Consanguinity can be defined as the close relationship between members of a family up to the second cousin. The relationship is sexual and may involve marriage. Also, it can be defined as a sexual relationship between two people who share the same biological ancestor. It is quite interesting that many people are not aware of how prevalent such relationships are. In reality, a lot of communities practice consanguinity. In fact, up to 10% of the world’s population practices consanguinity. The rates increase up to 80.6 % in the Middle East (Oniya, Konje, Karen & Ahmed, 2018). It is predictably older than Islam. The prevalence of these cases tends to reduce on the western side of the globe but is mostly within specific immigrant communities. For example, in the United States, these cases are common in Persian Jewish communities in Los Angelos and Muslim immigrants in the country. Other than the United States of America, other parts of the world have registered high ratings of the case. The highest recorded consanguineous rate, in a community is76% among Pakistani war communities.
Also, Qatar has recorded 54% of the rate at which these relationships are increasing, while Saudi Arabia has 56% of the case. In fact, in the Samtah province found in Saudi Arabia, the prevalence of consanguineous relationships is up to 80.6% (Oniya, Konje, Karen & Ahmed, 2018). Jordan is also listed among the countries with a high prevalence of up to 51.2%. Last but not least, Kuwait stands at the top of all countries at 68.0% consanguinity rate (Oniya, Konje, Karen & Ahmed, 2018).
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It is necessary for every couple to be aware of the risks associated with the practice. Not many people have knowledge of the risk imposed in these kinds of relationships. Firstly, there are ranges of medical disorders that affect the mother of the child Hamamy, 2012). These complications include increased susceptibility to infections, and also they run a risk of becoming schizophrenic. Moreover, they may stand a risk of getting asthma, cancer, and diabetes. There are also issues relating to pregnancy complications and an increased rate of miscarriages than those recorded with parents who are unrelated.
Furthermore, congenital problems tend to occur in the offspring of related parents. These problems include errors in the metabolic processes due to carrying a high number of recessive genes. These levels may be as high the offspring developing cataracts or deafness. Additionally, the child may be at risk of developing heart problems (Hamamy, 2012). Also, during pregnancy, there are high chances that the child may suffer from acute fetal malformations Hamamy, 2012).
Among the predisposing factors that promote consanguineous relationships is religion. Certain religion favors these relationships. It is particularly seen in Judaism and Buddhism whereby these relations are actually sanctioned. Also, in Islam, they believe it is allowed as the Sunnah shows that one of their prophets was in such a relationship (Oniya, Konje, Karen & Ahmed, 2018). On the other hand, in countries such as the Middle East and Pakistan, the practice seems to be cultural. They believe that such marriages are important in strengthening family ties and ensure that the bride is treated well since the couple is related. Also, among the perpetuating factors to this type of marriage in some countries is to preserve wealth. For instance, in the Middle East families own whole oil wells for themselves. To ensure that the wealth acquired does not go to other families, they opt for consanguinity.
However, the practice is on a decreasing rate as many people are becoming educated on its disadvantages. It is now generally accepted that the disadvantages of the relationship greatly outweigh the advantages. Such knowledge, coupled with the increasing social stigma, has caused a large decline in the practice. People have become educated and thus live wary of getting children who are malformed in one way or another. Also, in some countries, the practice has been particularly banned. For instance, marriage between cousins in the USA has been banned. Also, in Brazil and some parts of the Hindu community laws have been put up to curb the practice (Oniya, Konje, Karen & Ahmed, 2018).
When a couple comes for advice on the consanguineous relationship, it is important that their genetic information remains confidential. It is, therefore, a nurse’s ethical duty to ensure that they inform the spouses of the risk they impose on their family and offspring. It is also a nurses’ duty under law to warn of impending danger in such an event. Especially since I may be related to the patient, it is necessary that I allow them to know what might be at stake. Also, I would have to consider international trends and positions. If the patient is at immediate risk, without a doubt, I would have to disclose the information for effective intervention (“ASHG statement,” 1998).
I think it the matter of consanguineous relationship solely lays upon a person’s cultural belief. Despite the advancement in medicine, these cultures have been practicing such relationships since the Old Testament. Hence when confronted with a need to inform a party at risk, which comes from a culture that practice the same, I would not burden them with the science. The ethical obligations in play rely only upon scientific knowledge but do not look at the historical background of the practice.
Student’s post Response 1
It is truly evident that consanguineous marriages and relationships are common in most parts of the world. The cultural and religious inclinations that accompany them are deep-rooted and cannot be ignored. It is a practice that has been ongoing for years and for different reasons. Despite this prevalence in many countries, the practise bears with it certain genetic risks and consequences. The statement by Heidari et al. “Several studies came to the agreement that consanguinity is the most common risk factor for congenital anomalies” (2014) research has confirmed that many of the birth issues that occur in the offspring are due to the blood relation of the couples. An observation into the countries and communities that mainly practice such relationships shows the preservation of culture. For instance, you could note that mainly in the Middle East, the practice tends to be allowed and encouraged due to the deeds of their prophet. Moreover, in those countries rich in family wealth, they use it as a means of preserving the wealth among themselves, a sense of security (Oniya et al., 2018)
Moreover, too many people in the Buddhism religion, it is more as a way of living. I think one can argue that these predisposing and perpetuating factors are significant enough to outdo the social stigma accompanying the practice. However, it is true that the laws that have been implemented to curtail the spread of the practice are a big factor. Despite the fact that they may be denying people their cultural rights have been put in place to mitigate the risks involved by the practice. I think it is a way of protecting the unborn child from avoidable health issues. I also do believe that by all means, nurses do have the right to override ethical concerns and inform relatives and family regarding the impending consequences if a person is to engage in such a relationship. It is their right to know.
Student’s post Response 2
Consanguineous marriages and relationships are quite common, yet it is quite evident that they pose a significant risk on the offspring. I do concur that these relationships account for many of the infant malformations that occur in babies. These issues range from blindness, hearing loss, congenital heart disease, and all the stated conditions (Hamamy, 2012). And these issues do arise from the sharing of common identical alleles acquired from a similar ancestor. As much as it is only 25% of the children sired who become affected when their parents carry a disease allele, it is a high percentage compared to that of parents who are not related. It is a much healthier choice for their babies than taking a risk and ending up siring a child who will live with a lifetime condition. It has been unanimously observed that this practice is an age-old practice and mainly revolves around certain religious and cultural beliefs. And for that reason the practice is high in Middle East countries and parts of Asia. In western culture, it was not quite accepted and hence can mainly be found in communities made up of immigrants like Muslim and Pakistani communities.
Also, I do concur that in some cultures, it is almost an obligation to keep the money in the family, and so they tend to engage in consanguineous unions (Oniya et al., 2018). And as the practice is slowly declining in popularity through education and social stigma, I would not say that it is socially inappropriate. We have to remember that it has been practiced since the times of the Old Testament and is older than Islam. I think it is just an awareness that is coming to light as medicine advances. The benefits of abstaining from consanguineous relationships greatly outweigh the challenges of keeping up with the practice. Nonetheless, I do agree on the need to inform the spouses or relatives on crucial genetic information. And at the same time ensuring that we maintain their privacy and respect their decisions.
References
ASHG statement. (1998). Professional disclosure of familial genetic information. The American Society of Human Genetics Social Issues Subcommittee on Familial Disclosure. Am J Hum Genet , 62 , 474-483.
Hamamy, H. (2012). Consanguineous marriages. Journal of community genetics , 3 (3), 185-192.
Heidari, F., Dastgiri, S., Akbari, R., Khamnian, Z., Khanlarzadeh, E., Baradaran, M., ... & Tajaddini, N. (2014). Prevalence and Risk Factors of Consanguineous Marriage. European Journal of General Medicine, 11(4).
Oniya, O., Konje, J. C., Karen, N., & Ahmed, B. (2018). A review of the reproductive consequences of consanguinity. European Journal of Obstetrics & Gynecology and Reproductive Biology .
