Ethical Vignettes and Knowledge Economy: Priorities and Sequelae in Reproductive Health

Purchase on Springer.com

$39.95 / €34.95 / £29.95*

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

The objectives of this study were (1) to elucidate ethical priorities in reproductive health in studies published between 1986 and 2012, and (2) to address the place of clinical ethics in reproductive health knowledge economy through comparative analysis of country-based ethical vignettes and practices. A total of 101 studies are identified through the PubMed portal. Recruited studies are inclusive for their focus and level of evidence (I, II-1, 2, 3). Pooled prevalence of the ethical problems, their approximate determinants, and outcomes are modeled as measurable outcomes. Ethical debates are correlated with the extrapolated maternal and perinatal mortality rates. Calculations use cases as units of analysis. This meta-study prioritizes the following ethical issues: patient’s autonomy, adolescent pregnancy, fetal surgery, cross-border reproduction, health insurance constraints, surrogacy, stem cell registry, and reproductive health in mentally ill. Clinical pregnancy rate from the transferred embryos is 17–22 %. Sixty percent of couples consent for posthumous reproduction, and 47 % consent for fetal surgeries for the nonlethal conditions; 48.2 % of pregnant adolescents choose to continue their pregnancy, 45 % opt to terminate, and 6 % miscarry. Abortion debates take pro-choice (66.7%), pro-life (6.7 %), and balanced (26.7 %) arguments. No correlations are found between presented ethical problems, maternal and perinatal mortality ratios per country (r 2 = 0.117–0.209). Structurally too, the cost of prime knowledge products, like reproductive health education—has tripled adjusted for inflation. Nevertheless, the relative power of the costs for the malpractices and adverse outcomes against knowledge products remains assuredly higher. An accurate definition of the ethical norms is essential and may impact on the reproductive health knowledge economy on both system and case levels. At the system level, it promotes a moral foundation to maximize wellfare; at the case level, it assists physicians in identifying and resolving ethical issues to minimize legal aid expenses.