Centre for Ethics in Medicine, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, BS8 2BN, United Kingdom.
Health Policy. 2020 Jul;124(7):679-683. doi: 10.1016/j.healthpol.2020.04.014. Epub 2020 May 23.
Home use of misoprostol for early medical abortion has long been an established practice in several countries. It is a safe, effective, and dignified means of obtaining a legal abortion, with a low risk of complications. In the UK, however, the practice has only recently been permitted. Prior to the change, women were required to attend a clinic to be observed taking the drug, before being discharged to go home and see through the process. The requirement to attend a clinic was a result of political rather than medical reasoning; a desire not to provoke pro-life groups. It also highlighted an inconsistency whereby misoprostol was prescribed for home use to women who had suffered an incomplete miscarriage. Failure to permit home use of misoprostol for early medical abortion has caused women to suffer trauma when experiencing the effects of the drug when returning home from clinics, in addition to acting as an obstacle to access for women living in remote areas with no nearby clinic. Through an overview of recent developments in UK abortion policy, I demonstrate the lack of good, medical reasons for the delayed change. Further, I suggest appropriate future steps to be taken by policymakers.
在家中使用米索前列醇进行早期药物流产在多个国家早已是既定做法。这是一种安全、有效且有尊严的合法堕胎手段，其并发症风险较低。然而，在英国，这种做法直到最近才被允许。在改变之前，妇女必须前往诊所观察她们服药，然后才能回家完成整个过程。之所以要求妇女到诊所，并非出于医疗原因，而是出于政治考量，即避免激怒支持生命的团体。这种情况也突显了一种不一致性，即对于经历不完全流产的妇女，米索前列醇被开为家庭使用药物，但却不允许在家中使用米索前列醇进行早期药物流产。未能允许在家中使用米索前列醇进行早期药物流产，导致妇女在从诊所返回家中时因药物的影响而遭受创伤，同时也对那些居住在没有附近诊所的偏远地区的妇女的堕胎途径造成障碍。通过对英国堕胎政策的最新发展进行概述，我表明，对于这种延迟改变，缺乏良好的医学理由。此外，我还提出了决策者应采取的适当的后续步骤。
