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An Enlightening Online Seminar on Ethical & Legal issues in Obstetrics and Gynaecological  Practice

18 Jan 2023

On 23 October 2022, an online seminar on Ethical and Legal issues in Obstetrics and Gynaecological  Practice with the aim of strengthening IMU medical students’ knowledge on the many ethics and legal problems faced daily during Obstetrics & Gynaecology Practice and how to deal with these cases. The students who attended the online seminar shares more on their experience.

Raveennath Imbulana
Confidentiality, Privacy, and Security of patients Health Care information
Prof Sivalingam gave us a great overview on the importance of confidentiality and maintaining privacy for a patient. Patient privacy is your right to decide when, how, and to what extent others may access protected health data. Patient privacy maintains confidentiality and only shares your information with those who need it to provide medical care, and the relevant individuals. In a situation where we are not able to gain family’s consent, this strictly means that we will not proceed with the treatment/management.  
Ethical guidelines regarding HPV vaccination and screening to eliminate cervical cancer
Prof Ian gave us information on the pros and cons of HPV vaccination, and how it impacts on the screening for cervical cancer. Patient awareness is important, and not many know regarding the vaccination and its assistance in prevention. The cost of the vaccine is an issue as well.  
Ethical guidelines regarding testings for genetic predisposition to adult-onset disease
Prof Nazimah shared with us new research findings on how each individual can be predisposed to a certain condition based on their family. It was an interesting topic, but a threatening one as it explains on how we could be bound to get ill regardless of how healthy we are. 
Ethical aspects of HIV infection and reproduction
Prof James revised with us the effect of the news of infection with HIV on individuals and their partners, as well as their family. It was an eye-opening talk. 
Ethical guidelines for informed consent with special aspects regarding female tubal sterilisation in Malaysia
Dr Norazyati went through the importance of consent for bilateral tubal ligation. We get consent not only from the patient but from her husband as well. However, this would be an issue when the patient wants to do the procedure but the husband does not allow it. In my opinion, if the patient is of sound-mind and is of mature age, then consent should only be taken from the patient, however I understand that cultures can influence certain procedures in society.   
Ethical considerations in regard to sex selection for non-medical purposes
Dr Low went through each factor that would influence sex selection, its pros and cons. How different cultures / religions can affect such procedures. It was interesting to understand the current situation in Malaysia, and how as Drs we can hope for a change.
 Derrica Lau  
Confidentiality, Privacy, and Security of patients Health Care information
Organised, informative slides, presentation was practical and clinically oriented
Ethical guidelines regarding HPV vaccination and screening to eliminate cervical cancer

Covered important facts that will benefit the general public greatly

Ethical guidelines regarding testings for genetic predisposition to adult-onset disease
Learned new things regarding the testing for genetic predisposition to adult onset of diseases
Ethical aspects of HIV infection and reproduction
Covered social stigmata and concerns regarding HIV, great real-life scenarios were given
Ethical guidelines for informed consent with special aspects regarding female tubal sterilisation in Malaysia
Detailed information regarding patient’s perspective of tubal sterilisation, wonderful speaker    
Ethical considerations in regard to sex selection for non-medical purposes
Presenter’s enthusiasm and creativity with the “menu” of topics made the presentation interesting

Sharifah Hisham

The session was very well conducted. The speakers are  well informed and were able to share the information in a easily understandable and interesting manner. Prof Kavitha’s input regarding patients’ lack of proper understanding about pap smear despite counselling and consent taken shows that doctors have to put more effort during the counselling sessions. I especially enjoyed the talk on ethics in sex selection for non-medical purposes. With the growing development into science and technology, we have to keep track of what is done for  patient’s benefits and what is done unnecessarily.

Sheikh Sadia  
Confidentiality, Privacy, and Security of patients Health Care information
Dato’ Sivalingam has given us an excellent summary about the privacy and confidentiality of patients. He shed light on how important it is to do so and emphasized on why we should not proceed against patients’ will. He went into detail about how records are being stored in the Malaysian Medical Council and when to disclose patient information. At all points, patient consent is required, and we should keep the disclosures to the minimum. As a non-Malaysian, this makes me more knowledgeable, I could go back and follow these teachings in my country. 
Ethical guidelines regarding HPV vaccination and screening to eliminate cervical cancer

Prof Ian’s guideline on HPV vaccination is necessary to both doctors and public. There is still a need to make the public much more aware about this. Even though Malaysia has implemented giving the vaccines in schools, the rest of the world is still far behind. Therefore, this is another pointer for me to take home.

Ethical guidelines regarding testings for genetic predisposition to adult-onset disease

Prof Nazimah spoke about the ethical guidelines on testing for genetic predisposition, this topic is interesting to know. What I admire about Prof is that she is always updated to new guidelines and research.

Ethical aspects of HIV infection and reproduction
Prof James discussed about the implications of HIV. As the world is dealing with multiple sexual orientation, the topic of HIV is a must know for all doctors, especially the ones who will be working in the western countries. Even though our exposure is much limited, we should always be equipped with the knowledge of treating it or commence treatment.
Ethical guidelines for informed consent with special aspects regarding female tubal sterilisation in Malaysia
Dr Norazayati discussed about female sterilisation in Malaysia. The importance of keeping in mind the cultural and religious beliefs of the country you reside in and its people was asserted in her presentation. She has also spoken about the need for consent from the spouse/guardian. The consent is. however, controversial amongst the speakers. What was mentioned by Dr Nazimah regarding this was, according to religion there is no Fatwa in Islam which mentions we need the spouse’s consent, but it has become a culture in Malaysia that is being followed.
Ethical considerations in regard to sex selection for non-medical purposes
Dr Low discussed the topic that interested me the most. Factors that influence sex selection. He spoke about how foods (acidic/alkaline) could predispose a zygote to developing a certain gender. He then discussed about how this information would be useful in certain families like, ones who have only girls after multiple conception, families in China whose family number should be kept minimum in view of the increasing population. And one most important circumstance is to prevent female feticide.

In summary, it was an interesting discussion amongst everyone. Me and my groupmates also understood how different doctors approach the same topic in different ways, however, keeping in mind of all the ethical issues. Therefore, a certain topic is not right or wrong, it depends on perception, situation, patient and their families.

Bismil Shaji

I feel very grateful towards the faculty and MOH staff for holding such a useful and informative seminar.

I learnt a great deal about privacy, confidentiality and consent taking from patients in healthcare which helped me understand the importance of these aspects when treating a patient.

I also learnt about cervical cancer, which was one of most leading causes of cancer in women but has now become less common due to the newly scheduled procedures and the vaccinations introduced.

Zainab Akbar

The seminar was very eye-opening and discussed topics that have ambiguous answers.

Dato Siva opened the session with what I would say was the most important topic – privacy and confidentiality. As always, he managed to enforce the need for the practice of ethical medicine.

Prof Ian focused his topic on cervical cancer and the different modalities through which we can put an end to it. His presentation made it clear to us that this disease is very much preventable and treatable. He reminded us that opportunistic counseling and screening is vital- do not only focus on the single complaint that the patient may have, practice preventative medicine too.

Prof Nazimah discussed the ethical considerations around testing for predisposition to genetic disorders, which brought about a discussion on the social, cultural and religious perspectives. We know that this topic will continue to be a discussion amongst my peers and myself.

HIV is a vital topic for discussion and the ethical considerations surrounding it needs to be well discussed. Prof James was firm with his stance, yet empathetic of any counter-opinions. As medical students, we do not have enough exposure to the care and treatment of HIV patients and that in itself may make us wary. However, a disease does not define a patient and we much always strive to provide the best of care.

Dr Norazayati introduced an interesting topic to my colleagues and myself – female sterilisation in Malaysia. The importance of keeping in mind the cultural and religious beliefs of the country you reside and its people was asserted in her presentation. What the books teach us are merely tools, we must be able to appropriately apply them in the setting we are in.

And finally, Dr Low Kah Pin discussed sex selection, which is a rather controversial topic here in Malaysia. He discussed some interesting approaches and remained empathic of people’s views and beliefs, while also giving us interesting research findings such as the role of acidic/alkalinic foods during pregnancy, as a tool for sex selection.

Overall, I thoroughly enjoyed the session and it had armed me with information that I will use in the way I approach patients and the way I discuss these topics. I look forward to similar sessions in the future.

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