in that case, Islam allows abortion within those limits only.
- The end of sex according to Islam is to have children. So, it is not allowed in Islam that a woman can have abortion simply because it is her wish to do so, under the pretext of keeping her beauty and to avoid responsibility. This is considered as selfishness. - Should a pregnant woman make abortion without any justified reason such as the expectation of risk on the mother's life, then this act amounts to murder according so Islam.

Termination of Pregnancy (TOP)

Elective abortion of a viable fetus in a healthy mother is prohibited. 1. Abortion is permitted if continuation of pregnancy may cause the pregnant woman to die or cause serious deterioration of her health, both medical and mental, if done before 120 days after fertilization 2. Fetal congenital malformations in which abortion can be sought and is permitted are lethal malformations not compatible with extra uterine life such as bilateral renal aplasia,Trisomy 13, 18, etc. But even in these situations it is preferable to do it before the 120th day after fertilization or 19 weeks of gestation, calculated from the first day of the last menstrual period.

3. In non-lethal malformations such as severe hydrocephaly, cervical meningomyelocele, Downs syndrome and unbalanced translo-cations, abortion may be permissible before the 120th day of conception after consulting Islamic scholars and medical experts in the field. 4. Pregnancy occurring because of rape, war crimes and incest may be a cause to seek abortion. In all cases in which abortion is sought, the recommendation should be made by a team of Islamic scholars and medical experts in the field.

Prohibition of infanticide is mentioned in several Quranic verses:

Holy Quran says: "Say: Come, I will rehearse what God has really prohibited you from: Join nothing as equal with Him; be good to your parents, kill not your children on a plea of poverty; We provide sustenance for you and for them; approach not shameful deeds, whether open or secret; take not life, which God has made sacred, except by a way of justice and law (Chapter 6: Al-Anam, Verse 151).

Holy Quran says: "Kill not your children for fear of want; it is We who provide sustenance for them as well as for you; for verily killing them is a great sin. (Chapter 17 : Al- Isra, Verse 31).


Sesungguhnya setiap kamu dihimpunkan kejadiannya dalam rahim ibunya selama 40 hari sebagai mani , kemudian dia menjadi ketulan darah seperti tempoh tersebut juga (40 hari) , kemudian dia menjadi ketulan daging seperti tempoh tersebut juga , Kemudian diutuskan kepadanya malaikat , maka ditiupkan ruh padanya...........
(HR Imam Bukhari : 3036 , Imam Muslim : 2643) Berdasarkan hadis di atas , ruh akan ditiupkan kepada janin yang berada dalam perut si ibu ketika usianya 4 bulan.Manakala sebelum 4 bulan janin tersebut tidak bernyawa apatah lagi jika usianya baru 1 atau 2 minggu.

Habisla