The infant as donor: legal issues.
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Biomedical subjects
Publications and source records attributed to B M Dickens.
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Alarm over the prospect that prenatal diagnostic techniques, which permit identification of fetal sex and facilitate abortion of healthy but unwanted female fetuses has led some to urge their outright prohibition. This article argues against that response. Prenatal diagnosis permits timely action to preserve and enhance the life and health of fetuses otherwise endangered, and, by offering assurance of fetal normality, may often encourage continuation of pregnancies otherwise vulnerable to termination. Further, conditions in some societies may sometimes render excusable the inclination to abort certain healthy female fetuses. In places where abortion for fetal sex alone is recognised as unethical, however, medical licensing authorities already possess the power to discipline, for professional misconduct, physicians who prescribe or perform prenatal diagnosis purely to identify fetal sex, or those who disclose fetal sex when that is unrelated to the fetus's medical condition.
The responsibility of professionals in the medical management of violent and threatening patients is discussed using the Tarasoff case (American) and the Lawson case (Canadian) as landmark cases influencing subsequent jurisprudence. It is becoming increasingly important to be aware of the court's interpretations in such areas as confidentiality, predictions regarding dangerousness, the duty to warn, and the legal duty to strangers to the therapist/patient relationship. A number of other issues relating to the risks involved in management of patients potentially dangerous as a result of the use of drugs are also discussed.
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The primary purpose of this paper is to consider ethical and legal issues raised in medical management of adolescents with XYY, XXY and XXX chromosomal characteristics. It will therefore focus upon the issues of informing the parents of affected adolescents, and the adolescents themselves of their condition and its implications, upon medical and other responses to the implications, and upon research and experimentation conducted to relieve and improve the medical, psychologic, and educational state of affected children. Before considering these central issues of clinical management, however, at least brief attention must be paid to preliminary matters of a social, public health, or health policy nature. These matters concern prenatal identification of the chromosomal condition, and newborn screening programs aimed at detection of general or specific genetic abnormalities. Further, after the more central issues have been considered, some thoughts ought to be given to use and possible misuse of genetic data in modern societies, although space unfortunately will not permit such thoughts to be explored here [1].
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