Eur J Gynaecol Oncol. 2013;34(3):218-21.

Bioethical issues on the role of contemporary gynecologists concerning HPV vaccination.

Koumousidis A., Sofoudis Ch., Paltoglou G., Iavazzo Ch., Kalampokas Th., Tzoumas N., Salakos N.

Division of Colposcopy and Gynecological Oncology, 2nd Department OB-GYN, Aretaieion Hospital, University of Athens

 

ABSTRACT:
Debate is heating up whether or not to require girls to be vaccinated against HPV, a leading cause of cervical cancer. Prolepsis against this plague is mainly focused on early detection with Pap-test (screening) and recently, on administrating HPV-vaccines in youths.

Objective: To discuss the augmented role of contemporary gynecologist in this bioethical, for young population, field in order to contribute to a desired decrease of the malignancy.

Material and methods: We searched the web (data-warehouse: articles, forums, etc., data-mining: sequence analysis, classification) for HPV-vaccination’s and related bioethical issues, extracting useful information.

Results: HPV-vaccines have already caused debates on whether they must be mandatory (Texas 2007) and on whether they cause a pseudo-safeness mental state, making youths “forget” annually necessary Pap-tests or, worse, urging them in promiscuity and eventually, increasing the cervical cancer’s occurrence.

Conclusions: Greece, in order to apply appropriately the Constitutional Law 5§5 (: All persons have the right to the protection of their health…), needs to train contemporary gynecologists in adequate youth’s consulting and proper family approaching on HPV-vaccination issues. Enhancing gynecologist’s role, vaccination’s effectiveness (sensitivity, specificity) will be augmented and on the other hand, a Rule of Social Law will be established in our country.

PMID: 23967549

 

SUPPLEMENT:

Debate is heating up whether or not to require girls to be vaccinated against HPV, a leading cause of cervical cancer (CC). Prolepsis against this plague is mainly focused on early detection with Pap-test (screening) and recently, on administrating HPV-vaccines in youths. Bioethics as a harmonic joint that connects sciences together (life sciences, biotechnology, medicine, politics, law, and philosophy), reveals us several different canals of interaction among them in a way that on the one hand, practicing medicine can promote our personal, social, political, and philosophical consciousness while on the other hand, applying values of the latter sectors in the medical field, indicators like sensitivity or specificity and concepts such as «precaution», «therapy» and «follow-up» can be improved. Objective: To discuss the augmented role of contemporary gynecologist in this bioethical, for young population, field in order to contribute to a desired decrease of the malignancy. Material and methods: We searched the web (data-warehouse: articles, forums, and blogs, and applied data-mining analysis for HPV-vaccination’s and related bioethical issues: Association Rules (method for discovering interesting relations between variables within large databases), Sequence Analysis (comparison of sequences in order to find similarities, identification of intrinsic sequence features or sequence differences), Classification (identifying the sub-population to which new observations belong), Clustering (assignment of a set of observations into sub-sets (clusters) so that observations in the same cluster are similar in some sense), Forecasting (process of making statements about events whose actual outcomes (typically) have not yet been observed). We studied 98 different websites and made many different tables in order Association Rules, Sequence Analysis and Clustering to be properly applied. Results: Several “human” conclusions were made studying this web-population that was chosen using criteria, such as the quality and traffic of each website, the impact factor of various medical web-magazines, the potential voting (if any) of the on-line (e-)statements. We evaluated the quality of the written e-speech (grammar, syntaxes, structure of arguments/thoughts, etiology, conclusions), the qualifications (job, student) of the person who had made the e-statement, the described facts, the experiences and the habits that might have been reported in the e-context, the medical terminology (if any), the general personal beliefs/ethos of the writer.

For example, one of the websites (a forum discussion) that we checked out was: http://www.godlikeproductions.com/forum1/message1557424/pg1, and here is some useful material that was used: “HPV vaccine for my 17 year old daughter??….. Should I give my daughter this vaccine? Not sexually active yet, but the crowd says give it now. What does the glp community say? “ It is obvious that the way/quality of writing in combination with the cited aspect reveals us a web-person of low education-level, who has at least one daughter without early onset of her sexual contacts (>16 years old), tending mostly to choose “optional” on the vaccination issue. Her inquiry had been made in a forum of dubious quality/provided ideas (personal and not adequately, in the scientific sense of the word, proved), showing us her prejudiced stance, confusion, low level of information and increased fear towards the proposed medical methods. Moreover, in the same website in the page http://www.godlikeproductions.com/forum1/message1035537/pg1, the 11th answer urges women not to be advised by doctors while replying on the question: “Just got a CERTIFIED LETTER stating that I am late for my pap smear.“

HPV-vaccines have already caused debates on whether they must be mandatory (Texas 2007) and on whether they can cause a pseudo-safeness mental state, making youths “forget” annually necessary Pap-tests or, worse, urging them in promiscuity and eventually, increasing the cervical cancer’s occurrence. Discussion-Conclusions: The answer whether HPV vaccination should be mandatory or optional depends strongly on the culture of the population that this dilemma is addressed to, which mainly is a matter of the general education that is widely provided and moreover, of the spirit concerning the quality of the established law system within a democratic society. However, Bioethics, as a third force that intervenes in the system «mandatory-optional» seems to provide us with the happy medium to this dispute by just accepting both opinions and by applying the one according to the underneath educational and cultural matrix on which each society has been developed. As it is widely accepted, the doctor has always to inform the patient with honesty and respect to the inalienable right to the self-determination before taking any indicated medical action for precautionary, therapeutic, and/or other medical reasons. Proper parent’s as well as children’s consultation on a regular basis (every 6-12 months) before their child’s first coitus, would offer quite safe education before, during and after the administration of the vaccine. The State must give funds to ameliorate the training of the new gynecologists: books, extra training semesters in the specialty, conferences, programmes. This bioethical solution seems to be the only way to CC cases’ decrease and thus, to the increase in the sensitivity of the HPV/CC ‘s ‘precaution’ at large, including that of HPV-vaccination. Greece, in order to apply appropriately the Constitutional Law 5§5 (: All persons have the right to the protection of their health…), needs to train contemporary gynecologists in adequate youth’s consulting and proper family approaching on HPV-vaccination issues. Enhancing gynecologist’s role, vaccination’s effectiveness (sensitivity, specificity) will be augmented and on the other hand, a Rule of Social Law will be established in our country.

Multiselect Ultimate Query Plugin by InoPlugs Web Design Vienna | Webdesign Wien and Juwelier SchönmannMultiselect Ultimate Query Plugin by InoPlugs Web Design Vienna | Webdesign Wien and Juwelier Schönmann