Women Status in the Arab World from Reality - Bioethics Network on ...

Women
Status in the Arab
World
from
Reality
to Expectations


Bahaa

Darwish

Current Challenges in Women’s Health
Care and Medical Research

Cairo, 7
th

–

8
th

Dec. 2011






Why Caring
for Women

She is a mother



She
is
the
sister

She
is the daughter









Women Status in the Arab World

•
Education

•
World Economic Forum Report
the Arab World
Competitiveness Review
2010
:

•
“
Between
1980
and
2008
, average literacy rates in the
region increased from
39
to
73
% and the literacy gap
between males and females narrowed considerably”
(World Economic Forum
2010
:
12
).

•
“An
analysis of gender differences shows that gaps in
enrolment rates have closed significantly over the past
years and that girls appear to have caught up with boys
in terms of learning
performance”
(ibid
15
).




•
Health


•
Arab
Human Development Report
2009

•
“the

Arab

countries

made

greater

progress

in

forestalling

death

and

extending

life

than

most

other

developing

regions
.

This

can

be

observed

through

the

23

–
year

increase

in

life

expectancy

and

the

reduction

in

infant

mortality

rates

from

152

to

39

per

thousand

births”

(UNDP

2009
:

149
)


•
Premarital Genetic
T
esting


Prophet Mohamad:


"
Select
your
spouse carefully in the interest of
your
offspring




because
lineage is a crucial issue”


•
1998
, Kuwait “
Genetic
E
ngineering
,
Human
G
enome
and
Gene
T
herapy
from an Islamic
Perspective
”

•
Recommendations:

•
G
enetic screening is
highly
recommendable

for the couples before
marriage.

•
The
resulting information should be kept
confidential

and the
decision

of marriage should be entirely
left

in
the
end
to the
couple

•
It is
voluntarily

for the couples to undergo genetic
counselling
.

•
M
andatory

in several Arab countries, such as Egypt, Qatar




•
Female Genital Mutilation (Circumcision)

•
On the
22
nd

and
23
rd

November
2006
a conference on “preventing the
mutilation of the women’s body” was organized by Dar al
-
Ifta
’ in Egypt

•
Recommendation

•
“female
circumcision (FGM) is an old custom that appeared in some
human societies and that some Muslims practiced in some countries
without any basis in
Qur’anic

versus or in
hadith
sahih
”
(
Arda
, p.
215
).

•
And then:

•
“The circumcision which is practiced today harms women physically and
psychologically. Therefore, it should be avoided to comply with one of the
highest values of Islam that is to avoid harm to the human being, as the
Prophet said: “ la
darar

wa

la
darar

fi
-

l
-

islam
”
(ibid
)



•
During
the session of
28
th

June
2007
, the Islamic
Research Council of al
-
Azhar

took
part in the debate.
All the members agreed that there is no basis in
Shari’a

for female

circumcision, and that it “ is a harmful
custom that spread and grew steadily in a small
number of Islamic communities”.


•
This opinion has been shared by Dar al
-
Ifta
’, that in fact
issued a fatwa in July
2007
where it stated that “female
circumcision belongs to the category of traditions and
not of religious obligations
”.


•

There are similar arguments in the booklet
Khitan

al
-
inath

laysa

min
shari’a

al
-
Islam

(female circumcision is
not an Islamic rite), published in
2007
by the Ministry
of
Auqaf
. In his introduction, the Minister
Zaqzuq

says:

•

“It is outrageous to burden Islam with the
responsibility of the spread of this custom in these
countries or elsewhere. We have to differentiate
between what is religiously Islamic and is just a
traditional custom that is verily unacceptable and
absolutely rejected but widely spread in some Muslim
countries”.
(ibid, p.
216
)


•

In

the

same

booklet,

Tantawi

states
:
”

one

of

the

basic

principles

that

is

established

by

sari

a

is

:

“when

it

is

proven

that

an

act

is

harmful

,

it

is

obligatory

to

stop

this

act

“
.

Moreover

he

remembers

that

this

tradition

is

unknown

in

a

great

number

of

Arab

and

Islamic

countries
:

“I

personally

visited

a

great

number

of

Arab

and

Islamic

countries,

and

they

had

not

heard

of

female

circumcision”

(ibid
:

217
)
.


•
These

arguments

are

identical

to

those

used

by


al
-

anba

Musa

,

the

bishop

of

Youth

of

the

Coptic

Church

,

in


khitan

al

–
inath

:

ila

mata
,

published

in

2005
.


•
Al
-
anba

Musa

says
:

”When

God

created

man,

he

did

it

in

the

best

form

and

every

part

of

his

body

has

a

function

and

a

role

.
”

He

also

declares

that

chastity

has

nothing

to

do

with

a

harmful

practice,

because

”chastity

does

not

come

from

the

body,

but

from

will

and

spirit

“

and

it

is

built

“through

good

family,

educational

and

religious

upbringing”

(ibid
:

217
)
.




•
A

positive

change
:

•
A

statistic

from

2008

says

that

91
%

of

women

in

Egypt

between

15

and

49

have

been

cut
.


•
Despite

the

high

percentage,

it

is

anticipated

that

over

the

next

15

years

this

percentage

will

go

down

to

45
%

due

to

the

help

given

to

the

anti
-
FGM

campaign

by

religious

scholars

who

made

declarations

that

FGM

has

no

source

in

Qur’an

or

hadith
.

•
Women’s right to Consent (decide for themselves in health issues)

•
Assisted Reproductive Technologies (ART)

•
Egypt, all ART services , regulated by (decree No.
238
/
2003
),
stipulate couple informed consent

•
Libya, artificial insemination (law No.
75
/
1972
)

•
Qatar, (IVF)

•
Saudi Arabia, ART regulated by Regulation of Infertility
management No.
2870
/
1
/
12
(IVF and storage of embryos)

•
Tunisia, ART governed by Medically Assisted Procreation Decree No.
1027
/
2003
(selective abortion, embryos and gametes’ preservation
for reproductive purposes)

•
UAE, proposed Federal law (
2007
) (pre
-
implantation genetic
diagnosis for identifying genetic diseases)

•
Yemen (IVF)
(UNESCO Cairo Office
2011
:
51
-
55
)




Role of the Network

•
Awareness Raising

•
Legislation


1
-

More

strong

health

care

systems

(management)


2
-

Saving

women

in

Global

Clinical

Research


3
-

Saving

women

against

Pharmaceutical

companies



4
-

Legal

binding

of

consent

form








•
Saving
Women Against
Pharmaceutical
Companies

•
1996
, in Nigeria, Pfizer sponsored a clinical trial testing
trovafloxacin

under the trade name
Trovan
.

•
tested on children during an epidemic of
meningitis

•
F
ollow
up spinal tap
(optional)

•
Drug given orally, in US intravenously

•
blood tests on two separate
occasions.
2
nd

blood test was
abandoned for the shortage of staff

•
Children told they were sick

•
Signed informed consent??

(Macklin
2003
:
476
,
477
).




•
Legal

Binding

of

Consent

F
orm?

•
S
tudy

(
2006
),

Abou
-
Zeid

and

colleagues
:

64
%

of

researchers

who

submitted

proposals

for

funding

to

the

Eastern

Mediterranean

Regional

Office

(EMRO)

thought

that

informed

consent

was

needed

in

the

study
.

•
D
escription

of

risks,

assurances

of

confidentiality

and

voluntariness

of

participation

(missing

in

30
%

of

forms)

(Al
-
Riyami

2011
:

61
)

•
Study

(
2008
),

Abdur

Rab

and

colleagues
:

investigators

did

not

think

that

informed

consent

was

needed

in

29
%

of

the

proposals

(ibid
)
.



References



•
Al
-
Riyami
, A and DEEPALI JAJU, SANJAY JAJU AND HENRY J. SILVERMAN
2011
. The adequacy
of Informed Consent Forms In Genetic Research In Oman: A Pilot Study. In
Developing World
Bioethics

, vol.
11
, no.
2
pp.
57
-
62

•
Islamic
Organization of Medical Sciences
2005
Al
-
Meethak

Al
-
Islami

Al
-
Aalami

lelAkhlakeyyat

Al
-
Tebbeya

WalSehheya

(International Islamic Code of Health and Medical Ethics). Kuwait
IOMS


•
Macklin, R.
2003
Bioethics, Vulnerability and protection. In
Bioethics

Vol.
17
, no.
5
-
6
pp.
472
-
486

•
Pratt, B and
Bebe

Loff

2011
Justice in International Clinical Research in
Developing World
Bioethics

Vol.
11
, No.
2
, pp.
75
-
81

•
UNDP
2009
Human Arab Development Report
. Beirut, Arab Regional Office: United Nations
Development Planning.

•
UNESCO
2000
the
Ethics of Freshwater Use
: A Survey, Reykjavik, UNESCO

•
UNESCO
2004

Best Ethical Practice in Water Use
. Paris: UNESCO

•
UNESCO Cairo Office
2011
Ethics and law in Biomedicine and Genetics: An Overview of
National Regulations in the Arab States
. UNESCO Cairo Office.

•
World Economic Forum
2010
the Arab World Competitiveness Review
2010

Switzerland:
World Economic Forum
.