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COVID-19 期间的医学辅助生育:对医疗保健系统组织和夫妇生殖权利有何影响?

Medically assisted procreation in times of COVID-19: what impact on health care system organization and the reproductive rights of couples?

机构信息

Department of Anatomical, Histological, Medicolegal and Orthopedic Sciences, Sapienza University of Rome, Italy.

School of Law, Marche Polytechnic University, Ancona, Italy.

出版信息

Acta Biomed. 2021 Nov 3;92(5):e2021275. doi: 10.23750/abm.v92i5.11900.

Abstract

BACKGROUND AND AIM

The emergency caused by the spread of COVID-19 has overwhelmed health care facilities and required the reorganization of health systems in many nations worldwide. A year after its appearance, measures aimed at further containing disease transmission through massive vaccination campaigns. In pregnancy, vaccination should be administered with caution, in light of the lack of reliable data, since pregnant women have been excluded from experimentation. The pandemic has had a significant impact on assisted reproduction procedures in Italy. Methods: The authors have set out to analyze the measures issued by the Italian government in order to counter the spread of COVID-19, in addition to the national and international guidelines on assisted reproduction.

DISCUSSION

The purpose of these documents is precautionary in nature: such measures are based on the principles of responsibility and solidarity, essential to stave off the saturation of health systems, curb contagion, but also to lay out a set of rules to starting a pregnancy while preserving the health of couples, operators and newborns. The authors also expound upon the rights claimed by couples seeking access to MAP (i.e. the right to become a parent, the couple's right to health, interest in demographic development). Conclusions: The coronavirus disease 2019 (COVID-19) has had a major impact on infertile couples. Since the pandemic broke out, Italy, like most European countries, has interrupted most ordinary activities of the centers operating in the field of assisted fertilization. We believe that access to assisted fertilization techniques by sterile and infertile couples should be part of the right to health rather than of the supposed right to become parents or the increase in the birth rate, also evoked as the COVID-19 pandemic unfolded. The current system of compensation and reimbursements needs to be reconfigured in order to prevent any form of discrimination.

摘要

背景与目的

COVID-19 的传播所引发的紧急情况使全球许多国家的医疗设施不堪重负,需要对卫生系统进行重组。在出现一年后,各国采取了旨在通过大规模疫苗接种活动进一步控制疾病传播的措施。鉴于缺乏可靠数据,孕妇被排除在试验之外,因此在怀孕期间接种疫苗应谨慎进行。大流行对意大利的辅助生殖程序产生了重大影响。

方法

作者旨在分析意大利政府为应对 COVID-19 传播而发布的措施,以及辅助生殖方面的国家和国际指南。

讨论

这些文件的目的是预防性质的:这些措施基于责任和团结的原则,对于避免卫生系统饱和、遏制传染以及制定一套规则来开始妊娠以保护夫妻、操作人员和新生儿的健康至关重要。作者还阐述了寻求 MAP (即成为父母的权利、夫妻的健康权利、人口发展利益)的夫妇所主张的权利。

结论

2019 年冠状病毒病(COVID-19)对不孕夫妇产生了重大影响。自疫情爆发以来,意大利与大多数欧洲国家一样,中断了辅助受精领域中心的大部分常规活动。我们认为,应将不育和不孕夫妇获得辅助生育技术的机会纳入健康权,而不是所谓的成为父母的权利或出生率的增加,因为 COVID-19 疫情的爆发。需要重新配置当前的补偿和报销系统,以防止任何形式的歧视。

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