Cargando…

Controlling sickle cell disease in Ghana - ethics and options

Sickle Cell Disease (SCD) is a significant public health burden in Ghana. Recent studies indicate that 2% of Ghanaian newborns are affected by SCD; one in three Ghanaians has the hemoglobin S and/or C gene. As a means of controlling the disease, some authorities have recommended prenatal diagnosis (...

Descripción completa

Detalles Bibliográficos
Autores principales: Kyerewaa Edwin, Ama, Edwin, Frank, Etwire, Victor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282939/
https://www.ncbi.nlm.nih.gov/pubmed/22187596
_version_ 1782224149512454144
author Kyerewaa Edwin, Ama
Edwin, Frank
Etwire, Victor
author_facet Kyerewaa Edwin, Ama
Edwin, Frank
Etwire, Victor
author_sort Kyerewaa Edwin, Ama
collection PubMed
description Sickle Cell Disease (SCD) is a significant public health burden in Ghana. Recent studies indicate that 2% of Ghanaian newborns are affected by SCD; one in three Ghanaians has the hemoglobin S and/or C gene. As a means of controlling the disease, some authorities have recommended prenatal diagnosis (PND) and selective abortion. In the current era, SCD has a good prognosis and fairly reasonable quality of life. Advances in bone marrow transplantation have shown the disease is curable in selected patients. PND and selective abortion therefore raises a myriad of ethical dilemmas which are considered in this review. In the light of the demonstration of improved prognosis in recent times, PND and selective abortion appears to be applying capital punishment to the unborn child for “crimes” only the parents can be responsible for. In this review, we recommend control of SCD on three levels – preconception genetic testing and strategic reproductive choices, PND and education for carrier parents, and holistic management of persons with SCD. We emphasize the critical importance of self-management, especially self-awareness, in assuring a good quality of life for persons with SCD. We believe such an approach is cost-effective, and consistent with sound ethical principles and good conscience.
format Online
Article
Text
id pubmed-3282939
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher The African Field Epidemiology Network
record_format MEDLINE/PubMed
spelling pubmed-32829392012-02-21 Controlling sickle cell disease in Ghana - ethics and options Kyerewaa Edwin, Ama Edwin, Frank Etwire, Victor Pan Afr Med J Essay Sickle Cell Disease (SCD) is a significant public health burden in Ghana. Recent studies indicate that 2% of Ghanaian newborns are affected by SCD; one in three Ghanaians has the hemoglobin S and/or C gene. As a means of controlling the disease, some authorities have recommended prenatal diagnosis (PND) and selective abortion. In the current era, SCD has a good prognosis and fairly reasonable quality of life. Advances in bone marrow transplantation have shown the disease is curable in selected patients. PND and selective abortion therefore raises a myriad of ethical dilemmas which are considered in this review. In the light of the demonstration of improved prognosis in recent times, PND and selective abortion appears to be applying capital punishment to the unborn child for “crimes” only the parents can be responsible for. In this review, we recommend control of SCD on three levels – preconception genetic testing and strategic reproductive choices, PND and education for carrier parents, and holistic management of persons with SCD. We emphasize the critical importance of self-management, especially self-awareness, in assuring a good quality of life for persons with SCD. We believe such an approach is cost-effective, and consistent with sound ethical principles and good conscience. The African Field Epidemiology Network 2011-10-03 /pmc/articles/PMC3282939/ /pubmed/22187596 Text en © Ama Kyerewaa Edwin et al. http://creativecommons.org/licenses/by/2.0 The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Essay
Kyerewaa Edwin, Ama
Edwin, Frank
Etwire, Victor
Controlling sickle cell disease in Ghana - ethics and options
title Controlling sickle cell disease in Ghana - ethics and options
title_full Controlling sickle cell disease in Ghana - ethics and options
title_fullStr Controlling sickle cell disease in Ghana - ethics and options
title_full_unstemmed Controlling sickle cell disease in Ghana - ethics and options
title_short Controlling sickle cell disease in Ghana - ethics and options
title_sort controlling sickle cell disease in ghana - ethics and options
topic Essay
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3282939/
https://www.ncbi.nlm.nih.gov/pubmed/22187596
work_keys_str_mv AT kyerewaaedwinama controllingsicklecelldiseaseinghanaethicsandoptions
AT edwinfrank controllingsicklecelldiseaseinghanaethicsandoptions
AT etwirevictor controllingsicklecelldiseaseinghanaethicsandoptions