RESUMEN
PIP: Only 17% of US hospitals (265 public and 926 private hospitals) perform abortions, and hospital-based abortions represent only a small fraction of the number of abortions performed each year. Despite this low level of involvement, US hospitals have become involved in difficult situations concerning law, ethics, and standards of practice. A case in point is Baltimore's Saint Agnes Hospital, where the accreditation of the hospital's residency training program in obstetrics and gynecology was withdrawn in 1986 by the Accreditation Council for Graduate Medical Education. This decision was based on the hospital's refusal, for religious reasons, to perform abortions, sterilizations, and artificial insemination. The hospital further was cited for not providing family planning education to medical students. Saint Agnes Hospital maintained that the Council's decision represented discrimination against Catholic hospitals; as evidence, it cited the fact that, while Catholic- affiliated residency programs comprised only 10% of such programs, they accounted for 83% of programs in which deficiencies or concerns were identified by the Accreditation Council. Some Catholic hospitals deal with this situation by allowing residents to rotate to other facilities if they want to be trained in abortion services--an option Saint Agnes rejected. The number of hospitals that offer residents training in abortion has declined by 22% since 1977; at present, 13% of all gynecology-obstetrics residents have no access to such training.^ieng
Asunto(s)
Aborto Legal/provisión & distribución , Hospitales de Enseñanza/normas , Acreditación/legislación & jurisprudencia , Femenino , Humanos , Embarazo , Estados UnidosRESUMEN
PIP: The contributions from 3 infertility specialists that comprise this article give an overview of the present situation in terms of infertility and its etiology and look at recent advances in infertility management, the various public health and ethical issues involved, and changes that have occurred in the attitude of family planning clinics toward infertility management. Worldwide, an estimated 60-80 million people are affected by infertility, with sexually transmitted diseases and postabortion and postpartum pelvic infections contributing a growing share of these cases. Despite spectacular advances in infertility management, the investigation and successful treatment of infertility is expensive and remain inaccessible to poor couples in developing countries. This is a key equity issue between rich and poor and between developed and developing countries. Although procedures such as artificial insemination, in vitro fertilization, and embryo transfer offer hope to infertile couples, some methods will be unacceptable from a medical or ethical point of view and not every biological development should be introduced into clinical practice. Family planning programs can play a key role in preventing infertility through sex education and encouraging the use of harmless contraceptive methods. In all cases, however, it is important that family planning personnel who work with infertile couples assess the likely psychosocial impact on the family of a child produced by techniques such as artificial insemination or in vitro fertilization.^ieng
Asunto(s)
Atención a la Salud , Ética , Planificación en Salud , Servicios de Salud , Infertilidad , Inseminación Artificial , Medicina , Psicología , Reproducción , Sistema Urogenital , Conducta , Biología , Servicios de Planificación Familiar , Salud , Fisiología , Técnicas ReproductivasRESUMEN
The Supreme Rabbinical Appeal Court of Israel held that even though a husband had consented to his wife's artificial insemination with the sperm of a donor, he was exempt from paying maintenance for a child born as result of the procedure. A religious court in Haifa has ruled that a Jewish child born as the result of artificial insemination could only marry a proselyte for fear of marrying someone closely related. See Annual Survey of Family Law, Vol. 11, 1987, p. 182.