Medical management of infant intersex: the juridico-ethical dilemma of contemporary Islamic legal response

Technological advances in the field of medicine and health sciences not only manipulate the normal human body and sex but also provide for surgical and hormonal management of hermaphroditism (intersexuality). Consequently, sex assignment surgery has not only become a standard care for babies born with genital abnormalities in the West but even in some Muslim states. On the positive side, it goes a long way in saving children born with abnormal genitalia from numerous legal interdictions of the pre-sex corrective surgery. Nevertheless, the larger ethical and legal questions that medical management of genital abnormality raises to some extent have not been adequately appreciated by contemporary Muslim responses. This article, therefore, in principle argues against surgical management of intersexuality during early infancy from the Islamic legal perspective

Evaluation of Islamic perspectives regarding a medical condition known as disorders of sex development (DSD)

This study is conducted so as to evaluate Sunni Islamic perspectives concerning the medical issue known as Disorders of Sex Development (DSD). DSD is defined as a congenital condition in which development of chromosomal, gonadal or anatomical sex is atypical. It is a condition in which sex ambiguity occurs and can be detected within the scope of biological distraction. This issue is crucial since it severely impacts upon the identity of the patients and will lead to lower quality of life if the case is not managed in the best way. In Islam, these issues are typically considered in the context of khunūthah (hermaphroditism), which remained unchanged in nature. However, current biomedical technology has increased our insight into this complex condition. Biomedical studies have appeared to provide a large amount of information on abnormal human biological development. However, the connection between these two fields has been given little attention. Dynamism of Islamic perspectives is required to resolve biomedical issues over gender ambiguity. This research sets out, in order, to: i) conduct an in-depth research study from Islamic perspectives on cases related to sex ambiguity in terms of various types of khunthā and associated gender assignment by taking into account the type and the extent of the condition of DSD the patient is currently being faced with; ii) identify the Islamic bioethical underpinnings for DSD conditions affecting gender assignment, treatment and the decision-making process; and iii) determine the need for the involvement of Muslim scholars in a multidisciplinary team to manage patients with DSD. As cultural context is inseparable from biomedical ethics, this study is conducted by acknowledging its regional context of South East Asian especially in exploring the latter objective in Malaysia, Indonesia and Singapore. The data is collected through analysis of written material, in-depth interviews and questionnaires. The findings show the connection between khunūthah and DSD and the underlying concept of Islamic biomedical ethics opens a way to progressively move with current biotechnological findings on human biological development. It also becomes a tool in managing Muslim patients with DSD with regard to the gender assignment, the treatment and the decision-making process with the involvement of Muslim scholars in a multidisciplinary team

But in this twilight our choices seal our fate : the interplay autonomy and dignity in defining the international legal response to the beginning of life

Tutkielman aiheena on kansainvälisen oikeuden kysymys elämän alkamisesta ja elämän alkamisen ajankohdasta. Tutkielma lähestyy aihetta Yhdistyneiden kansakuntien lasten oikeuksien sopimuksen kolmannen lisäpöytäkirjan valossa. Astuessaan voimaan lisäpöytäkirja tulee mahdollistamaan yksilövalitusten käsittelyn erillisessä ihmisoikeuskomiteassa. Koska lasten oikeuksien sopimus jättää määrittelemättä elämän alkamisen ajankohdan, tutkielman perushypoteesina on, miten tuleva komitea ratkaisisi lasten oikeuksien sopimukseen jääneen jännitteen. Tämän hypoteesin ohella tutkielmaa suuntaa olettamus elämän alun määrittymisestä pitkälti oikeusperiaatteisiin rinnastuvien autonomian ja ihmisarvon käsitteiden kautta. Tutkielma lähestyy aihettaan sekä oikeuskäytännön että -kirjallisuuden valossa, sitoutumatta sen tarkemmin mihinkään yksittäiseen oikeustieteelliseen tutkimusmetodiin. Oikeuskäytännön kohdalla tarkastelu perustuu pääosin länsimaisten ylimpien oikeuksien antamille tuomioille kysymyksissä, jotka liittyvät elämän alkamisen tematiikkaan. Tämän ohella, rajatummin, käsitellään pohjoismaista elämän alun sääntelyä. Oikeuskäytännön sekä säädösten tarkastelun keskiössä on ennen kaikkea oikeudellinen argumentaatio sekä esiintuodun argumentaation jännitteisyys. Oikeuskäytännön pohjalta muotoutuu moniääninen ja usein kontekstisidonnainen kuva elämän alusta. Tämän oikeudellisen moniäänisyyden analyysi muodostaa tutkielman keskeisen sisällön. Autonomian ja ihmisarvon käsitteiden merkitystä oikeuskäytännön ja säädösten arvioinnille perustellaan tutkimuksessa yhtäältä niiden merkityksellä tuomioistuinten argumentaatiossa toisaalta periaatteiden saamalla tuella oikeustieteellisessä kirjallisuudessa. Tutkielma suhtautuu kriittisesti autonomian ja ihmisarvon käsitteisiin. Kriittisen luennan tarkoituksena on paljastaa oikeudellisen argumentaation sumeus ja sumeuden oikeudelliselle tulkinnalle aiheuttama epävarmuus. Tulkinnan epävarmuuden seurauksena myös vastaus elämän alulle näyttäytyy tutkielmassa ristiriitaisena ja osin perustelemattomana. Tutkielman keskeinen tulos on ennen kaikkea oikeuden jännitteiden tunnistamisessa sen lähestyessä elämän alun määrittelyä. Tutkielman tulosten pohjalta on mahdollista pyrkiä löytämään muotoutumassa olevan kansainvälisen oikeuden vastaus elämän alulle. Tuon vastauksen vakaus, perusteltavuus ja pysyvyys riippuvat siitä, miten onnistuneesti oikeudellinen argumentaatio kykenee yhdistämään yksilön autonomisen oikeuden päättää elämästään kollektiivin intressiin ylläpitää elämää.Siirretty Doriast

Islamic Ethics and the Genome Question

Islamic Ethics and the Genome Question is one of the first academic works, which examine the field of genomics from an Islamic perspective. The contributions in the volume also accommodate and interact with critical insights from outside the Islamic tradition. Readership: Researchers and students specialized in ethics, bioethics and Islamic studies. Additionally, this volume will be a source of important information for geneticists, genomicists and social scientists who are interested in the ethical discourse about genomics in the Muslim world

A mixed method review and quality criteria analysis : towards improving decision aids and informing care models in prenatal testing

Introduction: Les incertitudes des pronostics cliniques et les dilemmes moraux associés aux technologies des tests prénataux affectent les expériences et les processus décisionnels des femmes et des couples. D’une part, la validité des normes relatives au ‘consentement autonome’ et au conseil ‘non directif’ est remise en question. D’autre part, les aides à la décision sont prônées pour rehausser la prise de décision éclairée. L’objectif de ce mémoire est de construire un modèle de l’expérience des femmes et des couples qui font face aux tests prénataux afin d’identifier les facteurs qui amélioreraient les expériences, la prise de décision et le rôle des aides à la décision et informeraient le modèle de soin. Méthodologie: La modélisation et l’analyse des expériences des femmes et des couples qui affrontent les tests prénataux reposent sur une méta-ethnographie des études qualitatives et sur une analyse narrative thématique des études quantitatives. La critique d’un outil (PT) en matière de tests prénataux est également effectuée en ayant recours aux critères de qualité de l’International Patient Decision Aid Standards (IPDAS). Résultats: Un cadre conceptuel décrivant les expériences vécues est construit et l’analyse thématique le complète en soulignant que la prise de décision n’est que rarement éclairée. Les normes d’une ‘décision autonome’ et d’un ‘conseil non directif’ sont problématiques pour les femmes. Les aides à la décision amélioraient les scores de connaissances, sans pour autant modifier la perception du risque, ni les niveaux d'anxiété. L’outil PT favorise une prise de décision basée sur les préférences, mais les critères IPDAS sont difficilement applicables et leur rôle dans une décision de qualité est incertain. Discussion et conclusion: Les résultats éclairent les facteurs macro, méso et micro pouvant améliorer les expériences vécues des femmes et des couples et affecter la prise de décision et l’utilisation des aides à la décision. Un changement de paradigme préconisant le concept d’autonomie relationnelle dans le modèle de soins est suggéré. Dans le contexte des avancées en matière de test prénataux, une réévaluation des normes de pratique et de modèles de soin est requise. Le rôle des aides à la décision devra être élucidé.Introduction: The clinical prognostic uncertainties and moral dilemmas associated with technological advances of prenatal testing impact the experiences and decision-making of women and couples. While the validity of the norms of ‘autonomous consent’ and ‘non-directive’ counseling is being questioned, decision aids are promoted to enhance informed decision-making. The goals of this thesis are to develop a model of the experiences of women and couples in prenatal testing so as to identify factors that may improve experiences, decision-making, the role of decision aids and inform the care model. Methods: A model of the experiences of prenatal testing is developed through a meta-ethnography of qualitative studies and a narrative synthesis of the themes explored in quantitative studies. A prenatal testing (PT) decision tool is critically assessed using the International Patient Decision Aids Standards (IPDAS) quality criteria for decision aids. Results: A conceptual framework of the experiences of women and couples in prenatal diagnosis is constructed and complemented by a narrative thematic analysis showing that decision-making is rarely informed and that the norms of an ‘autonomous decision’ and a ‘non-directive’ counselling are problematic for women. Decision aids improve knowledge scores, but do no modify risk perception or anxiety levels. A PT tool increases preference based informed decision-making, but quality criteria are not always applicable and their role in quality decision-making is unclear. Discussion and conclusion: The results highlight macro, meso and micro-level factors that may improve the experiences of women and couples and inform decision-making processes as well as the use of decision aids. A paradigm shift towards the concept of relational autonomy in the prenatal diagnosis model of care is suggested. Advances in prenatal testing require a re-evaluation of the norms of practice and care model. The role of decision aids requires further elucidation

Stem Cells and Society

Stem cell research is one of the most promising, yet controversal, medical topics in today\u27s world. The purpose of this IQP is to investigate the potential applications of many different types of stem cells in various diseases, and to explore beyond the technology itself to discuss their legalities and ethics. Based on our research, our group concludes that, despite heated debates from both religious and political standpoints, stem cell therapies show strong benefits to society. We agree that embryonic stem cell research should be expanded, and agree with Obama\u27s recent legislation to allow federal funding to support this new technology

Cross-Cultural and Religious Critiques of Informed Consent

This book explores the challenges of informed consent in medical intervention and research ethics, considering the global reality of multiculturalism and religious diversity. Even though informed consent is a gold standard in research ethics, its theoretical foundation is based on the conception of individual subjects making autonomous decisions. There is a need to reconsider autonomy as relational—where family members, community and religious leaders can play an important part in the consent process. The volume re-evaluates informed consent in multicultural contexts and features perspectives from Buddhism, Confucianism, Hinduism, Christianity, Judaism and Islam. It is valuable reading for scholars interested in bioethics, healthcare ethics, research ethics, comparative religions, theology, human rights, law and sociology

But in this twilight our choices seal our fate – the interplay of autonomy and dignity in defining the international legal response to the beginning of life

A study motivated by opening for signatories of the Third Optional Protocol for the Convention on the Rights of the Child (CRC)&nbsp;and possible ramifications individual complaints procedure will have&nbsp;for the definition of a child. As there is no exact moment when life commences according to the CRC, the initial hypothesis of the work is that a definition provided nationally to the beginning of life&nbsp;will be challenged internationally. By analysing various responses provided by national, regional and international tribunals, the paper seeks to highlight the multifarious answers to this foundational question of legal personhood. The analysis reveals an innate incoherence in the legal response to the seemingly unitary question of life's commencement. True to the instability of the international law recognised in much of the international legal scholarship, the paper dissects the legal response through the lenses of human dignity and of autonomy. It is argued that framing of the question as either private or public throughly influences the legal response to subjects that are at the surface level similar (e.g. cryopreserved embryos and stem cell lines).</p

Global Bioethics

Two new factor have been added to the ideological change in the second half of the past century: the “ecological impact” of humankind on the environment due to the population increase; and the “ innovative impact of science, first with atomic physics, which introduced the scission of the fundamental unit of matter, the atom, and then witch molecular biology, which led to the decoding of genetic information and intervention of biological engineering that annihilate our concepts of individual and species as fundamental units in biology. This stage of fundamental rethinking is however overshadowed by the threat of ecological disaster and catastrophic population increase, which not only impose limits to development, but undermine the very survival of Humankind. The future survival our species in fact depends on the interaction between its reproductive characteristics and the productivity of the territory, which, even if increased by the intellectual capability of the human brain, has intrinsically limits. The adaptive choices (which are also biotechnological and biomedical) of the interaction between human population and the natural ambience is the conceptual basis of the new discipline “Global Bioethics”