Guilhem Dirce, Azevedo Anamaria Ferreira
Department of Nursing, College of Health Sciences, University of Brasilia, Campus Universitário Darcy Ribeiro, Brasilia, Brazil.
Dev World Bioeth. 2007 Aug;7(2):68-77. doi: 10.1111/j.1471-8847.2007.00201.x.
This study is an ethical reflection on the formulation and application of public policies regarding reproductive health in Brazil. The Integral Assistance Program for Women's Health (PAISM) can be considered advanced for a country in development. Universal access for family planning is foreseen in the Brazilian legislation, but the services do not offer contraceptive methods for the population in a regular and consistent manner. Abortion is restricted by law to two cases: risk to the woman's life and rape. This reality favors the practice of unsafe abortion, which is the third largest cause of maternal death in Brazil. Legal abortion is regulated by the State and the procedure is performed in public health centers. However, there is resistance on the part of professionals to attend these women. Prenatal care is a priority strategy for promoting the quality of life of these women and of future generations. Nonetheless, it is still difficult for these women to access the prenatal care services and to have the required number of consultations. Moreover, managers and health professionals need to be made aware of the importance of implementing the actions indicated by the public policies in the area of sexual and reproductive health, favoring respect for autonomy in a context of personal freedom.
本研究是对巴西生殖健康公共政策的制定与应用的伦理反思。妇女健康综合援助计划(PAISM)对于一个发展中国家而言可被视为先进的。巴西立法中预见到了计划生育的普遍可及性,但这些服务并未以常规且连贯的方式为民众提供避孕方法。法律将堕胎限制在两种情况:对女性生命的风险和强奸。这一现实助长了不安全堕胎行为,而不安全堕胎是巴西孕产妇死亡的第三大原因。合法堕胎由国家监管,手术在公共卫生中心进行。然而,专业人员存在抵触为这些女性提供服务的情况。产前护理是提高这些女性及后代生活质量的优先战略。尽管如此,这些女性获取产前护理服务并进行所需次数的咨询仍很困难。此外,需要让管理人员和卫生专业人员认识到在性健康和生殖健康领域实施公共政策所指明行动的重要性,在个人自由的背景下促进对自主权的尊重。