The reasons why women choose medical abortion vary in different countries. In most countries, the most common reasons for choosing medical abortion are as follows: (a) avoidance of surgery or general anesthesia; (b) perception that it is safer; and (c) perception that it is more natural than a surgical procedure. In most studies, over 80% of women who chose medical
Pak Chung Ho
Background The long-term safety of surgical abortion in the first trimester is well established. Despite the increasing use of medical abortion (abortion by means of medication), limited information is available regarding the effects of this procedure on subsequent pregnancies. Methods We identified all women living in Denmark who had undergone an abortion for non- medical reasons between 1999 and 2004
Jasveer Virk; Jun Zhang; Jørn Olsen
In a comparative study of the acceptability of medical abortion and surgical abortion among women in developing countries, patients at clinics in China, Cuba and India were allowed to choose between a surgical procedure and a medical regimen of mifepristone and misoprostol. The most common reasons women cited for choosing medical abortion were their desire to avoid surgery and general
Beverly Winikoff; Irving Sivin; Kurus J. Coyaji; Evelio Cabezas; Xiao Bilian; Gu Sujuan; Du Ming-kun; Usha R. Krishna; Andrea Eschen; Charlotte Ellertson
The prochoice movement has expressed much hope that medical abortion will increase the pool of abortion providers because it does not require surgical training and does not need to be performed in specialized settings. By offering a detailed case study of the events surrounding a methotrexate abortion in a rural community health center by a family practice physician who had not previously performed surgical abortion, this article suggests that the diffusion of medical abortion to new providers and new settings may be more complex than some have suggested. The article illustrates that abortion is not only a medical procedure, but also a social process involving relations with large, often unfriendly bureaucracies as well as with the local community in which the abortion takes place. While still retaining optimism that medical abortion will ultimately increase the number of providers and hence increase access to abortion, the author believes that such a change will be considerably more gradual than commonly thought. PMID:10846326
Background: We investigated the outcomes of women under age 21 who participated in a multi-center case series of early medical abortion using methotrexate and misoprostol.Methods: We enrolled 1973 women in a case series for medical abortion in the first seven weeks of pregnancy, using a standardized protocol and consent for methotrexate (50 mg\\/m2) and misoprostol (800 mg vaginally, repeated as
Lynn Borgatta; Amanda French; Olivera Vragovic; Michael Burnhill
... Public Health Advisory: Sepsis and Medical Abortion. ... The approved Mifeprex regimen for a medical abortion through 49 days' pregnancy is: ... More results from www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders
In 1993, President Clinton modified military policy on providing abortions at military medical facilities. Under the change, military medical facilities were allowed to perform abortions if paid for entirely by non-DOD funds (i.e., privately funded). Alth...
D. F. Burrelli
Medical abortion studies have traditionally relied on ultrasound to confirm gestational age, intrauterine location and abortion completion. However, the routine dependence on ultrasound can limit access to safe services for women living in low resource settings that are often most in need of safe abortion care. This review discusses the literature surrounding the safe provision of medical abortion without the
Bliss Kaneshiro; Alison Edelman; Robyn K. Sneeringer; Rodolfo Gomez Ponce de Leon
Women phoning to request an abortion at a free-standing abortion clinic who were less than 46 days from the last menstrual period were given a choice between a surgical abortion and a medical abortion induced with methotrexate and misoprostol. Twenty-six percent (116 of 405 women) chose a medical abortion. Younger women were more likely to choose a surgical abortion. There
Ellen R. Wiebe
Comparisons of the efficacy of different regimens of medical abortion are difficult because of the widely varying protocols (even for testing identical regimens), divergent definitions of success and failure, and lack of a standard method of analysis. In this article we review the current efficacy literature on medical abortion, highlighting some of the most important differences in the way that
James Trussell; Charlotte Ellertson
Medical abortion opens a new choice to women wishing to terminate a pregnancy. Increasingly, providers in the developing and developed world will begin to offer this option. Yet, the nomenclature and concepts used for measuring failure of surgical abortion are not directly adaptable because of important differences inherent in the method and in the way it is offered in a
Beverly Winikoff; Charlotte Ellertson; Shelley Clark
Medical abortion offers a new option to women seeking to terminate their pregnancies. In particular, the mifepristone-misoprostol regimen consists of simple pills, and is potentially suitable for self-administration. Yet access to and administration of this method of abortion remains tightly controlled. Is this strict control medically necessary? This paper identifies the seven steps women would need to accomplish in order
Charlotte Ellertson; Batya Elul; Beverly Winikoff
In 1993, President Clinton modified the military policy on providing abortions at military medical facilities. Under the change directed by the President, military medical facilities were allowed to perform abortions if paid for entirely with non-Departme...
D. F. Burrelli
Medical termination of pregnancy with mifepristone, a progesterone antagonist, is available to women in North America, the United Kingdom, much of Western Europe, Russia, China, Israel, New Zealand, Turkey and Tunisia, but not Australia. • Experience of mifepristone use in around two million abortions has shown that it is safe, effective, cheap to produce, and highly acceptable to women. •
Caroline M De Costa
The National Hospital Discharge Survey records for medical-legal, spontaneous, and "other" abortions (ICDA-8 640-641, 643, and 644 respectively) for 1970-1977 were analyzed to investigate the impact of liberalized access to abortion on abortion-related morbidity in the United States. The analysis suggests that in census regions where an increase in medical-legal abortions performed in hospitals occurred over the study period there was an associated decreased likelihood of a "spontaneous" or "other" abortion. The spontaneous and "other" abortion codes appear to have been used synonymously and a small number of each used to classify complications of both illegal and legal abortions performed outside hospitals. There was a significant reduction in length of stay for spontaneous and other abortions between 1970 and 1977. This is suggestive of decreasing severe presenting symptomatology for complicated abortion. The study further suggests that: during 1970-77 illegal abortions were largely replaced by legal procedures; increases in legal abortions beyond those replacing illegal have not resulted in increased rates of hospitalization for complicated abortion; and, the case morbidity rate for legal abortion appears to have declined.
Bracken, M B; Freeman, D H; Hellenbrand, K
Background Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students’ attitudes toward abortion education and presents a case for including abortion education in medical schools. Methods and Results A survey on knowledge of and attitudes toward abortion among medical students was conducted in two public universities and a private university in Malaysia in 2011. A total of 1,060 students returned the completed questionnaires. The survey covered about 90% of medical students in Years 1, 3, and 5 in the three universities. About 90% of the students wanted more training on the general knowledge and legal aspects of abortion, and pre-and post-abortion counseling. Overall, 75.9% and 81.0% of the students were in favor of including in medical education the training on surgical abortion techniques and medical abortion, respectively. Only 2.4% and 1.7% were opposed to the inclusion of training of these two methods in the curriculum. The remaining respondents were neutral in their stand. Desire for more abortion education was associated with students’ pro-choice index, their intention to provide abortion services in future practice, and year of study. However, students’ attitudes toward abortion were not significantly associated with gender, type of university, or ethnicity. Conclusions Most students wanted more training on abortion. Some students also expressed their intention to provide abortion counseling and services in their future practice. Their desire for more training on abortion should be taken into account in the new curriculum. Abortion education is an important step towards making available safe abortion services to enable women to exercise their reproductive rights.
Tey, Nai-peng; Yew, Siew-yong; Low, Wah-yun; Su'ut, Lela; Renjhen, Prachi; Huang, M. S. L.; Tong, Wen-ting; Lai, Siow-li
Abortion is legally restricted in most of Latin America where 95% of the 4.4 million abortions performed annually are unsafe. Medical abortion (MA) refers to the use of a drug or a combination of drugs to terminate pregnancy. Mifepristone followed by misoprostol is the most effective and recommended regime. In settings where mifepristone is not available, misoprostol alone is used.Medical abortion has radically changed abortion practices worldwide, and particularly in legally restricted contexts. In Latin America women have been using misoprostol for self-induced home abortions for over two decades.This article summarizes the findings of a literature review on women's experiences with medical abortion in Latin American countries where voluntary abortion is illegal.Women's personal experiences with medical abortion are diverse and vary according to context, age, reproductive history, social and educational level, knowledge about medical abortion, and the physical, emotional, and social circumstances linked to the pregnancy. But most importantly, experiences are determined by whether or not women have the chance to access: 1) a medically supervised abortion in a clandestine clinic or 2) complete and accurate information on medical abortion. Other key factors are access to economic resources and emotional support.Women value the safety and effectiveness of MA as well as the privacy that it allows and the possibility of having their partner, a friend or a person of their choice nearby during the process. Women perceive MA as less painful, easier, safer, more practical, less expensive, more natural and less traumatic than other abortion methods. The fact that it is self-induced and that it avoids surgery are also pointed out as advantages. Main disadvantages identified by women are that MA is painful and takes time to complete. Other negatively evaluated aspects have to do with side effects, prolonged bleeding, the possibility that it might not be effective, and the fact that some women eventually need to seek medical care at a hospital where they might be sanctioned for having an abortion and even reported to the police. PMID:23259660
Zamberlin, Nina; Romero, Mariana; Ramos, Silvina
The right to health under the International Covenant on Economic, Social, and Cultural Rights, to which Canada is a signatory, entitles women to available, accessible, and acceptable abortion care. Abortion care in Canada currently fails this standard. Medication abortion (the use of drugs to terminate a pregnancy) could improve abortion care in Canada, but its potential remains unrealized. This is in part attributable to the unavailability of mifepristone, the safest and most effective pharmaceutical for medication abortion. Given that it could improve abortion care, we investigated why mifepristone remains unapproved in Canada, whether its unavailability is attributable to government inaction, and whether Canada is therefore failing to fulfill its obligations under the right to health.
Grenon, Amy; Harrison-Wilson, Leigh
Objective: To evaluate the safety and efficacy of intravaginal misoprostol for medical evacuation of first trimester missed abortions.Methods: Seven women with a transvaginal ultrasound diagnosis of a first trimester missed abortion were treated with 800 ?g of misoprostol. Four 200 ?g misoprostol tablets were placed intravaginally, and a repeat dose of 800 ?g was repeated if products of conception were
Mark Wakabayashi; Mark Tretiak; Thomas Kosasa; Santosh Sharma; Tod Aeby; Lori Kamemoto; Leticia Diniega
Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants: Female patients presenting for medication abortion at a student health care
Emily M. Godfrey; Anita Bordoloi; Mydhili Moorthie; Emily Pela
Objective: To compare the efficacy of two routes of misoprostol administration (oral and vaginal) for treatment of missed abortion. Methods: Two hundred women with confirmed missed abortion received 800 mcg misoprostol either orally or vaginally. All women returned for follow-up care 2 days later. If the pregnancy was not completely evacuated at this time, women could wait an additional 5
N. T. N. Ngoc; J. Blum; E. Westheimer; T. T. V. Quan; B. Winikoff
... Public Health Advisory: Sepsis and medical abortion with mifepristone (Mifeprex). 3/17/2006. The Food and Drug Administration ... More results from www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders
Nigeria has restrictive abortion laws; unsafe abortion and its complications are major public health challenges. Access to reproductive health services in Nigeria, including medical abortion, is poor. We determined the socio-demographic characteristics, patterns of abortion practices, and experiences of medical abortions among abortion seekers in southeastern Nigeria. We carried out a descriptive, cross sectional survey of 100 consecutive medical abortion seekers in southeastern Nigeria. Subjects had a mean age of 23.5 + 4.4 years. Fifty-five percent of respondents were students. Sixty-four percent had a secondary educational level, 33% had a tertiary education level and 3% had a primary educational level. Fifty-eight percent of subjects were ages 18-20 years at coitarche; 25% had one or more previous deliveries and 49% had a previous termination of pregnancy. Forty-eight percent had used drugs for pregnancy terminations. Drugs used for termination included quinine combined with other drugs in 8%; gynaecosid alone in 6%, gynaecosid combined with other drugs in 6% menstrogen combined with other drugs in 6% and an unclassified drug in 14%. Thirty-three percent of subjects purchased their abortion drugs in a pharmacy. Three percent, 2%, and 0% of subjects had a knowledge of misoprostol, mifepristone and methotrexate, respectively. One percent of respondents had used misoprostol. We detected serious information gaps regarding abortion and poor access to reproductive health services. There is a need for policies and program to bridge this gap, and a need for revision of the present Nigerian abortion law. PMID:23082598
Adinma, Echendu Dolly; Adinma, Joseph Ifeanyi Brian-D; Iwuoha, Chima; Akiode, Akinsewa; Oji, Ejike; Okoh, Matthew
Medical tourism in Ireland, like in many Western states, is built around assumptions about individual agency, choice, possibility, and mobility. One specific form of medical tourism—the flow of women from Ireland traveling in order to secure an abortion—disrupts and contradicts these assumptions. One legacy of the bitter, contentious political and legal battles surrounding abortion in Ireland in the 1980s and 1990s has been securing the right of mobility for all pregnant Irish citizens to cross international borders to secure an abortion. However, these mobility rights are contingent upon nationality, social class, and race, and they have enabled successive Irish governments to avoid any responsibility for providing safe, legal, and affordable abortion services in Ireland. Nearly twenty years after the X case discussed here, the pregnant female body moving over international borders—entering and leaving the state—is still interpreted as problematic and threatening to the Irish state. PMID:21114071
Gilmartin, Mary; White, Allen
OBJECTIVE:To estimate the efficacy of vaginal misoprostol for medical management of missed abortion.METHODS:Fifty women with missed abortion were randomized to treatment with up to two 800-mg doses of misoprostol vaginally or a placebo. Participants were reviewed daily for 2 days, then again at 1 week. A blood sample for hemoglobin and serum ?-human chorionic gonadotropin (?hCG) was obtained on day
S. L Wood; P. H Brain
Background and methodologySouth Africa's Choice on Termination of Pregnancy Act of 1996 provides for safe termination of pregnancy (TOP) in designated facilities in the public and private health sectors. In 2001, mifepristone-misoprostol medical abortion was approved for TOP up to 56 days, but this method is not yet available in the public sector. Information on the operational requirements for integrating
Mary Kawonga; Kelly Blanchard; Diane Cooper; Lee Cullingworth; Teresa Harrison; Kim Dickson; Claire von Mollendorf; Beverly Winikoff
|Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants:…
Godfrey, Emily M.; Bordoloi, Anita; Moorthie, Mydhili; Pela, Emily
Objective To describe medical abortion (MA) practices among private providers in Vietnam. Methods The study subjects were women (n = 258) undergoing early MA through 12 private providers in Hanoi during February–June 2012. The women were interviewed on the day of their procedure and were followed up by telephone 14 days after mifepristone administration. Results Of the 258 women in the study, 97% used a regimen of mifepristone plus misoprostol; 80% were instructed to administer misoprostol at home. MA resulted in a complete termination in 90.8% of cases. All women were provided with information on potential complications and were instructed to return for a follow-up visit. We successfully followed up 77.5% (n = 200) of participants by telephone, while nearly two-thirds of women returned to the clinic for a follow-up visit. At follow-up, 39.5% of women reported having used a Help line service, while 7% had sought help from a health provider. A high unmet need for postabortion family planning was identified. Conclusion Follow-up of women, postabortion care, and the provision of family planning have been identified as important areas to address for strengthening MA services in the private sector in Vietnam.
Park, Min Hae; Nguyen, Thang Huu; Dang, Anh Thi Ngoc; Ngo, Thoai Dinh
A combination of the anti-progesterone mifepristone and gemeprost provides an effective non-surgical method for the induction of abortion at gestations up to 63 days, achieving complete abortion rates of over 95%. We report our experience with an alternate regimen, comprising a reduced dose of mifepristone in combination with vaginal misoprostol. A consecutive series of 2000 women requesting early medical abortion
P. W. Ashok; G. C. Penney; G. M. M. Flett; A. Templeton
This study examined the knowledge, attitude and practice of private medical practitioners in Calabar on abortion, post- abortion care and post-abortion family planning. Forty eight private practitioners who were proprietors of private clinics in the city were interviewed using a structured questionnaire. The results showed that 22.9% of the doctors routinely terminate unwanted pregnancies when requested to do so by
SJ Etuk; FE Okonofua
|Surveys of first- and fourth-year Johns Hopkins University (Maryland) medical students found little change in attitudes about abortion over four years. Attitudes correlated most strongly with personal beliefs about when a fetus is considered human life and somewhat with student gender. Results are used in a medical ethics course to illuminate…
Dans, Peter E.
Globally, abortion mortality constitutes at least 13% of maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing abortion mortality and morbidity in countries where they remain high is a matter of good public health policy, based on good medical practice, and an important part of initiatives
BackgroundUnsafe abortion is estimated to account for 13% of maternal mortality globally. Medical abortion is a safe alternative.MethodsBy estimating mortality risks for unsafe and medical abortion and childbirth for Tanzania and Ethiopia, we modelled changes in maternal mortality that are achievable if unsafe abortion were replaced by medical abortion. We selected Ethiopia and Tanzania because of their high maternal mortality
Rebecca F. Baggaley; Joanna Burgin; Oona M. R. Campbell
OBJECTIVES--To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester. DESIGN--Patient centred, partially randomised trial. Medical abortion was performed with mifepristone 600 mg followed 48 hours later by gemeprost 1 mg vaginal pessary. Vacuum aspiration was performed under general anaesthesia. SETTING--Teaching hospital in Scotland. PATIENTS--363 women undergoing legal induced abortion at
R C Henshaw; S A Naji; I T Russell; A A Templeton
BackgroundFrom 2001 to March 2006, Planned Parenthood Federation of America (Planned Parenthood) health centers throughout the United States provided medical abortions principally by a regimen of oral mifepristone, followed 24–48 h later by vaginal misoprostol. In late March 2006, analyses of serious uterine infections following medical abortions led Planned Parenthood to change the route of misoprostol administration and to employ
Mary Fjerstad; Irving Sivin; E. Steve Lichtenberg; James Trussell; Kelly Cleland; Vanessa Cullins
OBJECTIVE: We investigated safety, efficacy, and acceptability of an oral regimen of medical abortion compared with surgical abortion in three developing countries.STUDY DESIGN: Women (n = 1373) with amenorrhea ?56 days chose either surgical abortion (as provided routinely) or 600 mg of mifepristone followed after 48 hours by 400 ?g of misoprostol. This is the appropriate design for studying safety,
Beverly Winikoff; Irving Sivin; Kurus J. Coyaji; Evelio Cabezas; Xiao Bilian; Gu Sujuan; Du Ming-kun; Usha R. Krishna; Andrea Eschen; Charlotte Ellertson
|The purpose of the manual is to provide the medical assisting student a text which presents the common laboratory procedures in use today in physician's offices. The procedures for performing a complete urinalysis are outlined, along with those for carrying out various hematological tests. Information is also presented to help the student learn…
The purpose of the manual is to provide the medical assisting student a text which presents the common laboratory procedures in use today in physician's offices. The procedures for performing a complete urinalysis are outlined, along with those for carrying out various hematological tests. Information is also presented to help the student learn to…
The present study was done to compare the safety and efficacy of misoprostol administered orally and vaginally for medical management of first trimester missed abortion. 100 women with diagnosed missed abortion were taken for this prospective study. Group A comprised of 50 women who were given oral misoprostol and another 50 in-group B were administered vaginal misoprostol. Clinical outcome, time
Shashi Gupta; Surender Kumar
A survey of 405 abortion clinic patients identified confusion regarding the purpose of RU 486 and lack of commitment to required follow-up visits, suggesting a need for widespread educational efforts. PMID:10340020
Virgo, K S; Carr, T R; Hile, A; Virgo, J M; Sullivan, G M; Kaikati, J G
Objective: To determine whether management of incomplete first-trimester abortion with vaginal misoprostol in an under-resourced setting is a viable treatment option. Methods: A total of 94 women were randomized to 600 ?g of misoprostol intravaginally or to surgical curettage. The women receiving misoprostol were administered a second dose if the abortion was incomplete; and if still not complete after a
S. Moodliar; J. S. Bagratee; J. Moodley
According to this study based on survey data, little overt discrimination exists in medical admissions policy on the basis of applicants' personal or professional attitudes toward abortion and sterilization. Mandated by Congress to investigate charges of ...
Since the founding of family medicine, family phy- sicians have repeatedly defended its scope of prac- tice. The right to provide maternity care, colonos- copy, and surgical procedures has been disputed and defended in many forums. Medication abor- tion, an office-based service that many family phy- sicians would like to offer to women with unin- tended pregnancies, is a new
Linda W. Prine; Ruth Lesnewski
We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedicalisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in-depth interview guide. While women appreciated the non-invasiveness of medical
B. Ganatra; S. Kalyanwala; B. Elul; K. Coyaji; S. Tewari
Background:Abortion policy varies significantly between Northern Ireland and Norway. This is the first study to compare medical students’ attitudes towards abortion in two different countries.Objective:To assess medical students’ attitudes to abortion at the University of Oslo (UiO) and Queen’s University Belfast (QUB).Design:An anonymous questionnaire completed by 59 medical students at UiO and 86 medical students at QUB.Participants:Students who had completed
Many women are unprepared to make prenatal decisions about fetuses diagnosed with Down Syndrome because of societal pressures to have "normal" children, a negative view of persons with disabilities by many in society, a fear of legal liability by those in the medical community, the lack of genuine informed consent before undergoing genetic testing and abortion, and the failure of non-directive pre-abortion counseling in the medical community. Moreover, medical professionals fail to communicate correct and unbiased information before and during the genetic screening, diagnostic testing, and abortion decision-making process. This article addresses the contributing factors and causes that ultimately lead to a lack of informed consent and a very high abortion rate for fetuses diagnosed with Down Syndrome. PMID:18771038
Dixon, Darrin P
Abortion is a social problem and criminal sanctions are very ineffective in limiting it and are seldom applied (133 legal actions vs. 65,600 cases of induced abortion in 1965). Abortion is a social disease, as are prostitution, juvenile delinquency, drug abuse, and so far has been an insoluble problem. Colombian laws should be modified to reflect reality. Sex education must be emphasized, because ignorance is one of the main causes of abortion. Leniency should be applied toward women who cooperate with the authorities in identifying the person who performed an abortion. Legalization of abortion and enforcement of strict laws against it are considered as possible solutions, but both are rejected. The former is regarded as morally unacceptable and as imposing an excessive burden on scarce health services, the latter as even worse, imposing an equivalent burden on the court system, without s olving either health or social problems. The best and probably only solution is to improve education in family planning, to promote knowledge and motivation to enable the population to make sound and responsible decisions. PMID:4804875
Umaña, A O
We explored women's perspectives on using medical abortion, including their reasons for selecting the method, their experiences with it and their thoughts regarding demedica- lisation of part or all of the process. Sixty-three women from two urban clinics in India were interviewed within four weeks of abortion completion using a semi-structured in- depth interview guide. While women appreciated the non-invasiveness
B. Ganatra; S. Kalyanwalab; B. Elul; S. Tewarie
Abortion surfaced as a community problem when, following the passage of the 1967 Abortion Act in England and the subsequent rapid rise in medically induced abortion, a few doctors and a group of lay people in Auckland founded the Society for the Protection of the Unborn Child. Soon after this the opposition formed the Abortion Law Reform Association whose aims came to be vocalized by women's liberation groups like Women's Electoral Lobby and WONAAC. As in other countries, the media gave the proabortion movement a good boost and the medical profession did little to discourage it. A bold and significant move was made by the abortion promoters when they established a clinic in Remuera to carry out abortion in Auckland. There was a reaction and eventually (September 1974) a police raid and a court case based on a dozen cases that looked like infringements of the law. Dr. Woolnough, principal operator, was tried but the jury failed to agree. On a retrail he was acquitted. In August 1974 Dr. Gerard Wall introduced a private member's bill aimed at restricting therapeutic abortion to public hospitals. The bill was amended so that duly licensed institutions other than public hospitals were also acceptable for abortion procedures. The Remuera clinic which had ceased working when the provision of the Wall bill became operative transferred its operations to the Aotea Clinic in Epsom which had applied for and obtained a license. The following year the late Air Commodore Frank Gill introduced another bill (August 1976) aimed at changing the situation back toward Wall's position, i.e., restricting induced abortion to public hospitals. In December 1977 a law called the Contraception, Sterilization and Abortion Act was passed, which in essence allowed abortion where it seemed that the mother's life or mental or physical health would be seriously endangered, where the mother was very young or somewhat old, where the child was conceived of incest. Abortion figures raise the question of what has changed to make induced abortions increase markedly in Wellington and in the country. The 1st paradox of abortion is that the more science, the more technical advance, the more clinical skills, yet more induced abortions. There are other paradoxical aspects like the continued surfacing of mental health as a reason for induced abortion when so much psychiatric literature indicates that there are no neurotic or psychotic conditions for which abortion is beneficial. Whether or not the law has been subject to abuse, there has been a change in the handling of abortion by doctors. PMID:6578442
Bergin, J D
BackgroundBecause of religious beliefs against contraception and abortion, family planning education is limited at faith-based institutions. The purpose of this study was to assess medical students' satisfaction with family planning education at a faith-based medical school.
Maryam Guiahi; Karla Maguire; Zachary T. Ripp; Rachel W. Goodman; Kimberly Kenton
The objective of the present study was to develop an algorithm for the forensic medical assessment of the origin of the missed early post-traumatic abortions. The analysis of the available data on the main variants of traumatic pregnancy interruption was carried out. Diagnostic features of the missed early post-traumatic abortions are considered along with the possible errors in the use of the current approaches to forensic medical assessment of their origin. The proposed algorithm for the forensic medical assessment of the origin of the missed early post-traumatic abortions takes into consideration the specific features of the objects of interest and includes the analysis of the results of ultrasonic studies of the uterine cavity and histological investigations of the scraps of endometrial tissue. Absolute and probabilistic criteria for spontaneous and traumatic origin of the missed early post-traumatic abortions. The proposed algorithm is recommended for the use in routine clinical practice for the elucidation of the causes of the missed early post-traumatic abortions. PMID:23789405
Nedugov, G V
Abstract Objective To compare medical abortion practised at home and in clinics in terms of effectiveness, safety and acceptability. Methods A systematic search for randomized controlled trials and prospective cohort studies comparing home-based and clinic-based medical abortion was conducted. The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE and Popline were searched. Failure to abort completely, side-effects and acceptability were the main outcomes of interest. Odds ratios and their 95% confidence intervals (CIs) were calculated. Estimates were pooled using a random-effects model. Findings Nine studies met the inclusion criteria (n?=?4522 participants). All were prospective cohort studies that used mifepristone and misoprostol to induce abortion. Complete abortion was achieved by 86–97% of the women who underwent home-based abortion (n?=?3478) and by 80–99% of those who underwent clinic-based abortion (n?=?1044). Pooled analyses from all studies revealed no difference in complete abortion rates between groups (odds ratio?=?0.8; 95% CI: 0.5–1.5). Serious complications from abortion were rare. Pain and vomiting lasted 0.3 days longer among women who took misoprostol at home rather than in clinic. Women who chose home-based medical abortion were more likely to be satisfied, to choose the method again and to recommend it to a friend than women who opted for medical abortion in a clinic. Conclusion Home-based abortion is safe under the conditions in place in the included studies. Prospective cohort studies have shown no differences in effectiveness or acceptability between home-based and clinic-based medical abortion across countries.
Park, Min Hae; Shakur, Haleema; Free, Caroline
Alarm over the prospect that prenatal diagnostic techniques, which permit identification of fetal sex and facilitate abortion of healthy but unwanted female fetuses has led some to urge their outright prohibition. This article argues against that response. Prenatal diagnosis permits timely action to preserve and enhance the life and health of fetuses otherwise endangered, and, by offering assurance of fetal normality, may often encourage continuation of pregnancies otherwise vulnerable to termination. Further, conditions in some societies may sometimes render excusable the inclination to abort certain healthy female fetuses. In places where abortion for fetal sex alone is recognised as unethical, however, medical licensing authorities already possess the power to discipline, for professional misconduct, physicians who prescribe or perform prenatal diagnosis purely to identify fetal sex, or those who disclose fetal sex when that is unrelated to the fetus's medical condition.
Dickens, B M
Despite the lessening of federal restraints to abortion providers and the fact that the US Supreme Court has not overthrown Roe vs. Wade, access to abortion still remains a problem for women because there are not enough providers, especially in rural areas where the number dropped 51% from 1977 to 1988. A 1985 survey showed that only 34% of gynecologists perform abortions, with two-thirds doing no more than 4/month. Yet, 84% said abortion was necessary in some cases, and only 13% said it should never be done. These percentages have not changed since a survey 14 years earlier, but the number of disincentives to performing abortions, including harassment by anti-abortion forces, has grown. Also, financial renumeration has increased little in 2 decades, and younger physicians are not inspired by memories of the damage caused by illegal abortionists. Physicians who begin to perform abortions immediately after their residencies are not benefitting from as much training as was given in the past, despite the fact that studies show that residents have higher complication rates than experienced physicians and that proper training reduces complications. One explanation for the failure of residency programs to include abortion training is the fact that 90% of abortions occur in free-standing clinics rather than in hospitals. If abortion training is offered at all, it is usually offered as an elective, not part of a required rotation. There are some residency programs, however, which offer exemplary training in abortion, many at their own clinics. In these cases, residents rotate through the abortion training in their second or third year, with exemptions for those with moral objections. Abortion issues should also be covered in the public health, reproductive medicine, or ethics courses of medical schools; in fact, long before the students see abortions performed. The training programs which are failing to train gynecologic specialists are also ignoring medical generalists. In addition, abortion is rarely included in postgraduate refresher or continuing education courses. The shortage of physicians willing to provide abortions has raised the possibility of nurse-practitioners, physician's assistants, or even lay persons being trained to provide abortions. However, in some areas, paramedical personnel are in greater demand than physicians. In addition, they may not be able to obtain the necessary insurance and state laws would have to be changed to allow them to perform this procedure. Of course, the same disincentives that exist for physicians would exist for them. The solution to this problem lies in providing abortion education to all health care professionals and in making abortion training readily available to all interested physicians. Laws governing harassment and violence should be enforced, and compensation should be comparable to that of other medical procedures. PMID:8274871
Darney, P D
In October 2010 the District Court sitting in Cairns, Queensland, found Tegan Leach not guilty of attempting to procure her own abortion and Sergie Brennan not guilty of supplying Leach with the drugs Mifepristone and Misoprostol to procure an abortion. Brennan obtained the drugs from his sister in the Ukraine through the regular postal system. R v Brennan and Leach was the first case in Queensland's history where a woman was charged with procuring her own abortion. The drugs are accepted by the medical profession worldwide for medical abortions. A prosecution witness gave evidence that Mifepristone is not harmful or injurious to the health of a woman and it is listed as an essential medicine by the World Health Organisation and approved for use by the Australian Therapeutic Goods Administration. The jury found the defendants not guilty because they were not satisfied beyond reasonable doubt that the combination of the drugs Mifepristone and Misoprostol was a "noxious" substance under the Criminal Code (Old). This article concludes that there is no regulatory miracle which will stop the traffic of Mifepristone and Misoprostol into Australia and therefore an intelligent regulatory response is required which would make it unnecessary for women to seek Mifepristone and Misoprostol from overseas networks and the internet. Among other things, this would include the repeal of confusing, inappropriate and ineffective abortion laws. PMID:21528743
Though the law in India has permitted medical termination of pregnancy on broad legal grounds for over two decades, unsafe abortions carried out by unqualified providers show no signs of decreasing. A community-based study was undertaken in rural South India to determine the prevalence of induced abortion, women's reasons for seeking abortion, who was providing abortions and whether the procedures
Prathibha Varkey; Padma Priya Balakrishna; Jasmine Helan Prasad; Sulochana Abraham; Abraham Joseph
From November 2000 to July 2001, 321 consenting women were enrolled at four sites across the country in an effort to demonstrate that mifepristone medical abortion could safely be used by providers throughout Tunisia. Women who met the study's inclusion criteria were given 200 mg oral mifepristone and offered the choice of taking 400 ?g oral misoprostol 2 days later
Selma Hajri; Jennifer Blum; Nabiha Gueddana; Habib Saadi; Leila Maazoun; Hela Chélli; Rasha Dabash; Beverly Winikoff
Objectives:There is currently no consensus on how success should be defined after medical management of first-trimester missed abortion. The aim of this study was to determine the transvaginal ultrasound criterion associated with highest success rate and, at the same time, lowest long-term complications.
A. Reynolds; D. Ayres-de-Campos; M. A. Costa; N. Montenegro
Background Increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, which is achieved by increasing safe choices for pregnancy termination. Medical abortion for termination of early abortion is said to safe, effective, and acceptable to women in several countries. In Ethiopia, however, medical methods have, until recently, never been used. For this reason it is important to assess women's preferences and the acceptability of medical abortion and manual vacuum aspiration (MVA) in the early first trimester pregnancy termination and factors affecting acceptability of medical and MVA abortion services. Methods A prospective study was conducted in two hospitals and two clinics from March 2009 to November 2009. The study population consisted of 414 subjects over the age of 18 with intrauterine pregnancies of up to 63 days' estimated gestation. Of these 251 subjects received mifepristone and misoprostol and 159 subjects received MVA. Questionnaires regarding expectations and experiences were administered before the abortion and at the 2-week follow-up visit. Results The study groups were similar with respect to age, marital status, educational status, religion and ethnicity. Their mean age was about 23, majority in both group completed secondary education and about half were married. Place of residence and duration of pregnancy were associated with method choice. Subjects undergoing medical abortions reported significantly greater satisfaction than those undergoing surgical abortions (91.2% vs 82.4%; P < .001). Of those women who had medical abortion, (83.3%) would choose the method again if needed, and (77.4%) of those who had MVA would also choose the method again. Ninety four percent of women who had medical abortion and 86.8% of those who had MVA would recommend the method to their friends. Conclusions Women receiving medical abortion were more satisfied with their method and more likely to choose the same method again than were subjects undergoing surgical abortion. We conclude that medical abortion can be used widely as an alternative method for early pregnancy termination.
In major health facilities in Vietnam, many patients wait for an abortion while few patients are in family planning consultation rooms. The abortion procedure takes no more than 2 minutes/ patient. Anesthesia is rarely used. In the north, the predominant abortion method for first trimester abortions is dilatation and curettage (D&C) while, in the south, it is vacuum aspiration. For second trimester abortions, the methods from which to choose are D&C or saline solution. After the abortion, the patients rests for 30 minutes before returning home, often by bicycle or moped. Adolescent pregnancies are rare in Vietnam because of strict rules on premarital sex. At a clinic in Hanoi, only 7% of all abortions involve adolescents. Abortion is a fertility control method in Vietnam. The abortion rate is 2-4 abortions/live birth. 50% of the population of reproductive age use no contraception. 33% use IUDs. The 1992 total fertility rate was 3.2. While waiting for an abortion, women are suppose to receive counseling on contraception, but that is not the case. Clinics do not always have adequate equipment or antiseptics to perform abortions. They perform 30-50 abortions/2 hour sessions. During this time, sterilization of instruments is supposed to occur, which leaves little time for counseling. Abortions are performed the same day as requested. Women have no opportunity to discuss them with their husband or to obtain family consent. About 90% of women know at least 1 modern family planning method. About 50% of them have ever used a modern method. Most family planning practitioners are women (80% of physicians and all nurses and midwives). One week of formal training for midwives covers family planning. Midwives and general practitioners are authorized to perform menstrual regulation and to insert and remove IUDs. Medical students are required to work in an obstetrics/gynecology department for 20 weeks. PMID:12222254
Clinical language applied to early pregnancy loss changed in late twentieth century Britain when doctors consciously began using the term 'miscarriage' instead of 'abortion' to refer to this subject. Medical professionals at the time and since have claimed this change as an intuitive empathic response to women's experiences. However, a reading of medical journals and textbooks from the era reveals how the change in clinical language reflected legal, technological, professional and social developments. The shift in language is better understood in the context of these historical developments, rather than as the consequence of more empathic medical care for women who experience miscarriage. PMID:23429567
In the first 18 months since mifepristone was approved by the Food and Drug Administration (FDA) for use with misoprostol for early medical abortion, approximately 80,000 women have been treated. One-hundred thirty-nine adverse events were reported to Danco Laboratories LLC and subsequently reported to the FDA. Thirteen patients required blood transfusions, 10 patients were treated with antibiotics for infection and
Abstract Background Medical abortion in women with the scar of a classical caesarean section (CS) and a large uterine leiomyoma is rarely attempted; it carries the risk of uterine rupture and haemorrhage. Case A 34-year-old multiparous woman with prior classical CS and a 14 × 10 × 9 cm leiomyoma arising from the uterine isthmus had an induced abortion at 14 weeks' gestation. Mechanical cervical priming with Dilapan(®)-S followed by vaginal misoprostol administration resulted in the uncomplicated expulsion of the uterine contents. Conclusions An early second trimester medical abortion with misoprostol was successfully performed in a woman with prior classical CS and a large uterine leiomyoma. PMID:23692523
Seto, Mimi T Y; Ngu, Siew-Fei; Cheung, Vincent Y T; Pun, Ting-Chung
National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred
R. J. Cook; J. N. Erdman; B. M. Dickens
Purpose The aim of this study was to determine the impact of repeated first trimester mifepristone-induced medical abortions on the\\u000a risk of preterm birth in a subsequent pregnancy.\\u000a \\u000a \\u000a \\u000a \\u000a Methods This is a pregnancy-based cohort study. Clinical data were collected from seven public hospitals in Chengdu, China from January\\u000a 2006 to December 2009. Pregnant women with one or more first trimester mifepristone-induced medical
Hua Liao; Qiang Wei; Lijun Duan; Junli Ge; Yuanyang Zhou; Weiyue Zeng
National politics in the US, Poland, and Ireland have in recent years been afire with debate over abortion. Conflicting abortion laws almost scuttled the reunification of Germany. This paper describes how the abortion debate took hold in post-Communist Poland and how the issue came to be so entrenched in US politics in the wake of the US Supreme Court's 1973 decision on abortion in the case of Roe vs. Wade. It focuses upon abortion mainly as a method of birth control which women have always sought when needed regardless of the procedure's legal status. The controversies and campaigns recorded and the ideas offered focus upon women's access to affordable, safe, and legal abortion. The author argues that Poland is no place to be a woman and presents sections on the country's church, government, and medical profession; Roe vs. Wade; who opposes abortion rights and their broad success; the 1992 US presidential election; Bill Clinton's presidency; why the abortion debate has been different in Britain; and new issues on abortion. PMID:12290677
BackgroundThe FDA approval of mifepristone in 2000 broadened the available options for abortion. The aim of this study was to evaluate whether physicians in New Mexico have integrated the use of mifepristone into their practice.
Eve Espey; Larry Leeman; Tony Ogburn; Betty Skipper; Candace Eyman; Mariah North
In 1991, the abortion literature was characterized by articles relating to 1) epidemiologic issues in abortion care, 2) advances in knowledge and experience with medical abortifacients such as mifepristone (RU 486), and 3) cervical ripening prior to abortion with the use of both mifepristone and prostaglandins. Technical methods of achieving termination of pregnancy continue to be similar in the United States, the United Kingdom, and Europe, although induction-abortion times are generally slower in Europe than in the United States. Surgically, dilatation and evacuation procedures continue to be more common in the United States than in other countries. The effectiveness of mifepristone is undisputed, and the recommended dose for early first-trimester termination is being compared with lower dose alternative regimens. There is additional evidence that at least in the short term, the negative psychological sequelae of abortion are infrequent and are inconsequential as a public health issue. PMID:1504270
Blumenthal, P D
A proposal is presented for a Community College of Philadelphia course, entitled "Medical Office Laboratory Procedures," which provides a laboratory introduction to microscopic and chemical analysis of blood and urine as performed in the physician's office. Following a standard cover form, a statement of the purpose of the course discusses course…
|A proposal is presented for a Community College of Philadelphia course, entitled "Medical Office Laboratory Procedures," which provides a laboratory introduction to microscopic and chemical analysis of blood and urine as performed in the physician's office. Following a standard cover form, a statement of the purpose of the course discusses course…
A questionnaire-based study was undertaken to assess women's satisfaction with the home medical abortion service. Over a 15-month period, questionnaires were conducted at 24 h and 2 weeks following the procedure. A total of 127 women took part in the study and filled in a questionnaire at 24 h, with 77 completing the questionnaire at 2 weeks. At 24 h, over 95% of women who responded, agreed or strongly agreed that they felt prepared for the pain and bleeding that they experienced at home. At 2 weeks, 97.3% of respondents felt that they had had enough information and knew what to expect, and were therefore satisfied with the procedure. Only 15% of women were lost to clinical follow-up at 2 weeks. The majority of women are satisfied with the home medical abortion service. These high satisfaction rates are maintained at 2 weeks. Telephone follow-up 2 weeks after the abortion was safe and effective. PMID:23919859
McKay, R J; Rutherford, L
During the 1960s, there were important medical debates in Buenos Aires about the effects of the birth control pill on women's health and about its political, demographic and moral consequences. Other issues addressed by healthcare professionals in the Buenos Aires Society of Obstetrics and Gynaecology were abortion and changes in gender relations and sexual behaviours. These discussions are analyzed in this article, taking account of the specific national and international context and pointing to some of the consequences of these debates for the "contraception culture" of the country. PMID:18351170
Felitti, Karina A
The topic of this article is the use of unsafe abortion for unwanted pregnancies among adolescents. The significance of unsafe abortion is identified as a high risk of serious health problems, such as infection, hemorrhage, infertility, and mortality, and as a strain on emergency room services. The World Health Organization estimates that at least 33% of all women seeking hospital care for abortion complications are aged under 20 years. 50 million abortions are estimated to be induced annually, of which 33% are illegal and almost 50% are performed outside the health care system. Complications are identified as occurring due to the procedure itself (perforation of the uterus, cervical lacerations, or hemorrhage) and due to incomplete abortion or introduction of bacteria into the uterus. Long-term complications include an increased risk of ectopic pregnancy, chronic pelvic infection, and infertility. Mortality from unsafe abortion is estimated at 1000/100,000 procedures. Safe abortion mortality is estimated at 0.6/100,000. When infertility results, some cultures ascribe an outcast status or marriages are prevented or prostitution is assured. The risk of complications is considered higher for adolescents. Adolescents tend to delay seeking an abortion, lack knowledge on where to go for a safe procedure, and delay seeking help for complications. Peer advice may be limited or inadequate knowledge. Five studies are cited that illustrate the impact of unsafe abortion on individuals and health care systems. Abortions may be desired due to fear of parental disapproval of the pregnancy, abandonment by the father, financial and emotional responsibilities of child rearing, expulsion from school, or inability to marry if the child is out of wedlock. Medical, legal, and social barriers may prevent women and girls from obtaining safe abortion. Parental permission is sometimes a requirement for safe abortion. Fears of judgmental or callous health personnel may be barriers to seeking safe abortion. Some countries lack adequately trained medical personnel and supplies. Mortality and morbidity declines are considered possible with legalization, more trained health personnel, and family planning programs for youth and education for parents. PMID:12287144
The decline in mortality from abortions after Roe vs Wade was probably a result of the introduction of safer procedures for abortions, but the decline in mortality was greater for induced abortions than for other types of abortions. PMID:12530723
Smargisso, Dana M; Lester, David
Objective: Abortion can be a difficult event to cope with and can lead to the development of psychological disturbance. The aim of this prospective and longitudinal study was to assess and to predict Posttraumatic Stress Disorder (PTSD) symptoms following abortion. Moreover, this study aimed to assess whether the type of abortion had an impact on women’s experience. Method: Eighty-six women
C. Rousset; C. Brulfert; N. Séjourné; N. Goutaudier; H. Chabrol
Objective: Abortion can be a difficult event to cope with and can lead to the development of psychological disturbance. The aim of this prospective and longitudinal study was to assess and to predict Posttraumatic Stress Disorder (PTSD) symptoms following abortion. Moreover, this study aimed to assess whether the type of abortion had an impact on women’s experience. Method: Eighty-six women
C. Rousset; C. Brulfert; N. Séjourné; N. Goutaudier; H. Chabrol
In 2001, the Medical Practitioners Board of Victoria received a complaint from an Australian Government Senator regarding a late-term abortion carried out in February 2000 at the Royal Women's Hospital, Melbourne. • Five years later, the complaint of professional misconduct was finally dismissed by the Board as being frivolous and vexatious. • The action highlights a number of deficiencies in
11 Federal Elections 1 2010-01-01 2010-01-01 false Special procedure: Medical records. [Reserved] 1.6 Section 1.6 Federal Elections FEDERAL ELECTION COMMISSION PRIVACY ACT Â§ 1.6 Special procedure: Medical records....
Focusing on the legal aspects of abortion, this chapter considers the development of constitutional law on the right to abortion, rights for adults and minors, conscience clauses, and abortion and malpractice issues. In 1973 the US Supreme Court in the cases of Roe v. Wade held that the right of privacy grounded in the concept of personal liberty guaranteed by the 9th and 14th amendment to the US Constitution included a woman's right to decide whether or not to have an abortion. The cases held unconstitutional any statute that prohibited abortion and statutes that imposed such stringent requirements on abortion as to make abortion unavailable. The Court recognized the state's interest in protecting maternal health and preserving the life of the fetus but said that a woman's right to privacy was a paramount fundamental right and could be interfered with only if the state could show a compelling interest. The Court analyzed the right to abortion based on different stages of pregnancy. During the 1st trimester, a woman has a virtually unfettered right to have an abortion free from interference by state or federal government; the decision is between the woman and her physician. Due to the fact that abortions during the 2nd trimester are more dangerous to the health of the mother, the state can regulate the abortion procedure so long as the regulations are limited to preservation and protection of maternal health. Thus, the state can establish licensing requirements for facilities in which the procedure is to be performed as well as requirements concerning reporting and record keeping. During the 3rd trimester, the viability of the fetus allows the state's compelling interest in the protection of fetal life to be dominant over the mother's right to privacy. During this trimester, the state may, but is not required to, proscribe abortion except where necessary to preserve the life or health of the mother. During the 1973-83 period, numerous attempts were made to chip away at the Court's ruling. Most frequent efforts were to pass state statutes making it unreasonably difficult to obtain an abortion. A basic legal rule for medical practice is that a procedure cannot occur without first obtaining consent from the patient, and to obtain informed consent, the patient must be told of the risks, benefits, and alternatives to any procedure. The Supreme Court has stated that not all consent requirements for minors would be unconstitutional. Although parents cannot have an absolute veto power over their child's abortion decision, state statutes requiring parental notification are valid. The Court has held that spousal consent is unconstitutional since the right of privacy is specific to the pregnant woman. The Court has made it clear that the right to an abortion does not imply the duty of the state or federal government to pay for abortion for indigent women. In the summer of 1983 the Supreme Court decided a trilogy of cases involving the regulation of abortion by state and local governmental units. The Supreme Court imposed some limitations on abortion but upheld the Roe case. PMID:3709009
Goldman, E B
The subject of abortion is fraught with politics, emotions, and misinformation. A widespread practice reaching far back in history, abortion is again in the news. Psychiatry sits at the intersection of the religious, ethical, psychological, sociological, medical, and legal facets of the abortion issue. Although the religions that forbid abortion are more prominent in the media, many religions have more liberal approaches. While the basic right to abortion has been upheld by the U.S. Supreme Court, several limitations have been permitted, including parental notification or consent (with the possibility of judicial bypass) for minors, waiting periods, and mandatory provision of certain, sometimes biased, information. Before the Roe v. Wade decision legalizing abortion in 1973, many women were maimed or killed by illegal abortions, and psychiatrists were sometimes asked to certify that abortions were justified on psychiatric grounds. Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae. The psychiatric outcome of abortion is best when patients are able to make autonomous, supported decisions. Psychiatrists need to know the medical and psychiatric facts about abortion. Psychiatrists can then help patients prevent unwanted pregnancies, make informed decisions consonant with their own values and circumstances when they become pregnant, and find appropriate social and medical resources whatever their decisions may be. PMID:15985924
Stotland, Nada L
National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states' explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors' scrutiny. PMID:17889879
Cook, R J; Erdman, J N; Dickens, B M
Partial-birth abortion bans patterned after the federal bill passed by both houses of Congress are constitutional. The clear legislative definition can be easily distinguished from other abortion procedures. Abortion precedents do not apply to such bans because the abortion right pertains to unborn human beings, not to those partially delivered. Such bans are also rationally-related to legitimate state interests. Even if abortion jurisprudence is deemed to apply in the partial-birth abortion context, a ban is still constitutional under Casey because a ban on partial-birth abortions does not impose an undue burden on the abortion right. PMID:9707939
Bopp, J; Cook, C R
...2012-01-01 false Special procedures: Medical records. 4.26 Section 4.26 ...Act Â§ 4.26 Special procedures: Medical records. (a) No response to any request for access to medical records from an individual will be...
Tay?Sachs is a fatal genetic ailment preponderant among Jews. Modern medical techniques can detect carriers of the disease as well as identify affected fetuses, permitting the option of abortion. Abortion, however, is more than a simple medical procedure. It also has ethical and religious implications and these have a long history of discussion within Jewish tradition. While all forms of
BackgroundMigrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether
Sally B. Rose; Zhang Wei; Annette J. Cooper; Beverley A. Lawton
Two reproductive technologies—emergency contraception and medical abortion—have the potential to reduce unintended pregnancy significantly in Latin America. Lack of knowledge and negative attitudes about the methods may limit their impact, however. Results from focus group discussions with middle-class men and women of reproductive age residing in Mexico City indicate that knowledge about emergency contraception and medical abortion is low. After
Heather Gould; Charlotte Ellertson; Georgina Corona
...Procedures for obtaining medical care. (a...the ARNG incurs a disease or an injury...occurrence of a disease or injury may result in the loss of medical benefits. ...made. Under no condition will an...
PURPOSE Clinical innovations have made it more feasible to incorporate early abortion into family medicine, yet the outcomes of early abortion procedures in this setting have not been well studied. We wished to assess the outcomes of first-trimester medication and aspiration abortion procedures by family physicians. METHODS Prospective observational cohort study conducted from August 2001 to February 2005 of 2,550 women who sought pregnancy termination in 4 clinical practices of family medicine departments and 1 private office/training site. RESULTS The rate of successful uncomplicated procedures for medication was 96.5% (95% confidence interval [CI], 95.5%–97.0%) and for aspiration was 99.9% (CI, 99.3%–1). Adverse events and complications of medication abortions were failed procedure (ongoing pregnancy; n = 19, 1.45%); incomplete abortion (n = 16, 1.22%); hemorrhage (n = 9, 0.69%); and patient request for aspiration (n = 1, 0.08%). One (0.08%) missed ectopic pregnancy was seen among patients receiving medication. Four types of adverse outcomes were encountered with aspiration: incomplete abortion requiring re-aspiration (n = 21, 1.83%); hemorrhage during the procedure (n = 4, 0.35%); missed ectopic pregnancy (n = 3, 0.26%); and minor endometritis (n = 1, 0.09%). Missed ectopic pregnancies were successfully treated in the inpatient setting without mortality (overall hospitalization rate of 0.16 of 100). All other complications were managed within outpatient family medicine sites. Rates of complication did not vary by experience of physician or by site of care (residency vs private practice). CONCLUSIONS Complications of medication and aspiration procedures occurred at a low rate, and most were minor and managed without incident.
Bennett, Ian M.; Baylson, Margaret; Kalkstein, Karin; Gillespie, Ginger; Bellamy, Scarlett L.; Fleischman, Joan
In 2001, the Medical Practitioners Board of Victoria received a complaint from an Australian Government Senator regarding a late-term abortion carried out in February 2000 at the Royal Women's Hospital, Melbourne. Five years later, the complaint of professional misconduct was finally dismissed by the Board as being frivolous and vexatious. The action highlights a number of deficiencies in the way medical practitioner boards deal with complaints against medical practitioners; in particular, the Board's lack of discretion to deal with complaints lacking substance. Early mediation of the dispute between the Royal Women's Hospital and the Medical Practitioners Board could have avoided a great deal of suffering and expense. As a result of this case, it is likely that the Victorian Medical Practitioners Board will be given additional powers in the future to deal with complaints without merit. PMID:17407433
The objective of this study was to determine the reasons for choosing the medical instead of surgical method for the termination of early pregnancy, and to evaluate the experience and the level of satisfaction with the medical method among women in Helsinki who participated in a multinational efficacy study of medical abortion. The study respondents consisted of 123 women with
Helena Honkanen; Helena von Hertzen
BACKGROUND: To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. METHODS: Prospective study
Bastiaan M Gerritse; Annelies Schalkwijk; Ben J Pelzer; Gert J Scheffer; Jos M Draaisma
A story is recounted of how 1 physician, trained for and concerned about the preservation of life and health, dealt with question of voluntary abortion. Abortion is easy and safe, and if accomplished with all of the modern medical safeguards, abortion in the 1st 3 months of gestation is 10 times safer for a woman than continuing through a normal pregnancy and delivery. abortion from 13 weeks onwards is at least as safe as having a normal pregnancy and delivery. Thus, it is a medical fact that abortion does not exact a penalty from the woman. If she makes the decision early and is aborted in the 1st trimester, her safety is enhanced. This is the reasoning that influenced the justices of the Supreme Court of the US to arrive at the landmark decisions that now are law. If everyone agreed with what is legal and justifiable, this discussion would not bt taking place. Responsible people differ widely in their response to the questions of whether a fetus can be considered alive and is a fetus entitled to the same protection as that afforded any living person. A logical starting place is the moment of conception. Some people have argued that conception alone is not enough and that the conceptus cannot be considered "human" until implantation occurs. Various timetables have been suggested. 1 is that the fetus becomes "human" and assumes rights when it develops a human appearance. Another proposal is that the detection of fetal electrical brain activity be taken as a landmark. In traditional Judaism, a conceptus of up to 40 days has been considered to be nothing but an amorphous fluid. Temporally, the the next possible criterion for the assumption of rights by the fetus could be fetal movement. Viability, the ability of the fetus to survive if separated from the mother, has also been proposed as a criterion for granting rights to the fetus. All of these suggest that to define "human life" results not in an absolute truth but in answers which change with time, culture, technical ability, and even with underlying motivation. This physician can defend to himself that any woman has a right toprotect herself against the dangers of childbearing, that such risks can only be assumed voluntarily, and that this position has traditional roots. But the ethical questions continue. A society's desire for population increase should not be enforced upon the bodies of its women. This physician concurs with the judicial decision that society's interest in abortion should be confined to insuring the safety of the procedure and to treating abortion equally with all other medical procedures. At the same time abortion poses professional ethical problems for the physician. Such problems should be resolved privately between the physician and the patient. PMID:6608671
Rovinsky, J J
Sociocultural and psychological investigations were conducted to determine why lower class Chilean women undergo abortions despite strong social, religious, and legal sanctions. According to various estimates, there are 2 undetected illegal abortions in Chile for each abortion leading to hospitalization of the woman. Some 120,000-150,000 abortions are estimated to occur each year, compared to perhaps 300,000 live births. Illegal abortion is the principal cause of maternal mortality in Chile, carrying 4 times greater risk of death than term pregnancy. Because of the extreme difficulty of obtaining systematic information on abortion in the society at large, the studies were conducted in hospital wards treating women for septic abortions. Qualitative studies were 1st conducted using intensive methods such as life histories and a test of body image to assess knowledge of reproductive anatomy and physiology. A more extensive study was then done 2 of the 6 health services in metropolitan Santiago and a health service in Valparaiso. The sample of 357 women represented almost all of the women treated for abortion in the services during the time of the study. The women were lower class, primarily of urban origin, and 16-34 years old for the most part. 60% were single and 10% were separated or widowed. 75% had some secondary education but only 20% had finished secondary school. 1/2 of the sample had no gainful employment and 60% of the rest lacked any type of social insurance. 1/2 of the abortions were in single women abandoned by their partners or who lived with their parents and feared their reactions. 15% were single women who feared loss of employment. 30% were married with children and gave economic reasons for seeking abortion. The women were found to have erroneous ideas about the reproductive cycle, believing pregnancy to be possible only around the time of menstruation. Their beliefs were part of a coherent system passed down by oral tradition and not challenged by any scientific teaching imparted in the educational process. Very few used modern contraception. They relied instead on periodic abstinence during the days they erroneously believed to be fertile. They were not strongly motivated to seek modern contraception and many believed they lacked access or did not meet qualifications for family planning programs. The products of conception were not viewed as a truly living thing until after the 1st months of gestation. They believed that once the lesser abortifacient actions such as drinking concoctions were undertaken the child would inevitably be deformed. They were thus motivated for the 2nd stage, traumatic introduction of foreign objects into the uterus to provoke abortion usually at the hands of unskilled person under septic conditions. Most of the women knew of safer means of abortion but were unable to pay for them. PMID:12281977
Replies to the request by the Journal of Nursing on readers' positions against induced abortion indicate there is a definite personal position against induced abortion and the assistance in this procedure. Some writers expressed an emotional "no" against induced abortion. Many quoted arguments from the literature, such as a medical dictionary definition as "a premeditated criminally induced abortion." The largest group of writers quoted from the Bible, the tenor always being: "God made man, he made us with his hands; we have no right to make the decision." People with other philosophies also objected. Theosophical viewpoint considers reincarnation and the law of cause and effect (karma). This philosophy holds that induced abortion impedes the appearance of a reincarnated being. The fundamental question in the abortion problem is, "can the fetus be considered a human life?" The German anatomist Professor E. Bleckschmidt points out that from conception there is human life, hence the fertilized cell can only develop into a human being and is not merely a piece of tissue. Professional nursing interpretation is that nursing action directed towards killing of a human being (unborn child) is against the nature and the essence of the nursing profession. A different opinion states that a nurse cares for patients who have decided for the operation. The nurse doesn't judge but respects the individual's decision. Some proabortion viewpoints considered the endangering of the mother's life by the unborn child, and the case of rape. With the arguments against abortion the question arises how to help the woman with unwanted pregnancy. Psychological counseling is emphasized as well as responsible and careful assistance. Referral to the Society for Protection of the Unborn Child (VBOK) is considered as well as other agencies. Further reader comments on this subject are solicited. PMID:6913282
One of the goals of antireflux surgery (ARS) is to lower medications usage for heartburn symptoms. There has been some controversy as to whether this is accomplished by surgery. In addition, there is little comparative data of medical usage in patients suffering from gastroesophageal reflux disease (GERD) treated nonoperatively with those treated with surgery, and no data on additional esophageal procedures, such as upper endoscopy or dilation. The purpose of this study was to determine these differences in a matched group of medically and surgically treated patients with at least 1 year of follow-up. All patients who underwent ARS with at least 1 year of follow-up were included. These patients were matched to a group of medically treated patients for gender, age, and month of surgery to month of gastroenterologic clinic visit. Information was gathered through the medical record or direct contact for the present use of medications and additional esophageal procedures related to GERD. One hundred twenty-two patients in each group were studied. Medication usage consisted of 13% of ARS patients versus 95% of medical patients (P < 0.0001). ARS patients had used 359 patient-months of medications versus 3578 in the medical group (P < 0.0001). Only 25% of ARS patients prescribe medications actually responded to their use. Additional procedures consisted of 9% of ARS patients versus 64% of medical patients (P < 0.0001). In conclusion, ARS leads to decreased medication use and to decreased use of subsequent esophageal procedures. In addition, most postoperative ARS patients placed on medications do not respond, and therefore require an objective evaluation for their symptoms. PMID:12819498
Alarm over the prospect that prenatal diagnostic techniques, which permit identification of fetal sex and facilitate abortion of healthy but unwanted female fetuses has led some to urge their outright prohibition. This article argues against that response. Prenatal diagnosis permits timely action to preserve and enhance the life and health of fetuses otherwise endangered, and, by offering assurance of fetal
B M Dickens
The lazy-T procedure described by Smith corrects medial ectropion of the lower lid by combining a horizontal full-thickness shortening of the lid with excision of conjunctiva and tarsus inferior to the punctum to invert the lid. However, some cases of senile medial ectropion involve an element of vertical traction on the skin as well as horizontal lid laxity. A new procedure is described that makes use of skin gained from horizontal lower lid shortening in the form of a medially based transposition flap to produce vertical skin lengthening. It is useful to treat medial ectropions that have horizontal laxity along with cicatricial components and has successfully relieved this condition in eight patients. PMID:2487218
Meltzer, M A
The purpose of the study was to determine whether or not individuals assigned to field medical facilities have difficulty adjusting to the procedural differences found in field facilities. Problem areas identified concerned differences in equipment and la...
L. A. Johns T. H. Lamson
Background Evidence from developed countries has shown that abortion-related mortality and morbidity has decreased with the liberalization of the abortion law. This study aimed to assess the trend of hospital-based abortion complications during the transition of legalization in Ethiopia in May 2005. Methods Medical records of women with abortion complications from 2003 to 2007 were reviewed (n ¼ 773). Abortion
Yirgu Gebrehiwot; Tippawan Liabsuetrakul
Examined the relationship between the distress of 42 pediatric cancer patients (aged 2–20 yrs) in response to medical procedures and a number of psychosocial, medical, and demographic variables. Results indicate that the observation scale used to measure distress was a reliable, valid instrument. The 3 variables most highly predictive of distress included the age of the S, the number of
Susan M. Jay; Mickey Ozolins; Charles H. Elliott; Steven Caldwell
The course of the debate on abortion following the 1973 Supreme Court decision legalizing abortion has been marked by a variety of medical and scientific developments. Many of these new developments have important legal, psychologic, social, moral, and political implications. The cumulative impact of all these developments may pose a significant challenge to the social and legal foundations of Roe v. Wade. PMID:3523563
In recent times, certain well-publicised cases involving allegations of inadequate and dangerous medical practice have led to a number of reviews into, and consequent changes to, the New South Wales medical regulatory and disciplinary system. The overwhelming focus has been upon both whether the existing system provided sufficient protection for the public from dangerous or under-performing medical practitioners and what was needed to ensure such protection. While the focus upon public protection is unquestionable and laudable, this still leaves considerable scope for ensuring a medical practitioner is afforded procedural fairness during the course of investigative and disciplinary processes. It is questionable whether procedural fairness is being afforded where to do so does not compromise the protection of the public. It is argued that only limited changes are required to create a system which affords procedural fairness without compromising the integrity of the system. PMID:19205311
Bowen, Timothy; Saxton, Andrew
This article gives an overview of what is known about second trimester abortions in India, including the reasons why women seek abortions in the second trimester, the influence of abortion law and policy, surgical and medical methods used, both safe and unsafe, availability of services, requirements for second trimester service delivery, and barriers women experience in accessing second trimester services.
Suchitra S Dalvie
Early medical abortion with methotrexate and misoprostol 2 1 The views expressed herein do not necessarily represent the views of Planned Parenthood Federation of America, Inc. 2 2 We thank Olivera Vragovic, MBA, for her assistance with statistical analysis
Objective: To evaluate the introduction of an early medical abortion program with methotrexate and misoprostol, using a standardized protocol.Methods: A total of 1973 women at 34 Planned Parenthood sites participated in a case series of early medical abortion. Ultrasound was used to confirm gestational age of less than 49 days from the first day of the last menstrual period. Women
Lynn Borgatta; Michael S Burnhill; Judith Tyson; Kathryn K Leonhardt; Richard U Hausknecht; Sue Haskell
Targeted Regulation of Abortion Provider laws (or TRAP laws) are state laws that apply only to abortion providers and impose on them licensing fees, physical plant\\/personnel regulations, and requirements that exceed those imposed on other comparable health-care providers or medical facilities. According to prochoice supporters, the explicit or implicit goal of TRAP laws is to drive abortion providers from the
Marshall H. Medoff
BACKGROUND: A combination of mifepristone and misoprostol provides an effective method of medical abortion for early pregnancy. This is the first randomized trial comparing the use of sublingual misoprostol with vaginal misoprostol in combination with mifepristone for termination of early pregnancies up to 63 days. METHODS: A total of 224 women who requested legal termination of pregnancy up to 63
Oi Shan Tang; Carina C. W. Chan; Ernest H. Y. Ng; Sharon W. H. Lee; Pak Chung Ho
A recent case in the United States Supreme Court has indicated a change in course on the issue of abortion rights. In Gonzales v Carhart 127 S Ct 1610 (2007), the Supreme Court, in April 2007, upheld federal legislation banning a particular late-term abortion procedure with no exceptions (even to preserve the mother's life). This column examines the case in the context of recent Australian cases involving abortion issues. It extrapolates from Carhart to consider the potential for the Australian High Court to disrupt access to safe, medically supervised and performed abortion. PMID:17902487
Faunce, Thomas; Jefferys, Susannah
The authors studied state anxiety in women awaiting three different medical examinations: abdominal ultrasonography, mammography, and hysterosalpingography. These procedures differ in degree of intrusiveness and cause, respectively, low, intermediate, and high levels of pain and discomfort. The evidence supported the hypothesis that the degree of anxiety will correspond to the level of invasiveness. In addition, the study examined the impact
Aron Weller; Tamar Hener
cussed. Results: The concept of adjustment problems in chronic or severe illnesses is widely used in pediatrics. Many aspects of severe childhood diseases are traumatic, as defined by the DSM-IV: severe illnesses are life-threatening, medical procedures threaten the child's physical integrity, and disorganized behaviour periods are common. Conclusion: This concept, which remains insufficiently investigated, is a promising area of investigation
Anne Wintgens; Bernard Boileau
Psychological preparation for invasive medical and dental procedures has been based on the rationale that high levels of preprocedural fear are detrimental to patients' subsequent adaptation. After a brief survey of the theoretical and empirical evidence pertaining to this rationale, the major psychological approaches designed to alleviate preprocedural concern and enhance recovery are discussed. Outcome studies that have employed informative,
Karen O. Anderson; Frank T. Masur
Because the number of physicians available to perform abortions in the US is dwindling, certified nurse-midwives, nurse practitioners, and physician assistants should be trained and permitted to perform abortions. Roadblocks to this change are the fact that the Supreme Court would likely allow states to prevent mid-level practitioners from performing abortions in the name of protecting the health of the mother. Also, existing statutes would probably not be interpreted by courts to allow mid-level practitioners to perform abortions. However, physician assistants have been performing abortions in Vermont since 1975, and a 1981-82 comparative study affirmed that physician assistants are well-equipped to perform abortions (of 2458 procedures, the complication rate/1000 was 27.4 for physician assistants and 30.8 for physicians). However, controversy surrounds the provision of abortion by these physician assistants in Vermont, since the relevant statute suggests that abortion is illegal unless performed by a physician. However, the statute has not been changed since Roe vs. Wade and is likely unconstitutional. Court cases in Missouri and Tennessee suggest that courts may be willing to include abortion within the scope of progressive nursing practice acts, but a recent similar case in Massachusetts resulted in a narrow interpretation of nursing practice statutes. Because the definition of professional nursing varies with each state statute, it will be a formidable task to convince every jurisdiction to include abortion as a permissible mid-level practice. Even in Vermont, the nursing practice statute defines in an exclusive list what services the professional nurse may perform (whereas the physician assistant regulations limit their scope of practice only to that delegated by a supervising physician). States could, of course, pass statutes which include abortion as a permissible practice for the mid-level practitioner. However, specific legislation would provide a clear target for anti-choice forces and legal challenges. Other practical problems include a possible uproar in the medical community where obstetrical/gynecology specialists already oppose allowing nurse practitioners to provide routine gynecologic services. Also, if mid-level practitioners were allowed to perform abortions, physicians may abandon the practice altogether. However, given the present state of affairs, this may be the only practical starting point for approaching the crisis caused by the scarcity of abortion providers. PMID:8118134
Kowalczyk, E A
The rising costs of medical treatment in the United States are fueling a movement to outsource medical treatment. Estimates of the number of Americans traveling overseas for treatment range from 50,000 to 500,000. Charges for common procedures such as heart bypass can be $11,000 in Thailand compared to $130,000 in the United States. Knee…
|The rising costs of medical treatment in the United States are fueling a movement to outsource medical treatment. Estimates of the number of Americans traveling overseas for treatment range from 50,000 to 500,000. Charges for common procedures such as heart bypass can be $11,000 in Thailand compared to $130,000 in the United States. Knee…
Background To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS. Methods Prospective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed. Results Of the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS. Conclusions The Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.
Methods and apparatuses for the image guidance and documentation of medical procedures. One embodiment includes combining small field of view images into a recorded image of with a large field of view and aligning the small field of view real time image with the recorded image through correlation of imaging data. A location and orientation determination system may be used to track the imaging system and provide a starting set of image alignment parameters and/or provide change updates to a set of image alignment parameters, which is then further improved through correlating imaging data. The recorded image may be selected according to real time measurement of a cardiac parameter during an image guided cardiac procedure. Image manipulations planned based on the recorded image can be stored and applied to the real time information. The position of the medical device may be determined and recorded through manipulating a cursor in a 3-D image space shown in two non-parallel views.
In Planned Parenthood vs. Casey, the US Supreme Court upheld all but 1 provision of Pennsylvania law that further restricts access to abortion. The law has a 24-hour waiting period, parental consent for minors with a judicial bypass, husband notification, and the circumstances of each abortion are to be reported to the state for statistical purposes. The Court overturned the husband notification provision even though it had a bypass procedure. The most important aspect of the decision was the change from the strict scrutiny in which abortion was to be left alone unless the state could show a compelling need to regulate it to an undue burden test in which the state is allowed to regulate abortion so long as it does not place an undue burden on women trying to seek abortion services. The 24-hour waiting period was upheld; however, it was also acknowledged that since 83% of women live in counties without abortion services, this may turn out to be an undue burden and it is open to review at later date when statistical evidence is available. The Opinion was written by Justices O'Connor, Kennedy, and Souter. Chief Justice Rehnquist and Justices Scalia, White, and Thomas dissented saying that the undue burden standard was unprecedented in constitutional law and undefinable in practice. It is likely now that the Court will begin writing abortion policy as it clarifies each specific point of the law rather than ruling on fundamental legal principles. PMID:1351612
The rising costs of medical treatment in the United States are fueling a movement to outsource medical treatment. Estimates of the number of Americans traveling overseas for treatment range from 50,000 to 500,000. Charges for common procedures such as heart bypass can be $11,000 in Thailand compared to $130,000 in the United States. Knee replacement in the United States can cost $40,000 compared to $13,000 in Singapore.A new industry, medical tourism, has been created to advise patients on the appropriate facility in the right country for their condition, handle all travel arrangements, teleconference with physicians, and send medical records. To respond to the growth in medical travel, the Joint Commission (formerly the Joint Commission on Accreditation of Health Care Organizations) initiated the Joint Commission International (JCI) to accredit hospitals worldwide. Although outcome statistics from hospitals outside the United States are rare, first-person reports on quality are numerous. Making surgery possible for uninsured and underinsured individuals or self-insured state, municipal, and private entities is a major benefit of medical tourism. Mitigating against medical travel are the lack of legal remedies in place for malpractice and the possibility that travel itself can impose risk to patients. For example, lengthy air flights where the patient is in a fixed position for hours at a time can cause embolisms. If the trend toward medical tourism continues, continuing education, credentialing, and certification services may be required to help assure patient safety. PMID:18521877
Many cancer deaths are related to metastasis to distant organs due to dissemination of circulating tumor cells (CTCs) shed from the primary tumor. For many years, oncologists believed some medical procedures may provoke metastasis; however, no direct evidence has been reported. We have developed a new, noninvasive technology called in vivo photoacoustic (PA) flow cytometry (PAFC), which provides ultrasensitive detection of CTCs. When CTCs with strongly light-absorbing intrinsic melanin pass through a laser beam aimed at a peripheral blood vessel, laser-induced acoustic waves from CTCs were detected using an ultrasound transducer. We focused on melanoma as it is one of the most metastatically aggressive malignancies. The goal of this research was to determine whether melanoma manipulation, like compression, incisional biopsy, or tumor excision, could enhance penetration of cancer cells from the primary tumor into the circulatory system. The ears of nude mice were inoculated with melanoma cells. Blood vessels were monitored for the presence of CTCs using in vivo PAFC. We discovered some medical procedures, like compression of the tumor, biopsy, and surgery may either initiate CTC release in the blood which previously contained no CTCs, or dramatically increased (10-30-fold) CTC counts above the initial level. Our results warn oncologists to use caution during physical examination, and surgery. A preventive anti-CTC therapy during or immediately after surgery, by intravenous drug administration could serve as an option to treat the resulting release of CTCs.
Juratli, Mazen A.; Sarimollaoglu, Mustafa; Nedosekin, Dmitry A.; Galanzha, Ekaterina; Suen, James Y.; Zharov, Vladimir P.
Ending the silent pandemic of unsafe abortion is an urgent public-health and human-rights imperative. As with other more visible global-health issues, this scourge threatens women throughout the developing world. Every year, about 19-20 million abortions are done by individuals without the requisite skills, or in environments below minimum medical standards, or both. Nearly all unsafe abortions (97%) are in developing countries. An estimated 68 000 women die as a result, and millions more have complications, many permanent. Important causes of death include haemorrhage, infection, and poisoning. Legalisation of abortion on request is a necessary but insufficient step toward improving women's health; in some countries, such as India, where abortion has been legal for decades, access to competent care remains restricted because of other barriers. Access to safe abortion improves women's health, and vice versa, as documented in Romania during the regime of President Nicolae Ceausescu. The availability of modern contraception can reduce but never eliminate the need for abortion. Direct costs of treating abortion complications burden impoverished health care systems, and indirect costs also drain struggling economies. The development of manual vacuum aspiration to empty the uterus, and the use of misoprostol, an oxytocic agent, have improved the care of women. Access to safe, legal abortion is a fundamental right of women, irrespective of where they live. The underlying causes of morbidity and mortality from unsafe abortion today are not blood loss and infection but, rather, apathy and disdain toward women. PMID:17126724
Grimes, David A; Benson, Janie; Singh, Susheela; Romero, Mariana; Ganatra, Bela; Okonofua, Friday E; Shah, Iqbal H
...from the National Registry of Certified Medical Examiners. 390.115 Section 390...GENERAL National Registry of Certified Medical Examiners Â§ 390.115 Procedure for...from the National Registry of Certified Medical Examiners. (a) Voluntary...
This paper examines the extent to which there may be differences in attitudes toward abortion and intentions when one is faced with making an abortion decision for oneself. Data from a 1977 national survey were used. The results indicated that while such differences existed only on a limited scale in medically indicated situations of abortion, discretionary situations had a sizable
B. K. Singh; J. Sherwood Williams
This article gives an overview of what is known about second trimester abortions in India, including the reasons why women seek abortions in the second trimester, the influence of abortion law and policy, surgical and medical methods used, both safe and unsafe, availability of services, requirements for second trimester service delivery, and barriers women experience in accessing second trimester services. Based on personal experiences and personal communications from other doctors since 1993, when I began working as an abortion provider, the practical realities of second trimester abortion and case histories of women seeking second trimester abortion are also described. Recommendations include expanding the cadre of service providers to non-allopathic clinicians and trained nurses, introducing second trimester medical abortion into the public health system, replacing ethacridine lactate with mifepristone-misoprostol, values clarification among providers to challenge stigma and poor treatment of women seeking second trimester abortion, and raising awareness that abortion is legal in the second trimester and is mostly not requested for reasons of sex selection. PMID:18772082
Dalvie, Suchitra S
Mr. Corrie's argument for the Abortion (Amendment) Bill is based on a misunderstanding of the problem. All evidence supports the conclusion that is is impossible to prevent abortion by legislation. It was a recognition of this fact which persuaded many people of the necessity for a liberal Act in 1967. Since that time nothing has changed to alter the supposition that a large proportion of women denied legal abortion will seek an illegal abortion. The major medical establishment bodies recognize and accept this and are opposed to the Corrie Bill. Those who work in this area know that what is needed is a much greater effort in providing sex education and access to contraceptive advice and methods for those with special problems. 1 of the ironies of the proposed legislation is that abortion rates have until very recently been declining, following the major expansion of family planning provision in 1974. The attempt to lower the accepted limit for abortion to 20 weeks would only add to the anguish and problems of women and doctors in the very small proportion of cases involved, and it is difficult to see why the Lane Committee recommendation of 24 weeks cannot be accepted as a compromise. Of the 3 principle changes introduced in the Bill, it is the 1 which aims to separate counseling from operating which has the most important consequences. This measure is aimed at the 2 primary abortion charities which were established to meet the deficiencies of provision by the National Health Service. Between them they account for 30-40% of the abortions performed. There is no evidence for the suggestion that people working for these charities have a financial interest in drumming up work. PMID:6101772
Because abortion is illegal in Senegal, it is not easy to determine its frequency. Women suffering complications of illegal abortions are often unwilling to aid in their own treatment by divulging the means used to induce the abortion. Clandestine abortions are associated with poor hygienic conditions exposing the woman to risk of infection. Abortion operators are often ignorant of elementary notions of genital anatomy and unskilled in gynecological surgery. Death may result in a few minutes from shock or embolism. The operator is unable to take any action because of the illegal status of the abortion. Secondary complications may appear because of local trauma, infection, or from caustic or toxic agents. Hemorrhage may be external and abundant, originating in the cervix, vagina, or uterine cavity. It may occur within the abdominal cavity if an organ is perforated. In both cases surgical treatment may be required to save the woman's life. An infection or a state of toxicity may result from the abortion, or both may occur simultaneously. Infections of varying degrees of seriousness may be localized in the genital organs (pelviperitonitis), spread throughout the abdomen (general peritonitis), or spread throughout the organism. Pelviperitonitis results from performing abortions under septic conditions and from uterine retention of part of the embryo. Symptoms include abdominal pain, fever, vomiting, and arrest of intestinal transit. Symptoms are often masked by uninformed use of antibiotics, which allows the infection to spread to the other abdominal organs. Generalized peritonitis results from grave lesions of the genital or intestinal tracts produced by traumatizing instruments. In the absence of medical and surgical treatment, the patient's condition rapidly deteriorates and death ensues. Generalized infection may be due to septicemia, tetanus, or hepatonephritis. Hospitalization in a specialized service is required. Thromboembolic complications may also follow clandestine abortions. Late complications and sequelae may include chronic abdominal pain, menstrual disturbances, secondary sterility, or inability to have sexual relations because of vaginal lesions caused by caustic agents. Later pregnancies may be ectopic, or may spontaneously abort because of cervical lesions caused by trauma. Psychic sequelae may include depression or confusion. Information and contraceptive services should be made available to young girls to prevent illegal abortions. Social legislation should be modified to assist future mothers. PMID:12315024
In 1971, lay California abortion provider Harvey Karman set out to revolutionize second trimester abortion just as he had done for first trimester abortion with his eponymous suction curette, the Karman cannula. An ardent critic of hypertonic saline instillation and surgical procedures such as hysterotomy, his plan was to introduce a new abortion procedure he had developed--the super coil technique--which, he believed, would finally replace all other methods to become the one and only undisputed second trimester abortion technology. What resulted, however, was a medical fiasco that prompted investigations by American federal agencies, such as the CDC and the FDA. These investigations had the net effect of increasing regulations on the development, testing and implementation of reproductive technologies in the United States. PMID:18283597
Tunc, Tanfer Emin
...procedure concerning OSHA access to employee medical records. 1913.10 Section 1913...PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS Â§ 1913.10 Rules of agency...procedure concerning OSHA access to employee medical records. (a) General policy....
...procedure concerning OSHA access to employee medical records. 1913.10 Section 1913...PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS Â§ 1913.10 Rules of agency...procedure concerning OSHA access to employee medical records. (a) General policy....
...procedure concerning OSHA access to employee medical records. 1913.10 Section 1913...PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS Â§ 1913.10 Rules of agency...procedure concerning OSHA access to employee medical records. (a) General policy....
US anti-abortion groups have used misinformation on the long-term psychological impact of induced abortion to advance their position. This article reviews the available research evidence on the definition, history, cultural context, and emotional and psychiatric sequelae of induced abortion. Notable has been a confusion of normative, transient reactions to unintended pregnancy and abortion (e.g., guilt, depression, anxiety) with serious mental disorders. Studies of the psychiatric aspects of abortion have been limited by methodological problems such as the impossibility of randomly assigning women to study and control groups, resistance to follow-up, and confounding variables. Among the factors that may impact on an unintended pregnancy and the decision to abort are ongoing or past psychiatric illness, poverty, social chaos, youth and immaturity, abandonment issues, ongoing domestic responsibilities, rape and incest, domestic violence, religion, and contraceptive failure. Among the risk factors for postabortion psychosocial difficulties are previous or concurrent psychiatric illness, coercion to abort, genetic or medical indications, lack of social supports, ambivalence, and increasing length of gestation. Overall, the literature indicates that serious psychiatric illness is at least 8 times more common among postpartum than among postabortion women. Abortion center staff should acknowledge that the termination of a pregnancy may be experienced as a loss even when it is a voluntary choice. Referrals should be offered to women who show great emotional distress, have had several previous abortions, or request psychiatric consultation. PMID:9328746
Stotland, N L
This article describes the urgent need for modern family planning (FP) services and supplies in the Soviet Union, and presents the nation's high induced abortion rate as one of its most serious medical and social problems. With more than 6 million legal abortions per year, and another estimated 6 million performed illegally, the problem of induced abortion is placed on par with heart disease and cancer in the Soviet Union. Induced abortion is the primary method of birth control, responsible for terminating 2 out of 3 pregnancies. Many abortion seekers, especially those employing illegal services, suffer complications resulting in loss of ability to work or even death. The maternal mortality rate for 1988 was 43.0/10,000. Efforts to decrease the level of abortion have increased during reconstruction, and have been witness to a decline in the number of abortions by 866,000 over the period 1985-1988. Contributory factors behind this decline, as well as the decrease of the abortion ratio, are an increased contraceptive prevalence level totalling 13.7% of reproductive-age women, stabilization of the birth rate at a low level, a smaller proportion of reproductive-age women in the population, and rate reporting changes. Nonetheless, inadequate family planning services prevail in the Soviet Union. Instead of focusing upon abortion and contraception, services focus upon diagnosing and treating infertility, and offer neither FP information nor services for premarital youths. Moreover, contraceptive supplies suffer serious, ongoing shortages. Research is needed on the social, demographic, medical, and biological aspects of reproductive behavior in the Soviet Union. Regional differences, abortion law, public opinion on illegitimate pregnancy, abortion methods, health personnel training, and maternal and child health are also discussed. PMID:12284299
Khomassuridze, A G
The content of this work is conceived on the research of the consequences of surrogate motherhood as a process of assisted procreation, which represent a way of parenthood in cases when it is not possible to realize parenthood through a natural way. Surrogate motherhood is a process in which a woman (surrogate mother) agrees to carry a pregnancy with the intent to give the child to the couple with whom she has made a contract on surrogate maternity after the birth. This process of conception and birth makes the determination of the child's origin on its mother's side hard to determine, because of the distinction of the genetic and gestation phases of the two women. The concept of surrogate motherhood is to appear in two forms, depending on the existence or the non-existence of the genetic link between the surrogate mother and the child she gives birth to. There are gestation (full) and genetic (partial) surrogates each with different modalities and legal and ethical implications. In Serbia, Infertility Treatment and the Bio-medically Assisted Procreation Act from 2009 explicitly forbids surrogate motherhood, despite the fact that an infertile couple decides to use it, as a rule, after having tried all other treatment procedures, in cases when there is a diagnosis but the conventional treatment applied has not produced the desired results. Given the fact that no one has the right to ignore the sufferings of people who cannot procreate naturally, the medical practice and legal science in our country plead for a formulation of a legal framework in which to apply surrogate motherhood as an infertility treatment, under particular conditions. PMID:21528795
Jovic, Olga S
...procedures for notification of or access to medical records. 5b.6 Section 5b.6 ...procedures for notification of or access to medical records. (a) General. An individual...right to notification of or access to his medical records, including...
Central nervous system malformations are now frequently detected prenatally. Unfortunately, the progress in diagnosis having far outstripped that in therapeutics, the only question to answer is usually whether the pregnancy should be continued or terminated. Pediatric neurosurgeons have to deal with such problems more and more often. They are asked to give an opinion on the prognosis. In many cases the law requires their involvement in the decision about the possibility of a "therapeutic", or more correctly a medical, abortion. The final decision is based on the religious attitutes of the family and the neurosurgeon and on the law of the country in which the medical abortion would be performed. This article reviews the points of view of the main religions and also the laws in different countries. This knowledge may be of some help to neurosurgeons, especially when the religious attitudes of those involved are different or when their final decision is not in accordance with the law of the country. PMID:8906364
Hirsch, J F; Bhagwati, S N; Epstein, F; Hoppe-Hirsch, E; Mutluer, S; Raimondi, A J
Psychology and psychiatry have tended to approach abortion as a health issue for individual women and to focus on the potentially negative psychological effects of the procedure. This individualistic approach has created an impression of abortion as intrinsically risky for women and has provided a very limited account of the relationship between the social context in which women experience abortion
Mary Boyle; Jane McEvoy
The rate of induced abortions (9/1000 women aged 15-49 y in 2011) is low in Finland. Ninety-two per cent of them are performed on grounds of social reasons. Use of medical abortion (combination of mifepristone and misoprostol) has increased to nearly 90 % of abortions, also in abortions of 9-12 weeks of pregnancy. Intrauterine contraception started at the time of abortion lowers the risk of future unplanned pregnancies. Prophylactic antibiotics are recommended in cases of surgical evacuation of the uterus. Written instructions for patients and professionals are introduced in the guideline. PMID:23720946
In 1973, the United States Supreme Court, in a landmark decision, ruled that the 50 states could not regulate abortion up to 24-28 weeks' gestation, except as necessary to insure the safety of the woman, and severely limited state legislation of abortion after 28 weeks by a broad interpretation of the "health" restriction. This article will explore (1) the history of abortion prior to 1973, (2) the scope of the Court decision, (3) abortion from the perspective of medical ethics, and (4) the sequelae of permissive abortion 16 years after Roe v. Wade and Doe v. Bolton. PMID:10303844
Gerster, C F
Around 25% of abortions in South Africa are performed in the second trimester. This study aimed to better understand what doctors, nurses and hospital managers involved in second trimester abortion care thought about these services and how they could be improved. Nineteen in-depth interviews with abortion-related service providers and managers in the Western Cape Province, South Africa, were undertaken. Data were analysed using a thematic analysis approach. Participants expressed resistance to the dilation and evacuation (D&E) procedure, as this required more active provider involvement. Medical abortion was preferred as it required less provider involvement in the abortion process. A shortage of providers willing to perform D&E resulted in most public sector services being outsourced to private sector doctors. Respondents noted an increased demand for services and a concomitant lack of infrastructure, physical space and personnel to respond to these demands, sometimes resulting in fragmented or poor quality care. At medical induction sites, most thought introducing the combined mifepristone-misoprostol regimen would improve service capacity, although they were concerned about cost. Improving contraceptive services was also seen as a much-needed intervention to improve care and prevent abortion. Ongoing training, including values clarification, as well as emotional support and team-building for providers are needed to ensure sustainable, high-quality second trimester abortion services. PMID:22088440
Harries, J; Lince, N; Constant, D; Hargey, A; Grossman, D
A law passed in Utah in 1991 which prohibited abortion except in cases of life endangerment, rape, incest, risk of grave damage to a woman's medical health, or grave fetal defects. The exceptions for women who had been sexually abused were eliminated after 20 weeks gestation. In December 1992, US District Court Judge J. Thomas Greene found the ban unconstitutional as applied to abortions prior to 20 weeks but upheld it as applied to procedures after that point in pregnancy. A three-judge appellate panel later reversed the district court decision in August 1995 on the argument that the prohibition on post-20-week abortions could not stand independent of the ban on earlier procedures. The appeals court also struck down a requirement that physicians performing those abortions allowed after viability use the method most likely to give the fetus the best chance of survival, unless it would endanger a woman's life or cause grave damage to her medical health. In an unsigned opinion issued on June 17, 1996, the US Supreme Court reversed the appeals court decision which struck down Utah's original 1991 ban on abortions. Five justices ruling in Leavitt v. Jane L. found that the US Court of Appeals for the Tenth Circuit misapplied Utah precedent when it found that the criminal abortion statute could not be divided into two separate abortion bans, one before and one after 20 weeks gestation. Health care providers will now argue that the ban on post-20-week abortions should be struck down on constitutional grounds. This is the first challenge to a state abortion law to come under High Court review since Planned Parenthood v. Casey in 1992. PMID:12291525
The purpose of this article is to show that the current level of scientific evidence linking induced abortion with increased breast cancer risk is sufficient to support an ethical and legal duty to disclose fully the risk to women who are considering induced abortion. The article examines the relationship between this evidence and the elements of a medical malpractice claim alleging failure to obtain informed consent. The first part focuses on the elements of informed consent, which require the plaintiff to establish that the physician had a duty to disclose information, which he failed to disclose, that this failure to disclose was a legal cause of the plaintiff's decision to undergo the procedure, and the procedure was a legal cause of the plaintiff's injury. The second part compares two prevalent standards for determining which risks a physician has a duty to disclose. Part three reviews the scientific evidence of the abortion/breast cancer (ABC) link and explains why it survives both the Frye and the Daubert tests for admissibility of expert testimony. The fourth part assesses the materiality of the risk posed by the ABC link. Parts five and six discuss evidentiary issues and the possibility of punitive damage awards. PMID:10758700
The recent Supreme Court decision upholding Roe v. Wade and in particular, the dissent by Justice Sandra Day O'Connor, sheds new light on the issue of abortion. Let us consider any stage of a pregnancy when abortion is medically safe for the mother. If at that stage it is also medically viable to save the fetus, is an abortion performed
Patricia H. Werhane
Sixty-one forensic medical expert conclusions on the loss of professional working capacity are analyzed and typical errors are characterized. The procedure of forensic medical expert evaluation of the degree of loss of professional working capacity in accordance with the Civil Code and Civil Judicial Procedure Code of the Russian Federation and the actual norm-setting documents is described. PMID:10769588
Kapustin, A V; Tomilin, V V; Ol'khovik, V P; Panfilenko, O A; Pushakov, S M; Rivenson, M S; Serebriakova, V G
The establishment of standard history-taking will be discussed and will include examples of such histories developed in the clinic. The development of a protocol for performing and recording physical examinations will also be described. Special tests, such as pulmonary function and sputum cytology, will then be discussed. The integration of medical data into a data base will also be discussed with examples taken from the program in Pittsburgh. Presentation of the problems of obtaining adequate early medical information leads to the conclusion that medical surveillance programs must be integrated with industrial hygiene surveillance. The use of exposure measures to make and implement preventive medical decisions is essential until medical science provides tests with enhanced sensitivity and specificity for use in early detection of workplace disease.
Parkinson, D.K.; Grennan, M.J.
Over the last 40 years, the number of percutaneous interventional procedures using radiation has increased significantly, with many secondary care clinicians using fluoroscopically guided techniques. Many procedures can deliver high radiation doses to patients and staff, with the potential to cause immediate and delayed radiation effects. The challenge for interventionists is to maximize benefit, whilst minimizing radiation risk to patients
C Cousins; C Sharp
A prospective, nonconcurrent cohort analysis of 178 mifepristone\\/misoprostol and 199 suction curettage abortion subjects, ages ? 18 years, with intrauterine pregnancies ? 63 days estimated gestational age, was conducted to compare the outcomes of suction curettage abortion to those of medical abortion. The medical abortion subjects received 600 mg of mifeprisone orally, followed by 400 ?g of oral misoprostol 2
Jeffrey T Jensen; Susan J Astley; Elizabeth Morgan; Mark D Nichols
|Compared four standard-setting procedures for an objective structure clinical examination (OSCE) in medical education. Applied Angoff, borderline, relative, and holistic procedures to the data used to establish a cutoff score for a pass/fail decision. The Angoff and borderline procedures gave similar results; however, the relative and holistic…
Kaufman, David M.; Mann, Karen V.; Muijtjens, Arno M. M.; van der Vleuten, Cees P. M.
In Korea, China, and Taiwan--countries where son preference persists--the availability of prenatal screening techniques and induced abortion has produced an imbalance in the naturally occurring sex ratios of 104-107 male births for every 100 female births. Policy responses to sex-selective abortion were the focus of a 1994 International Symposium on Sex Preference for Children in the Rapidly Changing Demographic Dynamics in Asia sponsored by the United Nations Population Fund and the Government of the Republic of Korea. Modern technology (i.e., amniocentesis, ultrasound, and chorionic villi sampling) enables couples to control both family size and sex selection. According to data from the 1990 Korean Census, 80,000 female fetuses were aborted from 1986-90 as a result of son preference. In the late 1980s, the Governments of Korea, China, and India imposed bans on the use of medical technology for prenatal sex determination, but many observers maintain that regulations have served only to make the procedures clandestine and more expensive. To remedy the problems underlying sex-selective abortion, the Symposium recommended the following government actions: 1) implement policies and programs to diminish gender discrimination; 2) establish guidelines for the monitoring and regulation of prenatal testing; 3) utilize mass and folk media, interpersonal channels, and school curricula to promote gender equality; 4) strengthen the ethics curriculum of medical schools to address son preference; and 5) increase the capability of statistical and research organizations to collect gender-disaggregated data. PMID:12319402
Westley, S B
The first comprehensive national survey on frequency and radiation dose imparted to the population from radiological procedures was carried out in Kenya and reported here. This survey involved assessment of frequency, typical patient radiation exposure, and collective effective dose from general radiography, fluoroscopy, interventional procedures (IPs), mammography, and computed tomography. About 300 x-ray facilities across the country were invited to participate in the survey, and a 31% response was recorded. The individual and collective radiation burdens of more than 62 types of pediatric and adult radiological examinations were quantified using effective and collective dose. The average effective dose for each radiological examination was assessed from the x-ray efficiency performance tests and patient data from over 30 representative radiological facilities. The results found indicated that over 3 million x-ray procedures were performed in 2011, resulting in an annual collective effective dose of 2,157 person-Sv and an annual effective dose per capita of 0.05 mSv. The most frequent examinations were general radiography (94%), computed tomography (3.3%), and fluoroscopy (2.5%). Although the contribution of computed tomography was small in terms of frequency, this procedure accounted for 36% of the effective dose per capita. General radiography was the most frequent type of examination with a contribution of 55% of the effective dose per capita. PMID:24162056
Korir, Geoffrey K; Wambani, Jeska S; Korir, Ian K; Tries, Mark; Kidali, Mike M
The following guidelines reflect a collation of the evaluable medical literature about surgical abortion prior to 7 weeks of gestation. Early surgical abortion carries lower risks of morbidity and mortality than procedures performed later in gestation. Surgical abortion is safe, practicable and successful as early as 3 weeks from the start of last menses (no gestational sac visible on vaginal ultrasound) provided that (a) routine sensitive pregnancy testing verifies pregnancy, (b) the tissue aspirate is immediately examined for the presence of a gestational sac plus villi and (c) a protocol to identify ectopic pregnancy expeditiously--including calculation of readily obtained serial serum quantitative human chorionic gonadotropin titers when clinically appropriate--is in place and strictly adhered to. Manual and electric vacuum aspiration methods for early abortion demonstrate comparable efficacy, safety and acceptability. Current data are inadequate to determine if any of the following techniques substantially improve procedure success or safety: use of rigid versus flexible cannulae, light metallic curettage following uterine aspiration, uterine sounding or routine use of intraoperative ultrasound. PMID:23574709
Lichtenberg, E Steve; Paul, Maureen
Over the past decade, the number of procedures performed in office-based settings by a variety of practitioners—including surgeons, gastroenterologists, ophthalmologists, radiologists, dermatologists, and others—has grown significantly. At the same time, patient safety concerns have intensified and include issues such as proper patient selection, safe sedation practices, maintenance of facilities and resuscitation equipment, facility accreditation and practitioner licensing, and the office staff's ability to deal with emergencies and complications. An urgent need exists to educate practitioners about safety concerns in the office-based setting and to develop various educational strategies that can meet the continued growth of these procedures. This review outlines educational needs and possible solutions such as simulation exercises and education during residency training.
Urman, Richard D.; Punwani, Nathan; Shapiro, Fred E.
Nearly 40 years after enactment of the Medical Termination of Pregnancy Act of 1971, unsafe abortion continues to be a neglected women's health issue in India. This prospective study of women presenting for post-abortion care in 10 selected hospitals in Madhya Pradesh, India, aimed to understand the incidence, types and severity of post-abortion complications, probable causes of complications and consequences
Sushanta K. Banerjee; Kathryn Andersen
Objective: To survey attitudes about abortion in a sample of physicians practicing in the Bronx, New York, identify factors associated with those attitudes, and investigate how attitudes about abortion influence willingness to do it.Methods: A questionnaire mailed to obstetricians and gynecologists affiliated with a medical school in the Bronx elicited information on attitudes about abortion and the willingness to do
Aryan N Aiyer; George Ruiz; Allegra Steinman; Gloria Y. F Ho
Unwanted pregnancies put women in Kenya at risk of morbidity and mortality associated with childbearing; induced abortion is an option some women seek as a response to that situation. Qualitative research was carried out to document the case histories of 30 Kenyan women who underwent induced abortion. In-depth interviews were conducted among an urban group of low-income women to identify sources of information about induced abortion and the decision-making process, and to describe the abortion experience among this group. Being unmarried and unemployed contributed to the decision to abort. Two main types of induced abortion, one provided in private facilities by medical personnel, and the other performed by a variety of untrained practitioners, are described. PMID:1557793
Baker, J; Khasiani, S
AimsChild protection is currently a particular challenge to paediatricians. Local safeguarding procedures have been developed to guide practice by medical professionals, social care and police. They include guidance on the writing of child protection medical reports and inter-agency communication. Our aim was to improve the quality of care offered to children, by assessing our performance against the local guidelines and
B A Klepacka; R Brockelbank; L Hayman; S Banerjee
A study of 1,505 women obtaining abortions in a freestanding abortion clinic in Western New York state revealed that women having repeat abortions were more likely to be using contraception at the time of conception than women having first abortions. However, nearly one-half the non-contracepting repeaters were not contracepting at the time of the repeat pregnancy. Repeaters who were not contracepting at the time of the repeat pregnancy listed medical contraindications or lack of supplies as the major reasons for not contracepting at the time of the present conception--indicating that they had tried one or more methods since their first abortion. Repeaters were sexually more active than first timers, thus increasing their statistical risk of unwanted pregnancy even as they contracepted more than first timers. The data indicate that both first timers and repeaters overwhelmingly reject the premise that abortion is a primary or even a back-up birth control method. The essential difficulty for repeaters appears to be that they are victims of technological, organizational, and logistical inadequacies as well as statistical probabilities rather than being motivationally deficient or indifferent to the dangers of unprotected sexual intercourse.
Howe, B; Kaplan, H R; English, C
Currently, paper-based and/or electronic together with telecommunications links to Earth-based physicians are used to assist astronaut crews perform diagnosis and treatment of medical conditions during space travel. However, these have limitations, especially during long duration missions in which telecommunications to earth-based physicians can be delayed. We describe an experimental technology called GuideView in which clinical guidelines are presented in a structured, interactive, multi-modal format and, in each step, clinical instructions are provided simultaneously in voice, text, pictures video or animations. An example application of the system to diagnosis and treatment of space Decompression Sickness is presented. Astronauts performing space walks from the International Space Station are at risk for decompression sickness because the atmospheric pressure of the Extra-vehicular Activity space- suit is significantly less that that of the interior of the Station.
Iyengar, M S; Carruth, T N; Florez-Arango, J; Dunn, K
The medical profession classifi es abortion as induced or spontaneous. The lay public, however, tends to equate the term abortion\\u000a with one that is induced, whether therapeutically, self, or criminal, and to associate the term miscarriage with spontaneous\\u000a abortion (Beard et al. 1985).\\u000a \\u000a Spontaneous abortion is usually defi ned as the involuntary loss of a conceptus before the fetus has
T. Yee Khong
This study aims to contribute to the construction of a scenario regarding patient radiation exposure in Brazilian interventional radiology, aiming to provide data for the future drafting of specific legislation on interventional radiology because there is currently a lack of safety regulations for haemodynamics services in this country. Fourteen haemodynamics services in the states of Santa Catarina and Bahia were evaluated. The radiological devices were characterised through measurements of air kerma-area product, entrance surface air kerma (Ke), exposure time, spatial resolution (SR), low-contrast resolution and half-value layer. During the evaluation of instrument parameters, several non-conformities were found according to current Brazilian regulations, with SR presenting the most critical situation. The results of the present study indicate the need for the optimisation of clinical practices in complex radiological procedures, although the overall results for the dose scenario in the present study revealed values similar to those reported in international publications. PMID:22908350
Navarro, Valéria Coêlho Costa; Navarro, Marcus Vinícius Teixeira; Maia, Ana Figueiredo
Distraction is a strategy that has been shown to be effective and safe in the control of pain and distress. We assessed the utility of two simple distraction procedures for reducing children's pain and distress. Three conditions, control, brief film, and short story, were delivered during repeated medical procedures in a randomized sequence to eight young children with cancer. Scores
Selwyn Mason; Malcolm H. Johnson; Cheryl Woolley
Brief procedures for evaluating medication efficacy may reveal which candidate drugs warrant further testing in clinical trials and which do not. We previously carried out a study of smoking abstinence, involving the nicotine patch, and established the sensitivity of our procedure. In this study, we sought to cross-validate our earlier work by comparing short-term smoking abstinence due to varenicline (relative
K A Perkins; C Lerman; C A Fonte; M Mercincavage; M L Stitzer; K N R Chengappa; A Jain
Abortion is the most common and controversial issue in many parts of the world. Approximately 46 million abortions are performed worldwide every year. The world ratio is 26 induced abortions per 100 known pregnancies. Pakistan has an estimated abortion rate of 29 abortions per 1,000 women of reproductive age, despite the procedure being illegal except to save a woman's life. 890,000 abortions are performed annually in Pakistan. Many government and non-government organizations are working on the issue of abortion. Muslim jurists are unanimous in declaring that after the fetus is completely formed and has been given a soul, abortion is haram (forbidden). PMID:19957496
Ilyas, Muhammad; Alam, Mukhtar; Ahmad, Habib; Sajid-ul-Ghafoor
Theeffect ofinduced abortion onspon- taneous pregnancy loss insubsequent pregnancies was studied basedon3,416 pairs ofmatched dataina follow-up investigation. Pregnancy outcome wasex- amined alsoinrelation toabortion procedure, gesta- tion length attimeofabortion, andnumber ofprevious abortions. Ingeneral there wasnosignificant associa- tionbetween prior induced abortion andrisks of Induced abortion isconsidered themostcommonly usedsurgical procedure intheUnited States' andaccounts forabout 30percentofallknownpregnancies.2 Reported results ofstudies relating history ofinduced abortion to
PATRICIA G. STEINHOFF
The objective of this study was to describe the availability of early surgical and medical abortion among members of the National Abortion Federation (NAF) and to identify factors affecting the integration of early abortion services into current services. Telephone interviews were conducted with staff at 113 Planned Parenthood affiliates and independent abortion providers between February and April 2000, prior to
Janie Benson; Kathryn Andersen Clark; Susan Dudley
The organization of Health Care in Canada is such that many of the crucial decisions affecting the health of our population are made by politicians whose previous experience has not been in the health sector. This thesis is an attempt to present some of the medical and economic issues related to the prenatal diagnosis of disease in a form which
Elizabeth Ann Rhodes Kaegi
Since the 1973 Supreme Court decision legalizing abortion, medical and scientific developments have focused greater public and professional attention on the status of the fetus. Their cumulative effect may influence legal, social, and moral thought and set the stage for a change in public opinion and a challenge to legalized abortion. There is as yet no inexorable convergence of medical data and legal opinion that would undermine the rational of Roe v. Wade. But the prochoice movement must find room for an open airing of the moral questions if abortion is to remain what it should be--a legally acceptable act. PMID:3514547
José Barzelatto first distinguished himself as a leader with a vision in his years as a medical student. Later, principally as Director of the Reproductive Health Program at the World Health Organization and of the Ford Foundation program for women's sexual and reproductive rights, he contributed immensely toward the recognition of women's sexual and reproductive rights as part of their basic human rights. José Barzelatto's vision on abortion reflects his drive to promote social justice and respect individual rights, respect diversity, and promote a social consensus for a peaceful society. He believed that the fetus has moral value and did not accept abortion as a method of fertility control, but understood that abortion is a social phenomenon that cannot be changed with legal or moral condemnation. He accepted that condemning women who abort does not prevent abortion, is unfair, and causes great human suffering at a high social cost. José proposed nine points to form the basis for an overlapping consensus on abortion, on which to base a practical consensus that would allow societies to reduce the number of abortions and minimize their consequences. If we can agree on all or most of those points we would achieve the common objectives of: fewer women confronting the dilemma of how to deal with an unwanted pregnancy; fewer induced abortions; and fewer women suffering the consequences of unsafe abortion. PMID:20064638
Abstract: In the late 1960s, states began to liberalize their abortion laws, and a new era in women’s health began. Under the leadership of Jack Smith, the Centers for Disease Control and Prevention (CDC) established a voluntary abortion surveillance system that provided the first nationwide information on the numbers and characteristics of women having abortions. Studies of abortion morbidity done
Willard Cates; David A. Grimes; Kenneth F. Schulz
A practicing physician reviews the contribution of Jewish ethics, as it relates to the structure of Jewish law, to the issue of abortion. The topics approached include the status of the fetus, the relationship of fetus to mother, abortion and murder, therapeutic abortion, and the rights of the mother. The discussion describes rabbinic answers to abortion requests and is followed
Tomas J. Silber
Abortion stigma is widely acknowledged in many countries, but poorly theorised. Although media accounts often evoke abortion stigma as a universal social fact, we suggest that the social production of abortion stigma is profoundly local. Abortion stigma is neither natural nor ‘essential’ and relies upon power disparities and inequalities for its formation. In this paper, we identify social and political
Anuradha Kumar; Leila Hessini; Ellen M. H. Mitchell
In this paper, I argue that Thomson's famous attempt to reconcile the fetus's putative right to life with robust abortion rights is not tenable. Given her view, whether or not an abortion violates the fetus's right to life depends on the abortion procedure utilised. And I argue that Thomson's view implies that any late term abortion that involves feticide is
Specific guidance functions and trajectory design of return to launch site (RTLS) and transoceanic abort landing (TAL) intact abort profiles, as well as the increasing emphasis on contingency aborts, are presented. Various systems failures including Space Shuttle main engine failures and detailed technical analyses, including the design of powered flight abort trajectories, are considered. The most critical of flight abort situations is the RTLS, while TAL is the preferred abort when uphill capability is no longer available. It is concluded that one principle must remain to ensure continuing success of Space Shuttle flights: namely that intact and contingency aborts necessitate development to ensure safe return of the vehicle, payload, and crew whenever possible.
Schmidgall, Richard A.
eens who abort are up to 4 times more likely to commit suicide than adults who abort eens who abort are up to 4 times more likely to commit suicide than adults who abort eens who abort are up to 4 times more likely to commit suicide than adults who abort eens who abort are up to 4 times more
During the period between 1977 and the first quarter of 1988, 35 countries liberalized their abortion laws and four countries limited grounds for the procedure. Most legislation has extended abortion eligibility through traditional indications such as danger to maternal health or fetal handicap, but a number of other indications have been created such as adolescence, advanced maternal age, family circumstances, and AIDS or HIV infection. A number of countries have redesigned their abortion laws as part of a comprehensive package to facilitate access to and delivery of contraception, voluntary sterilization, and abortion services. Abortion litigation has increased and stimulated the liberalization of abortion provisions and the support of women's autonomous choice within the law. In Canada, the entire criminal prohibition of abortion was held unconstitutional for violating women's integrity and security. In contrast, Latin American and other constitutional developments may limit legal abortion to instances of danger to women's lives.
Cook, R J; Dickens, B M
Small island exigencies and a legacy of colonial jurisprudence set the stage for this three-year study in 2001-2003 of abortion practice on several islands of the northeast Caribbean: St. Martin, St. Maarten, Anguilla, Antigua and St Kitts. Based on in-depth interviews with 26 physicians, 16 of whom were performing abortions, it found that licensed physicians are routinely providing abortions in contravention of the law, and that those services, tolerated by governments and legitimised by European norms, are clearly the mainstay of abortion care on these islands. Medical abortion was being used both under medical supervision and through self-medication. Women travelled to find anonymous services, and also to access a particular method, provider or facility. Sometimes they settled for a less acceptable method if they could not afford a more comfortable one. Significantly, legality was not the main determinant of choice. Most abortion providers accepted the current situation as satisfactory. However, our findings suggest that restrictive laws were hindering access to services and compromising quality of care. Whereas doctors may have the liberty and knowledge to practise illegal abortions, women have no legal right to these services. Interviews suggest that an increasing number of women are self-inducing misoprostol abortions to avoid doctors, high fees and public stigma. The Caribbean Initiative on Abortion and Contraception is organising meetings, training providers and creating a public forum to advocate decriminalisation of abortion and enhance abortion care. PMID:18450240
Pheterson, Gail; Azize, Yamila
OBJECTIVES: We analyzed Medicare data to determine the influence of age, mortality during the study year, and high individual Medicare costs on the frequency of hospitalization for the most common major procedures and for general medical diagnoses.\\u000aMETHODS: We used 1992 Medicare data to classify the most frequent diagnosis related groups (DRGs), representing one-half of all admissions, as procedural or
Norman G. Levinsky; Arlene S. Ash; Wei Yu; Mark A. Moskowitz
A nationally representative survey was conducted among 3000 Catholics in Mexico during 2009 and 2010. Respondents were presented with a hypothetical situation about a young woman who decided to have an abortion and were asked their personal opinion of her. On the basis of a stigma index, it was found that the majority (61%) had stigmatizing attitudes about abortion; however, 81% believed that abortion should be legal in at least some circumstances. Respondents were significantly more likely to stigmatize abortion if they disagreed with the Mexico City law legalizing the procedure (odds ratio 1.66; 95% CI, 1.30-2.11) and believed that abortion should be prohibited in all cases (odds ratio 3.13; 95% CI, 2.28-4.30). Such stigma can lead women to seek unsafe abortions to avoid judgment by society. PMID:22920621
McMurtrie, Stephanie M; García, Sandra G; Wilson, Kate S; Diaz-Olavarrieta, Claudia; Fawcett, Gillian M
In 1969, the Center for Disease Control initiated surveillance of legal abortions in the United States. Since then, abortion laws, abortion reporting, and abortion ratios in the United States have changed dramatically. In 1969, there were 9 states with li...
We use unique data on abortions performed in New York State from 1971 to 1975 to demonstrate that women traveled hundreds of miles for a legal abortion before Roe. A 100-mile increase in distance for women who live approximately 183miles from New York was associated with a decline in abortion rates of 12.2 percent whereas the same change for women who lived 830miles from New York lowered abortion rates by 3.3 percent. The abortion rates of nonwhites were more sensitive to distance than those of whites. We found a positive and robust association between distance to the nearest abortion provider and teen birth rates but less consistent estimates for other ages. Our results suggest that even if some states lost all abortion providers due to legislative policies, the impact on population measures of birth and abortion rates would be small as most women would travel to states with abortion services. PMID:23811233
Joyce, Ted; Tan, Ruoding; Zhang, Yuxiu
Conditioned anxiety in response to recurrent medical procedures poses a significant problem in the adjustment of children with cancer. Though there is evidence that behavioral approaches can play a role in reducing anxiety, research in this area is hampered by the lack of objective measures of situation-specific anxiety. In the present study, an observational behavior rating scale was developed to
Ernest R. Katz; Jonathan Kellerman; Stuart E. Siegel
|Compared program efficacy in helping parents cope with children's painful medical procedures. Parents (n=72) of pediatric leukemia patients participated in either stress inoculation program or observed child participating in cognitive behavior therapy. Found parents in stress inoculation program reported lower anxiety scores and higher positive…
Jay, Susan M.; Elliott, Charles H.
Women who wish to terminate a pregnancy, and physicians willing to perform abortions, are subject to increasing harassment from groups which challenge the constitutional abortion right upheld by the Supreme Court in Roe v. Wade. Their vulnerability, in fact, parallels the vulnerability of the abortion right. This Article analyzes the inherent weakness and impending obsolescence of the trimester framework established in Roe. Present medical evidence of maternal health risks and fetal viability demonstrates that the trimester framework is inconsistent with current medical knowledge, and will likely be rendered obsolete by developments in medical technology. The Article suggests that adoption of an alternative constitutional basis for legal abortion is necessary to preserve the abortion right, and explores the utility of two arguments grounded in the equal protection doctrine. Finally, it discusses means of preserving legal abortion within the confines of the trimester framework established in Roe v. Wade. PMID:3068986
Mangel, C P
The purpose of this study was to evaluate the effectiveness of a high-probability (high-p) request sequence as a means of increasing compliance with medical examination tasks. Participants were children who had been diagnosed with autism and who exhibited noncompliance during general medical examinations. The inclusion of the high-p request sequence effectively increased compliance with medical examination tasks. In addition, the procedure was efficient, could be implemented by parents and medical professionals, and did not involve aversive procedures.
Riviere, Vinca; Becquet, Melissa; Peltret, Emilie; Facon, Bruno; Darcheville, Jean-Claude
Medical devices are many and various, ranging from tongue spatulas to implantable or invasive devices and imaging machines; their lifetimes are short, between 18 months and 5 years, due to incessant incremental innovation; and they are operator-dependent: in general, the clinical user performs a fitting procedure (hip implant or pacemaker), a therapeutic procedure using a non-implantable invasive device (arrhythmic site ablation probe, angioplasty balloon, extension spondyloplasty system, etc.) or follow-up of an active implanted device (long-term follow-up of an implanted cardiac defibrillator or of a deep brain stimulator in Parkinson's patients). A round-table held during the XXVIII(th) Giens Workshops meeting focused on the methodology of scientific evaluation of medical devices and the associated procedures with a view to their pricing and financing by the French National Health Insurance system. The working hypothesis was that the available data-set was sufficient for and compatible with scientific evaluation with clinical benefit. Post-registration studies, although contributing to the continuity of assessment, were not dealt with. Moreover, the focus was restricted to devices used in health establishments, where the association between devices and technical medical procedures is optimally representative. An update of the multiple regulatory protocols governing medical devices and procedures is provided. Issues more specifically related to procedures as such, to non-implantable devices and to innovative devices are then dealt with, and the proposals and discussion points raised at the round-table for each of these three areas are presented. PMID:23981256
Gilard, Martine; Debroucker, Frederique; Dubray, Claude; Allioux, Yves; Aper, Eliane; Barat-Leonhardt, Valérie; Brami, Michèle; Carbonneil, Cédric; Chartier-Kastler, Emmanuel; Coqueblin, Claire; Fare, Sandrine; Giri, Isabelle; Goehrs, Jean-Marie; Levesque, Karine; Maugendre, Philippe; Parquin, François; Sales, Jean-Patrick; Szwarcensztein, Karine
Globally, abortion mortality accounts for approximately 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high maternal mortality and morbidity from abortion tend to occur together. Unplanned and unwanted pregnancies constitute a serious public health responsibility. While fertility has declined by half in developing countries, the motivation to control and space births has risen faster than the rate of contraceptive use. Preventing maternal mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. A range of positive steps has been taken to reduce deaths and morbidity from abortion in a growing number of countries over the past 15 years. Making abortion legal is an essential prerequisite in making it safe. In this respect, changing the law does matter and assertions to the contrary are ill conceived and unsupported in practice. Although, in many countries, trends towards safer abortion have often occurred prior to or in the absence of changes in the law, legal changes need to take place if safety is to be sustained for all women. Religious laws may also require attention when legal change is being contemplated. There are three main ways of approaching this problem: liberalizing the existing law within the penal or criminal code; partially or fully legalizing abortion through a positive law or a court ruling; and decriminalising abortion by taking it out of the law. Women's health groups and other advocates, parliamentarians and health professionals, can work together to support the right of women not to die from unsafe abortions and to ensure they receive treatment for complications. Committed doctors can make a difference by providing treatment for abortion complications, interpreting the law in a liberal way and providing safe services where these are legal as well as training providers in the safest techniques to reduce mortality and morbidity. Although law, policy and women's rights are central to this issue, making abortions safe is above all a public health responsibility of governments. Moreover, reducing maternal mortality by making abortions safe is also an important part of the international commitment made in Cairo in 1994 at the ICPD and reaffirmed at the Cairo meeting in 1999. PMID:14556348
Experience with 50 first time aborters, 50 second time aborters, and 50 third time aborters residing in an urban area of Copenhagen suggests that women having a repeat abortion are more similar than dissimilar to women having a first induced abortion. There were no differences in socioeconomic status, educational level, or stated reasons for choosing abortion (usually socioeconomic and family
Mogens Osler; Henry P David; Janine M Morgall
Objective To assess acting interns’ (AI’s) experience with and perceived level of competency performing 6 basic medical procedures. Design Fourth-year medical students at the University of Cincinnati (UCCOM) are required to complete 2 AI rotations in Internal Medicine. All AIs in 2003–2004 (n?=?150) and 2004–2005 (n?=?151) were asked to complete a survey about whether during each of their rotations they had performed and felt competent performing the following procedures: phlebotomy, intravenous (IV) catheter insertion, arterial blood gas (ABG), nasogastric (NG) tube insertion, lumbar puncture (LP), and Foley catheter insertion. Results Four hundred sixty-seven of 601 possible surveys (across both years and both rotations) were completed (78% response rate). During both rotations, relatively few students performed the procedures, ranging from 9% for Foley catheter insertion (24/208) to 50% for both ABG and NG tube insertion (130/259). The two procedures most often performed were ABG (range 46–50%) and NG tube insertion (range 42–50%). Feelings of competency varied from 12% (LP) to 82% (Foley catheter). Except for LP, if students performed a procedure at least once, they reported feeling more competent (range 85% for ABG to 96% for Foley catheter insertion). Among the students who performed LP during a rotation, many still did not feel competent performing LPs: 23 (74%) in rotation 1 and 20 (40%) in rotation 2. Conclusion Many fourth-year students at UCCOM do not perform basic procedures during their acting internship rotations. Procedural performance correlates with feelings of competency. Lumbar puncture competency may be too ambitious a goal for medical students.
Goldenhar, Linda M.
An epidemiological study was conducted of the risk of spontaneous abortion among cosmetologists using more refined exposure data than the job title alone. The results suggest moderately increased risks of spontaneous abortion among cosmetologists who work...
E. M. John
|Reviews the current status of abortion laws pertaining to adolescents worldwide, examining questions raised by parental consent laws in the United States and by the relevant psychological research (risk of harm from abortion, informed consent, consequences of parental involvement in the abortion decision, and current debate). Discusses issues…
Adler, Nancy E.; Ozer, Emily J.; Tschann, Jeanne
Explores the complex feelings which can surround the subject of abortion and the difficulty some teachers may experience in trying to reconcile their personal beliefs with their professional responsibilities. Gives reasons for including abortion in the school curriculum rather than relying on parents\\/carers to cover the subject at home. Looks at how the subject of abortion can fit into different
Abortion is illegal in Burkina Faso except in cases of incest, rape, fetal defect, or when the woman's life or physical health is endangered. As a result, abortion procedures are often conducted illegally and unsafely and measuring incidence proves difficult. We estimate incidence of abortion and associated morbidity using two methodologies. The first is the Abortion Incidence Complications Method (AICM), which uses information on women hospitalized for abortion-related complications as well as health professionals' assessments of the proportion of women who seek treatment for complications from unsafe abortions. The second is the Anonymous Third Party Reporting (ATPR) method, which entails surveying women about their confidantes' abortions. We conclude that the AICM yields a more accurate result. We estimate that 87,200 abortion procedures were carried out in 2008, representing 25 for every 1,000 women aged 15-49. More than one in four procedures resulted in complications treated at a health facility. The abortion rate estimated using the ATPR approach was 72 percent of that estimated with the AICM. The ATPR method yields information on the characteristics of the women who have abortions as well as the providers and methods they use. PMID:21972666
Sedgh, Gilda; Rossier, Clémentine; Kaboré, Idrissa; Bankole, Akinrinola; Mikulich, Meridith
The issue of abortion, except when it is rendered moot because the fetus endangers the life of the mother, is not really a medical issue. The physician's role is to help patients achieve and maintain their maximum potential for physical, mental, and social well-being. To accomplish this, the physician must acquire a constantly evolving database of scientific knowledge, must evaluate this information in a critical and ethical manner, and must be prepared to apply what is learned. In the realm of applied ethics, no particular religion, profession, culture, class, or sex should be thought of as having all the answers in the realm of applied ethics. This physician's actions are predicated on the belief that, to a large extent, ethical precepts reflect the broader social and economic issues of the period in which they are articulated. If this is the case, then in today's world the population explosion, the postindustrial society, the women's rights movement, inequality of access, and the ability to perform prenatal diagnosis are all factors which have molded the approach to the issue of abortion. Only the last 3 of these can in any way be considered as medical. When considering the role of a physician in dealing with the issue of abortion in the adolescent, this individual relies on the concept articulated by the World Health Association (WHA): promoting the physical, emotional, and social well-being of one's patients. Each year in the US over 1 million 15-19 year olds become pregnant, resulting in over 600,000 births. Most of these pregnancies are unintentional, yet approximately 90% of the infants are kept in the home by mothers who are ill prepared to be parents. What is most disturbing is that the pregnancy rate for the younger mother, 16 years or under, is accounting for an ever increasing percentage of the total. Studies at the Adolescent Health Center of the Mount Sinai Hospital in New York City as well as national studies suggest that the younger teens are more likely to reject the abortion alternative. Vital statistics suggest that, for the most part, it is abortion rather than contraception that exerts an ameliorating effect on the birthrate of the younger mothers. The most disturbing aspect of these statistics is the magnitude of the very real problems associated with children bearing children. 2/3 of all women who have their 1st baby before the age of 20 will be below the poverty level. A correlation exists between poor marital adjustment and early childbearing. The divorce rate is 3 times higher when 1 spouse is younger than age 20. There are also problems for the infant of the teenage mother, including an increase in stillbirths and prematurity, and increase in small for date infants, and physical, psychological and social disadvantages over time for children born to mothers in their early teens. PMID:6608673
Morgenthau, J E
This paper offers an analysis of the book reviews published about the 1973 book Experience of Abortion: A case study of North-East Scotland, a volume edited by Gordon Horobin. The paper sets the scene at the time of publication of Experience of Abortion, including abortion as a societal issue, the 1967 Abortion Act and the role of the MRC Medical
Edwin van Teijlingen
Children participated in four role-plays designed to assess what the children themselves would do and what they would suggest a friend should do when encountering a medical procedure and a minor injury. Open-ended responses were coded into an empirically derived continuum suggested by past research. Similar responses were given to cope with medical procedures and injuries. However, children suggested more
Lizette Peterson; Jeffrey Crowson; Lisa Saldana; Sean Holdridge
During the RHIC Au-run in 2001 the 200 MHz storage cavity system was used for the first time. The rebucketing procedure caused significant beam debunching in addition to amplifying debunching due to other mechanisms. At the end of a four hour store, debunched beam could account for approximately 30%-40% of the total beam intensity. Some of it will be in the abort gap. In order to minimize the risk of magnet quenching due to uncontrolled beam losses at the time of a beam dump, a combination of a fast transverse kicker and copper collimators were used to clean the abort gap. This report gives an overview of the gap cleaning procedure and the achieved performance.
DREES,A.; AHRENS,L.; III FLILLER,R.; GASSNER,D.; MCINTYRE,G.T.; MICHNOFF,R.; TRBOJEVIC,D.
This meta-analysis evaluates the effect of hypnosis in reducing emotional distress associated with medical procedures. PsycINFO and PubMed were searched from their inception through February 2008. Randomized controlled trials of hypnosis interventions, administered in the context of clinical medical procedures, with a distress outcome, were included in the meta-analysis (26 of 61 papers initially reviewed). Information on sample size, study methodology, participant age and outcomes were abstracted independently by 2 authors using a standardized form. Disagreements were resolved by consensus. Effects from the 26 trials were based on 2342 participants. Results indicated an overall large effect size (ES) of 0.88 (95% CI = 0.57–1.19) in favour of hypnosis. Effect sizes differed significantly (p < 0.01) according to age (children benefitted to a greater extent than adults) and method of hypnosis delivery, but did not differ based on the control condition used (standard care vs. attention control).
Schnur, Julie B.; Kafer, Ilana; Marcus, Carolyn; Montgomery, Guy H.
IntroductionAbortion is one of the most widely discussed medical-ethical subjects in medical, legal, philosophical, and religious literature as well as in the lay press. There is hardly a religion or country in the world that is not currently concerned about this issue. The complexity of the topic relates to the fact that it deals with a being that is close
Investigated the validity of the Child—Adult Medical Procedure Interaction Scale- Revised (CAMPIS-R) using multiple concurrent objective and subjective measures of child distress, approach-avoidance behavior, fear, pain, child cooperation, and parents' perceived ability to help their preschool children during routine immuni- zations. Parents', staffs', and children's behaviors in the treatment room were videotaped and coded. Results indicate that the validity of
Ronald L. Blount; Lindsey L. Cohen; Natalie C. Frank; Pamela J. Bachanas; Adina J. Smith; M. Reena Manimala; Joseph T. Pate
This article reviews the technologies used to diagnose pregnancy and manage abortion in developing countries. The author discusses methods of diagnosing pregnancy—including physical examination, laboratory and home testing, and ultrasound—as well as methods for performing safe abortions. Due to manual vacuum aspiration (MVA) advances, vacuum aspiration has become safer and more feasible in low-resource settings. The discussion of medical abortion
Abstract Objectives To explore the demographic characteristics of women having multiple abortions, in order to identify abortion clients who might be at increased risk of repeat abortion. Methods On the basis of the registration data of most Dutch abortion clinics, responsible for 64% of all such procedures, women who procured a first abortion were compared to those who had one or more previously. Results of bivariate analyses and a multivariate binary logistic regression analysis are presented. Results Of all abortions, 36% were repeat abortions. Women aged over 20 were more likely to have repeat abortions, as were migrants, particularly those with a Caribbean background (from Surinam or the Netherlands Antilles) and women who had children. Effect sizes of other factors were very small. Surprisingly, women who had repeat abortions more often used contraception in the preceding six months than women who had a first abortion, but also this effect size was small as well. A multivariate logistic regression analysis led to similar results. Conclusions Abortion clients with a Caribbean background should be targeted for the prevention of more unwanted pregnancies. Not only should the use of reliable contraception be promoted, but also compliance and continuation. PMID:23964847
Picavet, Charles; Goenee, Maaike; Wijsen, Ciel
We investigated disparities in the prescription of analgesics following dental procedures that were expected to cause acute post-operative pain. Patients over the age of 19 years who had been treated by surgical and/or endodontic dental procedures were included in this study. We reviewed 900 consecutive charts and abstracted data on procedures, patients, and providers. We used chi-square and logistic regression models for analyses. There were 485 White subjects 357 African-American subjects included in this review; 81% of the African-American and 78% of White patients received a post-operative narcotic prescription (p=0.56). In multivariate regression models, patients over age 45 (p=0.003), those with insurance that covered medication and those with pre-existing pain (p=0.004) were more likely to receive narcotic analgesics. Students prescribed more narcotics than residents (p=0.001). No differences were found by race in prescribing analgesics.
Barasch, Andrei; Safford, Monika M.; McNeal, Sandre F.; Robinson, Michelle; Grant, Vivian S.; Gilbert, Gregg H.
Late abortion remains a complex and difficult issue in the United States, where about 10 percent of all abortions are performed at 13 or more weeks' gestation. The reasons why women delay having abortions appear to be largely personal, and most are not amenable to public health intervention. Dilatation and evacuation (D&E) is the most frequently used method of second-trimester abortion, and the safest. Its greatest safety advantage lies in the 13-16-week-interval; for later abortions, D&E and instillation abortion have similar risks of complications and death. The rare instances in which an abortion procedure ends in a live birth represent the most controversial aspect of second-trimester abortion. However, trends toward abortions at earlier gestational ages, use of D&E and increased reliance on ultrasonography to confirm gestational age should reduce the frequency with which such events occur. Research in the area of midtrimester abortion should seek ways to reduce the need for such procedures, to improve their safety and to minimize the trauma of the experience for women. PMID:6519237
Grimes, D A
The Abortion Assessment Project-India, begun in August 2000, is one of the largest studies on abortion ever undertaken in India. This article synthesises the findings of the six facility surveys, two community-based surveys, eight qualitative studies, policy review and commissioned working papers that were produced as part of the project by researchers from across India. Public investment in abortion services nationally was found to be grossly inadequate. 75% of facilities were found in the private sector in the six states and were overwhelmingly perceived to give better services. Although some important changes were made in the 1971 Medical Termination of Pregnancy Act related to clinic certification and medical abortion, further changes during the second phase of the government's Reproductive and Child Health Programme are recommended, based on this research and state and national-level consultations organised by the project These include integrating abortion services into primary and community health centres, increased investment in public facilities, promoting use of vacuum aspiration and medical abortion, convincing providers to stop using curettage, broadening the base of abortion providers by training paramedics to do first trimester abortions, and reskilling traditional providers to play alternative roles that support women's access to safe abortion services. PMID:15938165
Duggal, Ravi; Ramachandran, Vimala
Objective: Whether Canadian physicians can refuse to refer women for abortion and whether private clinics can charge for abortions are matters of controversy. We sought to identify barriers to access for women seeking therapeutic abortion and to have them identify what they considered to be most important about access to abortion services. Methods: Women presenting for abortion over a two-month
Ellen R. Wiebe; Supna Sandhu
This paper presents the results of in-depth interviews with ten clandestine abortion providers in urban Latin America. Three related issues are addressed: how abortion providers come to this line of work; their major difficulties; and their sources of job satisfaction. A variety of paths bring health professionals to the practice of abortion; common elements are a sense of calling, a desire to help women, personal experience with abortion, and a commitment to political change. Providers describe difficulties that include a lack of medical support, the need for secrecy, and threats of violence, extortion, and prosecution. In spite of difficulties, all providers report a great deal of fulfillment in their work, based on their satisfaction in saving women's lives, maintaining supportive relationships with colleagues, and empowering women. PMID:10374808
Rodriguez, K; Strickler, J
Septic abortion is a significant health problem with short- and long-term complications that affect the quality of life of\\u000a those fortunate enough to avoid mortality. Both spontaneous and induced abortion can result in septic complications, with\\u000a the latter disproportionately higher. Its incidence is high in environments with restrictive abortion laws, as clandestine\\u000a procedures by non-doctors in unhygienic settings are prevalent.
Henry Osazuwa; Michael Aziken
In early 1991 the abortion debate in Poland entered its new stage. The prolife and prochoice options had already clashed in the early 1930s over a new penal code and backstreet abortions. According to the code of 1932, induced abortion was allowed in cases of rape, incest, or for medical indications. Abortion was legalized in 1956, but subsequently it came under attack from Catholic circles, and by 1989 the Unborn Child Protection Bill was drafted which criminalized abortion. Only 11% of Polish women use modern contraceptives. The less efficient methods are the most prevalent: the natural method (Ogino-Knaus calendar), 35% of couples; coitus interruptus, 34%; condoms, 15%; oral contraceptives 7%; chemical spermicides, 2.5%; and the IUD 2%. According to size of Catholic Church estimate there are 600,000 abortions yearly. In contrast, official statistics indicate that the number of abortions is decreasing: 137,950 in 1980; 105,300 in 1988; 80,100 in 1989; 59,400 in 1990. In January 1991 the Constitutional Tribunal dismissed the motion of the Polish Feminist Association against the restrictive regulations of the Ministry of Health concerning abortion. After a parliamentary stalemate on the Unborn Child Protection Bill a commission consisting of 46 persona (1.2 of them women, 20 persons from the prochoice and 24 from the prolife lobby) continued the debate on the bill. Public opinion polls conducted by independent groups in November 1990 showed that about 60% of citizens were against the Senate's draft. Since then interest in the abortion issue has dwindled, and only 200 women and men took part in a prochoice demonstration in front of the parliament on January 25, 1991. In the spring of 1989 and in September 1990 thousands had participated in similar demonstrations. The prevailing attitude is that if the antiabortion bill is passed nothing can be done. PMID:12285924
The purpose of this review is to illustrate the utility and value of employing human self-administration procedures in medication development, including abuse liability assessments of novel medications and evaluation of potential pharmacotherapies for substance use disorders. Traditionally, human abuse liability testing has relied primarily on subjective reports describing drug action by use of questionnaires; similarly, drug interactions between putative treatment agents and the drugs of abuse have relied on these measures. Subjective reports are highly valued because they provide qualitative and quantitative information about the characteristics of central and peripheral pharmacodynamic effects as well as safety and tolerability. However, self-administration procedures directly examine the behavior of interest – that is, drug taking. The present paper 1) reviews the most commonly used human self-administration procedures, 2) discusses the concordance of subjective reports and self-administration within the context of medications development for substance use disorders, focusing primarily on illustrative examples from development efforts with opioid and cocaine dependence, and 3) explores the utility of applying self-administration procedures to assess the abuse liability of novel compounds, including “abuse deterrent” formulations (ADFs). The review will focus on opioid and cocaine dependence because a rich database from both clinical laboratory and clinical trial research exists for these two drug classes. The data reviewed suggest that drug-induced changes in self-administration and subjective effects are not always concordant. Therefore, assessment of self-administration in combination with subjective effects provides a more comprehensive picture that may have improved predictive validity for translating to the clinical setting.
Comer, SD; Ashworth, JB; Foltin, RW; Johanson, CE; Zacny, JP; Walsh, SL
With the possibility of the Supreme Court overturning the landmark Roe v. Wade (1973) case legalizing abortion, a review of abortion practices pre-Roe is instructive. Abortion became criminalized in the US around 1870, yet many abortions were performed. While estimates for the yearly number of pre-Roe illegal abortions roughly resemble today's number of legal abortions, the difference between legal and illegal abortion rests in the difference between the large number of women who died or were injured then, and the very few women who now die from illegal abortions. Along with the self-induced abortion, different categories of providers performed illegal abortions: physicians, nonphysicians, nurses, midwives, and lay people; all with varying skill, experience, and motives. While there were "butchers" and sexual exploiters, there were also competent, beloved physicians. There were the financially motivated physicians providing abortions full time, and the occasional providers acting with a sense of conscience, risking successful practices and jail. Within this "conscience" group of 44 interviewees gathered through personal networks, ads, etc., abortions were: performed outside of hospitals, reducing the risk of discovery, but creating greater medical risks; begun outside of a hospital with the intrusion into the uterus of an object, provoking a "spontaneous abortion" (miscarriage) needing completion by D and C (dilation and curettage) within a hospital, but only a limited number of such patients could be referred before arousing suspicion; and in a hospital under disguised circumstances, a very tricky undertaking with severe limitations, available only a few times before risking detection. Avoidance and lack of training by today's physicians and the well organized antiabortion groups will undoubtedly make illegal abortions even more difficult to engage in than the pre-Roe days. PMID:12317573
This dissertation is a new defense of the moral permissibility of abortion. The first chapter gives definitions, methodology, and an overview of the current abortion debate. The first chapter also addresses the Benefit of the Doubt Argument, which says that abortion should be treated as morally wrong on the chance that the anti-abortion position is correct and abortion is murder.
Kurt Charles Liebegott
Chronic illnesses often involve repeated hospitalization and invasive treatment procedures that can have a traumatic impact on child development. To explore possible consequences of treatment procedures, three groups of patients with congenital anomalies were examined longitudinally. At first admission, adolescents (ages 10-20, mean 15) with anorectal anomalies (n = 14), adolescents with Hirschsprung disease (n = 14), and hospitalized controls (n = 14) were assessed for treatment procedures, somatic function, mental health, and dissociative experiences. The assessment included the Adolescent Dissociative Experiences Scale (A-DES). At 10-year follow-up, the patients completed the Dissociative Experiences Scale (DES) and the Somatoform Dissociative Questionnaire (SDQ-20). Anal dilatation, an invasive medical treatment procedure performed daily by the parents the first 4 years, was correlated with the frequency and severity of persisting dissociative symptomatology. The procedure was the only significant predictor of A-DES and SDQ-20 scores, and one of two significant predictors of DES scores. This "experiment of nature" permitted a specific and unique opportunity to examine the impact of early traumatic exposure on child development in the absence of parental malevolence, and on later dissociative outcome in adolescence and adulthood. The findings might be valuable theoretically to our understanding of the development of psychopathology, and may lend itself for comparison with data on sexually abused children. PMID:16478561
Diseth, Trond H
Brief procedures for evaluating medication efficacy may reveal which candidate drugs warrant further testing in clinical trials and which do not. We previously carried out a study of smoking abstinence, involving the nicotine patch, and established the sensitivity of our procedure. In this study, we sought to cross-validate our earlier work by comparing short-term smoking abstinence due to varenicline (relative to placebo) in smokers with high intrinsic quit interest (n = 57) and those with low intrinsic quit interest (n = 67). All the subjects were randomly assigned to either abstinence reinforcement ($12/day) or no reinforcement. In a crossover design, all the subjects participated in two 3-week phases: ad libitum smoking (week 1), dose run-up of varenicline (1.0 mg b.i.d.) or placebo (week 2), and quit attempt on medication verified daily by carbon monoxide <5 ppm (week 3). As with the nicotine patch in the previous study, varenicline (relative to placebo) increased abstinence more effectively in those with high intrinsic quit interest than in those with low quit interest but did not affect abstinence due to reinforcement. These data confirm the feasibility of a brief, sensitive test of the efficacy of cessation medications in smokers with high quit interest. PMID:20485335
Perkins, K A; Lerman, C; Fonte, C A; Mercincavage, M; Stitzer, M L; Chengappa, K N R; Jain, A
The present paper, based on the results of international studies, is focused on the reconsideration of the psychological aspects of induced abortion. By presenting a narrow cross-section of the Hungarian demographic data, we would like to emphasise the necessity and the significance of a deeper understanding of the subject. Factors behind the decision-making, short- and long term outcomes of the intervention influencing primarily the mental health of women and partner-relationship aspects are discussed in details. While acknowledging the complexity of the subject deriving from the legal, ethical, moral, religious, medical, social and sociological concerns, our aim is to call attention to the psychological aspects of induced abortion and the importance of psychological care of women undergoing surgical operation. PMID:22232522
Sz Makó, Hajnalka; Veszprémi, Béla
Twenty-eight years after the United State Supreme Court issued its landmark Roe v. Wade, the struggle continues to ensure that all women have the full range of reproductive choices, including abortion. While the struggle can be addressed through its political, religious, and medical dimensions, it also can be examined through the perspectives of those who actually provide abortions. This paper
The variability of abortion laws and particularly, of the mechanisms employed to implement them attests to the sociocultural specificity of the concrete solutions to the universal problem of reproductive control. The present study examines the implementing mechanisms of the abortion law in Israel, which is a medical committee. Based on interviews with 29 social workers (all women) who serve on
Delila Amir; Orly Biniamin
The author explores the possible relationship between psychopathology and abortion. The paper starts with the updating of epidemiological data regarding the incidence of abortion, especially in the current Spanish society. In this partnership there are three sections in the study of these possible relations between the abortion and the psychopathology: (a) in the new emerging sexual behaviour, especially among young people, and psychopathological factors possibly determining their sexual behaviour; (b) in the psychological and psychopathological context that makes the decision to abort, in regard to the factors of the couple and their families of origin and social context, and (c) in the frequent psychopathological disorders that seem to arise from the abortion, according to recent data reported by many researchers in the international scientific community. The study of the so-called Post-Abortion Syndrome (PAS) puts an end to this cooperation, distinguishing psychopathological profile characteristic that distinguishes the various stages of this syndrome. PMID:19799478
Polaino Lorente, Aquilino
One of the most sensitive subjects in the field of non military foreign assistance is aid for abortion. Consequently, it is very difficult to gather data. Information from interviews was combined with scattered fragments of existing data in the effort to construct a composite picture of the international abortion scene. Apart from any outside intervention, induced abortion is a common practice in developing countries. Abortion is frequent and is a prominent cause of death and illness among women of childbearing age. Foreign aid is a small proportion of the total aid for population activities, and, with the exception of the United Nations agencies, most organizations supplying funds for abortion operate on a clandestine and usually illegal basis. The most common type of foreign aid involves the technique known as uterine aspiration, which goes under various code phases. Abortion can be a profit-making proposition in developing countries. In the United States the politics of abortion have had an overwhelming impact on foreign aid for abortion. As of 1979 only a handful of international donors were involved in direct support of abortion activities in the developing countries; others provided indirect assistance for research, meetings, and information activities. The Agency for International Development (AID) was an ardent supporter of abortion until it was brought to a standstill by the Helms Amendment of 1973. AID was forced to withdraw from most abortion activities. The only agencies operating openly in this field are the World Bank and the United Nations Fund for Population Activities. The International Planned Parenthood Federation has been the most outspoken advocate of legal abortion services in developing countries. PMID:7372467
Warwick, D P
This note focuses on the issue of the state's application of the criminal law as a sanction against women who choose to have abortions. History reveals that pre-Roe criminal-abortion law-both by its terms and in its application-expressed an incoherent attitude toward the culpability of these women. While criminal-abortion laws treated the abortionist as a serious felon, sending him to prison
Samuel W. Buell
One barrier in the US to wider acceptance of mifepristone for abortion is the additional cost of the routine use of two sonograms, that is, for pregnancy dating and confirmation of a complete abortion. The purpose of this study is to document how the accuracy of medical abortion clinicians experienced with pelvic exams and dating pregnancies in assessing gestational age
Stephen L. Fielding; Eric A. Schaff; Na-yon Nam
Objective: We sought to compare the acceptability of suction curettage abortion with that of medical abortion with mifepristone and misoprostol in American women. Study Design: We performed a prospective, serially enrolled, cohort analysis. The study population consisted of 152 subjects receiving mifepristone and misoprostol and 174 subjects undergoing suction curettage abortion aged ?18 years with intrauterine pregnancies of up to
Jeffrey T Jensen; S. Marie Harvey; Linda J Beckman
BackgroundMedication abortion has the potential to increase abortion availability, primarily through new provider networks; however, without a better understanding of how and why women make decisions regarding both their abortion method and their provider, expansion efforts may be misguided and valuable resources may be wasted.
Tara Shochet; James Trussell
\\u000a After reading this chapter and answering the discussion questions that follow, you should be able to\\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Critically analyze the history, incidence, and reasons for abortion from a global perspective.\\u000a \\u000a \\u000a \\u000a • \\u000a \\u000a \\u000a Identify and discuss differences in implementation of abortion laws and policies across different countries, and the public\\u000a health implications with particular attention to unsafe abortion and abortion-related mortality and
Comments were made about the US legislative agenda to provide universal health insurance coverage and basic health care which must cover the most controversial procedure, abortion. Compromises have been offered that would deny abortion to any women receiving a government subsidy, that would allow employers to opt out of coverage, that would allow a nurse or doctor to opt out of performing an abortion, and that would allow women to refuse abortion insurance coverage. Neither prochoice nor prolife groups have cooperated in reducing the demand for abortion. Over the past several years, the debate has evolved to the point where prolife groups are trying to make abortion impossible, not just illegal, by murdering doctors and escorts and blocking clinic entrances. A CNN poll revealed in the beginning of August 1994 that 8% agreed that force was justifiable for preventing abortion, and 3% agreed that killing a doctor was justifiable. Members of Congress have attempted to create a neutral or safety zone to no avail. This has created the illusion of peace, but the abortion war rages on. Health care reform must address this controversial question and move in one direction or another. The present system perpetrates a double standard because the financially comfortable are covered for abortion care, and the poor under Medicaid are denied abortion coverage. PMID:12289883
... or requirements that abortions after a specified gestation age be performed in a hospital, or that providers have admitting privileges in ... or consent of one or both parents before a minor has an abortion. 38 ... LJ. Ambulatory and inpatient procedures in the United States, 1996. CDC National Vital Health ...
The antiabortion groups and their lawyers have added a new weapon to their arsenal against physicians who perform abortions in the US: malpractice lawsuits. The nonprofit educational organization Life Dynamics generates material for personal injury lawyers and is participating in 80 cases. It has assembled 642 lawyers and 500 physicians in its abortion malpractice program. Life Dynamics calls for persons to support lawsuits to increase malpractice insurance rates of abortionists, thereby forcing them out of business. Its 2-day 1994 seminar in Texas addressed abortion injuries, an alleged link between abortion and breast cancer, and abortion as a likely source of post-traumatic stress disorder. A lawyer and general counsel of the Arizona Right-to-Life has filed two lawsuits against a Phoenix physician who performs abortion. The trial judge dismissed both cases and fined the lawyer for frivolous lawsuits. An appeal overturned the fines. The lawyer has three more lawsuits on the docket. The physician had complained to the Arizona Bar Association about the lawyer. Even though the physician's insurance company did not pay any claims, its underwriters deemed him an actuarial risk, thereby making him essentially uninsurable. Local medical associations have failed to take a position on the lawyer's legal misconduct because they do not want to alienate some members. The Planned Parenthood Federation of America agreed that the lawsuits brought against the Phoenix physician were fraudulent and that they do not aim to protect women but to revoke their right to choose. PMID:7728049
Charatan, F B
112 programs to formally train residents in abortion procedures and in the manage- ment of complications from spontaneous and elective abortions. Nevertheless, shortly after the 1973 Supreme Court decision in Roe v. Wade, a survey of residency programs found that most university departments of obstetrics and gynecology were not providing rou- tine abortion training in their programs. 3 A subsequent
H. Trent MacKay; Andrea Phillips MacKay
This publication outlines the "medical research" licensing procedure as specified in the amendment of the German Radiation Protection Ordinance of November 1, 2011. The general licensing requirements for the use of radiation have not been changed by the amendment. Three so-called use restrictions (i. e., dose limits of 10 mSv and 20 mSv, age limit of 50 years) have been modified. They will only apply to healthy volunteers in the future. In addition, there are considerable simplifications with respect to applications and licensing procedures of the Federal Office for Radiation Protection (Bundesamt für Strahlenschutz, BfS) regarding the use of radiation in the newly introduced "accompanying diagnostics" ("Begleitdiagnostik") case group. The newly established, independent panel of experts at the German Radiological Society (Deutsche Röntgengesellschaft, DRG) may provide essential support to principal investigators, qualified physicians and sponsors for differentiating between "medical research" and "health care", the latter not being subject to licensing. An expert statement will be issued by the DRG within four weeks of an inquiry. This consulting service is subject to confidentiality, and is free of charge for inquirers and without any commitment. PMID:22331822
Habeck, M; Epsch, R; Minkov, V; Langer, M; Griebel, J; Brix, G
South Africa's National Assembly voted 209 to 87 for passage of the "Choice on Termination of Pregnancy Act" on October 30; it was passed in the Senate, 49 to 21 (20 abstentions), on November 5. The African National Congress strongly supported the Act, while the National Party opposed it. Under the law, abortions during the first 12 weeks of pregnancy may to be performed by physicians or trained midwives. From week 13 through week 20, a physician, in consultation with the mother, may terminate the pregnancy after determining that continuing the pregnancy would threaten the woman's health (physical or mental) or circumstances (social or economic), or that the fetus is at substantial risk of suffering severe physical or mental abnormalities. Abortion is permitted after 20 weeks if two doctors (or midwives) decide continuing the pregnancy would endanger the mother's life or result in injury or severe malformation of the fetus. Only the pregnant woman's consent is required. Although an abortion provider must advise a young client to consult with parents, guardian, family members, or friends before the procedure, she is not required to comply. All women are to be informed of their rights under the Act; criminal penalties (up to 10 years) are mandated for unauthorized abortion providers, for persons who prevent a lawful abortion, or for those who obstruct access to an abortion facility. The new statute repeals the more restrictive Abortion and Sterilization Act of 1975, which permitted abortion only in cases of maternal life or health endangerment, severe fetal abnormality, rape, incest, or mental incapacity. PMID:12292092
The literature on psychosocial aspects of abortion is confusing. Individual publications must be interpreted in the context of cultural, religious, and legal constraints obtaining in a particular society at a given time, with due attention to the status and availability of alternatives to abortion that might be chosen by a woman with an “unwanted” pregnancy. A review of the literature shows that, where careful pre- and post-abortion assessments are made, the evidence is that psychological benefit commonly results, and serious adverse emotional sequelae are rare. The outcome of refused abortion seems less satisfactory, with regrets and distress frequently occurring. Research on the administration of abortion services suggests that counselling is often of value, that distress is frequently caused by delays in deciding upon and in carrying out abortions, and by unsympathetic attitudes of service providers. The phenomenon of repeated abortion seeking should be seen in the context of the availability and cost of contraception and sterilization. The place of sterilization with abortion requires careful study. A recommendation is made for observational descriptive research on populations of women with potentially unwanted pregnancies in different cultures, with comparisons of management systems and an evaluation of their impact on service users.
Illsley, Raymond; Hall, Marion H.
|Explored differences between 35 women who had abortions as teenagers and 36 women who had abortions as adults. Respondents reported on their premorbid psychiatric histories, the decision-making process itself, and postabortion distress symptoms. Antisocial and paranoid personality disorders, drug abuse, and psychotic delusions were significantly…
Campbell, Nancy B.; And Others
In order to determine why and how women in South Africa obtain illegal abortions, a descriptive study was conducted in six public hospitals in four provinces. Data were gathered via semi-structured, in-depth interviews with 25 women hospitalized with complications of self-confessed induced abortion (64% Africa, 20% Indian, and 16% Colored). 3 of the 5 married women were separated from their husbands. Almost half of the subjects were adolescents, and the mean age was 25 years. All of the women were aware of contraceptives but failed to use them or used them improperly. In some cases, the male partners disapproved of contraception or initiated intercourse in such a way that disempowered the women, making them unable to negotiate contraceptive usage. Most of the women felt they had no choice but to seek abortion because their sexual relationships or financial circumstances were unstable. The compulsion to seek abortion overrode all legal and religious considerations. The women, who had to self-induce or seek illegal abortion, felt that the current law placed a tremendous burden on them at a time of extreme trauma. The women also complained about their treatment at the hands of the abortionists and, later, by the hospital staff. Thus, the 1975 abortion and Sterilization Act has failed to limit the number of abortions. The law should be amended to make abortion accessible, safe, and less expensive to obtain. In addition, men should be targeted recipients of family planning and contraception information. PMID:9418421
Maforah, F; Wood, K; Jewkes, R
Sir Dugald Baird sketches the history of abortion legislation in Great Britain from the beginning of the century. In his views the 1967 Abortion Act has been one of the most important and beneficial pieces of social legislation enacted in Britain in the last 100 years. It has, however, brought problems both of administration in the hospitals and to individual
We describe case histories of three women with post-abortion mania, including two women who underwent a change in diagnosis from bipolar II to bipolar I disorder and another woman who had no prior history of psychiatric disturbance. It is argued that the study of post-abortion mania should provide an opportunity to better understand the aetiology of puerperal mania. PMID:23381493
Sharma, Verinder; Sommerdyk, Christina; Sharma, Sapna
Countries are grouped by the nature and extent of access to legal abortion. The categories include abortion on demand, for social reasons, for health reasons, for rape or incest or to save a mother's life, and only to save a mother's life. Abortion on demand is available for about 40% of the world's population and may have restrictions, such as parental consent or approval of state committees or physicians. There are 22 countries in Europe, 12 in the former Soviet Union, four in Asia, four in the Americas, one in the Middle East (Turkey), and one in Africa (Tunisia) which provide access to early abortion on demand. Abortion for social and economic reasons is available to 21% of the world's population in five countries in Asia, three in Europe (Great Britain, Finland, and Hungary), and one in Africa (Zambia). Abortion for health reasons is available to 16% of the world's population located in 21 countries in Africa, eight in the Americas, seven in Asia, five in Europe, and four in the Middle East. Laws governing about 5% of the world's population permit abortion only in the case of rape, incest, or when a mother's life is in danger (Brazil, Mexico, and Sudan). 18% of the world's population is covered by laws which permit an abortion only when a mother's life is in danger; this includes 19 countries in Africa, 11 in the Americas, nine in Asia, seven in the Middle East, and one in Europe (Ireland). PMID:12287145
The social policy towards abortion determined by the Roe vs. Wade decision can be overturned at any time depending upon how the US Supreme Court reacts to challenges to its earlier ruling. Roe vs. Wade was decided by a 7 to 2 vote, and the members of the Supreme Court appointed by Presidents Reagan and Bush were chosen to uphold a conservative (anti-abortion) ideology. Although more than half of the present Court was appointed by these presidents, President Clinton now has the opportunity to appoint 2 more Justices. The public policy positions which are currently available to the Supreme Court or to Congress can be ranked on a chart from liberal to conservative. In this article, 7 different positions are described in detail, and the public policy implications of the implementation of each position are described. The first position considered is the extreme conservative position of "no abortion; no exceptions" as defined by author and Roman Catholic theologian Gerald Kelly. The only procedures allowed which would end the life of a fetus would be those to remove an ovary or fallopian tube in the case of an extrauterine pregnancy (permissible under the doctrine of double effect). In the most extreme interpretation of this situation (which Kelly does not seem to hold), those who perform abortions would be prosecuted for murder. The next position considered is the most liberal position, which is espoused by Michael Tooley, and which holds that abortion and early infanticide are both permissible. The third position is that which allows no abortion but has limited exceptions in cases of rape or incest. The appropriate consideration for abortion presented next is that of the late Joseph Fletcher who believed that whatever love requires is the proper response to the situation. Philosopher Dan Callahan espouses the notion that abortion should be performed for compelling reasons only (after effective counseling). The trimester approach to the problem of abortion is that set forth by Justice Harry Blackmun in Roe vs. Wade. This approach gives a woman freedom to decide to have an abortion during the first 2 trimesters of her pregnancy only. This approach has essentially dictated public policy in the US since 1973. The last position considered is that which maintains that a woman's right to equality demands that she have sole control over whether or not to have an abortion. PMID:8118140
McIntyre, R L
The January 1973 Supreme Court decision concerning abortion did not settle the issue. In fact, the issue becomes increasingly more critical. Supporters of "freedom of choice" thought the victory was theirs when the decision was announced by the Court, but advocates of an anti-abortion position were incensed by the decision. After a few months of letter writing, the anti-abortion forces developed a more comprehensive, long-range strategy. Their objective is a constitutional amendment barring abortion. Supporters of "freedom of choice" do have several important elements in their favor. 1st, the majority of public opinion is on the side of freedom of choice. 2nd, the position being advocated is clearly non-discriminatory and non-coercive. Unlike the opposition, those who support freedom of choice are not trying to impose their beliefs on any other group of people and are actually trying to protect each and every individual's freedom of choice. This seasoned and reasonable view needs to be presented nationally in a seasoned and reasonable manner. More mail from both men and women needs to be directed toward each member of the House and Senate with special emphasis on the members of the House and Senate Judiciary committees. In addition to sending more mail, Zero Population Growth chapters and members could help by: 1) initiating "freedom of choice" letters to editors of local newspapers; 2) having persons representing the "freedom of choice" point of view appear on local television shows and before community groups; and 3) enlisting the help of the local medical and legal communities to lend their expertise to an intelligent discussion of the issue. PMID:12276913
Abstract The Model for Assistance in the Orientation of a User within Coding Systems (MAOUSSC) project has been designed to provide a representation for medical and surgical procedures that allows several applications to be developed from several viewpoints. It is based on a conceptual model, a controlled set of terms, and Web server development. The design includes the UMLS knowledge sources associated with additional knowledge about medico-surgical procedures. The model was implemented using a relational database. The authors developed a complete interface for the Web presentation, with the intermediary layer being written in PERL. The server has been used for the representation of medico-surgical procedures that occur in the discharge summaries of the national survey of hospital activities that is performed by the French Health Statistics Agency in order to produce inpatient profiles. The authors describe the current status of the MAOUSSC server and discuss their interest in using such a server to assist in the coordination of terminology tasks and in the sharing of controlled terminologies.
Burgun, Anita; Denier, Patrick; Bodenreider, Olivier; Botti, Genevieve; Delamarre, Denis; Pouliquen, Bruno; Oberlin, Philippe; Leveque, Jean M.; Lukacs, Bertrand; Kohler, Francois; Fieschi, Marius; Le Beux, Pierre
Patients' memories of painful medical procedures may influence their decisions about future treatments, yet memories are imperfect and susceptible to bias. We recorded in real-time the intensity of pain experienced by patients undergoing colonoscopy (n = 154) and lithotripsy (n = 133). We subsequently examined patients' retrospective evaluations of the total pain of the procedure, and related these evaluations to
Donald A Redelmeier; Daniel Kahneman
Modern thinking on abortion, reflected in recent legal developments around the world, has turned from concentration upon criminality in favor of female and family well-being. New laws enacted during the last decade are coming to focus upon conditions of health and social welfare of women and their existing families as indications for lawful termination of pregnancy. Regulations governing the delivery of services may be restrictive, however, so as to limit in practice access to means of safe, legal abortion made available in theory. Requirements may be imposed that only medical personnel with unduly high qualifications perform procedures, or that they be undertaken only in institutions meeting standards higher than similar health care requires. Approval procedures may be established involving second medical opinions or committees to monitor observance of the law, which may delay abortions and therefore increase their hazards. Parental and spousal consent requirements may exist in addition with the same effects, or to veto a pregnant female's request. Regulations may be employed more positively, however, to encourage contraceptive practice. A disappointment with legislative reform is that it may fail to improve circumstances if public resources are not applied to achieve the supply of services newly rendered legitimate, and illegal practice may persist.
Cook, R J; Dickens, B M
|Two physicians debate whether abortions should be available on request regardless of medical indications. The crux of the issue is whether the fetus should be considered body tissue over which the woman has complete control or whether society has an interest in the embryo and should protect it. (Author/BY)|
Nathanson, Bernard; Lawrence, George
Unsafe abortion in Sudan results in significant morbidity and mortality. This study of treatment for complications of unsafe abortion in five hospitals in Khartoum, Sudan, included a review of hospital records and a survey of 726 patients seeking abortion-related care from 27 October 2007 to 31 January 2008, an interview of a provider of post-abortion care and focus group discussions
Joyce Kinaro; Tag Elsir Mohamed Ali; Rhonda Schlangen; Jessica Mack
In an attempt to more fully understand the reactions of student nurses in the participant observer role on an abortion unit, the verbal reactions and dreams of upper-division baccalaurate student nurses were studied. The majority of students exhibited anxiety upon observing an abortion. The anxiety exemplified either through verbal comments or dreams about death and mutiliation was sublimated by defense mechanisms including suppression, denial and/or rationalization. Recommendations for student nurses involved in abortion procedures include: informal discussions of the anticipated experience; assessment of individual student strengths to allow for specific preparation for the new clinical setting; use of audiovisual materials relative to nursing; an opportunity for students to discuss their individual reactions and feelings after participating in an abortion procedure; and scheduling the abortion observation after other opportunities to deliver health care have been met. PMID:255393
Hurwitz, A; Keane, M
This paper shows that the counterexamples proposed by Strong in 2008 in the Journal of Medical Ethics to Marquis's argument against abortion fail. Strong's basic idea is that there are cases--for example, terminally ill patients--where killing an adult human being is prima facie seriously morally wrong even though that human being is not being deprived of a "valuable future". So Marquis would be wrong in thinking that what is essential about the wrongness of killing an adult human being is that they are being deprived of a valuable future. This paper shows that whichever way the concept of "valuable future" is interpreted, the proposed counterexamples fail: if it is interpreted as "future like ours", the proposed counterexamples have no bearing on Marquis's argument. If the concept is interpreted as referring to the patient's preferences, it must be either conceded that the patients in Strong's scenarios have some valuable future or admitted that killing them is not seriously morally wrong. Finally, if "valuable future" is interpreted as referring to objective standards, one ends up with implausible and unpalatable moral claims. PMID:19407035
Di Nucci, E
The question that arises is whether it is constitutional for a state to require all abortions after the 1st trimester to be performed in a hospital despite evidence that certain 2nd-trimester procedures may be performed safely in outpatient facilities and are safer than childbirth. In the Supreme Court's Roe v. Wade decision, 1973, the Court held that in the interest of protecting the health of the pregnant woman, it would be permissible for a state to require that 2nd-trimester abortions be performed in a hospital. In the years immediately following the Roe decision, many states enacted a hospital requirement for mid-trimester abortions; these laws were rarely challenged and never overturned. In late 1977, in response to a lawsuit filed by a New Jersey physician challenging the validity of the state medical board's rule that all 2nd trimester abortions be performed in a hospital, a state superior court ordered the board to reconsider its position and to hold public hearings on the rule. Ultimately, the board issued a new regulation allowing licensed clinics to perform outpatient abortions by the dilatation and evacuation method through 16 menstrual weeks and/or 14 gestational weeks. The New Jersey case was followed by 2 federal district court decisions (1980) striking down hospital requirements in Missouri and Louisiana. In discussing the arguments presented focus is on the evidence supporting the safety of outpatient dilatation and evacuation procedures, the ultimate test of determining whether the legislature acted reasonably in deciding that the regulation would promote maternal health, and a case now before the U.S. Court of Appeals for the 4th Circuit which presents substantially different circumstances and issues from other hospital challenges. PMID:12262415
Background: Unsafe abortion is an important cause of maternal mortality and morbidity, particularly marked in developing countries with restrictive abortion laws. It has both bioethical and human rights implications, violating their key principles and components. Objective: To highlight the magnitude of complications of unsafe abortion and examine the legal,bioethical, sexual and reproductive right implications of unsafe abortion as well as to review post abortion care (PAC) in Nigeria. Data Source: Information derived from online web-search, literature review of articles from learned journals, serials and monographs from local and supra-national agencies working on abortion, and reproductive health. Results: About 20 million unsafe abortions are performed annually globally resulting in about 80, 000 maternal deaths. Asia and Africa have the highest number of maternal deaths. In Nigeria, 760, 000 abortions are performed annually. Abortion law in Nigeria is restrictive. Unsafe abortion violates three key bioethical principles at micro and mega-ethical levels. It also violates eleven of the twelve components of sexual and reproductive rights. PAC is approved as an effective approach to reducing abortion morbidity and mortality and promoting women's reproductive rights. Conclusion: Stakeholders can promote the ethical, sexual and reproductive rights of women through the following interventions: advocacy, liberalization of restrictive abortion law, training of health workers on PAC services, inter-organisational collaboration, development of right based code of ethics and inclusion into medical training curriculum. Socio-economic empowerment of women, provision of PAC services equipments in health facilities, and improvement of access to quality family planning services will also help promote the rights of women. PMID:22669827
The authors investigate the effect of abortion access on teen birthrates using county-level panel data. Past research suggested that prohibiting abortion led to higher teen birthrates. Perhaps surprisingly, the authors find that more recent restrictions in abortion access, including the closing of abortion clinics and restrictions on Medicaid funding, had the opposite effect. Small declines in access were related to
Thomas J Kane; Douglas Staiger
Working in abortion care presented a unique set of social, emotional and practical challenges for staff. Because of working in abortion care some staff expressed a sense of isolation from other colleagues. They said that those who didn’t work in abortion care considered it an unpopular job and perceived patients requesting abortion as more ‘challenging ‘and ‘problematic’ than other patients,
Edna M Astbury-Ward
The Swedish abortion legislation of 1975 gave women the right to make a decision about abortion before the end of the 18th week of pregnancy. The number of abortions is rising in Sweden as a chosen method of birth control. The attitudes of students toward abortion were studied in 1986–1987. A questionnaire containing items on how sex education is taught,
Marianne E. Lindell; Henny M. Olsson
The 4th amendment of the Medical Device Law introduced the authorization procedure for clinical trials with medical devices. The Federal Institute for Drugs and Medical Devices ("Bundesinstitut für Arzneimittel und Medizinprodukte", BfArM) has now drawn the first substantial interim balance on the basis of daily practice in order to describe results achieved by applications of clinical trials with medical devices. Overall, realization of the new authorization procedure of clinical trials is well underway. This empirical practical analysis of the first 405 applications points out further possibilities for improvements for future applicants. Furthermore, initial figures demonstrate the cooperative relationship with national and international applicants. Because the by far largest percentage of the premarket clinical trials with medical devices in the European Community are conducted in Germany (28%), the analysis also provides a comparison with other European countries in order to detect differences in specific areas as the result of the implementation of Directive 2007/47/EC. PMID:22290172
Fischer, T; Renisch, B; Broich, K
Abortion was completely illegal in Portugal until 1984. Illegal abortion provision was a matter of silence until then and treated as a "black market" issue rather than as a health issue. The first attempts to change the abortion law began in 1982 after two trials and a national campaign for legal abortion and contraception. In 1984, the law was changed and abortion became legal on four grounds: risk to the woman's life, risk to her physical or mental health, fetal malformation and pregnancy resulting from rape. At the beginning of the 1990s, the Family Planning Association (APF), some women's organisations, trade unions, health professional associations and other NGOs came together to form the Right to Choose Platform. In 1993 a Report on the Abortion Situation in Portugal was presented to the Parliament and Ministries of Health and Justice, followed by public debates. In 1998 the law was changed to allow existing grounds to be applied beyond 12 weeks of pregnancy but bills and a referendum to make abortion available on request to 12 weeks of pregnancy were lost by a tiny margin twice in this period. At the end of 2001 the biggest trial on illegal abortion started in Maia, a small town in the north of the country, which had an immediate and enormous impact on public opinion. An increasing number of public opinion-makers, some prestigious health professionals and even the President of the Republic have recently declared that the law should be changed. The election of a right-wing parliamentary majority in March 2002, however, means that abortion law reform will again be postponed. PMID:12369320
Many laser medical procedures can be improved by dispensing exogenous fluids onto the tissue during irradiation. Examples include the dispensing of coolants, photoabsorptive enhancers, photoreflective tissue shields, photoactivated tissue solders, fillers, or surface sealants. The main obstacle to the use of such auxiliary fluids is the difficulty of dispensing them in a convenient, interactive fashion while operating the laser. We have adapted ink-jet printing technology to this problem of dispensing auxiliary fluids during laser procedures. The technology can dispense fluids with exquisite volumetric, spatial, and temporal precision. In principle, one or more fluids can be dispensed interactively from nozzles similar in size to the optical fibers and microlenses that are used for the lasers. Compact handpieces or endoscopic tools that will incorporate fluid MicroJets and laser optics can be envisioned. The enhancements to laser surgical technology that could be afforded by the use of fluid jetting will be discussed. Examples from ongoing work in dentistry, orthopedics, and dermatology are presented. Supported in part by NIH SBIR's DE10687 and GM50602.
Frederickson, Chris J.; Hayes, Donald J.; Wallace, David B.; Ussery, D.; Arcoria, Charles J.; Motamedi, Massoud; Jennett, E.; Diven, D.
The objective was to systematically review the literature to identify and grade tools used for the end point assessment of procedural skills (e.g., phlebotomy, IV cannulation, suturing) competence in medical students prior to certification. The authors searched eight bibliographic databases electronically - ERIC, Medline, CINAHL, EMBASE, Psychinfo, PsychLIT, EBM Reviews and the Cochrane databases. Two reviewers independently reviewed the literature to identify procedural assessment tools used specifically for assessing medical students within the PRISMA framework, the inclusion/exclusion criteria and search period. Papers on OSATS and DOPS were excluded as they focused on post-registration assessment and clinical rather than simulated competence. Of 659 abstracted articles 56 identified procedural assessment tools. Only 11 specifically assessed medical students. The final 11 studies consisted of 1 randomised controlled trial, 4 comparative and 6 descriptive studies yielding 12 heterogeneous procedural assessment tools for analysis. Seven tools addressed four discrete pre-certification skills, basic suture (3), airway management (2), nasogastric tube insertion (1) and intravenous cannulation (1). One tool used a generic assessment of procedural skills. Two tools focused on postgraduate laparoscopic skills and one on osteopathic students and thus were not included in this review. The levels of evidence are low with regard to reliability - ? = 0.65-0.71 and minimum validity is achieved - face and content. In conclusion, there are no tools designed specifically to assess competence of procedural skills in a final certification examination. There is a need to develop standardised tools with proven reliability and validity for assessment of procedural skills competence at the end of medical training. Medicine graduates must have comparable levels of procedural skills acquisition entering the clinical workforce irrespective of the country of training. PMID:22927716
Morris, Marie C; Gallagher, Tom K; Ridgway, Paul F
Small island exigencies and a legacy of colonial jurisprudence set the stage for this three-year study in 2001-2003 of abortion practice on several islands of the northeast Caribbean: Anguilla, Antigua, St Kitts, St Martin and Sint Maarten. Based on in-depth interviews with 26 physicians, 16 of whom were performing abortions, it found that licensed physicians are routinely providing abortions in contravention of the law, and that those services, tolerated by governments and legitimised by European norms, are clearly the mainstay of abortion care on these islands. Medical abortion was being used both under medical supervision and through self-medication. Women travelled to find anonymous services, and also to access a particular method, provider or facility. Sometimes they settled for a less acceptable method if they could not afford a more comfortable one. Significantly, legality was not the main determinant of choice. Most abortion providers accepted the current situation as satisfactory. However, our findings suggest that restrictive laws were hindering access to services and compromising quality of care. Whereas doctors may have the liberty and knowledge to practise illegal abortions, women have no legal right to these services. Interviews suggest that an increasing number of women are self-inducing abortions with misoprostol to avoid doctors, high fees and public stigma. The Caribbean Initiative on Abortion and Contraception is organising meetings, training providers and creating a public forum to advocate decriminalisation of abortion and enhance abortion care. PMID:16291485
Pheterson, Gail; Azize, Yamila
This privately posted page offers extensive and highly credible information on legislation and jurisprudence relating to abortion in the US. The site offers thoroughly linked discussions of constitutional law, Roe v. Wade, Planned Parenthood v. Casey, state and federal abortion laws, including partial-birth abortion laws, and much more. The hypertext links are to primary documents including court decisions, texts of legislation, court briefs, and oral argument transcripts. There is also an index to primary documents for ease of access. We found the page to have no political agenda. As the author states, "this page is being constructed to help people, regardless of their political bent, understand the background and state of abortion law in America, and access related legal material--especially that which is less available and less well known."
Computer models provide a framework for better understanding of complex phenomena. Events such as launch aborts are rare, and detailed field information about the chemical load they introduce into the atmosphere is rare. A good model will make predictions...
B. B. Brady A. McIlroy L. R. Martin
Objective Abortion either medical or criminal has distinctive physical, social, and psychological side effects. Detecting types and frequent psychological side effects of abortion among post abortion care seeking women in Tehran was the main objective of the present study. Method 278 women of reproductive age (15-49) interviewed as study population. Response rate was 93/8. Data collected through a questionnaire with 2 parts meeting broad socio-economic characteristics of the respondents and health- related abortion consequences. Tehran hospitals were the site of study. Results The results revealed that at least one-third of the respondents have experienced psychological side effects. Depression, worrying about not being able to conceive again and abnormal eating behaviors were reported as dominant psychological consequences of abortion among the respondents. Decreased self-esteem, nightmare, guilt, and regret with 43.7%, 39.5%, 37.5%, and 33.3% prevalence rates have been placed in the lower status, respectively. Conclusion Psychological consequences of abortion have considerably been neglected. Several barriers made findings limited. Different types of psychological side effects, however, experienced by the study population require more intensive attention because of chronic characteristic of psychological disorders, and women's health impact on family and population health.
Doctors have been placed in an anomalous position by abortion laws which sanction the termination of a fetus while in a woman's womb, yet call it murder when a physician attempts to end the life of a fetus which has somehow survived such a procedure. This predicament, the doctors' dilemma, can be resolved by adopting a strategy which posits the right to ownership of one's own body for human beings. Such an approach will generate a consistent policy prescription, one that sanctions the right of all pregnant women to abortions, yet grants the fetus, after it becomes viable as a potentially independent person, a right to its own body. The doctors' dilemma is surmounted, then, by requiring that abortions of viable fetuses be performed in a manner that will produce a live delivery. Hence, infanticide and termination of viable fetuses are proscribed.
Paul, E F; Paul, J
...for medical/psychiatric/psychological records. 1701.13 Section...for medical/psychiatric/psychological records. Current and...medical, psychiatric or psychological testing records by writing...govern administration of these types of records, including...
...for medical/psychiatric/psychological] 32 NATIONAL DEFENSE...for medical/psychiatric/psychological records. Current and former...medical, psychiatric or psychological testing records by writing...govern administration of these types of records, including...
The problem of criminal abortion in the United States is of enormous magnitude, both in terms of incidence and of resultant morbidity and mortality. Several studies suggest that one of every five pregnancies terminates in criminal abortion, or a total of more than one million abortions for 1960, with a possibility of more than 5,000 deaths resulting therefrom. The inadequate laws regarding therapeutic abortion in most jurisdictions contribute much to the problem. Tracing the origins of these laws provides additional clues concerning the development of this enigma. Suggested answers to the problem include: (1) Broadening and clarifying therapeutic abortion laws to reflect current medical practice, yet provide stringent controls; (2) prevention of unwanted pregnancy through consultation centers for women, encouragement of contraceptive research and education of the public.
Kummer, Jerome M.; Leavy, Zad
Iran has had replacement fertility since 2000. Upholding a small family size has led some couples to terminate unwanted pregnancies. Abortion is, however, permitted only on medical grounds in Iran. Using data from the Iran Low Fertility Survey, this study assessed sociodemographic correlates of abortion among a random sample of 5526 ever-married women aged 15-54 years, and used in-depth interviews to explore reasons for and psychological consequences of abortion among 40 women who had experienced an unintended pregnancy. Although social and economic concerns were the main reasons cited for seeking abortion, women experienced anxiety and depression when seeking pregnancy termination and thereafter. Social stigmatization arose from a belief that abortion is sinful and that misfortune experienced thereafter is punishment. Inadequate knowledge and misunderstanding of relevant Sharia laws discouraged women from seeking care when they experienced complications. Iran's reproductive health policies should be revised to integrate pre- and postabortion counseling. PMID:22920623
Hosseini-Chavoshi, Meimanat; Abbasi-Shavazi, Mohammad Jalal; Glazebrook, Diana; McDonald, Peter
Formalin-fixed, paraffin-embedded fetal livers and lungs from 139 cases of swine abortion were investigated retrospectively for chlamydiae by means of immunohistochemistry. Using a genus-specific anti- body, chlamydial antigen was found in eight livers obtained from five (3.6%) abortion cases from different herds. All lung sections were negative. Chlamydiae were also labeled in five of the eight positive livers using a
R. Thoma; F. Guscetti; I. Schiller; N. Schmeer; L. Corboz; A. Pospischil
A bill prohibiting the use of state funds to pay for state employees' health benefits related to "nontherapeutic abortions" passed the House on September 9 by a vote of 60-34. The measure, HB 395, defines a "nontherapeutic abortion" as a procedure performed when the life of the mother would not be endangered by carrying the pregnancy to term; the bill was amended to exempt victims of rape and incest from the funding restriction. Under HB 395, the state would pay for benefit plans that allow state employees to purchase an optional rider for abortion coverage. Also on September 9, the House passed HB 421 by a vote of 66-28. The measure amends Ohio's informed consent law for abortion by requiring a physician, but not necessarily the same physician who will perform the procedure, to meet with the patient in person and in a private setting 24 hours prior to the procedure. Just before the vote was taken, an amendment was offered and approved 68-26 which changes Ohio's parental notification law to parental consent. Both bills have been referred to the Senate for consideration. PMID:12292675
The legalization of abortion in the United States by the Supreme Court in 1973 bypassed the political process in the majority of the states. Since then, however, political controversy and agitation in relation to abortion has become nationwide. From largely Catholic-based opposition, it has grown to encompass religious fundamentalists and to be a major part of the New Right's agenda. Abortion is now, pro and con, part of the platform of both political parties. The sweeping nature of the Supreme Court's decisions leaves the opposition with very little room to restrict abortion, short of overturning the decisions through a constitutional amendment. Such an amendment requires a two-thirds majority of Congress and passage is unlikely. However, funding bans on scores of federal programmes have succeeded in restricting access to abortion for the poor, the young and minorities. These restrictions are part of a long-term strategy to educate the public as to the evils of abortion with the aim of making it illegal again, either through the adoption of a constitutional amendment or by obtaining a reversal by a hoped-for change in membership of the Supreme Court. PMID:3849417
Rosoff, J I
Background: The provision of ambulatory dermatologic procedural care is not well characterized. Objective: Our purpose was to determine the frequency that different cutaneous procedures are performed by different physician specialties and the diagnoses corresponding to these procedures. Methods: Outpatient dermatologic procedures recorded in the 1993 and 1994 National Ambulatory Medical Care Survey were analyzed. To define dermatologic procedures and diagnoses,
Alan B. Fleischer; Steven R. Feldman; Richard E. White; Barry Leshin; Robert Byington
In the US attitudes toward abortion in the 1980s seem to have reached a more liberal plateau, much more favored than in the 1960s or earlier, but not longer moving in a liberal direction. Catholic attitudes basically have followed the same trend. Traditionally Catholic support has been slightly lower than Protestant, and both are less inclined to support abortion than Jews or the nonreligious. During the 1970s support among non-black Catholics averaged about 10 percentage points below non-black Protestants. Blacks tend to be anti-abortion and thereby lower support among Protestants as a whole. A comparison of Protestants and Catholics of both races shows fewer religious differences -- about 7 percentage points. There are some indications that this gap may be closing. In 1982, for the 1st time, support for abortions for social reasons, such as poverty, not wanting to marry, or not wanting more children, was as high among Catholics as among Protestants. 1 of the factors contributing to this narrowing gap has been the higher level of support for abortion among younger Catholics. Protestants show little variation on abortion attitudes, with those over age 65 being slightly less supportive. Among Catholics, support drops rapidly with age. This moderate and possibly vanishing difference between Catholics and Protestants contrasts sharply with the official positions of their respective churches. The Catholic Church takes an absolute moral position against abortion, while most Protestant churches take no doctrinaire position on abortion. Several, such as the Unitarians and Episcopalians, lean toward a pro-choice position as a matter of social policy, though fundamentalist sects take strong anti-abortion stances. Few Catholics agree with their church's absolutist anti-abortion position. The big split on abortion comes between what are sometimes termed the "hard" abortion reasons -- mother's health endangered, serious defect in fetus, rape, or incest. Support among Catholics for "hard" reasons ranges from about 80-88%. Abortion for social reasons such as poverty or not wanting additional children ranges from 35-50%. Catholic support for abortion also varies by geographical region, community type, and ethnic group. Support tends to be strongest in the Northeast, in large cities, and among descendants of immigrants from Italy, Eastern Europe, and France. Support is weakest among Catholics in the Southwest, in small towns or rural areas, and among the Irish and Hispanics, especially Mexican-Americans. Among Catholics, many factors cause opinion to deviate from the national average. A 2nd major political implication is the comparative dedication or commitment of supporters and opponents. Analysis of election returns in 1978 in particular failed to demonstrate any measurable anti-abortion vote, but this does not mean that in a particular constituency it could not be made a serious issue. PMID:12178931
Smith, T W
In 1965, 71% of legal abortions in the United States were performed using the surgical procedure of dilation and curettage. By 1972, a mere seven years later, approximately the same percentage (72.6%) of legal abortions in the United States were performed using a completely new abortion technology: the electrical vacuum aspirator. This article examines why, in less than a decade, electric vacuum suction became American physicians' abortion technology of choice. It focuses on factors such as political and professional feasibility (the technology was able to complement the decriminalization of abortion in the US, and the interests, abilities, commitments, and personal beliefs of physicians); clinical compatibility (it met physician/patient criteria such as safety, simplicity and effectiveness); and economic viability (it was able to adapt to market factors such as production, cost, supply/demand, availability, and distribution). PMID:19230345
Tunc, Tanfer Emin
The article reports upon the characteristics of 300 abortion applicants in Arkansas manifesting significant stress from unwanted pregnancy between May 1, 1970 and June 30, 1971. The sample is limited by the fact that all of these women had been willing to seek medical aid. Patients ranged from ages 13-47, 131 of them ages 17-21. 35% had had some college education; another 29% were high school graduates. 50.6%, 20.6%, and 27.3% were single, divorced, and married, respectively. 59.6% of the patients were primiparas. 18.3%, 9.6%, and 12.3% were classified as being neurotic, having psychophysiologic tendencies (gastrointestinal problems, obesity, chronic headaches), and having sociopathic features (passive-aggressive, frankly rebellious, delinquent, antisocial, alcoholic), respectively. 12 women had noticeable schizoid features; 4 women had mildly active schizophrenia. Fathers of the women were usually blue-collar workers (55.3%) or white-collar workers (24.6%). The most frequent ordinal sibling position among the women was oldest child (38%). Parental instability (1 or both parents lost through death, divorce, father usually away working, chronic alcoholism, etc.) was reported by 39.6% of the patients. Patients' attitudes toward the unwanted pregnancy included dislike of inexpediency of the situation (82.6%), self-depreciation (55.6%), and aversion (28.6%). Precipitated psychiatric disorders were for the greatest part mild. Manifesting symptoms included depression (66.7%), anxiety (21%), and mixed anxiety and depression (12.2%). Suicidal threats and gestures were made by 22 and 8 patients, respectively. In summary, the study reveals a group of predominantly Caucasian women from unstable, middle-class urban families who were going through an adjustment reaction to adolescence or adult life. PMID:4265812
Henker, F O
The purpose of this study was to use music to distract and relax pediatric patients during medical procedures. Procedural support via live music therapy interventions included a variety of activities such as music paired with breathing exercises, counting to music, developing sequence in song, and manipulation of musical and play objects.\\u000aBecause invasive and non-invasive are two radically different types
Sabina Yolanda Barton
Traditionally, the medical community has sided against abortion. However, over the past century there has been a change in this stance. This paper will explore the position of the physician and the medical community in regards to abortion. From the physician's perspective, is there not a conflict between performing an abortion and the physician's duty to save life? Does the physician not feel some hypocrisy in working to save some fetuses and aborting others? The issue of abortion can also lead to the question of what the physician's obligations are; is he or she obligated to the woman and her best interests or to the principle of upholding life? Another discussion will be devoted to abortion in Israel and the factors affecting the decision making process of the "Abortion Committees". Members of these committees weigh issues that are not expressed forthrightly in the law, such as the social situation of the pregnant woman under consideration. Furthermore, the physician's outlook and even conscience can sway his or her decision in some cases. A review committee set up by the Ministry of Health found that in many cases in which abortion was permitted, there was no legal back up for the decision. That is to say, in some cases there was found to be no correlation between the decision and the legal guidelines set out. In light of this, the committee made a number of recommendations. One of these recommendations was that in cases that permission for an abortion was granted based on a reasonable concern for the welfare of the mother or fetus, this decision should be based on medical evidence that there was in fact danger to the mother or fetus. PMID:12362485
End-of-life medical expenses are a significant proportion of all health care expenditures. These costs were studied using costs of services from Medicare claims and cause of death (CoD) from death certificates. In the absence of a unique identifier linking the two datasets, common variables identified unique matches for only 33% of deaths. The remaining cases formed cells with multiple cases (32% in cells with an equal number of cases from each file and 35% in cells with an unequal number). We sampled from the joint posterior distribution of model parameters and the permutations that link cases from the two files within each cell. The linking models included the regression of location of death on CoD and other parameters, and the regression of cost measures with a monotone missing data pattern on CoD and other demographic characteristics. Permutations were sampled by enumerating the exact distribution for small cells and by the Metropolis algorithm for large cells. Sparse matrix data structures enabled efficient calculations despite the large dataset (?1.7 million cases). The procedure generates m datasets in which the matches between the two files are imputed. The m datasets can be analyzed independently and results combined using Rubin's multiple imputation rules. Our approach can be applied in other file linking applications. PMID:23645944
Gutman, Roee; Afendulis, Christopher C; Zaslavsky, Alan M
Background: Schizophrenia patients have difficulty mastering even rote procedural tasks in rehabilitation settings. Although most studies demonstrate intact procedural learning in schizophrenia, recent findings demonstrate that a critical component of procedural learning is dependent on sleep. This study tested the hypothesis that patients with schizophrenia have a deficit in sleep-dependent procedural learning. Methods: Using a simple, well-characterized test of motor
Dara S. Manoach; Matthew S. Cain; Mark G. Vangel; Anjali Khurana; Donald C. Goff; Robert Stickgold
In Jewish law right and wrong, good and evil, are absolute values which transcend time, place, and environment. They defy definition by human intuition or expediency. Jewish law derives from the Divine revelation at Mount Sinai as expounded by sages faithful to, and authorized by, its writ. The Talmud rules that if a woman is in hard travail, and her life must be saved, the child must be aborted and extracted. The mother's life comes first. The fetus is not a human life until it is born. But 19th century Rabbinical works state that it is immoral to destroy a monster child. Modern rabbis are unanimous in condemning abortion, feticide, or infanticide as an unconscionable attack on human life. However, Jewish law allows abortion if the pregnancy will cause severe psychological damage to the mother. No civilized society could survive without laws which occasionally cause some suffering or personal anguish. One human life is worth a million lives, because each life is infinite in value. In cases of rape or incest Jewish law still does not sanction abortion. Man's procreative responsibilities are serious and carry rights and obligations which would be upset by liberalized abortion laws. If a person kills a person who is mortally wounded, the killer is guilty of a moral offense. PMID:12309928
Legal, procedural, and institutional restrictions on safe abortion services—such as laws forbidding the practice or policies preventing donors from supporting groups who provide legal services—remain a major access barrier for women worldwide. However, even when abortion services are legal, women face social and cultural barriers to accessing safe abortion services and preventing unwanted pregnancy. Interpersonal communication interventions play an important
Allison Bingham; Jennifer Kidwell Drake; Lorelei Goodyear; C. Y. Gopinath; Anne Kaufman; Sanju Bhattarai
This study uses pooled cross-section time-series data, over the years 1982, 1992 and 2000, to estimate the impact of various restrictive abortion laws on the demand for abortion. This study complements and extends prior research by explicitly including the price of obtaining an abortion in the estimation. The empirical results show that the real…
Medoff, Marshall H.
|This study uses pooled cross-section time-series data, over the years 1982, 1992 and 2000, to estimate the impact of various restrictive abortion laws on the demand for abortion. This study complements and extends prior research by explicitly including the price of obtaining an abortion in the estimation. The empirical results show that the real…
Medoff, Marshall H.
This paper concerns the medical, religious, and social discourse around abortion. The primary goal of this paper is to better\\u000a understand how seven of the world’s major religious traditions (Roman Catholic, Lutheran, Jewish, Islamic, Buddhist, Confucian,\\u000a and Hindu) address abortion ‘in the clinic’. We do not aim to critique these commentaries but to draw out some of the themes\\u000a that
Moira Stephens; Christopher F. C. Jordens; Ian H. Kerridge; Rachel A. Ankeny
The latest World Health Organization data estimate that the total number of unsafe abortions globally has increased to 21.6 million in 2008. There is increasing recognition by the international community of the importance of the contribution of unsafe abortion to maternal mortality. However, the barriers to delivery of safe abortion services are many. In 68 countries, home to 26% of the world's population, abortion is prohibited altogether or only permitted to save a woman's life. Even in countries with more liberal abortion legal frameworks, additional social, economic, and health systems barriers and the stigma surrounding abortion prevent adequate access to safe abortion services and postabortion care. While much has been achieved to reduce the barriers to comprehensive abortion care, much remains to be done. Only through the concerted action of public, private, and civil society partners can we ensure that women have access to services that are safe, affordable, confidential, and stigma free. PMID:23477700
Culwell, Kelly R; Hurwitz, Manuelle
The National Medical Care Utilization and Expenditure Survey (NMCUES) was designed to collect data about the U.S. civilian noninstitutionalized population during the 1980. Information was obtained on health, access to and use of medical services, associat...
... ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000 CLAIMS FOR COMPENSATION UNDER THE ENERGY EMPLOYEES OCCUPATIONAL ILLNESS COMPENSATION PROGRAM ACT OF 2000, AS AMENDED Medical and Related Benefits Medical Treatment...
The mortality and morbidity of women who terminated their pregnancy before the 1973 Supreme Court decision in Roe v Wade are compared with post-Roe v Wade mortality and morbidity. Mortality data before 1973 are from the National Center for Health Statistics; data from 1973 through 1985 are from the Centers for Disease Control and The Alan Guttmacher Institute. Trends in serious abortion-related complications between 1970 and 1990 are based on data from the Joint Program for the Study of Abortion and from the National Abortion Federation. Deaths from illegally induced abortion declined between 1940 and 1972 in part because of the introduction of antibiotics to manage sepsis and the widespread use of effective contraceptives. Deaths from legal abortion declined fivefold between 1973 and 1985 (from 3.3 deaths to 0.4 death per 100,000 procedures), reflecting increased physician education and skills, improvements in medical technology, and, notably, the earlier termination of pregnancy. The risk of death from legal abortion is higher among minority women and women over the age of 35 years, and increases with gestational age. Legal-abortion mortality between 1979 and 1985 was 0.6 death per 100,000 procedures, more than 10 times lower than the 9.1 maternal deaths per 100,000 live births between 1979 and 1986. Serious complications from legal abortion are rare. Most women who have a single abortion with vacuum aspiration experience few if any subsequent problems getting pregnant or having healthy children. Less is known about the effects of multiple abortions on future fecundity. Adverse emotional reactions to abortion are rare; most women experience relief and reduced depression and distress. PMID:1433765
Children participated in four role-plays designed to assess what the children themselves would do and what they would suggest a friend should do when encountering a medical procedure and a minor injury. Open-ended responses were coded into an empirically derived continuum suggested by past research. Similar responses were given to cope with medical procedures and injuries. However, children suggested more reactive coping strategies (e.g., cry, pull away) for themselves and more proactive responses (e.g., think of something fun, take deep breaths) for friends. This finding questions the assumption that children choose the most effective coping strategy in their repertoire when they themselves confront an aversive stimulus, suggesting that preparation for invasive procedures should include motivational components. PMID:10194056
Peterson, L; Crowson, J; Saldana, L; Holdridge, S
Parental investment decisions in human beings, including infanticide, have usually been considered in relation to the postnatal survival probabilities of their children. A number of factors which influence parental ability and willingness to invest in offspring have been identified from these studies. Here we argue that at least some of the same factors which influence investment decisions postpartum also affect the decision to terminate a current pregnancy through voluntary abortion. We show that both female age and marital status influence the probability of abortion, with the key variable being the likelihood of future marriage. Thus, abortion procedures extend a woman's ability to manage her reproduction into the prenatal period.
Lycett, J E; Dunbar, R I
The article considers three theses about postabortion regret which seek to illustrate its pertinence to reasoning about abortion, and which are often deployed, either explicitly or implicitly, to dissuade women out of that reproductive choice. The first is that postabortion regret renders an abortion morally unjustified. The second is that that a relatively high incidence of postabortion regret-compared with a lower incidence of postnatal regret in the relevant comparator field-is good evidence for the moral impermissibility of abortion choice. The third is that high rates of postabortion regret suggest that abortion is not the most prudent or welfare-maximising choice for the woman concerned. All three theses argue for the compellingness of knowledge about postabortion regret in moral and practical reasoning about abortion, especially from the pregnant woman's point of view. This article argues that all three theses are flawed. In particular, it seeks to remind readers that feelings of regret directed at past decisions are often decoupled from the fact of the matter about their moral or rational justification. Moreover, certain features of reproductive decisions in particular make regret an especially unsuitable yardstick for actual justification in this context, and even less epistemically reliable as evidence for a lack of justification than it may be in other fields of decision-making. The implication is that rates of postabortion regret, even if they can be presumed to be higher than rates of postnatal regret, are not as pertinent to moral and practical reasoning about abortion as is sometimes suggested. PMID:22930678
After noting in its introduction that in Roe vs. Wade the US Supreme Court federalized (rather than nationalized) abortion policy with the result that states were given parameters in which they could develop their own abortion policies, this article reviews subsequent Supreme Court decisions about abortion from Doe vs. Bolton in 1973 through Bray vs. Alexandria Women's Health Clinic in 1993. The narrative review is illustrated by a table which indicates year, ruling, case name, and major findings for each of the 23 cases. The review reveals that the parameters set for states by the Supreme Court have been subject to change and reversal as the composition of the Court has changed. The Court has also given states wide discretion in the area of paying for abortions for women who are eligible for Medicaid with the result that 30 states provide no abortion funding unless a Medicaid patient's life is endangered by the pregnancy. The Supreme Court rulings have also allowed states to develop widely differing policies about parental consent/notification before a minor can obtain an abortion. Of the 35 states with parental consent notification laws on their books, only 15 actually enforce them. Other state restrictions include the requirement for the performance of specified tests before an abortion can occur, a prohibition on the use of public facilities for abortions, and a prohibition on public employees participating in the performance of an abortion. State activity in the realm of abortion legislation is expected to continue as an outcome of the Webster and Casey decisions, but with the election of President Clinton, more abortion policy developments are expected to take place on the federal level. These include repeal of the "gag rule" which banned abortion counseling in federally-supported family planning clinics, passage of the Freedom of Choice Act (stuck in committee in 1992) to codify the rulings in Roe vs. Wade, passage of the Freedom of Access to Clinic Entrances Act, provision of additional Medicaid funding for abortions, and the introduction of RU-486 for medically induced abortions. Changes in the Court composition as a result of Clinton-appointed Supreme Court justices will also lead to changes in policy development. PMID:12288251
Mcfarlane, D R
Sharon Pratt Kelly, the mayor of the District of Columbia, has announced that, effective May 1, 1994, the city will use its Medical Charities Fund to pay for "medically appropriate" abortions for women with annual incomes of US$13,200 who do not have health insurance that covers abortions. This income level represents 185% of the federal poverty level for single women. The determination as to whether an abortion is "appropriate" will be made by the woman's physician. From 1989-93, there was a ban on the use of District of Columbia tax monies to cover abortions for local women. In 1988, however, approximately 4000 District women received funding for their abortions. The US$1 million Medical Charities Fund was originally set up to cover emergency room bills for low-income District residents who did not qualify for Medicaid. $650,000 is expected to be added to the fund; in addition, the District's 1995 budget will allocate funding earmarked for abortion coverage for low-income women. PMID:12318702
ExtractAlthough many microorganisms can cause sporadic intrauterine infections in ewes, only a few are responsible for the classical outbreaks of abortion that result in significant financial loss. New Zealand is free from major causes of infectious abortion such as Chlamydophila abortus (enzootic abortion), Coxiella burnetii, Salmonella enterica serovar Abortus-ovis, Brucella melitensis, and the viruses of Bluetongue, Wesselsbron disease and Akabane
Attitudes toward the desirability of abortion were significaantly related to sex, college, classification, level of church activity, residence background, family size, exposure to abortion, and attitude toward premarital sex. The data suggest an increasing acceptance of abortion in the future. (Author)
Maxwell, Joseph W.
|Attitudes toward the desirability of abortion were significaantly related to sex, college, classification, level of church activity, residence background, family size, exposure to abortion, and attitude toward premarital sex. The data suggest an increasing acceptance of abortion in the future. (Author)|
Maxwell, Joseph W.
Violence against abortion clinics and other activities directed toward patients and staff of abortion facilities have been termed terrorism by the pro?choice movement. However, the Federal Bureau of Investigation denies that these actions are terrorism. Instances of abortion clinic violence for 1982–1987 were examined in order to determine whether there is a correspondence between these incidents and definitions or models
Michele Wilson; John Lynxwiler
Women having an induced abortion in an urban clinic were studied. First, second, and third time aborters (N=150) were interviewed. Variables including reasons for choosing abortion, life situations, contraceptive risk-taking, and ease of becoming pregnant were examined. Related studies and suggestions for postabortion counseling are discussed.…
Osler, Mogens; David, Henry P.; Morgall, Janine M.
Changes in homicide and arrest rates were compared among cohorts born before and after legalization of abortion and those who were unexposed to legalized abortion. It was found that legalized abortion improved the lives of many women as they could avoid unwanted births.
|Changes in homicide and arrest rates were compared among cohorts born before and after legalization of abortion and those who were unexposed to legalized abortion. It was found that legalized abortion improved the lives of many women as they could avoid unwanted births.|
|Women having an induced abortion in an urban clinic were studied. First, second, and third time aborters (N=150) were interviewed. Variables including reasons for choosing abortion, life situations, contraceptive risk-taking, and ease of becoming pregnant were examined. Related studies and suggestions for postabortion counseling are discussed.…
Osler, Mogens; David, Henry P.; Morgall, Janine M.
This paper shows that the counterexamples proposed by Strong in 2008 in the Journal of Medical Ethics to Marquis’s argument against abortion fail. Strong’s basic idea is that there are cases—for example, terminally ill patients—where killing an adult human being is prima facie seriously morally wrong even though that human being is not being deprived of a “valuable future”. So
E Di Nucci
In late imperial China, a number of purported methods of abortion were known; but who actually attempted abortion and under what circumstances? Some historians have suggested that abortion was used for routine birth control, which presupposes that known methods were safe, reliable, and readily available. This paper challenges the qualitative evidence on which those historians have relied, and presents new evidence from Qing legal sources and modern medical reports to argue that traditional methods of abortion (the most common being abortifacient drugs) were dangerous, unreliable, and often cost a great deal of money. Therefore, abortion in practice was an emergency intervention in a crisis: either a medical crisis, in which pregnancy threatened a woman's health, or a social crisis, in which pregnancy threatened to expose a woman's extramarital sexual relations. Moreover, abortion was not necessarily available even to women who wanted one. PMID:21328808
Sommer, Matthew H
BACKGROUND: Although abortion or termination of pregnancy (TOP) has become an increasingly normalized component of women's health care over the past forty years, insufficient attention has been paid to women's experiences of surgical or medical methods of TOP. OBJECTIVE: To undertake a narrative review of qualitative studies of women's experiences of TOP and their perspectives on surgical or medical methods.
Mabel LS Lie; Stephen C Robson; Carl R May
WHEN THE REFORM New York abortion law was passed and came into effect in July, 1970, one of the most extraordinary upheavals in medical practice occurred in U.S. history. An operation which had been illegal, stigmatized, and clandestinely performed under the most sordid circumstances suddenly became legal and accessible, at least in New York City. Most traditional medical practitioners and
WARREN M. HERN; MARLENE R. GOLD; ANNAGAIL OAKS
This report describes the findings of a preliminary investigation of women who sought treatment for abortion from the Gynecological Emergency Ward at the University Teaching Hospital (UTH) in Lusaka, Zambia. Barriers to obtaining legal abortions are identified and the harsh experiences of women seeking treatment for complications of illegally induced abortion are discussed. The data contribute to an understanding of the intensity of abortion for Zambian women and draw attention to the value of small-scale, qualitative research on women's reproductive health care needs. It is suggested that a study be planned at UTH to determine how health care delivery can be improved for women who seek abortion. PMID:2219228
Castle, M A; Likwa, R; Whittaker, M
Standard approaches to the morality of abortion typically founder on the question of the “personhood” of the fetus. This paper attempts to avoid this problem by developing an alternative approach in which philosophical positions are derived not from a presumed right to life but from the special moral obligations of parents to nurture their immature children. After a discussion of
M. E. Winston
Although it has received comparatively little attention in the literature, the question of what exactly grounds a parent's obligation to his or her offspring is of central importance to the abortion debate. This essay argues that the true ground of such obligations lies in the biological bond that exists between parents and children, a bond that is forged at conception
Andrew J. Peach
Repetitive abortions reveal an ambivalence towards contraception. The desire for pregnancy does not always go along with a desire for motherhood. It is a neurotic expression full of guilt that shows that these women did not overcome a childish rivality with their mothers, and remain within a symbiotic relationship with them. PMID:10758588
|A roundtable discussion on legal abortion includes Dr. Alan F. Guttmacher, President of The Planned Parenthood Federation of America, Robert Hall, Associate Professor of Obstetrics and Gynecology at Columbia University College of Physicians and Surgeons, Christopher Tietze, a diretor of The Population Council, and Harriet Pilpel, a lawyer.…
Guttmacher, Alan F.; And Others
This paper provides an overview of legal, religious, medical and social factors that serve to support or hinder women's access to safe abortion services in the 21 predominantly Muslim countries of the Middle East and North Africa (MENA) region, where one in ten pregnancies ends in abortion. Reform efforts, including progressive interpretations of Islam, have resulted in laws allowing for early abortion on request in two countries; six others permit abortion on health grounds and three more also allow abortion in cases of rape or fetal impairment. However, medical and social factors limit access to safe abortion services in all but Turkey and Tunisia. To address this situation, efforts are increasing in a few countries to introduce post-abortion care, document the magnitude of unsafe abortion and understand women's experience of unplanned pregnancy. Religious fat?wa have been issued allowing abortions in certain circumstances. An understanding of variations in Muslim beliefs and practices, and the interplay between politics, religion, history and reproductive rights is key to understanding abortion in different Muslim societies. More needs to be done to build on efforts to increase women's rights, engage community leaders, support progressive religious leaders and government officials and promote advocacy among health professionals. PMID:17512379
This paper tried to collect, classify and analyse the discourse about abortion in 1920~1930. In Korea, modern medical abortion operation started in 1920~30s. At that time abortion was prohibited by the Japanese Government-General of Korea, because the Japanese Government-General of Korea needed large population which was used for labor and exploitation. Hence, the Empire of Japan de-penalized Japanese criminal law related to birth control but Korean law was not revised between 1910~1945. Nevertheless, there were quite a few women who wanted abortion when they had children born in sin or they were too poor to raise their children, so they had abortion secretly. At that time the women generally had abortion through toxic drugs or foods and violence (dropping from a high place or beating their stomach). But high class women did it by medical operation. In 1920s, there was few Korean (modern) medical doctors who could operate for abortion, instead Japanese immigrant medical doctors did it--as the newspaper of that time showed(there were many pieces of news that Japanese doctor who helped abortion was arrested by the police). As time went by Korean doctors got their say about the technique and various knowledge of abortion in newspapers, magazines, and academic Journals; this was especially the case starting in 1930. It is worth noting that they were sometimes arrested for illegal abortion operations. Furthermore, from the late 1920s the insist that abortion should be permitted for women and poor people, appeared. This insist was affected by Japan, the Soviet Union and other countries which was generous with abortion. PMID:23695751
Lee, Young- Ah
This article examines the struggle over abortion law reform that preceded the enactment in 1975 of the first statutory law on abortion in South Africa. The ruling National Party government produced legislation intended to eliminate access to doctors willing to procure abortions in an attempt to prevent young, unmarried white women from engaging in premarital (hetero) sexual activity. It was also aimed at strictly regulating the medical profession’s actions with regards to abortion. The production of the abortion legislation was directly influenced by international struggles for accessible abortion and, more broadly, sexual liberation. The regime believed South Africa was being infiltrated by Western "immorality" and the abortion law was an attempt to buttress racist heteropatriarchal apartheid culture. Examining the abortion controversy highlights the global circulation of ideas about reproduction in the twentieth century and foregrounds a neglected dimension of the history of sexual regulation in apartheid South Africa: the disciplining and regulation of white female reproductive sexuality. PMID:20857591
Klausen, Susanne M
This document contains the full text of the "Partial-Birth Abortion Ban Act of 1997" passed by the US Congress and vetoed by President Clinton. This Act prohibits "partial-birth" abortions except in cases when such an abortion is necessary to save the life of a mother. The Act defines a partial-birth as an abortion during which a living fetus is partially vaginally delivered and then killed before the delivery is complete. This procedure is further defined as "deliberately and intentionally" delivering "into the vagina a living fetus... for the purpose of performing a procedure the physician knows will kill the fetus." The Act gives the father of the fetus or the parents of a minor mother the right to sue for damages unless the father or parents consented to the abortion. The Act protects women who undergo a partial-birth abortion from prosecution. PMID:9707940
Question: Recently I observed the use of vaccuum aspiration in an attempt to induce abortion in a woman 16 weeks' pregnant, after dialation of the cervix to 14 mm under paracervical block anesthesia. Only amniotic fluid and a segment of the umbilical cord could be aspirated. The patient was returned to bed, and an oxytocin (Pitocin) infusion was begun. She aborted 24 hours later with no complications. Why is this procedure considered inferior to amniocentesis and saline solution instillation as a technique for inducing abortion? Answer: Transcervical rupture of the fetal membranes for the purpose of inducing second trimester abortion is unreliable as a method and is fraught with the most serious complication of intrauterine infection (Schwartz, R.H.: Septic abortion, Philadelphia, J.B. Lippincott, 1968, p. 17). On the other hand, Roufa et al. (Clinical Obstetrics and Gynecology 14:119, 1971) report no failures of abortion and only 1 significant intrauterine infection in 229 patients aborted in the second trimester by the hypertonic, intraovular, saline solution instillation method. The cervicovaginal portion of the reproductive tract is bacteriologically a contaminated area teeming with a variety of organisms. White and Koontz (Obstetrics and Gynecology 32:402, 1968) cultured the cervices of 57 pregnant women in all trimesters of pregnancy, and a significant number of these women harbored pathogens. In general the skin is preferable to the cervicovaginal tract as a route of entry into the intraovular space. PMID:12333580
Nathanson, B N
70 patients, 16-42 years of age, underwent abortion induced by prostaglandin administration. 21 patients underwent extraamnial PGF2 alpha instillation; 250 mcg was administered the first hour and 750 mcg every hour afterward. Complete abortion occurred in 25% of the cases and incomplete abortion in 57%. The average total dosage was ca 14800 mcg with an average induction-abortion interval of ca 26 hours. 48 of the patients received 250 mcg i.m. injections of 15(s)-15-methylprostaglandin F2 alpha every 2 hours. The rate of complete abortions was 48% and of incomplete abortions was 48%. The average total dosage was 3022 mcg for nulliparae and 2480 mcg for multiparae. The average induction-abortion interval was ca 18 hours for nulliparae and ca 14-1/2 hours for multiparae. Most patients experienced severe gastrointestinal side effects. 1 patient underwent intraamniotic PGF2 alpha instillation, but experienced such severe pain and side effects that the procedure was not used again. PMID:460461
Blacquière, J F; Treffers, P E
This meta-analysis investigates the efficacy of hypnosis in adults undergoing surgical or medical procedures compared to standard care alone or an attention control. Through a comprehensive literature search N=34 eligible randomized controlled trials (RCTs) were included, comprising a total of 2597 patients. Random effects meta-analyses revealed positive treatment effects on emotional distress (g=0.53, CI 95% [0.37; 0.69]), pain (g=0.44, CI 95% [0.26; 0.61]), medication consumption (g=0.38, CI 95% [0.20; 0.56]), physiological parameters (g=0.10, CI 95% [0.02; 0.18]), recovery (g=0.25, CI 95% [0.04; 0.46]), and surgical procedure time (g=0.25, CI 95% [0.12; 0.38]). In conclusion, benefits of hypnosis on various surgically relevant outcomes were demonstrated. However, the internal validity of RCTs seems limited and further high methodological quality RCTs are needed to strengthen the promising evidence of hypnosis for adults undergoing surgery or medical procedures. PMID:23628907
Tefikow, S; Barth, J; Maichrowitz, S; Beelmann, A; Strauss, B; Rosendahl, J
Presents an expert system for three dimensional image processing. In analyzing three dimensional gray images, e.g. CT images, a process for extraction of interest regions from each image is frequently required. However, it is difficult to construct all extinction procedure with parameters optimized for each purpose. The proposed system can automatically construct a three dimensional object extraction procedure based on
A. Shimizu; Xiang-Rong Zhou; J. Hasegawa; J. Toriwaki
Objective. Voiding cystourethrography (VCUG) is a commonly performed radiologic procedure in children that can be both painful and frightening. Given the distress that some children experience during the VCUG and the need for children to be alert and cooperative during the procedure, finding a psychologi- cal intervention that helps children to manage anxiety, distress, and pain is clearly desirable. This
Lisa D. Butler; Barbara K. Symons; Shelly L. Henderson; Linda D. Shortliffe; David Spiegel
Presents findings from a 1980 survey undertaken with the cooperation of the National Abortion Rights Action League (NARAL) and the National Right to Life Committee (NRLC), conducted among 750 members of each organization (response rates were 63% among NARAL and 57% among NLRC members). NRLC members were found to be more likely to have come from large families, and to prefer and have large families. About 70% of NRLC members are Roman Catholic, compared to 4% of NARAL members and about 28% of the general population. 17% of NARAL members are Jewish, compared to almost no NRLC members and 2% for the general population. Protestants and blacks are relatively underrepresented in both organizations. 9 in 10 NRLC members report that religion is very important to them and that they attend services at least once a week, compared to 1 in 5 NARAL members. NRLC members are more likely to have experienced difficulties becoming pregnant, to have had a miscarriage and to have had an unplanned pregnancy. NARAL members are much more likely to have used birth control pills or to be surgically sterilized. Of those who had had an abortion, among the women surveyed, 94% had joined NARAL and only 6% had joined NRLC. High levels of fertility and fertility aspirations among NRLC members appear to reflect a generally conservative approach to personal morality. NRLC members are much more likely to oppose sex education in schools, and birth control information for teenagers, and to favor stricter public policy on divorce. They are also relatively more likely to be opposed to premarital, extramarital, and homosexual relations, and contraceptive sterilization among married couples. The majority of NLRC members oppose the Equal Rights Ammendment; majority of NARAL supports it. The majority of members of both organizations support political, social and economic equality of women in other respects. Attitudes toward abortion were about as expected, although 7 in 10 NRLC members favored legal abortion if the woman's life would be endangered otherwise, and 4 in 10 NARAL members oppose abortion to prevent the birth of a child not of the desired sex. NRLC members are much more likely to be Republicans and describe themselves as conservative. But while more than 8 in 10 NRLC members would oppose a candidate they otherwise support if they disagreed with their abortion stand, fewer than 1/2 the NARAL members say they are 1 issue voters. PMID:7286166
Purpose: The purpose of the current study is to explore third- year medical students’ interest in learning about family planning, exposure to family planning (contraception and abortion) and perceived barriers and benefits to family planning education in their obstetrics and gynecology rotation. Method: We conducted four focus groups with 27 third-year medical students near the end of their rotation in obstetrics and gynecology. Results: Students desired education in family planning but perceived limited exposure during their rotation. Most students were aware of abortion but lacked factual information and abortion procedural skills. They felt systemic and faculty-related barriers contributed to limited exposure. Students discussed issues such as lack of time for coverage of contraception and abortion in the curricula and rotation itself. Perceived benefits of clinical instruction in family planning included increased knowledge of contraceptive management and abortion the ability to care for and relate to patients, opportunity for values clarification, and positive changes in attitudes towards family planning. Conclusions: Medical students who desire full education in family planning during their obstetrics and gynecology rotation may face barriers to obtaining that education. Given that many medical students will eventually care for reproductive-age women, greater promotion of opportunities for exposure to family planning within obstetrics and gynecology rotations is warranted.
Smith, Kimberly G.; Gilliam, Melissa L.; Leboeuf, Mathieu; Neustadt, Amy; Stulberg, Debra
...determines that such records are not exempt from disclosure, NACIC will, after consultation with the Director of Medical Services, CIA, determine: (1) Which records may be sent directly to the requester and (2) Which records should not be sent...
This study examines the association between religion and attitudes toward the practice of abortion and abortion policy in Brazil. Drawing upon data from the 2002 Brazilian Social Research Survey (BSRS), we test a number of hypotheses with regard to the role of religion on opposition to the practice of abortion and its legalization. Findings indicate that frequently attending Pentecostals demonstrate the strongest opposition to the practice of abortion and both frequently attending Pentecostals and Catholics demonstrate the strongest opposition to its legalization. Additional religious factors, such as a commitment to biblical literalism, were also found to be significantly associated with opposition to both abortion issues. Ultimately, the findings have implications for the future of public policy on abortion and other contentious social issues in Brazil. PMID:22303535
Ogland, Curtis P; Verona, Ana Paula
The Indian Medical Termination of Pregnancy (MTP) Act came into force in 1972, in response to the high mortality and morbidity associated with illegal abortion. However, 25 years on, both restrictions in the law and the way it is implemented through service delivery have failed to meet the abortion needs of large numbers of women. Using data from a larger
Manisha Gupte; Sunita Bandewar; Hemlata Pisal
The linguistic and semiotic analysis of the discourse over the political, social, and medical aspects of abortion is the topic of this article. In the fall of 1989 we interviewed 30 experts from various professional backgrounds who held opposing viewpoints on abortion. Half were pro-life; half were prochoice. The analysis of the terminology employed by pro-life experts reveals several techniques
Abortion represents a particularly interesting subject for a social movements analysis of healthcare issues because of the involvement of both feminist pro-choice activists and a segment of the medical profession. Although both groups have long shared the same general goal of legal abortion, the alliance has over time been an uneasy one, and in many ways a contradictory one. This
C. E. Joffe; T. A. Weitz; C. L. Stacey
Like many Communist or post-Communist nations, Russia has one of the highest abortion rates in the world. These rates have created a legacy of significant medical problems. Complications from abortion are the cause of more than one in four maternal deaths...
This essay argues that Sandra Day O'Connor's moral reasoning concerning abortion cases represents a female-associated jurisprudence. A female-associated jurisprudence negotiates a moral ground that values the rights of individuals as interdependent members of communities. From the recognition of the need to balance such interests emerges a jurisprudence that emphasizes the interconnectedness of all parties and all competing interests in a
Patricia A. Sullivan; Steven R. Goldzwig
Between June 1978, when the Law nr. 194 was introduced, and the end of 1979, about 250,000 legal abortions were carried out in Italy. Wide discrepancies exist among Italian Regions. Generally, in Northern and Central Italy the incidence of abortion is comparable to most other Countries with liberalized laws. The Region of Emilia Romagna, where social and medical facilities are easily available, con probably offer a better estimate of abortion occurrence in Italy. Minors and Women in the second trimester of pregnancy are still particularly prone to recourse to clandestine abortion. Conscientious objection is a major limiting factor in the implementation of the law. PMID:7211112
Filicori, M; Flamigni, C
Since the RHIC Au-Au run in the year 2001 the 200 MHz cavity system was used at storage and a 28 MHz system during injection and acceleration. The rebucketing procedure potentially causes a higher debunching rate of heavy ion beams in addition to amplifying debunching due to other mechanisms. At the end of a four hour store, debunched beam can easily account for more than 50% of the total beam intensity. This effect is even stronger with the achieved high intensities of the RHIC Au-Au run in 2004. A beam abort at the presence of a lot of debunched beam bears the risk of magnet quenching and experimental detector damage due to uncontrolled beam losses. Thus it is desirable to avoid any accumulation of debunched beam from the beginning of each store, in particular to anticipate cases of unscheduled beam aborts due to a system failure. A combination of a fast transverse kickers and the new 2-stage copper collimator system are used to clean the abort gap continuously throughout the store with a repetition rate of 1 Hz. This report gives. an overview of the new gap cleaning procedure and the achieved performance.
Abortion is forbidden under normal circumstances by nearly all the major world religions. Traditionally, abortion was not deemed permissible by Muslim scholars. Shiite scholars considered it forbidden after implantation of the fertilised ovum. However, Sunni scholars have held various opinions on the matter, but all agreed that after 4 months gestation abortion was not permitted. In addition, classical Islamic scholarship had only considered threats to maternal health as a reason for therapeutic abortion. Recently, scholars have begun to consider the effect of severe fetal deformities on the mother, the families and society. This has led some scholars to reconsider the prohibition on abortion in limited circumstances. This article reviews the Islamic basis for the prohibition of abortion and the reasons for its justification. Contemporary rulings from leading Shiite scholars and from the Sunni school of thought are presented and reviewed. The status of abortion in Muslim countries is reviewed, with special emphasis on the therapeutic abortion law passed by the Iranian Parliament in 2003. This law approved therapeutic abortion before 16 weeks of gestation under limited circumstances, including medical conditions related to fetal and maternal health. Recent measures in Iran provide an opportunity for the Muslim scholars in other countries to review their traditional stance on abortion. PMID:17074823
Hedayat, K M; Shooshtarizadeh, P; Raza, M
A female Catholic theologian imagines a just society that does not judge women who decide to undergo an abortion. The Church, practitioners, and the courts must trust that women do make person-enhancing choices about the quality of life. In the last 15 years most progress in securing a woman's right to abortion has been limited to white, well-educated, and middle or upper middle class women. A just society would consider reproductive options a human right. Abortion providers are examples of a move to a just society; they are committed to women's well-being. There are some facts that make one pessimistic about achieving abortion in a just society. The US Supreme Court plans to review important decisions establishing abortion as a civil right. Further, some men insist on suing women who want to make their own reproductive decisions--an anti-choice tactic to wear away women's right to reproductive choice. Bombings of abortion clinics and harassment campaigns by anti-choice groups are common. These behaviors strain pro-choice proponents emotionally, psychically, and spiritually. Their tactics often lead to theologians practicing self-censorship because they fear backlash. Abortion providers also do this. Further, the reaction to AIDS is that sex is bad. Anti-abortion groups use AIDS to further their campaigns, claiming that AIDS is a punishment for sex. Strategies working towards abortion in a just society should be education and persuasion of policymakers and citizens about women's right to choose, since they are the ones most affected by abortion. Moreover, only women can secure their rights to abortion. In a just society, every health maintenance organization, insurance company, and group practice would consider abortion a normal service. A just society provides for the survival needs of the most marginalized. PMID:12178856
Hunt, M E
Objective: To study incidence and determinants of emotional distress following induced abortion. Setting: Department of Obstetrics and Gynecology, Lund University, University Hospital Malmö, Sweden. Subjects: A series of 854 participants at 12-month postabortion follow-up, representing 66.5% of the 1?285 women undergoing induced abortion at Malmö, 1989. Methods: Analysis of data elicited at a semistructured interview 1 year after induced abortion,
Hanna Söderberg; Lars Janzon; Nils-Otto Sjöberg
This article responds to two important recent treatments of abortion rights. I will mainly discuss Ronald Dworkin's recent writings concerning abortion: his article "Unenumerated rights: whether and how Roe should be overruled," and his book Life's Dominion. In these writings Dworkin presents a novel view of what the constitutional and moral argument surronding abortion is really about. Both debates actually turn, he argues, on the question of how to interpret the widely shared idea that human life is sacred. At the heart of the abortion debate is the essentially religious notion that human life has value which transcends its value to any particular person; abortion is therefore at bottom a religious issue. Dworkin hopes to use this analysis to show that the religion clauses of the First Amendment provide a "textual home" for a woman's right to choose abortion. I wish to scrutinize this suggestion here; I want to probe the precise consequences for abortion rights of such an understanding of their basis. I will argue that the consequences are more radical than Dworkin seems to realize. The other work I will examine here is the important 1992 Supreme Court decision on abortion, Planned Parenthood v. Casey. The controlling opinion in that case, written jointly by Justices Kennedy, O'Connor, and Souter, strongly reaffirmed Roe v. Wade, but also upheld most of the provisions of a Pennsylvania statute that had mandated various restrictions on abortion. The justices' basis for upholding these restictions was their introduction of a new constitutional standard for abortion regulations, an apparently weaker standard than those that had governed previous Supreme Court abortion decisions. I think there is a flaw in Casey's new constitutional test for abortion regulations, and I will explain, when we turn to Casey, what it is and why it bears a close relation to Dworkin's reluctance to carry his argument as far as it seems to go. PMID:11660187
Targeted Regulation of Abortion Providers (or TRAP) laws impose medically unnecessary and burdensome regulations solely on abortion providers in order to make abortion services more expensive and difficult to obtain. Using event history analysis, this article examines the determinants of the enactment of a TRAP law by states over the period 1974–2008. The empirical results find that Republican institutional control of a state's legislative/executive branches is positively associated with a state enacting a TRAP law, while Democratic institutional control is negatively associated with a state enacting a TRAP law. The percentage of a state's population that is Catholic, public anti-abortion attitudes, state political ideology, and the abortion rate in a state are statistically insignificant predictors of a state enacting a TRAP law. The empirical results are consistent with the hypothesis that abortion is a redistributive issue and not a morality issue. PMID:22141177
Medoff, Marshall H; Dennis, Christopher
Researchers examining the efficacy of medical procedures make assumptions about the nature of placebo. From these assumptions they select the sham interventions to be used in their trials. However, placebo is not well defined. A number of definitions are contradictory and sometimes misleading. This leads to problems in sham-controlled studies of medical procedures and difficulties interpreting their results. The author explores some of the contradictory definitions of placebo and assumptions and consequences of these. Principal among these is the assumption that the placebo is inert when it is not, which introduces bias against the tested medical procedures and devices. To illustrate the problem, the author examines the use of sham procedures in clinical trials of the medical procedures surgery and acupuncture in which the sham was assumed to be inert but was not. Trials of surgery and acupuncture should be re-examined in light of this. PMID:16646730
At the same time that American women celebrate the freedoms won thus far for so many Americans, American women must realize they face some of the greatest threats to liberty in recent memory. To understand this movement against American women, it is necessary to first understand the roots of the historic movement for women's rights. Reproductive freedom for many years topped the agenda of the modern women's movement. At a time and in a land where rights were being enriched and liberty prized, choice took a prominent role, specifically, the right to abortion but also generally to repdocuctive freedom and the many underlying issues involved. This is why the various efforts to criminalize abortion effect every citizen, because they pose a serious threat to the constitutional rights of each individual. This is the intellectual view, or the "head" argument. The Constitution states that: "Congress shall make no laws respecting an establishment of religion, or prohibiting the free exercise thereof; the enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people; and no state shall make or enforce any laws which shall abridge the privileges or immunities of citizens of the US." Each of these clauses expresses the philosophy on which the Constitution was founded -- individual liberty. While there has been some legitimate disagreement over what constitutes an inalienable right, the concept is clear: the government should not become involved in personal philosophical or religious matters, except to permit the freedom of personal philosophical or religious expression. The anti-abortion contignent makes its case by claiming that a fertilized egg is a cona fide person and should, therefore, be guaranteed the Constitution's full roster of protections. In its landmark Roe v. Wade opinion, the Supreme Court held what pro-choice activities have been claiming for years. Since there is no empirical test by which measure personhood, the government should not define it. The right to an abortion is secured in the same Constitution that secures the right to speak out and to pray to whomever one wants. Moral values are not eht issue but the value of individual freedom is. It is necessary at this time to reintroduce the women into the public dialogue. She seems to be forgotten in this most recent wave of concern over fetal rights. The task is to present a "heart" argument, that is, to remember the woman. The opponents of abortion want to spread the belief that women who have abortions are all the same -- selfish and cold hearted people who choose abortion simply as a matter of convenience. This is not the case, and it is necessary to remind people of the woman's point of view. PMID:12340405
Today slightly more than one in three applicants to medical school is accepted. In this situation of high demand for training, high stakes for the individuals who receive it, and high stakes for the society in terms of its ability to provide care equitabl...
J. C. Baratz C. W. Fenton
Aim To assess physicians’ knowledge and practices for obtaining patients’ informed consent to medical procedures. Methods An anonymous and voluntary survey of knowledge and practices for obtaining informed consent was conducted among 470 physicians (63% response rate) working in 6 hospitals: 93 specialists in anesthesiology, 166 in internal medicine, and 211 in surgery. Results Only 54% physicians were acquainted with the fact that the procedure for obtaining consent was regulated by the law. Internists and surgeons were better informed than anesthesiologists (P?=?0.024). More than a half of respondents (66%) were familiar with the fact that a law on patient rights was passed in Croatia; there were no differences among different specialties (P?=?0.638). Only 38% of the physicians were fully informed about the procedure of obtaining consent. Internists and surgeons provided detailed information to the patient in 33% of the cases and anesthesiologists in 16% of the cases (P?0.050). Internists reported spending more time on informing the patient than anesthesiologists and surgeons (P?0.001). There were no differences in knowledge and practices for obtaining informed consent between physicians working in university and those working in community hospitals (P???0.05 for all questions). Conclusion Physicians in Croatia have no formal education on informed consent and implement the informed consent process in a rather formal manner, regardless of the type of hospital or medical specialty. Systemic approach at education and training at the national level is needed to improve the informed consent process.
Jukic, Marko; Kvolik, Slavica; Kardum, Goran; Kozina, Slavica; Tomic, Ana; Juraga
Despite permissive laws and a well-developed network of facilities, the incidence of unsafe abortion and the resulting maternal mortality is unacceptably high in Central and Eastern Europe and Central Asia, with one-quarter of all maternal deaths reported to occur as a consequence of abortion. Among the reasons that oblige women to submit themselves to risky procedures are new legislative barriers
Stelian Hodorogea; Rodica Comendant
n Overall rates of abortion in the United States peaked soon after the procedure was legalized in 1973, remained fairly constant through the 1980s, and have declined steadily since then. However, the overall rate masks large differences and varying patterns across time for demo- graphic subgroups. n A substantial drop in the abortion rates of teenagers and women aged 20-24
Stanley K. Henshaw; Kathryn Kost
In 1980 the state and federal government spent about 60 million dollars in aid to indigent women seeking abortion under the joint federal-state Medicaid program. The picture remained essentially the same in 1981. Since the implementation of the Hyde Amendment in 1977 (with the exception of a 7 month period in 1978) severe restrictions on federal funding of abortions have been the rule. As a result, state rather than federal funding has accounted for 82% and 92% of public funds spent to finance abortions for poor women in 1981 and 1982, respectively. In a recent survey by the Alan Guttmacher Institute (AGI) in which all states except Alaska, Nebraska, Oregon and Arizona responded, 14 states were found to have voluntarily paid for all or all medically necessary abortions for the entire 2-year period. Since the implementation of the Hyde Amendment the trend has been for the federal government to assume 90% of the cost of contraceptive and voluntary sterilization services for Medicaid recipients, with the vast majority of abortions being paid for by the state. Since the 1980 Supreme court decision upholding the constitutionality of the Hyde Amendment, and the 1980 elections which moved antiabortion supporters into power in the White House, prochoice supporters have been pessimistic about continued funding for abortions for indigent women. However, the AGI survey shows encouraging indications that the funding situation may have stabilized and may improve slightly in the future. PMID:6811313
Gold, R B
The US Supreme Court crafted its Roe vs. Wade ruling based on privacy protections embedded in the US Constitution and the competing interests of the states to protect maternal health and potential life. In its later Casey decision, the Court allowed states to promote their interest in potential life by surrounding abortion with obstacles as long as these did not pose an "undue burden" on the woman's privacy rights. Recent "partial-birth" abortion bans enacted by 17 states seek to weaken Roe by 1) including such broad definitions that they in effect ban all abortions, 2) seeking to create constitutional rights for fetuses, and 3) forwarding states' interests not recognized by Roe. In addition, "partial-birth" abortion bans that outlaw medically-accepted abortion methods do not further any state interest recognized by Roe because 1) they are not designed to dissuade the woman, 2) fetal survival is impossible, and 3) they undermine protection of maternal health. Such bans ignore the distinction between pre- and postviability abortions called for in Roe and flout Roe's protection of the life and health of women. In effect, such bans attack every important aspect of the Roe vs. Wade ruling. PMID:12293726
They only certain outcomes of the Webster decision is that state legislatures will be stimulated to enact more legislation regulating abortion. However it is unlikely that the worst prochoice fears will be realized. A return to the 19th century abortion prohibition era is very unlikely because of trends in Western societal attitudes and laws. Since 1973 and the Roe decision there have been more than 300 bills or acts enacted by state legislatures that regulate abortion. Whether it is criminal prohibitions, licensing requirements, zoning restrictions, parental participation, spousal participation, informed consent, health and sanitation regulations, post viability regulations, laws protecting the right of health care workers not to participate in abortion, public funding restrictions, or regulations of fetal experimentation, abortion regulations have definitely been wide spread. The democratic process is going to produce a moderate position on abortion as a result of the Webster decision for 7 reasons: (1) the period before Roe was a time when abortion legislation was in a trend towards moderation. In 1962 abortion prohibitions were in place in all states. In 1967 4 states adopted an abortion reform position that allowed for abortion in the hard cases: (1) maternal health, (2) fetal defect, (3) rape/incest. Over the next 5 years 9 more states followed and 3 others went even farther by allowing unrestricted abortion during early pregnancy. (2) public opinion is consistent and strong in favoring abortion restrictions except for the hard cases. (3) the trend towards moderation in abortion regulations is closely related to other legal trends toward moderation. No fault divorce was a move towards moderation. The abortion experience in Western Europe was towards moderation. (5) Medical technological developments are putting the power of abortion in the hands of women. Abortificant drugs that can be used without medical assistance give women greater freedom. (6) The history of abortion law enforcement is very moderate. (7) Judicial power continues as all member of the Supreme Court have stated publicly that the Constitution does allow some room for abortion. PMID:2628653
Wardle, L D
A Muslim woman in her sixteenth week of pregnancy was informed that her ultrasound scan showed spina bifida, and laboratory results confirmed the diagnosis. The child would have various complications and, most probably, would need medical care for life. With the consent of her husband she decided to terminate the pregnancy. Her decision sparked controversy among Muslim clerics in her community, sparking debate between those who would allow abortion for medical reasons and those who oppose abortion for any reason. This paper will review the philosophical and theological arguments of the pro-life and pro-choice groups as well as the Islamic perspective concerning a woman's autonomy over her reproductive system, the sanctity of the fetus and the embryo, therapeutic abortion, and ensoulment. PMID:23573379
Khitamy, Badawy A B
A Muslim woman in her sixteenth week of pregnancy was informed that her ultrasound scan showed spina bifida, and laboratory results confirmed the diagnosis. The child would have various complications and, most probably, would need medical care for life. With the consent of her husband she decided to terminate the pregnancy. Her decision sparked controversy among Muslim clerics in her community, sparking debate between those who would allow abortion for medical reasons and those who oppose abortion for any reason. This paper will review the philosophical and theological arguments of the pro-life and pro-choice groups as well as the Islamic perspective concerning a woman’s autonomy over her reproductive system, the sanctity of the fetus and the embryo, therapeutic abortion, and ensoulment.
Khitamy, Badawy A. B.
Abortion in dairy cattle is commonly defined as a loss of the fetus between the age of 42 days and approxi- mately 260 days. Pregnancies lost before 42 days are usually referred to as early embryonic deaths, whereas a calf that is born dead between 260 days and full term is defined a stillbirth. A low rate of abortions is
This piper begins with at1 overview 01' inedical robotics aiid theii describes an algorithm for automatic needle placement using a six degree 01' freedom (DOF) robot during minimally invasive spine procedures. The term fluoroscopy servoing is given to this process since an x-ray tluoroscope is used as thc visualization tool. A software application was developed to segment the needle in
G. Corral; L. Ibanez; C. Nguyenm; D. Stoianovici; N. Navab; K. Cleary
|This study developed and tested an educational game used in teaching health care concepts to preschool children. It was hypothesized that exposure to the game, which was called "Hospital Windows," would increase children's knowledge of health care equipment and procedures and decrease their fears of health care. Subjects, who were randomly…
Henkins-Matzke, Ann; Abbott, Douglas A.
Human reproductive cloning (HRC) has not yet resulted in any live births. There has been widespread condemnation of the practice in both the scientific world and the public sphere, and many countries explicitly outlaw the practice. Concerns about the procedure range from uncertainties about its physical safety to questions about the psychological well-being of clones. Yet, key aspects such as
Racial differences have recently been described in hospital practice, most notably with regard to cardiac procedure utilization. To evaluate the possible reasons behind these differences, we analyzed statistics generated from a surgical referral conference at a large, tertiary care Veterans Affairs hospital between the years 1988 and 1996. In this setting, there is no financial incentive for physicians to recommend
Steven P. Sedlis; Vincent J. Fisher; David Tice; Rick Esposito; Lori Madmon; Eric H. Steinberg
Efficient application of wound treatment procedures is vital in both emergency room and battle zone scenes. In order to train first responders for such situations, physical casualty simulation kits, which are composed of tens of individual items, are commonly used. Similar to any other training scenarios, computer simulations can be effective means for wound treatment training purposes. For immersive and high fidelity virtual reality applications, realistic 3D models are key components. However, creation of such models is a labor intensive process. In this paper, we propose a procedural wound geometry generation technique that parameterizes key simulation inputs to establish the variability of the training scenarios without the need of labor intensive remodeling of the 3D geometry. The procedural techniques described in this work are entirely handled by the graphics processing unit (GPU) to enable interactive real-time operation of the simulation and to relieve the CPU for other computational tasks. The visible human dataset is processed and used as a volumetric texture for the internal visualization of the wound geometry. To further enhance the fidelity of the simulation, we also employ a surface flow model for blood visualization. This model is realized as a dynamic texture that is composed of a height field and a normal map and animated at each simulation step on the GPU. The procedural wound geometry and the blood flow model are applied to a thigh model and the efficiency of the technique is demonstrated in a virtual surgery scene.
Aras, Rifat; Shen, Yuzhong; Li, Jiang
Background Bowel perforation though rarely reported is a serious complication of induced abortion, which is often performed illegally by persons without any medical training in developing countries. A sudden increase in the number of patients in our centre in recent years prompted the authors to analyze this problem. The study was conducted to describe our own experiences in the surgical management of these patients. Methods This was a retrospective study involving patients who were jointly managed by the surgical and gynecological teams at Bugando Medical Centre (BMC) for bowel perforation secondary to illegally induced abortion from January 2002 to December 2011. The statistical analysis was performed using SPSS version 17.0. Results A total of 68 patients (representing 4.2% of cases) were enrolled in the study. Their ages ranged from 14 to 45 years with a median age of 21 years. Majority of patients were, secondary school students/leavers (70.6%), unmarried (88.2%), nulliparous (80.9%), unemployed (82.4%) and most of them were dependent member of the family. Previous history of contraceptive use was reported in only 14.7% of cases. The majority of patients (79.4%) had procured the abortion in the 2nd trimester. Dilatation and curettage (82.4%) was the most common reported method used in procuring abortion. The interval from termination of pregnancy to presentation in hospital ranged from 1 to 14 days (median 6 days ). The ileum (51.5%) and sigmoid colon (22.1%) was the most common portions of the bowel affected. Resection and anastomosis with uterine repair was the most common (86.8%) surgical procedure performed. Complication and mortality rates were 47.1% and 10.3% respectively. According to multivariate logistic regression analysis, gestational age at termination of pregnancy, delayed presentation, delayed surgical treatment and presence of complications were significantly associated with mortality (P<0.001). The overall median length of hospital stay (LOS) was 18 days (1day to 128 days ). Patients who developed complications stayed longer in the hospital, and this was statistically significant (P=0.012). Conclusion Bowel perforation following illegally induced abortion is still rampant in our environment and constitutes significantly to high maternal morbidity and mortality. Early recognition of the diagnosis, aggressive resuscitation and early institution of surgical management is of paramount importance if morbidity and mortality associated with bowel perforation are to be avoided.
Contact lens care solutions are known to have toxic effects on the ocular surface. The ISO 10993-5 standard describes test methods to assess the cytotoxicity of medical devices, but it needs some improvements to discriminate contact lens care multipurpose solutions. First we evaluated the biological hazards associated with the use of ophthalmic solutions, running a collaborative study with the French medical agency to propose adapted tools to study contact lens care solutions' ocular cytotoxicity (human cell line, short incubation times, and no dilution of solutions to test). Then we took into account the potential risk of these ophthalmic solutions adsorbed on contact lenses and released on the ocular surface, highlighting the addition of a rinse step with unpreserved marine solution in the contact lens cleaning procedure to avoid side effects of contact lens care solutions. PMID:23338805
Dutot, Mélody; Vincent, Jacques; Martin-Brisac, Nicolas; Fabre, Isabelle; Grasmick, Christine; Rat, Patrice
The psychological consequences of induced abortion are complex and subject to both considerable controversy and methodological criticisms. While many women report feelings of relief immediately after the procedure, others report feelings of anxiety, which they attribute to their abortions. The purpose of the present study was to examine risk of generalized anxiety following unintended pregnancies ending in abortion or childbirth
Jesse R. Cougle; David C. Reardon; Priscilla K. Coleman
Abortion is the termination of pregnancy prior to the 180th day, during which time the fetus is not yet viable outside the womb. Spontaneous abortion is the body's expulsion of a fetus during the 1st months of pregnancy. It is usually not very painful, does not involve much bleeding, and is rarely complicated by infection. Spontaneous abortion is much more frequent at the outset of pregnancy and may occur unnoticed. Its causes are unknown in over half of cases. The most important causes are developmental problems in the products of conception. Causes of spontaneous abortions of maternal etiology are most frequently uterine malposition or malformation. Serious illness in the mother is a less common cause of spontaneous abortion than once believed. Induced abortion is caused by the destruction of a normally implanted and healthy embryo. Its complications are related to the amount of bleeding or the introduction of germs from outside which can spread rapidly. Placental retention is a danger of all induced abortions. Induced abortion is common and in some countries it even creates demographic problems. Abortion is legal in many countries as an expression of the right to choose, but in others it is only legal on therapeutic grounds. Defenders and detractors of abortion have written extensively about it, with some works being sincere and some only tactical. The great majority of moralists are opposed to abortion, while biologists and scientists are divided on the question. The Spanish penal code punishes all persons who cause the death of a fetus or impede the process of gestation. The Catholic Church has considered abortion a homicide and against divine and natural laws. Legal or illegal, it is certain that the number of abortions increases each day. In the face of this reality, the need is for measures to avoid abortion whenever possible. Sex education in schools, full information on contraceptive methods and creation of family planning centers are some means of avoiding abortions. Women who have decided to seek abortions will do so whether or not they are legal. Spanish women who can't afford to spend a weekend in London resort to illegal abortions in unhygienic and dangerous conditions. Very early abortions are similar to late menstrual periods. When the fetus is older the effort to produce the abortion must be greater, and the discomfort to the woman may also be greater. Generally, 10-20% of women who have had complicated abortions suffer from later gynecological disorders such as sterility, dysmenorrheic pains, menstrual problems or obstetric accidents, or from psychological sequelae. At present, when the Spanish government is considering a reform of the penal code regarding abortion, it is important to consider that Spain is a democratic society, in which each citizen has a right to individual freedoms. PMID:6554010
Bastit i Costa, M A
We previously reported that patients with schizophrenia failed to demonstrate normal sleep-dependent improvement in motor procedural learning. Here, we tested whether this failure was associated with the duration of Stage 2 sleep in the last quartile of the night (S2q4) and with spindle activity during this epoch. Fourteen patients with schizophrenia and 15 demographically matched controls performed a motor sequence
Dara S. Manoach; Katharine N. Thakkar; Eva Stroynowski; Alice Ely; Sophia K. McKinley; Erin Wamsley; Ina Djonlagic; Mark G. Vangel; Donald C. Goff; Robert Stickgold
We previously reported that patients with schizophrenia failed to demonstrate normal sleep-dependent improvement in motor procedural learning. Here, we tested whether this failure was associated with the duration of Stage 2 sleep in the last quartile of the night (S2q4) and with spindle activity during this epoch. Fourteen patients with schizophrenia and 15 demographically matched controls performed a motor sequence
Dara S. Manoach; Katharine N. Thakkar; Eva Stroynowski; Alice Ely; Sophia K. McKinley; Erin Wamsley; Ina Djonlagic; Mark G. Vangel; Donald C. Goff; Robert Stickgold
The debate over abortion remains controversial as ever. This article offers an explanation of the main Islamic attitudes towards abortion and areas of need to change in the related rules and regulations in Islamic communities with a special attention to Iran. A selected collection of Islamic references, as well as discussions with experts have been used as a basis for
The decision to seek an abortion is never easy. Women have different reasons for choosing an abortion and their social, economic and religious background may influence how they cope. Furthermore, once pregnant, the alternatives of childbirth and adoption or keeping the baby may not be psychologically neutral. Research studies in this area have been hampered by methodological problems, but most of the better-quality studies have shown no increased risk of mental health problems in women having an abortion. A consistent finding has been that of pre-existing mental illness and subsequent mental health problems after either abortion or childbirth. Furthermore, studies have shown that only a minority of women experience any lasting sadness or regret. Risk factors for this include ambivalence about the decision, level of social support and whether or not the pregnancy was originally intended. More robust, definitive research studies are required on mental health after abortion and alternative outcomes such as childbirth. PMID:20303831
Background: Evidence of risk of Creutzfeldt-Jakob disease (CJD) associated with medical procedures, including surgery and blood transfusion, is limited by susceptibility to bias in epidemiological studies. Methods: Sensitivity to bias was explored using a central-birth-cohort model using data from 18 case-control studies obtained after a review of 494 reports on medical procedures and risk of CJD, systematic for the period
Jesús de Pedro Cuesta; María Ruiz Tovar; Hester Ward; Miguel Calero; Andrew Smith; Concepción Alonso Verduras; Maurizio Pocchiari; Marc L. Turner; Frode Forland; Daniel Palm; Robert G. Will
Maternal mortality has declined considerably in Bangladesh over the past few decades. Some of that decline--though precisely how much cannot be quantified--is likely attributable to the country's menstrual regulation program,which allows women to establish nonpregnancy safely after a missed period and thus avoid recourse to unsafe abortion. Key Points. (1) Unsafe clandestine abortion persists in Bangladesh. In 2010, some 231,000 led to complications that were treated at health facilities, but another 341,000 cases were not. In all, 572,000 unsafe procedures led to complications that year. (2) Recourse to unsafe abortion can be avoided by use of the safe, government sanctioned service of menstrual regulation (MR)--establishing nonpregnancy after a missed period, most often using manual vacuum aspiration. In 2010, an estimated 653,000 women obtained MRs, a rate of 18 per 1,000 women of reproductive age. (3) The rate at which MRs result in complications that are treated in facilities is one-third that of the complications of induced abortions--120 per 1,000 MRs vs. 357 per 1,000 induced abortions. (4) There is room for improvement in MR service provision, however. In 2010, 43% of the facilities that could potentially offer it did not. Moreover, one-third of rural primary health care facilities did not provide the service. These are staffed by Family Welfare Visitors, recognized to be the backbone of the MR program. In addition, one-quarter of all MR clients were denied the procedure. (5) To assure that trends toward lower abortion-related morbidity and mortality continue, women need expanded access to the means of averting unsafe abortion. To that end, the government needs to address barriers to widespread, safe MR services, including women's limited knowledge of their availability, the reasons why facilities do not provide MRs or reject women who seek one, and the often poor quality of care. PMID:23155545
Hossain, Atlaf; Maddow-Zimet, Isaac; Singh, Susheela; Remez, Lisa
This report describes the social and demographic characteristics of 457 unmarried women who underwent a first trimester induced abortion at hospitals and family planning clinics in Sichuan province, China. The data show a very low level of medical complications. However, improved access to contraception for unmarried women is needed in order to reduce the incidence of unintended pregnancies and induced
Luo Lin; Wu Shi-Zhong; Chen Xiao-Qing; Li Min-Xiang; Thomas W. Pullum
Kernels cultured in vitro were induced to abort by high temperature (35°C) and by culturing six kernels/cob piece. Aborting kernels failed to enter a linear phase of dry mass accumulation and had a final mass that was less than 6% of nonaborting field-grown kernels. Kernels induced to abort by high temperature failed to synthesize starch in the endosperm and had elevated sucrose concentrations and low fructose and glucose concentrations in the pedicel during early growth compared to nonaborting kernels. Kernels induced to abort by high temperature also had much lower pedicel soluble acid invertase activities than did nonaborting kernels. These results suggest that high temperature during the lag phase of kernel growth may impair the process of sucrose unloading in the pedicel by indirectly inhibiting soluble acid invertase activity and prevent starch synthesis in the endosperm. Kernels induced to abort by culturing six kernels/cob piece had reduced pedicel fructose, glucose, and sucrose concentrations compared to kernels from field-grown ears. These aborting kernels also had a lower pedicel soluble acid invertase activity compared to nonaborting kernels from the same cob piece and from field-grown ears. The low invertase activity in pedicel tissue of the aborting kernels was probably caused by a lack of substrate (sucrose) for the invertase to cleave due to the intense competition for available assimilates. In contrast to kernels cultured at 35°C, aborting kernels from cob pieces containing all six kernels accumulated starch in a linear fashion. These results indicate that kernels cultured six/cob piece abort because of an inadequate supply of sugar and are similar to apical kernels from field-grown ears that often abort prior to the onset of linear growth.
Hanft, Jonathan M.; Jones, Robert J.
This paper is devoted to the novel computer technologies employed in the studies of histological preparations. These technologies allow to visualize digital images, structurize the data obtained and store the results in computer memory. The authors emphasize the necessity to properly document digital images obtained during forensic-histological studies and propose the procedure for the formulation of electronic documents in conformity with the relevant technical and legal requirements. It is concluded that the use of digital images as a new study object permits to obviate the drawbacks inherent in the work with the traditional preparations and pass from descriptive microscopy to their quantitative analysis. PMID:23405466
Putintsev, V A; Bogomolov, D V; Fedulova, M V; Gribunov, Iu P; Kul'bitski?, B N
Background Medical knowledge encompasses both conceptual (facts or “what” information) and procedural knowledge (“how” and “why” information). Conceptual knowledge is known to be an essential prerequisite for clinical problem solving. Primarily, medical students learn from textbooks and often struggle with the process of applying their conceptual knowledge to clinical problems. Recent studies address the question of how to foster the acquisition of procedural knowledge and its application in medical education. However, little is known about the factors which predict performance in procedural knowledge tasks. Which additional factors of the learner predict performance in procedural knowledge? Methods Domain specific conceptual knowledge (facts) in clinical nephrology was provided to 80 medical students (3rd to 5th year) using electronic flashcards in a laboratory setting. Learner characteristics were obtained by questionnaires. Procedural knowledge in clinical nephrology was assessed by key feature problems (KFP) and problem solving tasks (PST) reflecting strategic and conditional knowledge, respectively. Results Results in procedural knowledge tests (KFP and PST) correlated significantly with each other. In univariate analysis, performance in procedural knowledge (sum of KFP+PST) was significantly correlated with the results in (1) the conceptual knowledge test (CKT), (2) the intended future career as hospital based doctor, (3) the duration of clinical clerkships, and (4) the results in the written German National Medical Examination Part I on preclinical subjects (NME-I). After multiple regression analysis only clinical clerkship experience and NME-I performance remained independent influencing factors. Conclusions Performance in procedural knowledge tests seems independent from the degree of domain specific conceptual knowledge above a certain level. Procedural knowledge may be fostered by clinical experience. More attention should be paid to the interplay of individual clinical clerkship experiences and structured teaching of procedural knowledge and its assessment in medical education curricula.
Measurements of doses to hands, legs and eyes are reported for operators in four different hospitals performing vertebroplasty or kyphoplasty. The results confirm that occupational doses can be high for interventional spine procedures. Extremity and eye lens doses were measured with thermoluminescent dosimeters positioned on the ring fingers, wrists, legs and near the eyes of interventional radiologists and neurosurgeons, over a period of 15 months. Doses were generally larger on the left side for all positions monitored. The median dose to the left finger was 225 ?Sv per procedure, although a maximum of 7.3 mSv was found. The median dose to the right finger was 118 ?Sv, but with an even higher maximum of 7.7 mSv. A median left eye dose of 34 ?Sv (maximum 836 ?Sv) was found, while the legs received the lowest doses with a median of 13 ?Sv (maximum 332 ?Sv) to the left leg. Annual dose to the hand assessed by the cumulated doses almost reached the annual dose limit of 500 mSv, while annual dose to the eyes exceeded the eye lens dose limit of 20 mSv yr(-1). Different x-ray systems and radiation protection measures were tested, like the use of lead gloves and glasses, tweezers, cement delivery systems and a magnetic navigation system. These measurements showed that doses can be significantly reduced. The use of lead glasses is strongly recommended for protection of the eyes. PMID:23803582
Struelens, L; Schoonjans, W; Schils, F; De Smedt, K; Vanhavere, F
Background Intravenous medication administrations have a high incidence of error but there is limited evidence of associated factors or error severity. Objective To measure the frequency, type and severity of intravenous administration errors in hospitals and the associations between errors, procedural failures and nurse experience. Methods Prospective observational study of 107 nurses preparing and administering 568 intravenous medications on six wards across two teaching hospitals. Procedural failures (eg, checking patient identification) and clinical intravenous errors (eg, wrong intravenous administration rate) were identified and categorised by severity. Results Of 568 intravenous administrations, 69.7% (n=396; 95% CI 65.9 to 73.5) had at least one clinical error and 25.5% (95% CI 21.2 to 29.8) of these were serious. Four error types (wrong intravenous rate, mixture, volume, and drug incompatibility) accounted for 91.7% of errors. Wrong rate was the most frequent and accounted for 95 of 101 serious errors. Error rates and severity decreased with clinical experience. Each year of experience, up to 6?years, reduced the risk of error by 10.9% and serious error by 18.5%. Administration by bolus was associated with a 312% increased risk of error. Patient identification was only checked in 47.9% of administrations but was associated with a 56% reduction in intravenous error risk. Conclusions Intravenous administrations have a higher risk and severity of error than other medication administrations. A significant proportion of errors suggest skill and knowledge deficiencies, with errors and severity reducing as clinical experience increases. A proportion of errors are also associated with routine violations which are likely to be learnt workplace behaviours. Both areas suggest specific targets for intervention.
Rob, Marilyn I; Woods, Amanda; Parry, Dave
We previously reported that patients with schizophrenia failed to demonstrate normal sleep-dependent improvement in motor procedural learning. Here, we tested whether this failure was associated with the duration of Stage 2 sleep in the last quartile of the night (S2q4) and with spindle activity during this epoch. Fourteen patients with schizophrenia and 15 demographically matched controls performed a motor sequence task (MST) before and after a night of polysomnographically monitored sleep. Patients showed no significant overnight task improvement and significantly less than controls, who did show significant improvement. While there were no group differences in overall sleep architecture, patients showed significant reductions in fast sigma frequency power (45%) and in spindle density (43%) during S2q4 sleep at the electrode proximal to the motor cortex controlling the hand that performed the MST. Although spindle activity did not correlate with overnight improvement in either group, S2q4 sleep duration in patients significantly correlated with the plateau level of overnight improvement seen at the end of the morning testing session, and slow wave sleep (SWS) duration correlated with the delay in reaching this plateau. SWS and S2q4 sleep each predicted the initial level of overnight improvement in schizophrenia, and their product explained 77% of the variance, suggesting that both sleep stages are necessary for consolidation. These findings replicate our prior observation of reduced sleep-dependent consolidation of motor procedural learning in schizophrenia and link this deficit to specific sleep stages. They provide further evidence that sleep is an important contributor to cognitive deficits in schizophrenia. PMID:19665729
Manoach, Dara S; Thakkar, Katharine N; Stroynowski, Eva; Ely, Alice; McKinley, Sophia K; Wamsley, Erin; Djonlagic, Ina; Vangel, Mark G; Goff, Donald C; Stickgold, Robert
We previously reported that patients with schizophrenia failed to demonstrate normal sleep-dependent improvement in motor procedural learning. Here, we tested whether this failure was associated with the duration of Stage 2 sleep in the last quartile of the night (S2q4) and with spindle activity during this epoch. Fourteen patients with schizophrenia and 15 demographically matched controls performed a motor sequence task (MST) before and after a night of polysomnographically monitored sleep. Patients showed no significant overnight task improvement and significantly less than controls, who did show significant improvement. While there were no group differences in overall sleep architecture, patients showed significant reductions in fast sigma frequency power (45%) and in spindle density (43%) during S2q4 sleep at the electrode proximal to the motor cortex controlling the hand that performed the MST. Although spindle activity did not correlate with overnight improvement in either group, S2q4 sleep duration in patients significantly correlated with the plateau level of overnight improvement seen at the end of the morning testing session, and slow wave sleep (SWS) duration correlated with the delay in reaching this plateau. SWS and S2q4 sleep each predicted the initial level of overnight improvement in schizophrenia, and their product explained 77% of the variance, suggesting that both sleep stages are necessary for consolidation. These findings replicate our prior observation of reduced sleep-dependent consolidation of motor procedural learning in schizophrenia and link this deficit to specific sleep stages. They provide further evidence that sleep is an important contributor to cognitive deficits in schizophrenia.
Manoach, Dara S.; Thakkar, Katharine N.; Stroynowski, Eva; Ely, Alice; McKinley, Sophia K.; Wamsley, Erin; Djonlagic, Ina; Vangel, Mark G.; Goff, Donald C.; Stickgold, Robert
We offer evidence that legalized abortion has contributed significantly to recent crime reductions. Crime began to fall roughly eighteen years after abortion legalization. The five states that allowed abortion in 1970 experienced declines earlier than the rest of the nation, which legalized in 1973 with Roe v. Wade. States with high abortion rates in the 1970s and 1980s experienced greater
John J. Donohue; Steven D. Levitt
We offer evidence that legalized abortion has contributed significantly to recent crime reductions. Crime began to fall roughly 18 years after abortion legalization. The 5 states that allowed abortion in 1970 experienced declines earlier than the rest of the nation, which legalized in 1973 with Roe v. Wade. States with high abortion rates in the 1970s and 1980s experienced greater
John J. Donohue; Steven D. Levitt
The objective of this study was to analyze physicians' attitudes towards induced abortion with normal fetuses and fetuses known to have an abnormality in various degrees. A total of 193 physicians (internists, pediatricians, gynecologists and neurologists) answered a self-administered questionnaire. The questions were about voluntary abortion; voluntary abortion with malformed fetus; abortion because the fetus has anencephaly; and two questions
E. Casanueva; R. Lisker; A. Carnevale; E. Alonso
As a result of the moral and social conflicts surrounding abortion, workers involved in counseling potential abortion recipients are subject to certain strains. The author uses observations made at one abortion clinic to support her conclusion that these strains, as well as the methods of coping developed by staff and administration, must be considered in formulating any policy on abortion. PMID:10244755
The new Penal Code in 2009 was an opportunity for Timor-Leste to allow some legal grounds for abortion, which was highly restricted under Indonesian rule. Public debate was contentious before ratification of the new code, which allowed abortion to save a woman's life and health. A month later, 13 amendments to the code were passed, highly restricting abortion again. This paper describes the socio-legal context of unsafe abortion in Timor-Leste, based on research in 2006-08 on national laws and policies and interviews with legal professionals, police, doctors and midwives, and community-based focus group discussions. Data on unsafe abortions in Timor-Leste are rarely recorded. A small number of cases of abortion and infanticide are reported but are rarely prosecuted, due to deficiencies in evidence and procedure. While there are voices supporting law reform, the Roman Catholic church heavily influences public policy and opinion. Professional views on when abortion should be legal varied, but in the community people believed that saving women's lives was paramount and came before the law. The revised Penal Code is insufficient to reduce unsafe abortion and maternal mortality. Change will be slow, but access to safe abortion and modern contraception are crucial to women's ability to participate fully as citizens in Timor-Leste. PMID:19962638
Belton, Suzanne; Whittaker, Andrea; Fonseca, Zulmira; Wells-Brown, Tanya; Pais, Patricia
Objective—To determine if the bark from western juniper (Juniperus occidentalis) will induce late term abortions in cattle. Animals—6 two-year-old Angus heifers. Procedures—Bark from western juniper trees was collected, dried, and finely ground. Pregnant cows were dosed starting on day 250 of gesta...
The impact of headache on the person and society represents a public health issue. Recently a study evaluated 51% of headache's prevalence in Europe, of which 14% is affected by migraine. Besides, 4% of adult population is affected by chronic forms, which constitute therefore an even more relevant problem in terms of health and social policies. The International Classification of Headache Disorders, II version (ICHD-II) recognises 24 types of chronic headache and states primary episodic headaches as chronic when attacks appear for more than 15 days per month, for at least three months. Headache given by drugs overuse, defined by ICDH-II in 2004 (and revised in 2005) as Medication Overuse Headache (MOH), is associated with overuse of a combination of analgesics, barbiturates, opioids, ergot alkaloids, aspirin, AINS, caffeine and triptans. Patients affected by MOH present a reduced work performance and a significant alteration in the quality of life. Furthermore, some psychological and behavioural states seem particularly important in promoting and sustaining drug abuse. The management and rehabilitation of patients affected by CDH, abusing symptomatic drugs, consists in the withdrawal and/or gradual reduction of their assumption, because of tolerance and addiction possibilities. PMID:17953286
de Filippis, S; Salvatori, E; Farinelli, I; Coloprisco, G; Martelletti, P
Preparation of thin serial sections for comparative macromorphologic investigations has always represented a grave technical problem, especially in the case of regions in which bone as well as soft tissue are to be documented within their natural relations to each other in any desired sectional plane. Non-decalcified specimens up to the size of a whole cadaver are embedded in physiologic medium, precisely positioned, and deep-frozen to a specimen-ice block. A newly developed device, working on the basis of blades rotating at high speed, allows quick, successive removal of sections from the surface of the specimen block, with a thickness of each section infinitely variable between 0.1 and 5 mm. Following each cut, the new surface of the block can be documented photographically or on videotape for macromorphologic evaluation. So far more than 1,000 human, animal, and botanical specimens have been sectioned and evaluated with this method. In none of the cases were specimens damaged. Furthermore, any desired sectional plane could be adjusted: consequently a definite correlation between these sections and previous sonography, magnetic resonance (MR), or computed tomography (CT) images could be established. As serial cryosectioning becomes available to a far wider circle of medical and natural scientists, high-quality results should be obtained at lower costs. PMID:8793215
Kathrein, A; Klestil, T; Birbamer, G; Buchberger, W; Rabl, W; Kuenzel, K
This study used data from a community-based survey to examine women's experiences of abortion in Nigeria. Fourteen percent of respondents reported that they had ever tried to terminate a pregnancy, and 10% had obtained an abortion. The majority of women who sought an abortion did so early in the pregnancy. Forty-two percent of women who obtained an abortion used the services of a non-professional provider, a quarter experienced complications and 9% sought treatment for complications from their abortions. Roughly half of the women who obtained an abortion used a method other than D&C or MVA. The abortion prevalence and conditions under which women sought abortions varied by women's socio-demographic characteristics. Because abortion is illegal in Nigeria except to save the woman's life, many women take significant risks to terminate unwanted pregnancies. Reducing the incidence of unwanted pregnancy and unsafe abortion can significantly impact the reproductive health of women in Nigeria. PMID:17711597
Bankole, Akinrinola; Sedgh, Gilda; Oye-Adeniran, Boniface A; Adewole, Isaac F; Hussain, Rubina; Singh, Susheela
Abortion coverage under various health care reform proposals has dominated the political reproductive rights debate, while poor women's access to abortion under Medicaid presents a current practical concern. Under the Clinton administration's proposed Health Security Act, abortion would be covered under "services for pregnant women," and Medicaid would eventually be incorporated into the national health plan. A final version is a long way off. For now, the Hyde amendment, limiting Medicaid coverage of abortion, controls the issue. Congress has made only negligible progress in freeing federal funds for Medicaid abortions: only in situations of life endangerment, rape, or incest. States are required to cover abortions that are medically necessary under the new guidelines, which now include pregnancy arising from rape and incest. The federal policy defers to state law on the definition of rape and incest, allowing for reasonable reporting or documentation requirements, while disallowing unduly burdensome regulations by allowing the treating physician reimbursement when the physician certifies that the patient was unable for physical or psychological reasons to comply with the requirement. States disagreeing with the new abortion policy immediately registered their opposition. Utah's health department, which has a "life only" law, has pledged not to implement the new federal policy until there is further clarification. The Health Care Financing Administrator responded by writing that "the decision to implement this policy nationwide was not discretionary." Congress chose not to add statutory language deferring to the states, and under U.S. Constitutional law, where state law or policy conflicts with federal law, federal law takes precedence. The next battle will certainly center on attempts to amend the Hyde amendment itself as well as health care legislation along the "states' option" lines. PMID:12345518
Nearly 20% of the 208 million pregnancies that occur annually are aborted. More than half of these (21.6 million) are unsafe, resulting in 47,000 abortion-related deaths each year. Accurate reports on the prevalence of abortion, the conditions under which it occurs, and the experiences women have in obtaining abortions are essential to addressing unsafe abortion globally. It is difficult, however,
Jessica D. Gipson; Davida Becker; Joanna Z. Mishtal; Alison H. Norris
This qualitative study was done in rural Bangladesh among the women seeking abortion-related care at six health facilities in two rural sub-districts of Bangladesh in 1996–1997. It looked at contraceptive use, why women had abortions, who made the abortion decision, who provided the abortions, the complications of abortion that developed, where and how soon the women sought treatment. A majority
Shameem Ahmed; Ariful Islam; Parveen A. Khanum
Congenital anomalies contribute a significant proportion of infant morbidity and mortality, as well as fetal mortality. They are generally grouped into three major categories: structural/metabolic, congenital infections, and other conditions. The most prevalent conditions include congenital heart defects, orofacial clefts, Down syndrome, and neural tube defects. Several prenatal diagnostic procedures have been introduced, both cytogenetic (such as chorion biopsy, amniocentesis and funiculocentesis) and biophysical (ultrasound 2-D, 3-D and 4-D, ultrasonography with Doppler, etc.). Insufficient data are currently available from Saudi Arabia on the epidemiology of the lethal congenital abnormalities which should be a priority due to high rate of consanguineous marriages among first cousins and their association with congenital anomalies. In terms of consanguinity and birth defects, a significant positive association has been consistently demonstrated between consanguinity and morbidity, and congenital defects with a complex etiology appear to be both more prevalent in consanguineous families and have a greater likelihood of recurrence. A debate regarding aborting a malformed fetus still exists among the senior Islamic scholars in many of the Islamic countries. The progressive interpretations of Islam have resulted in laws allowing for early abortion on request in two countries; six others permit abortion on health grounds and three more also allow abortion in cases of rape or fetal impairment. In Saudi Arabia, efforts to legalize abortion in certain circumstances have been recently discussed among Senior Religious Scholars and specialized physicians to permit abortions in certain circumstances. In this mini-review we discuss the current debate regarding aborting a malformed fetus in Saudi Arabia with a focus on the Islamic perspective.
Al-Alaiyan, Saleh; AlFaleh, Khalid M.
This paper does not attempt to deal with the legitimate ethical or moral debate on abortion. Utilizing abortion as a subject I will show how science and medicine in general, and abortion in particular, were used as weapons of mass destruction by Nazi physicians in their zeal to comply with the political climate of the time. Nazi policy on abortion and childbirth was just one of the methods devised and designed to ensure the extermination of those whom the Nazis deemed had "lives not worth living." Physicians implemented these policies, not with the fate of their patients in mind, but rather in the name of the "state." When discussing pregnancy, abortion and childbirth during the Holocaust it is imperative to include an essay of how these issues affected the Jewish prisoner doctors in the ghettos and camps. Nazi policy dictated their actions too. From an extensive search of their testimonies, I conclude that for these doctors ethical discourse comprised a fundamental component of their functioning. I do not propose to judge them in any way and one should not, in my opinion, argue whether their behavior was or was not morally acceptable under such duress; nevertheless, unlike their Nazi counterparts, a key theme in their testimonies was to "keep their medical values." PMID:17402341
A mild, short, depressive and guilt ridden period following abortion is quite common, but a severe psychological reaction is rare. The indication for the abortion and the preabortal psychological state of the patient are the two most important factors. Almost all reported instances of postabortion psychoses have occurred in patients who had severe preabortal psychiatric problems. Women undergoing abortion for socioeconomic or psychosocial indications appear to be at minimal risk for long-term negative psychological sequelae. In contrast, women in whom abortion is carried out because of exposure to rubella and the risk of fetal malformation, maternal organic disease or the prenatal diagnosis of a genetically defective fetus are at greater risk and may need supportive psychotherapy. PMID:1099808
Blumberg, B D; Golbus, M S
Abortion is an important health issue for Australian women, yet there are large variations across Australia in abortion service provision and in state laws regulating abortion practice. We conducted a survey of tertiary students in Far North Queensland to ascertain their knowledge of local abortion services and of abortion law in Queensland. Important gaps were demonstrated in their knowledge of the law and of the availability of abortion services. PMID:22413818
Phillips, Tegan; Eltherington, Jessica; de Costa, Caroline; Woods, Cindy
The capability of the HL-20 lifting-body spacecraft to perform an abort maneuver from the launch pad to a horizontal landing was studied. This study involved both piloted and batch simulation models of the vehicle. A point-mass model of the vehicle was used for trajectory optimization studies. The piloted simulation was performed in a fixed-base simulator. A candidate maneuver was developed and refined for the worst-case launch-pad-to-landing-site geometry using an iterative procedure of off-line maneuver analysis followed by piloted evaluations and heuristic improvements to the candidate maneuver. The resulting maneuver demonstrates the launch site abort capability of the HL-20 and dictates requirements for nominal abort motor performance. The sensitivity of the maneuver to variations in several design parameters was documented.
Jackson, E. Bruce; Rivers, Robert A.; Chowdhry, Rajiv S.; Ragsdale, W. A.; Geyer, David W.
Abortion is illegal in Uganda except to save the life of the woman. Nevertheless, the practice is quite common: about 300,000 induced abortions occur annually among Ugandan women aged 15-49 (Singh et al., 2005) and a large proportion of these women require treatment for post-abortion complications. In the male-dominant culture of Uganda, where men control most of the financial resources, men play a critical part in determining whether women receive a safe abortion, or appropriate treatment if they experience abortion complications. This study examines men's roles in determining women's access to a safer abortion and post-abortion care. It draws on in-depth interviews carried out in 2003 with 61 women aged 18-60 and 21 men aged 20-50 from Kampala and Mbarara, Uganda. Respondents' descriptions of men's involvement in women's abortion care agreed that men's stated attitudes about abortion often prevented women from involving them in either the abortion or post-abortion care. Most men believe that if a woman is having an abortion, it must be because she is pregnant with another man's child, although this does not correspond with women's reasons for having an abortion--a critical disjuncture revealed by the data between men's perceptions of, and women's realities regarding, reasons for seeking an abortion. If the woman does experience post-abortion complications, the prevailing attitude among men in the sample was that they cannot support a woman in such a situation seeking care because if it had been his child, she would not have had a covert abortion. Since money is critical to accessing appropriate care, without men's support, women seeking an abortion may not be able to access safer abortion options and if they experience complications, they may delay care-seeking or may not obtain care at all. Barriers to involving men in abortion decision-making endanger women's health and possibly their lives. PMID:20846465
Moore, Ann M; Jagwe-Wadda, Gabriel; Bankole, Akinrinola
Cytogenetic data on products of conception from spontaneous abortions studied over a 10-year period have been reviewed for\\u000a double trisomies. A total of 3034 spontaneous abortions were karyotyped between 1986 and 1997. Twenty-two cases with double\\u000a trisomy, one case with triple trisomy, and a case with a trisomy and monosomy were found. The tissues studied were mostly\\u000a sac, villi, or
K. S. Reddy
A Paris court last week challenged a 1993 law that makes it a criminal offense to obstruct abortions. The court acquitted nine anti-abortion protestors who had broken into the maternity ward of the public hospital Pitie-Salpetriere last November and prayed at the entrance of a ward where patients are admitted for abortions. The judges ruled that the protestors had not interfered with abortions being carried out because none were taking place at the time of the demonstration; furthermore, the judges stated, because the fetus could be considered a person (child), the protestors were protected by other laws which give immunity to those breaking a law in order to protect another person's life, or to defend a child that had been abandoned. The court continued to say that a fetus should be protected, whether or not it was considered a person, because it was definitely more than nothing. The Syndicat de la Magistrature, the association of French magistrates, believes the tribunal has denied the right to abortion guaranteed in the 1975 law. Veronique Neietz, who drafted the 1993 law, was "scandalized" by the decision and believes the decision of the court was made in retribution for a recent parliamentary decision to exclude anti-abortion protestors from the general amnesty given after presidential elections to minor offenders. During the same week of this court decision, two tribunals, in Lyons and in Bourg-en-Bresse, sentenced 45 anti-abortionists to suspended prison terms with fines. PMID:7613424
Approximately one third of the women in the United States have an abortion during their lives. In the year 2008, 1.21 million abortions were performed in the United States (Jones and Koolstra, Perspect Sex Reprod Health 43:41-50, 2011). The psychiatric outcomes of abortion are scientifically well established (Adler et al., Science 248:41-43, 1990). Despite assertions to the contrary, there is no evidence that abortion causes psychiatric problems (Dagg, Am J Psychiatry 148:578-585, 1991). Those studies that report psychiatric sequelae suffer from severe methodological defects (Lagakos, N Engl J Med 354:1667-1669, 2006). Methodologically sound studies have demonstrated that there is a very low incidence of frank psychiatric illness after an abortion; women experience a wide variety of feelings over time, including, for some, transient sadness and grieving. However, the circumstances that lead a woman to terminate a pregnancy, including previous and/or ongoing psychiatric illness, are independently stressful and increase the likelihood of psychiatric illness over the already high baseline incidence and prevalence of mood and anxiety disorders among women of childbearing age. For optimal psychological outcomes, women, including adolescents, need to make autonomous and supported decisions about problem pregnancies. Clinicians can help patients facing these decisions and those who are working through feelings about having had abortions in the past. PMID:21814081
Stotland, Nada L
The sociodemographic characteristics of abortion seekers and the reasons they give for procuring termination were studied in 356 clients selected from two abortion clinics in the city of Colombo. Nearly 80% were Buddhists and about 10% were Christians. Almost all had some formal education but only 20% were employed outside the home. Over 95% were currently married and at the peak of their childbearing age. More than one-half were aged 30 years or over, while adolescents only constituted about 3%. Fourteen per cent were nulliparous and about two-thirds had one or two living children at the time of obtaining the abortion. A significantly high proportion also had a very young child. In total, the 356 women had had 1130 pregnancies, and the mean rate of abortion was 42 per 100 pregnancies. Over one-quarter had had more than one abortion and about 10% had had three or more. Almost all abortions were performed within the first trimester with a mean gestation period of 6 weeks. About one-third of the clients were using some method of contraception at the time they became pregnant. The most common reasons cited for the present abortion were 'pregnancy too soon after previous delivery', 'no more children desired' or 'curtailment of opportunity for foreign employment'. Unmarried women constitute a special group of abortion seekers who have different needs and behave differently from married women. Their needs are not currently being met by reproductive health programmes in Sri Lanka, and it is important that they should be given special attention in the future. An interesting finding is that a significant minority of the abortion seekers answered negatively to the question regarding providing medical facilities for abortions without difficulty. This underscores the ambivalence many people have to abortion. PMID:12117211
Ban, Deok Jin; Kim, Jinhyun; De Silva, W Indralal
The purpose of this study is to describe the knowledge and attitudes regarding abortion of a sample of health professionals in Mexico. In particular, we aim to explore their association with the practice of abortion and the care of post-abortion complications, taking into consideration the present legal framework in Mexico. The data come from an anonymous and computerized survey applied to participants attending a national meeting of gynecology and obstetrics in Mexico in 2009 (n=418). The attitudes of health professionals in relation to abortion play a key role in promoting access to both medical and surgical abortion services. We did not find a statistical association between living in a largely restrictive federal entity and the practice of abortions, which may be explained by the lack of knowledge that these survey participants had about abortion laws in their federal entity. This lack of knowledge about abortion legislation can hinder a woman's access to these services even when the legal framework such access. PMID:23989628
García-Núñez, Nubia Naneri; Atienzo, Erika Elizabeth; Dayananda, Ila; Walker, Dilys
A simple cost-benefit approach to the abortion debate is unlikely to be persuasive if efficiency arguments conflict with widely held concepts of justice or rely on improbable notions of consent. Illustrative of the limitations of economic analyses are the models proposed by Meeks and Posner to make a case against abortion on demand. Meeks posits a tradeoff between the consumer surplus women gain from access to abortion and the expected loss of earnings that would have accrued to the aborted conceptuses. From here, Meeks derives the critical price elasticity that equates welfare gains and losses and argues that a ban on abortion represents a Kaldor-Hicks improvement in welfare if the price elasticity of demand falls above the critical level. Basic to his model are several questionable assumptions: an independence of ability to pay for an abortion and income, all women who select abortion have the same linear demand for the procedure, an abortion ban would eliminate the practice of abortion, economic efficiency generally requires slavery, and the morally relevant population includes the unborn. Posner, on the other hand, argues that an abortion ban would be efficient if the average surplus lost by a woman who chooses not to break the law is less than half the average value of the fetus saved. He assumes that it takes 1.83 abortions avoided to increase the population by 1 individual and favors reducing the current abortion rate by 30% rather than banning the procedure. Although Posner's model does not require specification of any particular value for the fetus, it neglects the increased health risk for pregnant women of illegal abortion. Moreover, Posner assumes that all women obey the law if it is in their economic interest to do so. Detrimental to both models is an assumption that sound normative judgments can be made on the basis of average values for observable data and the goal of maximizing wealth is logically prior to the specification of individual rights. It is concluded that economic arguments can be persuasive on the abortion issue only if there is agreement that cost-benefit analysis is an appropriate basis for decision making. PMID:12318563
Background Efficacy and safety of various treatments using fractional laser or radiofrequency depend, to a large extent, on precise movement of equipment head across the patient’s skin. In addition, they both depend on uniform distribution of emitted pulses throughout the treated skin area. The pulses should be closely adjacent but they should not overlap. Pulse overlapping results in amplification of irradiation dose and carries the danger of unwanted effects. Methods Images obtained in infrared mode (Flir SC5200 thermovision camera equipped with photon detector) were entered into Matlab environment. Thermal changes in the skin were forced by CO2RE laser. Proposed image analysis and processing methods enable automatic recognition of CO2RE laser sites of action, making possible to assess the correctness of performed cosmetic procedures. Results 80 images were acquired and analyzed. Regions of interest (ROI) for the entire treatment field were determined automatically. In accordance with the proposed algorithm, laser-irradiated Li areas (ROI) were determined for the treatment area. On this basis, error values were calculated and expressed as percentage of area not covered by any irradiation dose (?o) and as percentage area which received double dose (?z). The respective values for the analyzed images were ?o=17.87±10.5% and ?z=1.97±1.5%, respectively. Conclusions The presented method of verifying the correctness of performing low-invasive esthetic medical (cosmetic) procedures has proved itself numerous times in practice. Advantages of the method include: automatic determination of coverage error values ?o and ?z, non-invasive, sterile and remote-controlled thermovisual mode of measurements, and possibility of assessing dynamics of patient’s skin temperature changes.
In a 3-3 vote on May 19, (1994) the Colorado Social Services Board rejected proposed emergency regulations that would have limited Medicaid coverage for abortions to circumstances in which federal matching funds are available. The regulations were proposed in response to U.S. District Court Judge Edward Nottingham's May 5 ruling, which permanently enjoined a state constitutional amendment and state statutes that prohibit public funds for abortion except where the life of the woman is endangered. Judge Nottingham found that the state measures are invalid because they conflict with the current Hyde Amendment, which provides federal Medicaid funds for abortions in cases of life endangerment, rape, and incest. In the absence of any restrictive provisions, Colorado is required to fund all medically necessary abortions. CRLP (Center for Reproductive Law and Policy), which represented plaintiffs in Hern v. Beye, provided testimony against the proposed emergency regulations during a hearing before the Board vote. Meanwhile, some other states are moving toward complying with federal Medicaid law. The Nebraska Department of Social Services is considering regulations that would extend state funding for abortion to include pregnancies resulting from rape or incest. A May 19 public hearing was held on the proposal, which is awaiting final approval. When the Louisiana legislature convenes for a special session on June 6, Governor Edwin Edwards is expected to introduce a bill to authorize Medicaid coverage for abortions in cases of rape and incest. Finally, Indiana and Ohio are reportedly moving toward compliance with the federal mandate. In contrast, however, Missouri Department of Social Services Director Gary Stangler filed suit in federal court on May 24 against Health and Human Services officials for issuing the federal directive requiring compliance with the Hyde Amendment. Pennsylvania officials filed a similar action in mid-March. Lawsuits filed by CRLP against Arkansas, Louisiana, Michigan, North Dakota, Oklahoma, and Pennsylvania for non-compliance are still pending; similar challenges were also filed by Planned Parenthood in Michigan and Montana. PMID:12319329
This article examines the impact of the continuing politicization of the abortion issue in the US on the rights of women and on the emerging concept of fetal rights. The introduction 1) attributes the "final and total politicization" of a woman's right to control her reproduction to the "undue burden" standard introduced by the Supreme Court in its 1992 Casey decision and 2) claims that, if unchecked, the concept of fetal rights may give the state's interest in protecting potential life supremacy over women's rights. The next section presents an in-depth discussion of the politicization of the right to abortion that covers such topics as how the courts before Casey became the forum for debating abortion policy, how the "undue burden" standard fails to set definite parameters of acceptable state behavior, how the Casey decision in effect abandons the trimester-based framework of reference provided in Roe vs. Wade, how Casey allows states to subtly coerce women seeking abortions, how the Casey decision failed to reduce the intense politicization of abortion, and how the court failed to protect individual rights to health care and abortion funding from states. Part 3 of the article begins its exploration of the concept of "fetal rights" with a sketch of the history of this concept in the US courts starting in 1884 when damages for miscarriage were denied. Ways in which fetal rights compete with the rights of a pregnant woman are described, the Supreme Court is blamed for allowing states to develop this concept, and issues of patient confidentiality versus reporting requirements are considered. It is concluded that the Supreme Court will have to act to limit fetal rights. PMID:12348324
Marsh, F H
This paper discusses the controversy of the banning of ¿partial-birth abortion¿ in the state of Nebraska. This controversy arises as a result of how several major news sources described the Nebraska statute--that is, as a pre-viability abortion ban, and not a ban on late-term abortion procedures. This issue did not only occur in Nebraska, but also in Michigan when abortion opponents simultaneously initiated a publicity scheme to mislead the public into believing the ban was about ¿gruesome¿ late-term procedures. The deceptive term ¿partial-birth abortion¿, also seemed to suggest abortions performed on viable fetuses and the language describing the ban was confusing and slippery. In response to this controversy, Janet Benshoof, the president of the Center for Reproductive Law and Policy (CRLP) immediately made a statement to counteract the allegation imposed by abortion opponents. Also, CRLP Communications Deputy Director Margie Kelly spends a considerable amount of time informing the press of the extreme measures of the laws. PMID:12322529
Objective: To describe a patient with congenital cervical atresia who became pregnant through IVF and thawed transmyometrial ET and then experienced a missed abortion.Design: Case report.Setting: University hospital.Patient(s): A patient with congenital cervical atresia who underwent reconstructive surgery at 23 years of age and underwent IVF twice at 28 and 30 years of age.Intervention(s): Abortion management.Main Outcome Measure(s): Medical follow-up
Nobuhiko Suganuma; Madoka Furuhashi; Takayuki Moriwaki; Shin-ichiro Tsukahara; Tomoko Ando; Yutaka Ishihara
The objectives of this surveillance are twofold: (1) to document the number and characteristics of women obtaining abortions, and (2) to eliminate preventable mortality and morbidity related to abortion. This report documents the most recent data availabl...
US Vice President Al Gore is pessimistic about the likelihood of consensus on abortion and contraception at the 1994 World Population Conference given opposition on the part of the Vatican, governments of nations with large Roman Catholic populations, and Muslim fundamentalists. Although the Clinton Administration is advocating safe, legal abortion and accessible contraception, it does not intent to push for abortion rights in countries where the procedure is illegal. On the other hand, Gore has expressed confidence that the Cairo conference will forge a new approach to population and development based on improvements in women's status. PMID:12319073
The authors evaluated empirical research addressing the relationship between induced abortion and women’s mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women’s responses following abortion. This article reflects and updates the report of the American Psychological Association Task Force on Mental
Brenda Major; Mark Appelbaum; Linda Beckman; Mary Ann Dutton; Nancy Felipe Russo; Carolyn West
Students (N=118) were classified as pro-choice, anti-abortion, or mixed on the basis of their responses to 10 fictitious case histories of women who requested abortion. Attitudinal differences are discussed in the context of the public controversy over abortion. (Author/CM)
Allgeier, A.R.; And Others
For more than two decades, legal abortion has been the subject of heated political debate and adversarial social movement activity; however, national polls have shown little change in aggregate levels of support for abortion. This analysis examines how the determinants of abortion attitudes have changed between 1977 and 1996, using data from the General Social Surveys. While in early time
Jennifer Strickler; Nicholas L. Danigelis
|This report hypothesized that Indian university students approve of abortion, that religiosity neutralizes the influence of education in abortion attitudes, and that Indian students are more liberal in their attitudes on abortion than American Catholic students. To test these hypotheses, the author collected data from 150 students from two…
Bardis, Panos D.
The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…
Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn
Contributes to rhetoric, moral reasonings scholarship, and journalism scholarship by examining public rhetoric on abortion and American popular media coverage (1940s to 1990s). Finds that the feminine means of moral reasoning has emerged into the foreground of discourse on abortion. Compares emergence of a common-ground rhetoric on abortion with a…
Patterson, Maggie Jones; Hall, Megan Williams
|Contributes to rhetoric, moral reasonings scholarship, and journalism scholarship by examining public rhetoric on abortion and American popular media coverage (1940s to 1990s). Finds that the feminine means of moral reasoning has emerged into the foreground of discourse on abortion. Compares emergence of a common-ground rhetoric on abortion with…
Patterson, Maggie Jones; Hall, Megan Williams
|The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…
Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn
We assess whether adolescents who faced a higher risk of having been aborted are more likely to use controlled substances. We find that adolescents born in states that legalized abortion before national legalization in 1973, during the years when only those states permitted abortion, were much less likely to use drugs than persons from the same birth cohorts born elsewhere.
This review examines the relationship between maternal alcohol consumption during pregnancy and spontaneous abortions. Although very high spontaneous abortion rates have been reported for alcoholic women, it is still uncertain if this is due to the direct effects of alcohol or the indirect effects of alcoholism-re lated disorders such as cirrhosis. The higher rates of spontaneous abortion among alcoholics may
ERNEST L. ABEL
The doctor's task is to heal where possible, to relieve suffering and always to comfort. He attempts to prevent illness and to promote health, within the framework of primum non nocere ('do no harm'). Therapeutic abortion for fetal indications cannot be considered therapeutic, and should therefore be called iatrogenic abortion. The doctor has sufficient responsibilities of his own, and should not take over the responsibilities of other people or help them shirk their own. The philosophies of materialism, totalitarianism and hedonism are evil, and very dangerous for society. PMID:7089763
de Muelenaere, C W
A prospective study of the maternal mortality and morbidity and other related social problems among 144 cases of procured abortion in Ilorin, Nigeria over a 24-month period is presented. A mortality rate of 90.3 per thousand procured abortions was recorded. Genital sepsis, haemorrhagic anaemia, gut injury, uterine perforation and vesico vaginal fistulae (VVF) were encountered. Poor referral system, late presentation, poor blood transfusion services and inadequate availability of drugs had adverse effects on the patients. The implications (the menace and frequency) of these and possible measures like improving the literacy level, the moral standards, contraceptive practice and family life education (sex education) are discussed. PMID:7498012
Anate, M; Awoyemi, O; Oyawoye, O; Petu, O
This paper examines the impact anti-abortion activities have on state abortion rates. Using 1992 data from the 50 U.S. states, the empirical results find that anti-abortion harassment activities (picketing, picketing with contact, vandalism, bomb threats, and stalking) did not significantly reduce the demand for abortion within a state nor did they cause a change in the location of the abortion
Marshall H. Medoff
:Progressive men and women have found it extremely difficult to address issues of reproductive and sexual behavior-abortion, above all. Reproductive politics, in left circles, is not just about fighting the antiabortion movement or right-wing sexual conservatives for the hearts and minds of \\
Animals allocate time and effort to a range of core (e.g., sleeping, feeding, drinking) and "luxury" (e.g., playing, exploring) activities. A luxury activity is characterized by low resilience and, as such, will be reduced when time or energy resources are limited, including under conditions of stress or discomfort. One seemingly luxurious activity available to cows on an increasing number of dairy farms is rubbing against an automated brush. The current study examined the effect of distance from food, heat load, and an intrusive medical procedure (i.e., artificial insemination and transrectal pregnancy examination) on the resilience of brush usage. The probability of using the brush decreased significantly when food was located distantly from the brush (mean=0.53) compared with days when food was located closer to the brush (mean=0.81). Brush usage also decreased at high temperature and humidity levels, with an average decrease of 0.062 brushing events for an increase of 1 temperature-humidity index unit (95% confidence interval=-0.93-0.030). In addition, a significant reduction of approximately 50% in brushing activity was observed on days of artificial insemination compared with the preceding 3d and the following 3d. These findings show that brush usage is a low resilience activity that reduces under a range of conditions. It may thus have the potential to be used as an indicator of a range of health and welfare problems in cows. Further research should be conducted to assess the sensitivity and specificity of this suggested tool and its possible contribution to the early detection of morbidity. PMID:23958014
Mandel, R; Whay, H R; Nicol, C J; Klement, E
Unsafe abortion's significant contribution to maternal mortality and morbidity was a critical factor leading to liberalization of Nepal's restrictive abortion law in 2002. Careful, comprehensive planning among a range of multisectoral stakeholders, led by Nepal's Ministry of Health and Population, enabled the country subsequently to introduce and scale up safe abortion services in a remarkably short timeframe. This paper examines factors that contributed to rapid, successful implementation of legal abortion in this mountainous republic, including deliberate attention to the key areas of policy, health system capacity, equipment and supplies, and information dissemination. Important elements of this successful model of scaling up safe legal abortion include: the pre-existence of postabortion care services, through which health-care providers were already familiar with the main clinical technique for safe abortion; government leadership in coordinating complementary contributions from a wide range of public- and private-sector actors; reliance on public-health evidence in formulating policies governing abortion provision, which led to the embrace of medical abortion and authorization of midlevel providers as key strategies for decentralizing care; and integration of abortion care into existing Safe Motherhood and the broader health system. While challenges remain in ensuring that all Nepali women can readily exercise their legal right to early pregnancy termination, the national safe abortion program has already yielded strong positive results. Nepal's experience making high-quality abortion care widely accessible in a short period of time offers important lessons for other countries seeking to reduce maternal mortality and morbidity from unsafe abortion and to achieve Millennium Development Goals.
Intelligent agents that are intended to work in dynamic environ- ments must be able to gracefully handle unsuccessful tasks and plans. In addition, such agents should be able to make rational de- cisions about an appropriate course of action, which may include aborting a task or plan, either as a result of the agent's own deliber- ations, or potentially at
John Thangarajah; James Harland; David Morley; Neil Yorke-smith
Most research on abortion has focused on the determinants of attitudes among the public or elites, or on the tactics of activists on both sides of the issue. To date, however, there has been little attention to the formation and behavior of pro-life and pro-choice organizations. This paper addresses these latter questions and compares the resources and strategies of PACs
In December 1989, following the fall of communism in Romania, the ban on access to abortion and birth controls methods was lifted. This paper attempts to analyze the educational achievements of children affected by the lift of this ban, using administrative data of secondary school admission exam scores and placement outcomes. We find robust evidence that children born after the
In 'After-birth abortion: why should the baby live?', Giubilini and Minerva argue that infanticide should be permitted for the same reasons as abortion. In particular, they argue that infanticide should be permitted even for reasons that do not primarily serve the interests (or would-be best interests) of the newborn. They claim that abortion is permissible for reasons that do not primarily serve the interests (or would-be interests) of the fetus because fetuses lack a right to life. They argue that newborns also lack a right to life, and they conclude that therefore, the same reasons that justify abortion can justify infanticide. This conclusion does not follow. The lack of a right to life is not decisive. Furthermore, the justificatory power of a given reason is a function of moral context. Generalisations about reasons across dissimilar moral contexts are invalid. However, a similar conclusion does follow-that fetus-killing and newborn-killing are morally identical in identical moral contexts-but this conclusion is trivial, since fetuses and newborns are never in identical moral contexts. PMID:23637451
Purpose: To understand which adolescents in Havana, Cuba, seek abortions and reasons for pregnancy termination.Methods: The sample included all adolescents (n = 248) under the age of 20 years who sought pregnancy termination over a 1-month period in 1995. The participants completed a questionnaire exploring a range of issues including age of onset of sexual intercourse, pregnancy history, and reasons
Jorge Peláez Mendoz; Aldo Rodriguez Izquiendo; Cristina Lammers; Robert Wm Blum
At a university hospital, 642 women seeking induced abortion for an unwanted pregnancy were surveyed before the procedure regarding their perception of what psychological and behavioral factors, if any, played a role in their becoming pregnant: 35 percent said they had had intercourse during what they believed was a “safe period”; 33 percent believed that they had experienced a contraceptive failure; 29 percent indicated fear of side effects influenced their use of a contraceptive method; 27 percent and 21 percent, respectively, indicated that they had thought pregnancy “couldn't happen to me” or had “put the thought of pregnancy out of my mind.” The women's responses indicated that a number of additional attitudes, beliefs, and behaviors were also important and that for any individual woman at least three or four factors had often combined in a dynamic sequence to greatly increase her risk of pregnancy. The implications of the findings for educational and counseling programs are discussed.
Miller, Warren B.
The Department of Defense is publishing this final rule to revise the definition of ``unlabeled or off-label drug'' to ``off-label use of a drug or device.'' This provision codifies the coverage of those medically necessary indications for which there are demonstrations from medical literature, national organizations, or technology assessment bodies that the off-label use is safe and effective and in accordance with nationally accepted standards of practice in the medical community. Additionally, this rule removes the partial list of examples of unproven drugs, devices, and medical treatments or procedures proscribed in TRICARE regulations. We are removing the partial list from the regulation but will maintain the partial list in the TRICARE Policy Manual at www.tricare.mil. PMID:22737762
The presence of significant intensities of un-bunched beam is a potentially serious issue in the LHC. Procedures using damper kickers for cleaning both the Abort Gap (AG) and the buckets targeted for injection, are currently in operation at flat bottom. Recent observations of relatively high population of the AG during physics runs brought up the need for AG cleaning during luminosity operation. In this paper the results of experimental studies performed in October 2011 are presented.
Gianfelice-Wendt, E.; /Fermilab; Bartmann, W.; Boccardi, A.; Bracco, C.; Bravin, E.; Goddard, B.; Hofle, W.; Jacquet, D.; Jeff, A.; Kain, V.; Meddahi, M.; /CERN
This paper simulates the possible operation of multi?option referendums in Ireland in two important issue areas, neutrality and abortion. First, we explain the four main multi?option ballot and vote?counting procedures. We then construct full preference schedules over a range of options for each of our two issues. Finally, we show the outcomes of referendums in which these hypothetical but empirically
John Baker; Richard Sinnott
The contention that abortion harms women constitutes a new strategy employed by the pro-life movement to supplement arguments about fetal rights. David C. Reardon is a prominent promoter of this strategy. Post-abortion syndrome purports to establish that abortion psychologically harms women and, indeed, can harm persons associated with women who have abortions. Thus, harms that abortion is alleged to produce are multiplied. Claims of repression are employed to complicate efforts to disprove the existence of psychological harm and causal antecedents of trauma are only selectively investigated. We argue that there is no such thing as post-abortion syndrome and that the psychological harms Reardon and others claim abortion inflicts on women can usually be ascribed to different causes. We question the evidence accumulated by Reardon and his analysis of data accumulated by others. Most importantly, we question whether the conclusions Reardon has drawn follow from the evidence he cites. PMID:19594725
Dadlez, E M; Andrews, William L
Students (N = 118) were classified as pro-choice, anti-abortion, or mixed on the basis of their responses to ten fictitious case histories of females who requested abortion. The distribution of participants on the abortion issue was quite similar to the results of a 1979 national survey. As expected, these groups differed on attitudes toward abortion as murder, the legalization of abortion, and the morality of premarital sex. The groups differed significantly in levels of sex guilt, but did not exhibit significant differences in levels of sexual knowledge. The results were discussed within the context of the public controversy over abortion. It was suggested that the affective messages accompanying the sexual socialization of children and adolescents may be more predictive of orientations toward abortion than the weight of intellectual arguments regarding the rights of the fetus, the point at which a fetus becomes viable, or a woman's right to have control over her own body. PMID:7270307
Allgeier, A R; Allgeier, E R; Rywick, T
NATO faces several challenges if Combat Casualty Care is to be improved further, especially if a smaller 'foot print' is one future planning factor. In 45 papers and 29 posters the RTO-HFM 182 symposium on 'Use of Advanced Technology and New Procedures in...
Induced abortion is widely practiced in Indonesia by both married and unmarried women. This paper draws on ethnographic research, conducted between 1996 and 1998, which focused on reproductive health and sexuality among young single women on the island of Lombok in Eastern Indonesia. While abortion for married women is tacitly accepted, especially for women with two or more children, premarital pregnancy and abortion remain a highly stigmatised and isolating experience for single women. Government family planning services are not legally permitted to provide contraception to single women and their access to reproductive health care is very limited. Abortion providers were highly critical of unmarried women who sought abortions, despite their willingness to carry out the procedure. The quality of abortion services offered to single women was compromised by the stigma attached to premarital sex and pregnancy. Women who experienced unplanned premarital pregnancy faced personal and familial shame, compromised marriage prospects, abandonment by their partners, single motherhood, a stigmatised child, early cessation of education, and an interrupted income or career, all of which were not desirable options. Young women were only able to legitimately continue premarital pregnancy through marriage. In the absence of an offer of marriage, single women necessarily resorted to abortion to avoid compromising their futures. PMID:11468844
Bennett, L R
The purpose of this retrospective study was to evaluate the utility of the manual vacuum aspiration (MVA) for management of incomplete first-trimester abortions. All patients treated for incomplete first trimester abortion using MVA under local anesthesia at University Hospital Center in Dakar from January 1, 2002 to December 31, 2003 were included. A total of 2379 pregnancy losses were recorded among the 14476 patients admitted during the study period. First-trimester abortion was treated using the MVA method under local anesthesia in 1372 cases (57.7%). For 87% of patients, the duration of hospitalization was less than 12 hours. The epidemiological characteristics of these women were young age (mean, 29 years old), low parity (mean, 2 children) and low gestational age (mean, 10 weeks after amenorrhea). Spontaneous abortion accounted for 94.4% of cases and clandestine abortion for 5.6%. No complications occurred during MVA procedures and no morbidity was observed with a follow-up of one year. These findings show that MVA is a safe and effective method for completing incomplete first-trimester abortions. In our practice use of this simple technique led to a considerable improvement in post-abortion care. PMID:17691436
Cisse, C T; Faye, K G; Moreau, J C
This article discusses the legal and epidemiologic status of abortion in Italy, and its relationship to fertility and contraception. Enacted in May 1978, Italy's abortion law allows the operation to be performed during the 1st 90 days of gestation for a broad range of health, social, and psychological reasons. Women under 18 must receive written permission from a parent, guardian, or judge in order to undergo an abortion. The operation is free of charge. Health workers who object to abortion because of religious or moral reasons are exempt from participating. Regional differences exist concerning the availability of abortion, easy to procure in some places and difficult to obtain in others. After an initial increase following legalization, the abortion rate was 13.5/1000 women aged 15-44 and the abortion ratio was 309/1000 live births -- an intermediate rate and ratio compared to other countries. By the time the Abortion Act of 1978 was adopted, Italy already had one of the lowest fertility levels in Europe. Thus, the legalization of abortion has had no impact on fertility trends. Contrary to initial fears that the legalization of abortion would make abortion a method of family planning, 80% of the women who sought an abortion in 1983-88 were using birth control at the time (withdrawal being the most common method used by this group). In fact, most women who undergo abortions are married, between the ages of 25-34, and with at least one child. Evidence indicates widespread ignorance concerning reproduction. In a 1989 survey, only 65% of women could identify the fertile period of the menstrual cycle. Italy has no sex education in schools or national family planning programs. Compared to most of Europe, Italy still has low levels of reliable contraceptive usage. This points to the need to guarantee the availability of abortion. PMID:12284546
Spinelli, A; Grandolfo, M E
Access to abortion services in the United States continues to decline. It does so not because of significant changes in legislation or court rulings but because fewer and fewer physicians wish to perform abortions and because most states now have "conscientious objection" legislation that makes it easy for physicians to refuse to do so. We argue in this paper that physicians have an obligation to perform all socially sanctioned medical services, including abortions, and thus that the burden of justification lies upon those who wish to be excused from that obligation. That is, such persons should have to show how requiring them to perform abortions would represent a serious threat to their fundamental moral or religious beliefs. We use current California law as an example of legislation that does not take physicians' obligations into account and thus allows them too easily to declare conscientious objection.
Meyers, C; Woods, R D
The Roman Catholic Church has held the most absolute and extreme position against abortion taken by any religious group. Opposition to abortion by US Catholic bishops has been unflagging since Roe vs. Wade was decided. The current strategy embraced by the bishops is to restrict access to abortion as a prelude to attaining a complete ban on the procedure. The bishops, of course, have a political and constitutional right to champion public policy issues. This ability is limited only by the laws regarding tax-exempt status which make it impossible for the bishops to endorse political candidates. Opponents of the positions of the bishops, in turn, have a right to challenge their positions. The bishops, acting jointly as the United States Catholic Conference (USCC), express their own opinions, not the opinions of the 53 million US Catholics and have been criticized by both conservative and progressive groups in the church. Since women can not become Catholic bishops, or even priests, they are excluded from meetings of the USCC. Catholic lay groups have expressed the view that there is more than one legitimate Catholic position regarding abortion and have even filed briefs in favor of retaining the decision reached in Roe vs. Wade. The bishops, however, are able to draw on a multitude of institutions to further their view and have enhanced the operations of their 28 statewide lobbying offices as the abortion battle has shifted to the states. The Webster decision signaled a return of the bishops to a prominent position in the anti-abortion campaign. Prior to Webster, they kept their distance from the Protestant religious right. With Webster, the bishops felt the time was right to press hard to further restrictions to access to abortion. As they began to apply pressure, a pro-choice backlash developed, with leading Catholic politicians adopting strong pro-choice positions. The bishops reacted by taking such aggressive actions as denouncing certain politicians by name. This behavior caused even more alienation of middle-of-the-road Catholics from the bishops' position. The bishops tried to recover by hiring a professional public relations firm and the pollster used by the Reagan administration. The public relations firm was dismissed within a year. Religious observers wonder why the church is so adamantly against abortion in every circumstance, despite the beliefs of its members. In fact, in 1974, the Congregation for the Doctrine of the Faith noted the church's opposition to abortion but fell short of calling it murder and was honest about the church's ambiguity over the personhood of a fetus or at what stage in development the creator endows a fetus with a soul. This question has been debated by theologians since the early centuries of the church. Even the current Pope favors the term "that which is in the process of becoming" when discussing a fetus. In addition, church history and positions regarding the possibility of a "just war" make the church's adherence to the impossibility of a "just abortion" hard to justify. This hard-line position has removed the church from a position in which it could help women and society understand the values which must underly every decision to have an abortion. PMID:8274867
NASA goals are set on resumption of human activity on the Moon and extending manned missions to Mars. Abort options are key elements of any system designed to safeguard human lives and stated requirements stipulate the provision of an abort capability throughout the mission. The present investigation will focus on the formulation and analysis of possible abort modes during the Earth departure phase of manned Mars interplanetary transfers. Though of short duration, the departure phase encompasses a mission timeline where failures have frequently become manifest in historical manned spacecraft necessitating the inclusion of a departure phase abort capability. Investigated abort modes included aborts to atmospheric entry, and to Earth or Moon orbit. Considered interplanetary trajectory types included conjunction, opposition, and free-return trajectory classes. All abort modes were analyzed for aborts initiated at multiple points along each of these possible departure trajectories across all launch opportunities of the fifteen-year Earth-Mars inertial period. The consistently low departure velocities of the conjunction trajectories facilitated the greatest abort capability. An analysis of Mars transportation architectures was performed to determine the amount of available delta V inherent in each candidate architecture for executing departure aborts. Results indicate that a delta V of at least 4 km/s is required to achieve a continuous departure phase entry abort capability with abort flights less than three weeks duration for all transfer opportunity years. Less demanding transfer years have a corresponding increase in capability. The Earth orbit abort mode does not become widely achievable until more than 6 km/s delta V is provided; a capacity not manifest in any considered architecture. Optimization of the Moon abort mode resulted in slight departure date shifts to achieve improved lunar alignments. The Moon abort mode is only widely achievable for conjunction transfers during the optimum transfer years and delta V values greater than 4 km/s. A lesser delta V potential of 3 km/s is sufficient to enable entry aborts during the least demanding transfer opportunity years. Extensive abort capability is achievable for high delta V capable Mars architectures. Less propulsively capable architectures achieve moderate abort capability during favorable opportunity years.
Dissel, Adam F.
This integrative review aims to identify evidence in four electronic databases (MEDLINE, CINAHL, PsyINFO, and COCHRANE) regarding the effectiveness of complementary and alternative medical interventions, either alone or as an adjunct to pharmacological therapy, in alleviating procedure-related pain, anxiety, and distress in children and adolescents with cancer. A total of 32 articles met inclusion criteria. Results suggest that mind-body interventions, including hypnosis, distraction, and imagery, may be effective, alone or as adjuncts to pharmacological interventions, in managing procedure-related pain, anxiety, and distress in pediatric oncology. PMID:21035021
Landier, Wendy; Tse, Alice M
|The purpose of this study was to evaluate the effectiveness of a high-probability (high-"p") request sequence as a means of increasing compliance with medical examination tasks. Participants were children who had been diagnosed with autism and who exhibited noncompliance during general medical examinations. The inclusion of the high-"p" request…
Riviere, Vinca; Becquet, Melissa; Peltret, Emilie; Facon, Bruno; Darcheville, Jean-Claude
Abortion is illegal in Rwanda except when necessary to protect a woman's physical health or to save her life. Many women in Rwanda obtain unsafe abortions, and some experience health complications as a result. To estimate the incidence of induced abortion, we conducted a national sample survey of health facilities that provide postabortion care and a purposive sample survey of key informants knowledgeable about abortion conditions. We found that more than 16,700 women received care for complications resulting from induced abortion in Rwanda in 2009, or 7 per 1,000 women aged 15-44. Approximately 40 percent of abortions are estimated to lead to complications requiring treatment, but about a third of those who experienced a complication did not obtain treatment. Nationally, the estimated induced abortion rate is 25