Ethical issues in labour care in Sri Lanka

  • Krishani J Jayasinghe

Student thesis: Master's ThesisMaster of Science by Research (MScR)


The overall aim of this project was to identify ethical issues in health care provision during childbirth in Sri Lankan context.
The project was originally planned as a descriptive empirical bioethics project. I expected to interview in-depth postpartum women to capture their views, perceptions, and experiences of childbirth. The aim was to produce contextualized ethical analysis, which is sensitive to lived experiences but still critically normative. However, due to Covid-19 restrictions, data collection became impossible, and I changed the methodology of the project. I performed a theoretical analysis instead, based on the three vignettes developed to facilitate interviews with women.
In this dissertation, chapter 1 describes the Sri Lankan healthcare context, in which the ethical issues were identified. I provide a brief account of the empirical project in chapter 2, to give a flavor of work that I would have carried out, and to lay a foundation for the later chapters. In chapter 3, I provide a descriptive account of ethical principles, which will be utilized in theoretical analysis. In chapter 4-6, I engage with ethical issues which can be identified in vignettes. In chapter 7 I discuss common themes emerging from the analysis and the way forward.
Addressing ethical aspects of care provision is the way forward for Sri Lanka to improving quality of obstetric care. The normative analysis identified the nature of Sri Lankan medical context (- paternalistic), patient doctor relationship (-trust based), patients (- extra vulnerable, less autonomous) and underlying ethical issues of care provision (- lack of respect for autonomy of patients, neglect of best interest of patients). It is also important to understand how Sri Lankan women perceive and experience ethical issues in labour care, before taking steps to address them.
Date of Award25 Jan 2022
Original languageEnglish
Awarding Institution
  • University of Bristol
SupervisorJonathan C S Ives (Supervisor), Zuzana Deans (Supervisor) & Athula Sumathipala (Supervisor)

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