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PubMed1998

The public health versus clinical approaches to maternity services: the emperor has no clothes.

This paper explores the conflict between practice based on science, or based on peers, and between the recommendations of public health agencies and the recommendations of organizations of clinicians, with specific reference to maternity services. The WHO European Regional Office, as a public health agency, has been bringing to the attention of the public and of governments two serious problems brought about by the present hegemony of the clinical approach: (1) The reliance on standards of practice rather than scientific evidence, and (2) Having doctors decide health policy, leading to the failure to honour the self-determination of the individual and family and basic human reproductive rights.

Decision Making, Organizational↗
PubMed1998

[The Program for Integrated Women's Health Care]

The Program for Integrated Women's Health Care (PAISM) was launched by the Brazilian Ministry of Health in 1983 as a new and different approach to women's health. Paradoxically, the PAISM also became the first case in which the Brazilian state explicitly proposed and implemented (albeit partially) a program regulating fertility. This raised suspicions as to disguised promotion of birth control. However, a brief analysis of the history of this program and its social significance suggests that the PAISM was a pioneering undertaking (even within the international scenario) in proposing integrated women's health care as opposed to isolated family planning measures. This helps explain why women's movements in Brazil immediately began to struggle to see it properly implemented. The program contained the definition of reproductive health adopted by the World Health Organization in 1988, which was expanded and consolidated in Cairo in 1994 and Beijing in 1995. Consequently, adoption of the PAISM meant a significant step towards recognition of women's reproductive rights, even before gaining the various international forums for struggle.

Journal Article↗
PubMed1998

[Regret by women following sterilization]

Female sterilization is the most widely used contraceptive method among Brazilian women, although it has not been provided by the National Health System. Due to its legal ambiguity, it has not been recommended by Medical Boards as an ethical procedure. A study in which 3,149 women were asked about contraceptive use was carried out in the Greater São Paulo Metropolitan Area between March and July 1992. A total of 407 women under 40 years of age who had been submitted to sterilization at least one year prior to the interview were asked about their adjustment after the operation. Fifteen in-depth interviews with regretful women were analyzed in order to elucidate the nature of such feelings. The results include: adjustment after sterilization, provision of the sterilization procedure, knowledge of contraceptive methods, previous use of methods among sterilized women, and factors associated with regret. The qualitative results focus on the misinformation of sterilized women. Results indicate a need for regulating the procedure in order to ensure women's health, reproductive rights, and the fundamental principles of medical ethics.

Journal Article↗
PubMed2005

The legal aspects of parental rights in assisted reproductive technology.

This paper provides an overview of the different legal approaches that are used in various jurisdictions to determine parental rights and obligations of the parties involved in third party assisted reproduction. Additionally, the paper explores the differing legal models that are used depending on the method of surrogacy being utilized. The data demonstrates that a given method of surrogacy may well result in different procedures and outcomes regarding parental rights in different jurisdictions. This suggests the need for a uniform method to resolve parental rights where assisted reproductive technology is involved.

Contracts↗
PubMed2005

Sexual and reproductive health and rights in the United Kingdom at ICPD+10.

At the mid-point of the Programme of Action of the 1994 International Conference on Population and Development, we reviewed the situation in the UK in key areas. In recent years, greater attention has been paid to sexual health at a national policy level, including strategies on teenage pregnancy and sexual health, but there is still a long way to go. The law against female genital mutilation has been strengthened, twice as many men attend family planning clinics as ten years ago, access to abortion services funded by the National Health Service has improved substantially, up to 80% of contraceptive advice and care is accessed through general practice, a national screening programme for chlamydia is being rolled out, the age of consent has been equalised for men and women and for heterosexuals and homosexuals, and new recommended standards for sexual health and HIV services have been developed. However, many family planning services do not involve young men, waiting times for an abortion are too long, the abortion law has never been extended to Northern Ireland, and there are rising rates of STIs and HIV. Rapid improvements in sexuality education, training and improved resources for family planning and abortion providers and the re-introduction of national public information campaigns about all aspects of sexual health are all required.

Adolescent↗
PubMed1998

[Progressive Catholic perspectives on reproductive health and rights: the political challenge of orthodoxy]

Catholics do not follow official Roman Catholic teachings on matters of sexuality and reproduction, including the position that contraception , even for married couples, is always evil, and that direct abortion , even to save a woman's life, is always illegal. Less well known is the extent of the Church's involvement in policy-making on these same issues. For example, it has forced the closing of in vitro fertilization (IVF) services from Poland to Uruguay. As the Church has never declared any of the dominant views, over time, regarding when a fetus becomes a person as a doctrine or dogma, there is no theological justification for the absolute condemnation of abortion. Neither is there a theory on "just abortion" similar to the "just war" that allows killing under certain circumstances. The enormous gap between the Church's positions and the views of worshippers has led Catholics to shape a workable and honorable sexual and reproductive ethic of their own The Church could make a positive contribution if it chose to accompany people on this quest rather than to raise roadblocks.

Journal Article↗
PubMed2003

The case for regulating collaborative reproduction: a children's rights perspective.

There is little regulation of collaborative reproduction--the use of the eggs, sperm, or embryos of a third party to create a child biologically unrelated to at least one intending parent. This Article argues that the dearth of regulation should be assessed from a children's rights perspective and accordingly adjusted. After examining the effects of the experimental reproductive technologies, it concludes that traditional family law preferences and policies are undercut by the deliberate creation of collaboratively reproduced children. The lack of regulation might stem from constitutional protection afforded parents in the right of privacy and substantive due process cases. The author, however, contends that collaborative reproduction implicates the rights of children and requires a separate balancing of rights not contemplated in other cases. Collaborative reproduction also requires regulation because of its spill over effects on the acceptability of cloning. The Article concludes by offering several possible regulatory responses to the problems posed by collaborative reproduction.

Child↗
PubMed1999

The close connection between classical rights and the right to health, with special reference to the right to sexual and reproductive health.

Although several international and regional human rights instruments, including the Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights, give explicit recognition to a broad right to health, this right, at present, offers little real protection to interests in individual and community health, including reproductive and sexual health. This is so, the author argues, because the mechanisms now in place for supervision and enforcement of this and other "social human rights" are extremely weak. In these circumstances, better protection is available indirectly, through enforcement of certain "classical human rights," such as the right to life, the right to be free from inhuman and degrading treatment, and the right to found a family, that contribute to--and depend upon--realisation of a right to health.

Family Planning Services↗
PubMed2000

Rights to sexual and reproductive health: the ICPD and the convention on the elimination of all forms of discrimination against women.

This article examines women's rights to sexual and reproductive health as recognized by the ICPD and expressed in the Women's Convention and other international human rights documents. Rights relating to reproductive and sexual health include the rights to life, liberty, and the security of the person; to health care and information; and to nondiscrimination in the allocation of resources to health services and in their availability and accessibility. Of central importance are the rights to autonomy and privacy in making sexual and reproductive decisions, as well as the responsibility of health care providers to ensure informed consent and confidentiality in relation to health services. The article presents country examples from States parties' periodic reports under the Women's Convention that reflect systemic violations of the above rights in varied forms.

Abortion, Induced↗