Sasi Aiswarya
St. John's Medical College, Bangalore, India.
Asian Bioeth Rev. 2019 Dec 4;11(4):367-376. doi: 10.1007/s41649-019-00105-2. eCollection 2019 Dec.
Late-term abortions (after 20 weeks of gestation) are an issue of immense debate in India, where the Medical Termination of Pregnancy Act, 1971 permits abortions only up to 20 weeks of gestation. In special situations, such as pregnancy arising out of rape especially in the case of minors and the late diagnosis of congenital anomalies, there are no clear guidelines on the legal protocol that is to be followed, often resulting in a lack of consistency in terms of legal decision-making, as well as undue prolongation of legal procedures. The Medical Termination of Pregnancy Act prohibits late-term abortions on the basis of personhood and viability of the foetus, to reduce sex-selective abortions and as it considers such abortions to be unsafe. However, a legal prohibition of late-term abortions does not prevent them, and this has led to a surge in the number of illegal, unsafe abortions that are detrimental to the health of women. There is also physical, mental and financial distress to women who are forced to continue their pregnancy, coupled with a lack of governmental support for the same. In comparison of India's abortion laws with Singapore's, which are more liberal, and Philippines, which are more restrictive, liberalisation of abortion laws appears to have a better outcome in reducing the incidence of unsafe abortions. This paper argues that the way forward is to liberalise the laws in terms of not only extending the gestational limit to at least 24 weeks but also making exceptions allowing no gestational limit in special cases that warrant them, such as rape victims and late foetal anomalies. The laws, drafted and implemented in consultation with medical professionals in the field, must also be lucid and not leave any room for misinterpretation by courts and health care providers.
晚期堕胎(妊娠20周后)在印度是一个极具争议的问题,1971年的《终止妊娠法》仅允许在妊娠20周内进行堕胎。在特殊情况下,例如未成年人遭受强奸导致怀孕以及先天性异常的晚期诊断,对于应遵循的法律程序没有明确的指导方针,这往往导致法律决策缺乏一致性,以及法律程序的过度延长。《终止妊娠法》基于胎儿的人格和生存能力禁止晚期堕胎,以减少性别选择性堕胎,并认为此类堕胎不安全。然而,法律禁止晚期堕胎并不能阻止这种行为,这导致非法、不安全堕胎数量激增,对妇女健康有害。被迫继续妊娠的妇女还会面临身体、心理和经济上的困扰,同时缺乏政府对此的支持。与新加坡更为宽松、菲律宾更为严格的堕胎法律相比,堕胎法律的自由化在减少不安全堕胎发生率方面似乎有更好的效果。本文认为,前进的方向是放宽法律,不仅将妊娠期限延长至至少24周,而且在特殊情况下,如强奸受害者和晚期胎儿异常等有正当理由的情况下,允许无妊娠期限限制的例外情况。与该领域医学专业人员协商起草和实施的法律也必须清晰明了,不给法院和医疗服务提供者留下任何误解的空间。