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The Importance of the International Community in Protecting the Right to Abortion: The Cases of Malta and of the US Supreme Court. Healthcare (Basel) 2023; 11:healthcare11040520. [PMID: 36833054 PMCID: PMC9957392 DOI: 10.3390/healthcare11040520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/29/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
According to the World Health Organization (WHO), abortion is often necessary and is not a criminalizable medical act. Unfortunately, despite the global trend in recent years tending towards liberalization of abortion as a fundamental right of women in certain circumstances, it is still not guaranteed in all countries of the world in the same way. Moreover, the abortion debate is often characterized by unscientific opinions based on political and/or religious ideologies. Recently, a European episode has rekindled the debate on abortion: in Malta, a tourist was unable to have an abortion, with consequent risks, even serious ones, on her health. In addition, even in the United States a Supreme Court ruling created a considerable stir: the Roe v. Wade (1973) ruling that had legalized abortion at the federal level was revoked. After the ruling of the Supreme Court, each state of the USA can decide for itself whether and how to legalize abortion. These recent international developments are particularly worrying and make even more evident the need for abortion to be protected at an international level as an inalienable and fundamental human right, and therefore not to be limited.
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Wayessa ZJ, Boneya BA, Hadona EA. Knowledge, Attitude and Associated Factors Toward Ethiopian Abortion Law Among Reproductive Age Women in Bule Hora Town, Southern Oromia, Ethiopia, 2022. Health Serv Res Manag Epidemiol 2023; 10:23333928231220493. [PMID: 38145213 PMCID: PMC10748687 DOI: 10.1177/23333928231220493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Abstract
Objectives A woman's health and wellbeing are impacted by illegal abortion since improper procedures can lead to consequences like extreme bleeding, infection, and damage to the reproductive organs and low awareness and attitude toward abortion law is one of the public health problems in Ethiopia. This study aimed to assess the knowledge, and attitude, and identify the effect of short birth interval and wealth index on the abortion law among reproductive-age women in Bule Hora town, Southern Oromia, Ethiopia. Methods A community-based cross-sectional study design was conducted from June 20 to July 20, 2022. A systematic random sampling technique was carried out to select 402 reproductive-age women. Data was collected by using a structured questionnaire with face-to-face interviews after the tools were pretested. The data was cleaned, coded, and entered into Epidata 3.1 and exported to STATA 14 for analysis. The model goodness of fit was checked using the Hosmer-Lemeshow test. Statistical significance is declared at P < .05 and a 95% confidence interval. Results The study revealed that 153 (38%) of respondents had good knowledge and 192 (47%) had a favorable attitude toward the Ethiopian abortion law, with a 100% response rate. Women's educational status, having information regarding the criteria of legal abortion services, and short birth intervals as a reason for induced abortion were significantly associated with knowledge. On the other hand, women who attended secondary education and above, have information regarding the criteria of legal abortion services, wealth index middle/average and richer, using the contraceptive method, and short birth interval as a reason for induced abortion were predictors of attitude toward Ethiopian abortion law. Conclusion This study shows that knowledge and attitude toward Ethiopian abortion law was not sufficient. So focusing on awareness creation and health education strategies by mobilization of the community to minimize the knowledge and attitude gap is essential.
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Affiliation(s)
| | - Balela Areri Boneya
- Department of Public Health, Bule Hora University Teaching Hospital, Bule Hora, Ethiopia
| | - Elias Amaje Hadona
- Department of Public Health, Institute of Health, Bule Hora University, Bule Hora, Ethiopia
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Pellico-López A, Paz-Zulueta M, Manjón-Rodríguez JB, Sánchez Movellán M, Ajo Bolado P, García-Vázquez J, Cayón-De las Cuevas J, Ruiz-Azcona L. Evolution of Legislation and the Incidence of Elective Abortion in Spain: A Retrospective Observational Study (2011-2020). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9674. [PMID: 35955037 PMCID: PMC9368144 DOI: 10.3390/ijerph19159674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND According to the WHO, "unsafe abortion occurs when a pregnancy is terminated either by people lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both". AIM To review the legislation that ensures access to elective abortion and the main indicators of elective abortion in Spain. METHODS A retrospective observational study was conducted across all regions of Spain from 2011 to 2020. The regulations of each region on the creation of the clinical committee and the creation of the registry of conscientious objector professionals were identified. Data were collected on rates of elective abortions per 1000 women, type of health center where the intervention was performed, interval of weeks of gestation, and cause. RESULTS After Law 2/2010 entered into force, the Spanish regions created a clinical committee; however, very few regions have a registry of conscientious objectors. During the study period, the average annual rate in Spain was 11.10 elective abortions per 1000 women between 15 and 44 years of age, showing a decreasing trend (annual percentage change of -1.92%). Only 10.67% of abortions were performed at public centers. In 90.18% of the cases, abortions were performed at the woman's request. CONCLUSION Spain legislated late compared to most European Union countries. The current law is similar to that of other member states, allowing abortion at the woman's request in the first fourteen weeks and thereafter for medical reasons. Most abortions are performed at private centers, although many territorial inequalities are observed.
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Affiliation(s)
- Amada Pellico-López
- Departamento de Enfermería, Universidad de Cantabria, Avda. Valdecilla s/n, 39008 Santander, Spain
- Cantabria Health Service, Avda. Derechos de la Infancia 31, 39340 Cantabria, Spain
| | - María Paz-Zulueta
- Departamento de Enfermería, Universidad de Cantabria, Avda. Valdecilla s/n, 39008 Santander, Spain
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Grupo de Investigación en Derecho Sanitario y Bioética (GRIDES), C/Cardenal Herrera Oria s/n, 39011 Cantabria, Spain
| | | | - Mar Sánchez Movellán
- Sección de Programas de Salud de la Mujer, Dirección General de Salud Pública, Consejería de Sanidad, Gobierno de Cantabria, C/Federico Vial 13, 39009 Cantabria, Spain
| | - Purificación Ajo Bolado
- Sección de Programas de Salud de la Mujer, Dirección General de Salud Pública, Consejería de Sanidad, Gobierno de Cantabria, C/Federico Vial 13, 39009 Cantabria, Spain
| | - José García-Vázquez
- Consejería de Salud de Asturias, C/Ciriaco Miguel Vigil, 9, CP, 33005 Oviedo, Spain
| | - Joaquín Cayón-De las Cuevas
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Grupo de Investigación en Derecho Sanitario y Bioética (GRIDES), C/Cardenal Herrera Oria s/n, 39011 Cantabria, Spain
- Departamento de Derecho Privado, Universidad de Cantabria, Avda, de los Castros s/n, 39005 Santander, Spain
| | - Laura Ruiz-Azcona
- Departamento de Enfermería, Universidad de Cantabria, Avda. Valdecilla s/n, 39008 Santander, Spain
- Global Health Research Group, Universidad de Cantabria, Avda. Valdecilla, s/n, 39008 Santander, Spain
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Gulino M, Miele MT, Marcuccilli F, Cammarano A, Montanari Vergallo G. Late termination of pregnancy in case of congenital CMV infection: ethics, medicine and law. J Matern Fetal Neonatal Med 2022; 35:9786-9791. [PMID: 35337216 DOI: 10.1080/14767058.2022.2053104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This paper provides a recent legal case which calls into discussion the women's safe access to voluntary termination of pregnancy (VTP) after the first 90 days. On 15 January 2021, the Italian Supreme Court sentenced a physician to damage compensation because he did not correctly inform the patient, in her 22nd week of pregnancy, about the risks to the fetus relating to an infection from cytomegalovirus (CMV). The option for VTP was not offered since, at the time of the woman's request, medical investigations did not show the evidence of fetal malformations, neither there were concrete risks for the life of the mother, as Italian law requires. The baby was born with severe brain injuries. The case is noteworthy because it offers a new precedent to extend legal requirements for late VTP. The impact of this decision must be tested in the clinical practice. Further studies are necessary to evaluate possible law amendments extending access conditions for this practice and new policies promoting the strengthening of informative and assistance procedures, including psychological help, to the pregnant woman are needed, as well.
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Affiliation(s)
- Matteo Gulino
- Department of Clinical Science and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Martino Tony Miele
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Fabbio Marcuccilli
- Laboratory of Clinical Microbiology and Virology, University Hospital Tor Vergata, Rome, Italy
| | - Andrea Cammarano
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Gianluca Montanari Vergallo
- Department of Anatomical, Histological, Medico-Legal and Orthopaedic Sciences, "Sapienza" University of Rome, Rome, Italy
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Negro F, Varone MC, Del Rio A, Marinelli S, Basile G. Conscientious objection to abortion: how to strike a legal and ethical balance between conflicting rights? ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2022279. [PMID: 36043952 PMCID: PMC9534259 DOI: 10.23750/abm.v93i4.13477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/09/2022] [Indexed: 01/26/2023]
Abstract
The Italian Supreme Court ruling no. 18901 of May 13, 2021 has determined that doctors who are opposed to abortion can refuse to perform it on grounds of conscience, but such a refusal does not exempt them from providing assistance to the woman before and after the procedure itself. The legalization of abortion should be considered within a broader strategy to put an end to underground and unsafe abortions, to raise awareness and enhance reproductive education and accessibility to contraceptive methods. The authors have set out to briefly analyze the legal and ethical complexities inherent in the effort to reconcile women's reproductive autonomy and freedom of choice with conscience-based refusal on the part of numerous healthcare professionals. Such an apparent conflict highlights the need for an ethically tenable solution that takes into account the dignity of unborn children, based on the conviction of many healthcare professionals primarily based on moral and religious tenets, that life begins at conception as well as the reproductive freedom and autonomy of women.
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Affiliation(s)
- Francesca Negro
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Forensic
| | - Maria Cristina Varone
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Forensic
| | - Alessandro Del Rio
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Section of Forensic
| | | | - Giuseppe Basile
- Trauma Unit and Emergency Department, IRCCS Galeazzi Orthopedics Institute, Milano, Italy, Head of Legal Medicine Unit, Clinical Institute San Siro, Milan, Italy
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