Ethical issues in denial of church wedding based on couple’s hemoglobin genotype in Enugu, south eastern Nigeria

Abstract

Background Sickle cell anemia (SCA) is a major genetic disease with the greatest burden in sub-Saharan Africa. To try to help reduce this burden, some churches in Nigeria conduct premarital sickle cell hemoglobin screening and refuse to conduct weddings when both individuals are identified as carriers of sickle cell trait. Main body This paper explores the ethical challenges involved in such denials. We assess whether churches have the right to decline to marry adults who understand the risks and still prefer to get married, and whether couples should be denied church weddings based on the risk that their child may suffer from sickle cell anemia. We examine the moral and ethical dimensions of such denials and explore the underlying socio-cultural context involving the purpose of marriage and the meaning of the wedding ceremony in societies where premarital screening is one of the few tools available to reduce the risk of having children with SCA. The potential role of the church is also examined against the background of church beliefs, the duty of the church to its members and its role in reducing the suffering of its members and /or their children. Conclusion We argue that the church should impose these burdens on couples only if doing so promotes a sufficiently compelling goal and there is no less burdensome way to achieve it. We then argue that the goal of reducing the number of individuals in Nigeria who have SCA is compelling. However, testing earlier in life offers a less burdensome and potentially even more effective means of achieving this goal. This suggests that, advocating for earlier screening and helping to support these programs, would likely better promote the church’s own goals of helping its parishioners, increasing the number of church weddings, and reducing the burden of SCA in Nigeria.

The Potential Impact of Mass Media Education in the Psycho-Social Life and Epidemiology of Sickle Cell Disease in Nigeria

“…Another approach to the treatment of the disease is a bone marrow transplant. This process is highly sophisticated and demands well-trained doctor or experts (Euzebus, Puline, & David, 2019). It is an expensive method therefore only very few individuals who suffer from the disease can afford it.…”

“…This situation is very much peculiar to those in Sub-Saharan Africa where many carriers are grossly poor and are financially precarious (Bruno, 2012). For instance, in Nigeria, the University of Benin Teaching Hospital recorded the first bone marrow transplantation (Euzebus, Puline, & David, 2019). Preventive methods such as Pre-natal diagnosis and termination of affected pregnancies have been an approach to preventing the birth of any SCD carrier.…”

“…Preventive methods such as Pre-natal diagnosis and termination of affected pregnancies have been an approach to preventing the birth of any SCD carrier. Although this approach is not popularly welcomed for religious and ethical reasons (Euzebus, Puline, & David, 2019), the media has a great role to play in the advocacy for subsidizing the cost for treatment by the eligible bodies and the enlightenment of the public on the opportunities.…”

“…Owners of media houses and stations should sponsor an advocacy or media campaign program for the government, international bodies, etc to assist in the subsidizing of born marrow transplant to an affordable cost. This will enable the masses to access such treatment opportunity since a majority of citizen fall within the low-income category (Euzebus, Puline, & David, 2019;Elizabeth, Donald, Smruti, Kathleen, Mei, Daies, & Igor, 2018).The mass media should liaise with doctors in the campaign for improvement in the health sector. The aftermath of such effort can yield employment of sufficient experts hence; a multidisciplinary team made up of a physician, haematologist, nurses, psychiatrist, physical therapist, a pain specialist and a social worker could be available to attend to patients with SCD (Cynthia, Nitya, Diana, & Lakshmanan, 2019;Steven, Nahed, & Troy, 2000).…”

Distribuição por mesorregião dos casos de anemia e traço falciforme que realizaram a triagem neonatal no Estado do Pará, Brasil no período de 2013 a 2017

“…É caracterizada por uma mutação no gene da hemoglobina normal (Hb A) originando a hemoglobina S (Hb S). Essa hemoglobina pode sofrer polimerização tornando a forma do eritrócito semelhante a uma foice, que é mais rígido e têm dificuldade de passar pelos vasos sanguíneos, dificultando a circulação do sangue2 . O acúmulo de hemácias falcizadas, desencadeia o fenômeno de vaso oclusão e hipóxia, acarretando em lesão tecidual, isquemia tecidual, sequestro esplênico, vasculopatia cerebral, insuficiência renal, pulmonar e cardíaca 3 .A doença acomete aproximadamente 7% das populações originarias do Continente Africano, da Região Mediterrânea, do Sudeste Asiático, do Oriente Médio e Extremo Oriente4 .…”