Hastings Cent Rep. 2020 May;50(3):40-43. doi: 10.1002/hast.1130.
Common hospital and surgical center responses to the Covid-19 pandemic included curtailing "elective" procedures, which are typically determined based on implications for physical health and survival. However, in the focus solely on physical health and survival, procedures whose main benefits advance components of well-being beyond health, including self-determination, personal security, economic stability, equal respect, and creation of meaningful social relationships, have been disproportionately deprioritized. We describe how female reproduction-related procedures, including abortion, surgical sterilization, reversible contraception devices and in vitro fertilization, have been broadly categorized as "elective," a designation that fails to capture the value of these procedures or their impact on women's overall well-being. We argue that corresponding restrictions and delays of these procedures are problematically reflective of underlying structural views that marginalize women's rights and interests and therefore threaten to propagate gender injustice during the pandemic and beyond. Finally, we propose a framework for triaging reproduction-related procedures during Covid-19 that is more individualized, accounts for their significance for comprehensive well-being, and can be used to inform resumption of operations as well as subsequent restriction phases.
医院和外科中心在应对新冠疫情时的常见措施包括减少“择期”手术,这些手术通常是基于对身体健康和生存的影响来决定的。然而,在仅仅关注身体健康和生存的情况下,那些主要益处是超越健康、包括自我决定、人身安全、经济稳定、平等尊重和创造有意义的社会关系的健康相关手术,被不成比例地降低了优先级。我们描述了女性生殖相关手术,包括堕胎、手术绝育、可逆避孕措施和体外受精,这些手术被广泛归类为“择期”手术,这种分类方式未能体现这些手术的价值或它们对女性整体健康的影响。我们认为,这些手术相应的限制和延迟反映了潜在的结构性观点,这些观点边缘化了女性的权利和利益,因此有可能在疫情期间及以后传播性别不公正。最后,我们提出了一个在新冠疫情期间对生殖相关手术进行分类的框架,该框架更加个体化,考虑到了它们对全面健康的重要性,并可用于为手术的恢复以及随后的限制阶段提供信息。