RESUMO

As Latin American countries seek to guarantee sexual and reproductive health and rights, opponents of women's rights and reproductive choice have become more strident in their opposition, and are increasingly claiming conscientious objection to providing these services. Conscientious objection must be seen in the context of the rights and interests at stake, including women's health needs and right to self-determination. An analysis of law and policy on conscientious objection in Peru, Mexico and Chile shows that it is being used to erode women's rights, especially where it is construed to have no limits, as in Peru. Conscientious objection must be distinguished from politically-motivated attempts to undermine the law; otherwise, the still fragile re-democratisation processes underway in Latin America may be placed at risk. True conscientious objection requires that a balance be struck between the rights of the objector and the health rights of patients, in this case women. Health care providers are entitled to their beliefs and to have those beliefs accommodated, but it is neither viable nor ethically acceptable for conscientious objectors to exercise this right without regard for the right to health care of others, or for policy and services to be rendered ineffectual because of individual objectors.

Assuntos

RESUMO

Las normas de regulación de la fertilidad, propuestas en el documento del Ministerio de Salud de Chile, plantean diversos problemas biomédicos en el contexto de una cierta visión de la procreación humana, de la sexualidad y de la familia. Hay serias objeciones desde una antropología que respeta la naturaleza personal de la mujer y del hombre, especialmente en el riesgo que existe en la promoción de métodos que podrían afectar la vida de seres humanos inocentes en sus etapas iniciales de desarrollo. Del análisis de la literatura se ha concluido que existen antecedentes científicos importantes, que se analizan en este documento, y que indicarían que el uso de la llamada “píldora del día después” podría estar poniendo en riesgo la vida del embrión humano preimplantacional.

Fertility regulation rules, proposed by the Chilean Health Ministry, involve several biomedical problems within the context of a given view point of human procreation, human sexuality and family. There are serious objection from an anthropology that respects the personal nature of woman and man, particularly in the danger that the life and survival of preimplantational human embryo could be affected by such methods. From an exhaustive analysis of the scientific literature, that are discussed in this document, it was concluded that the so called “emergency contraception pill” could be jeopardizing the life and survival of the preimplantation human embryo.

Assuntos

RESUMO

El presente artículo intenta dar cuenta de un debate de relevancia moral, social y política en Chile: la controversia acerca de la anticoncepción de emergencia y la iniciativa de las autoridades de gobierno de facultar a los servicios de salud del Estado para distribuir el fármaco comúnmente llamado píldora del día después. Se abordan diferentes perspectivas de análisis y se recae, finalmente, en un examen bioético a la luz de una revisión de la perspectiva principialista clásica para advertir algunas de sus insuficiencias analíticas y, por lo mismo, resituar la problemática desde la perspectiva de los derechos humanos.

This essay tries to show a moral, social and politically relevant debate in Chile: the controversy about emergency contraception and the decision of government authorities to authorize state health care services to distribute the drug commonly known as the day after pill. Different views of analysis are studied to reach, finally, a bioethical reflection of the problem considering a re-examination of the classical principles perspective, to point out some of its analytical inadequacies and, for this reason, to rethink the problem under a human rights perspective.

O presente artigo tenta apresentar um debate de relevância moral, social e política no Chile: a controvérsia em torno da anticoncepção de emergência e a iniciativa das autoridades de governo de facultar os serviços de saúde do Estado para distribuir o fármaco popularmente conhecido como pílula do dia seguinte. Abordam-se diferentes perspectivas de análise e se fixa, finalmente, num exame bioético do problema, à luz de uma revisão da perspectiva principialista clássica, para alertar a respeito de algumas de suas insuficiências analíticas e por, isto mesmo, recolocar a problemática a partir da perspectiva dos direitos humanos.

Assuntos

RESUMO

OBJECTIVE: To describe New Mexico pharmacists' knowledge, attitudes, and beliefs toward the prescribing of oral emergency contraception (EC) in their practices. DESIGN: Cross-sectional study. SETTING: New Mexico in January through March 2004. POTENTIAL PARTICIPANTS: New Mexico pharmacists. INTERVENTIONS: Questionnaire containing 74 items. MAIN OUTCOME MEASURE(S): Mean scores were calculated for individual knowledge items, overall knowledge scores, and attitude/belief items. Knowledge and attitude/belief scores were compared across demographic variables using t tests, ANOVA, and chi-square analyses. RESULTS: Of 1392 deliverable questionnaires, 555 (40%) were returned and 523 (38%) were usable; 136 contained written comments. Pharmacists had overall knowledge scores of 71.2% +/- 11.3%. Pharmacists who had participated in a state-approved EC prescribing training program and had time in their practice setting to prescribe EC had significantly higher knowledge scores. Mean scores indicated that pharmacists have positive attitudes and beliefs toward prescribing EC. Overall, 40% of respondents indicated that they would like to become certified to prescribe EC. Pharmacists who agreed that they would like to be certified to prescribe EC were significantly more likely to be male, non-Hispanic, non-Christian, to have liberal or moderate political views, and to indicate that they had employer/manager approval, time, and privacy in their practice setting to prescribe EC. CONCLUSION: New Mexico pharmacists have positive attitudes/beliefs toward EC prescribing; however, their knowledge in this area is average. Although religious, moral, and political views influence pharmacists' willingness to prescribe EC, factors such as education and practice environment must be addressed if more pharmacists are to accept this EC prescriptive authority.

Assuntos

RESUMO

Conscientious objection refers to the possibility that an individual decides not to comply with a legal mandate because of his or hers convictions, which is accepted by some political constitutions. The classical example is to refuse participation in obligatory military service for personal reasons of conscience, but in the present paper we refer to its use in medical practice utilizing three examples: euthanasia, abortion and the refusal to prescribe emergency contraception. We conclude that in all situations patients rights supersedes conscientious objection.

Assuntos

RESUMO

The use of levonorgestrel for emergency post coital contraception after rape, has raised strong and recurring discussions during 2004 and 2005 in Chile. The debate has been centered in its presumed post fertilization or anti implantation effect, that some consider an abortive action. There are no scientific evidences supporting this effect, with divergences about the ontological status of the embryo. Therefore, the use of levonorgestrel implies bioethical decisions that, in a democratic and pluralistic society, should be solved considering individual and collective responsibilities, conditions of equity and the informed autonomy of the affected women. Their moral values and their capacity to assume the consequences of an assault on their dignity, honor and self-esteem, in addition to physical and mental injuries, should also be considered.

Assuntos

RESUMO

Las píldoras anticonceptivas de emergencia (PAE) han sido usadas en Chile desde los inicio de 1960. En 2001 se inician las demandas contra el Instituto de Salud Pública (ISP) por la aprobación de las PAE con sólo Levonorgestrel, por considerarlas abortivas. No pudo salir una marca, el Postinal, pero sí se aprobó con receta médica retenida el Postinor II. El juicio continúa en la Corte Suprema. El Ministerio de Salud ha tenido determinaciones contradictorias, con lo cual las mujeres usuarias del sistema público de salud están limitadas al uso de las PAE sólo en casos de violación. Aquellas mujeres que pueden comprarlas con una receta médica, las usan en casos de un coito no protegido contra el embarazo. La información científica, con mucha participación de investigadores chilenos, no ha podido demostrar que el Levonorgestrel afecte al óvulo fecundado o a su implantación en el endometrio. La anticoncepción de emergencia se ha trasformado en un debate público como tema valórico, con desinformación tanto de la población, como de los profesionales de la Salud.

Assuntos