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Although abortion for health reasons is not considered a crime in Peru, the State does not allow its inclusion in public policy, thus violating women's right to terminate a pregnancy when it affects their health. When examining the article in the Criminal Code which decriminalizes this type of abortion, provisions are identified which protect women and set the conditions to offer this type of service. This document sets the debate about the arguments used by the Peruvian State for not approving a therapeutic abortion protocol which would regulate the provision and financing of therapeutic abortion in public services, and explains why this obligation should be complied with, based on the conceptual framework of "health exception" In addition, it presents two cases brought before the judicial court in which the Peruvian State was found guilty of violating the human rights of two adolescents to whom a therapeutic abortion was denied.

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OBJECTIVE: To describe pregnancies with conjoined twins according to the request for legal termination of pregnancy. METHODS: Retrospective review of pregnancies with conjoined twins, with no possibility of extrauterine survival or postnatal surgical separation, observed at a tertiary teaching hospital, between 1998 and 2010. RESULTS: Amongst 30 cases seen during the study period, six (20.0%) couples decided to continue with the pregnancy, termination of pregnancy was not requested due to advanced gestational age (> 25 weeks) in 5 cases (16.7%). Legal authorization to terminate the pregnancy was requested in 19 (63.3%) cases: permission was granted in 12 (63.2%), denied in five (26.3%) and information was missing in two (10.5%) cases. A successful vaginal delivery was performed in 83.3% of the cases undergoing termination of pregnancy and a cesarean section was performed in all the remaining cases (p < 0.01). CONCLUSION: In pregnancies with conjoined twins and without fetal prognosis, legal termination of the pregnancy is an alternative. Moreover, a successful vaginal delivery can be performed in most cases before the third trimester, further reducing maternal risks and parental suffering.

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Este artículo analiza desde un punto de vista general las razones por las cuales no parece recomendable innovar en la legislación vigente sobre aborto terapéutico. Se explicitan las definiciones utilizadas respecto de aborto, los dilemas éticos que se han generado, las diferencias que existen desde el punto de vista ético entre aborto directo (incluye el terapéutico y aborto indirecto. Se presentan, además, las cifras disponibles desde el punto de vista de Salud Pública para el aborto en Chile, se analizan las consecuencias físicas y psicológicas del aborto en la mujer y, finalmente, se presentan los desafíos para el futuro y se hace una propuesta de cómo avanzar en el debate para superar la disputa entre aquellos que están a favor de una nueva legislación y los que estamos a favor de no innovar.

This article analyzes, in general terms, why innovation of the existing legislation on therapeutic abortion does not seem advisable. It discusses the definitions regarding abortion, the ethical dilemmas that have been generated in this respect and the differences between direct abortion (including therapeutic abortion) and indirect abortion. Abortion figures available in Chile from a public health perspective are presented. There is an analysis of the physical and psychological consequences for women having an abortion. Finally, the article discusses future challenges and offers a proposal to achieve consensus in order to overcome the dispute between those who advocate new legislation and those who oppose innovation.

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Scientific and technological development plays an essential part in shaping contemporary societies, and medicine and health care are considered to be particularly receptive to the incorporation of new concepts, techniques and products, producing impacts not only on the health problems for which they were originally intended, but also varied 'side-effects', less frequently recognised and studied. In this study the point of departure was the hypothesis that the intensive diffusion in Brazil of prenatal ultrasound would create new problems for individuals (pregnant women, their families and health professionals) and society in coping with foetal malformations, due to the existence of a very restrictive induced abortion legislation. The objective of the research was to study the social visibility of these problems, in the written mass media. The period under analysis went from 1991 to 1996. The four most important daily newspapers and two medical council journals were studied, with a criteria oriented selection of articles, and their macrotextual thematic analysis. The results indicate that the basic elements in the relationships between medical technology, prenatal diagnosis, foetal malformations and induced abortions stayed the same along the period - a restrictive Penal Code, the public recognition of the disseminated and usually tolerated practice of induced abortion, done in risky conditions for the majority of women, with very evident consequences on maternal health, a divided Congress, a divided 'public opinion', religious opposition and new scientific and technological practices in health care. Nevertheless, tension between these 'contradictory' factors increases, so much so, that new elements are introduced which make an accommodation possible, without implying in major changes of position. This is achieved through the development of new alliances between Science, the judiciary and obstetrical leaders, which benefit individual initiatives, instead of leading to a public recognition of the problem and changes in the law.

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