Restrictions on women's right to abortion: informed consent, spousal consent, and record keeping provisions.
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The Court held that a minor who is emancipated because of marriage may obtain an abortion without parental or spousal consent. It concluded that since the law views emancipated minors as having reached the age of majority, no consent should be required.
Data on the provision of seven types of reproductive health care were collected from private physicians in four specialties: general/family practitioners (GP/FPs), general surgeons, obstetrician-gynecologists and urologists. All ob-gyns, and eight in 10 GP/FPs, provide the pill, IUD or diaphragm. Over nine in 10 ob-gyns provide infertility and obstetric care and prenatal genetic screening; but only one-third or fewer of GP/FPs do so. Ob-gyns and urologists are far more likely to perform sterilizations than are GP/FPs and surgeons (nine in 10, compared with one-fifth to one-half). Although ob-gyns are the most likely to perform abortions, only four in 10 do so. Among ob-gyns who do not perform tubal sterilizations or abortions, and among urologists who do not perform vasectomies, the primary reason is moral or religious objections (reported by 59-71 percent). For GP/FPs and surgeons who do not perform the three procedures, the leading reason is that they do not perform surgery or that type of surgery; however, 34 percent of nonproviders in these specialties report moral or religious opposition to abortion. Eight in 10 ob-gyns will provide contraceptives to minors without parental consent, but only six in 10 GP/FPs will do so. One-half of doctors who perform female sterilizations, and eight in 10 of those who do vasectomies, require spousal consent. Among those who perform abortions, half require parental consent for minors. Access to private reproductive health care is quite limited for the poor, because many physicians will not accept Medicaid reimbursements or reduce their fees for low-income patients.(ABSTRACT TRUNCATED AT 250 WORDS)
OBJECTIVE: Law no. 2004-800 dated August 6, 2004, establishes new legal measures to facilitate live organ donation, in view of the shortage of organs for transplantation. We sought to assess the knowledge of this statute among hospital personnel. METHOD: We sent an e-mail questionnaire to 1015 persons working at Amiens university hospital center. It contained eleven closed questions (yes/no/don't know) about permissible live organ and tissue donation and two questions requesting personal opinions about live donation. We compared responses according to profession and department. RESULTS: Questionnaires were returned by 245 respondents. The questions for which more than 70% provided correct answers concerned the fundamental principles of bioethics (consent revocable at any time, donations by adults, donations between spouses, bone marrow donations by minors). Fewer than half the respondents knew the correct answers about the new legal measures adopted in the statute (extension of the circle of potential donors, possible exceptions for donations by minors and incompetent adults). Knowledge of the law concerning assisted reproduction techniques was much poorer: fewer than 30% knew that sperm or oocyte donation requires spousal consent. Three quarters of the respondents have discussed their wishes with their family; 65% would provide a live kidney donation, although some only for a family member. In all 31% have organ donor cards. DISCUSSION: Donations by live donors raise psychological as well as ethical and legal issues. This survey increased the awareness of hospital staff, provided them with information about the relevant law and, we hope, stimulated their thinking about the topic of live donations.
Despite 30 years of liberal legislation, the majority of women in India still lack access to safe abortion care. This paper critically reviews the history of abortion law and policy in India since the 1960s and research on abortion service delivery. Amendments in 2002 and 2003 to the 1971 Medical Termination of Pregnancy Act, including devolution of regulation of abortion services to the district level, punitive measures to deter provision of unsafe abortions, rationalisation of physical requirements for facilities to provide early abortion, and approval of medical abortion, have all aimed to expand safe services. Proposed amendments to the MTP Act to prevent sex-selective abortions would have been unethical and violated confidentiality, and were not taken forward. Continuing problems include poor regulation of both public and private sector services, a physician-only policy that excludes mid-level providers and low registration of rural compared to urban clinics; all restrict access. Poor awareness of the law, unnecessary spousal consent requirements, contraceptive targets linked to abortion, and informal and high fees also serve as barriers. Training more providers, simplifying registration procedures, de-linking clinic and provider approval, and linking policy with up-to-date technology, research and good clinical practice are some immediate measures needed to improve women's access to safe abortion care.
Modern thinking on abortion, reflected in recent legal developments around the world, has turned from concentration upon criminality in favor of female and family well-being. New laws enacted during the last decade are coming to focus upon conditions of health and social welfare of women and their existing families as indications for lawful termination of pregnancy. Regulations governing the delivery of services may be restrictive, however, so as to limit in practice access to means of safe, legal abortion made available in theory. Requirements may be imposed that only medical personnel with unduly high qualifications perform procedures, or that they be undertaken only in institutions meeting standards higher than similar health care requires. Approval procedures may be established involving second medical opinions or committees to monitor observance of the law, which may delay abortions and therefore increase their hazards. Parental and spousal consent requirements may exist in addition with the same effects, or to veto a pregnant female's request. Regulations may be employed more positively, however, to encourage contraceptive practice. A disappointment with legislative reform is that it may fail to improve circumstances if public resources are not applied to achieve the supply of services newly rendered legitimate, and illegal practice may persist.
The text of this Ordinance authorizing the practice of contraception, including sterilization, in the Niger, is as follows: "1) The use of modern methods of contraception shall be authorized throughout the national territory. "Contraception" means any action aimed at the voluntary regulation of fertility by the use of natural, medical, or surgical methods. Contraception may be either reversible or irreversible. 2) Unless there are medical contraindications, the following shall qualify for modern, reversible contraceptive methods: any person who has reached the age of majority; any minor who is duly authorized by the person exercising parental authority or legal guardianship; and any mentally handicapped person, on medical advice. 3) Only the following persons may qualify for irreversible methods or surgical sterilization: women above 35 years of age with at least four living children; women whose lives may be endangered by pregnancy; male persons having at least six living children. The written consent of the person concerned shall be required in order to qualify for the methods referred to in the first paragraph. 4) In order for married persons to qualify for irreversible methods or surgical sterilization, the written assent of the spouse shall be required. 5) Any contraventions of this Ordinance shall be punished in accordance with the code of ethics and criminal law. 6) All earlier provisions contrary to this Ordinance, and in particular the Law of 31 July 1920, shall be repealed. 7) This Ordinance shall form part of the body of law of the State and shall be enforced as such."
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