Tackling Ethical Issues in Women’s Healthcare

Tackling Ethical Issues in Women’s Healthcare Women’s Healthcare Ethical Issues • The Western healthcare system has been a traditionally male-dominated field o There are 50-200% more male physicians compared to female physicians in almost all specialties (Association of American Medical Colleges, 2017) • Women have historically been excluded from medical research o 1977-1993: All women with childbearing potential were excluded from participating in phase I and phase II clinical trials (Food and Drug Administration, 2018) o Inadequate female representation in clinical trials can result in overdosing, underdosing, and adverse drug reactions in women (Zucker & Prendergast, 2020) Women’s Healthcare Ethical Issues • Healthcare provider inexperience with symptoms unique to women may lead to overall lower quality of care received by female patients compared to male patients • This can also result in worse end outcomes with increased risk of complications and mortality o Women have different underlying pathophysiology and presentation of symptoms for several emergency diseases including heart attacks (McGregor et al., 2017) o Women with cardiovascular disease are more likely to have delays in care, underutilization of therapies, and less aggressive treatment (Johnson et al., 2021) o Women are less likely to have heart attacks, but they are 2x more likely to die from heart attacks when compared to men (McGregor et al., 2017) Community Health “Community health refers to non-clinical approaches for improving health, preventing disease and reducing health disparities through addressing social, behavioral, environmental, economic and medical determinants of health in a geographically defined population.” Community Health • Things to consider: o Is there is a need for more education related to women’s healthcare in this community? o Are there socioeconomic disparities which need to be addressed? Ø Access to care, income level, educational level, occupation, nutrition, housing, etc o Are there race disparities which need to be addressed? o Are there implicit biases which need to be addressed? o Are there certain cultural behaviors, practices, or beliefs within women in this population that are increasing the risk of disease? o And etc… Topics for Further Study • We need a multidisciplinary approach to tackle these problems References Association of American Medical Colleges. (2022). Active physicians by sex and specialty, 2017. https://www.aamc.org/data-reports/workforce/interactive-data/active-physicians-sex-andspecialty-2017. Food and Drug Administration. (2018, February 16). Gender studies in product development: Historical overview. https://www.fda.gov/science-research/womens-health-research/gender-studies-productdevelopment-historical-overview. Johnson, H. M., Gorre, C. E., Friedrich-Karnik, A., and Gulati, M. (2021). Addressing the bias in cardiovascular care: Missed & delayed diagnosis of cardiovascular disease in women. American Journal of Preventative Cardiology, 8. http://doi.org/10.1016/j.ajpc.2021.100299. McGregor, A. J., Beauchamp, G. A., Wira, C. R. III, and Perman, S. M. 2017. Sex as a biological variable in emergency medicine research and clinical practice: A brief narrative review. Western Journal of Emergency Medicine, 18(6): 1079-1090. http://doi.org/10.5811/westjem.2017.8.34997. Zucker, I. and Prendergast, B. J. (2020). Sex differences in pharmacokinetics predict adverse drug reactions in women. Biology of Sex Differences, 11 (2020):32. https://doi.org/10.1186/s13293-02000308-5.