Zika virus infection in Brazil and human rights obligations

January 13, 2017

Many thanks to the authors of this useful new article in the Ethical and Legal Issues section of the International Journal of Gynecology and Obstetrics.  Debora Diniz and Sinara Gumieri are affiliated with the Anis Institute of Bioethics, Human Rights and Gender, Beatriz Galli is Senior Policy Advisor at Ipas Brazil, and Rebecca Cook and Bernard Dickens are professors emeriti at the University of Toronto’s Faculty of Law.

 The February 2016, the WHO declaration that congenital Zika virus syndrome constitutes a Public Health Emergency of International Concern reacted to the outbreak of the syndrome in Brazil. Public health emergencies can justify a spectrum of human rights responses, but in Brazil, the emergency exposed prevailing inequities in the national healthcare system. The government’s urging to contain the syndrome, which is associated with microcephaly among newborns, is confounded by lack of reproductive health services. Women with low incomes in particular have little access to such health services. The emergency also illuminates the harm of restrictive abortion legislation, and the potential violation of human rights regarding women’s health and under the UN Conventions on the Rights of the Child and on the Rights of Persons with Disabilities. Suggestions have been proposed by which the government can remedy the widespread healthcare inequities among the national population that are instructive for other countries where congenital Zika virus syndrome is prevalent.

Free access to PDF for 12 months.
Typescript online.

Related Resources:
“The Zika Virus and Brazilian Women’s Right to Choose,” op/ed by Debora Diniz, February 8, 2016.  New York Times.
“Zika: More than a health issue (Dec 1, 2016)  53-minute  TV interview with English subtitles.
“Zika” documentary  30 minutes, April 2016, with English subtitles;
“Zika emergency pushes women to challenge Brazilian abortion law”  Guardian news report.
Zika: Do Sertão nordestino à ameaça global  by  Debora Diniz  (Rio de Janeiro:  Civilização Brasileira, 2016).  Portuguese: Book or e-bookSinopseA história contada.
[Zika: from Brazilian backlands to global threat] Forthcoming in English from Zed Books in September 2017, this book analyses scientific discoveries regarding Zika in Brazil as well as the impact of the epidemic on poor black and brown women’s lives.

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Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca.   For Program publications and resources, see our website, online here.     TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.


REPROHEALTHLAW Updates – Nov. 2016

November 24, 2016

SUBSCRIBE TO REPROHEALTHLAW: To receive these updates monthly by email, enter your address in upper right corner of this webpage, then check your email to confirm the subscription.

DEVELOPMENTS

Gender Justice Uncovered Awards – internationally elected, from cases abstracted by Women’s Link Worldwide:   Best and Worst Judgments of the year.

India: High Court on its own Motion v.  The State of Maharashtra, Suo Motu Public Interest Litigation No. 1 of 2016,  Civil Appellate Jurisdiction, High Court of Judicature at Bombay,  India, September 19, 2016. [Prison inmate granted abortion on compassionate grounds.]  Judgment online.

Spain: Tribunal Constitucional, Sentencia S.T.C. 145/2015, 25 de junio de 2015, 2015182 BOE 66654.  [Seville pharmacy had been fined €3,000 in 2008 for refusing to sell emergency contraceptive, but Spanish constitutional court overturns decision on appeal.]  Spanish judgment now online, including dissenting opinions.  Published decisionEnglish newspaper report. Summary by Women’s Link Worldwide

Tanzania: decision against child marriage:  Rebeca Z. Gyumi v The Attorney General, Miscellaneous Civil Cause No. 5 of 2016, Date of Judgment: 8/7/2016,  [Tanzanian age of marriage laws are found discriminatory and unconstitutional]   Decision online Comment by Girls Not Brides.org

CALLS FOR PAPERS:

“Disability and Sexual and Reproductive Health and Rights”  Reproductive Health Matters 25.49, (June 2017). Submit paper by  (extended) deadline Dec. 10, 2016.   Detailed call for papers.

Disability: “The notion of maternal immunity in tort for pre-natal harms causing permanent disability for the born alive child”  Human Rights Controversies,  Special Issue of The International Journal of Human Rights.  Submit paper by February 1, 2017.  Detailed call for papers

“Equality rights, human rights or social justice…”  Journal of Law and Equality (peer-reviewed, student-run) is currently accepting submissions for its Spring 2017 publication.  It publishes research articles, case comments, notes, and book reviews by a diverse group of commentators including professors, practitioners, and students.  Submit papers to  JLE  at gmail. com

RESOURCES

[abortion] “Mandatory Waiting Periods and Biased Counseling Requirements in Central and Eastern Europe: Restricting Access to Abortion, Undermining Human Rights, and Reinforcing Harmful Gender Stereotypes.” Center for Reproductive Rights.  Fact Sheet online.

[abortion law, Chile]   Debates y reflexiones en torno a la despenalización del aborto en Chile, Lidia Casas Becerra y Delfina Lawson  (LOM, 2016).  Libro en línea, 325 paginasIndice en Espanol.

[abortion law, Latin America, constitutions]  Paola Bergallo and Agustina Ramón Michel, “Constitutional Developments in Latin American Abortion Law,”  International Journal of Gynecology and Obstetrics 135 (2016) 228–231.   PDF online here

[abortion, rape and child marriage  in Sri Lanka]  Submission    to    the    Committee    against    Torture    re  the Sri    Lanka’s Fifth    State    Party    Report, October    2016 by the OMCT (World Organization Against Torture) and Global Justice Center, focuses on how Sri Lankan law violates the Convention Against Torture by banning abortion in most circumstances, and by authorizing rape in certain instances and child marriage.
Press Release     Shadow Report

[conscientious objection, Canada] “Let Thy Conscience Be Thy Guide (But Not My Guide!): Physicians and the Duty to Refer” (October 12, 2016) Daphne Gilbert, McGill Journal of Law and Health 2016 10(2).  Abstract and Article.

[fetal abnormality testing] “Ethical and Legal Aspects of Noninvasive Prenatal Genetic Diagnosis,” by Bernard M. Dickens,  International Journal of Gynecology and Obstetrics 124.2 (2014): 181-184. Abstract and Article.

[personhood and assisted reproduction, Argentina]   “The Lingua Franca of Reproductive Rights: The American Convention on Human Rights and the Emergence of Human Legal Personhood in the New Civil and Commerce Code of Argentina,” by Martin Hevia and Carlos Herrera Vacaflor, 23 U. Miami Int’l & Comp. L. Rev. 687 -740. Article online.

US-focused news, resources, and legal developments are available on Repro Rights Prof Blog.  View or subscribe.

JOBS

Links to other employers in the field of Reproductive and Sexual Health Law are online here

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TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.   Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth *law at utoronto*ca.  For Program publications and resources, see our website, online here


Noninvasive Prenatal Genetic Diagnosis

November 24, 2016

Congratulations to Prof. Bernard M. Dickens whose article, abstracted below, is now universally available.

Bernard M. Dickens, “Ethical and Legal Aspects of Noninvasive Prenatal Genetic Diagnosis,”   International Journal of Gynecology and Obstetrics 124.2 (2014): 181-184. online here.

Abstract:  The new technology that will allow genetic testing of a fetus within the first trimester of pregnancy by isolating cell-free fetal DNA (cffDNA) in the mother’s blood raises a range of ethical and legal issues. Considered noninvasive, this test is safe and reliable, and may avoid alternative genetic testing by amniocentesis or chorionic villus sampling, which risks causing spontaneous abortion. Ethical and legal issues of cffDNA testing will become more acute if testing expands to fetal whole-genome sequencing. Critical issues include the state of the science or diagnostic art; the appropriateness of offering the test; the implications of denying the test when it is available and appropriate; disclosure and counseling following test results; and management of patients’ choices on acquiring test results. A challenge will be providing patients with appropriate counseling based on up-to-date genetic knowledge, and accommodating informed patients’ legal choices.  Full text is online here.

Related Reading:
Rebecca J. Cook, “Stigmatized meanings of criminal abortion law,” chapter 16 of Abortion Law in Transnational Perspective: Cases and Controversies (University of Pennsylvania Press, 2014), 347-369, analyzes the decision of R.R. v. Poland (European Court of Human Rights),  which held that a woman in Poland should not have been denied access to genetic prenatal examinations which would have enabled her to decide whether or not to seek a legal abortion in Poland. Abstract of this chapter.   Book: Abortion Law in Transnational Perspective.   Libro: El aborto on el derecho transnacionalRR v Poland decision.

Bernard M. Dickens, “Preimplantation Genetic Diagnosis and ‘Saviour Siblings’International Journal of Gynecology and Obstetrics, Vol. 88, pp. 91-96, 2005  is online here.

76+ other articles on Ethical and Legal Issues in Reproductive Health are on our Program webpage here.

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Constitutional Developments in Latin American Abortion Law

November 24, 2016

Congratulations to two Argentine scholars,  Paola Bergallo and Agustina Ramón Michel, who recently co-authored a useful article in the Legal and Ethical Issues section of the International Journal of Gynecology and Obstetrics.

Paola Bergallo and Agustina Ramón Michel, “Constitutional Developments in Latin American Abortion Law,”  International Journal of Gynecology and Obstetrics 135 (2016) 228–231.   PDF online here.

Abstract: For most of the 20th century, restrictive abortion laws were in place in continental Latin America. In recent years, reforms have caused a liberalizing shift, supported by constitutional decisions of the countries’ high courts. The present article offers an overview of the turn toward more liberal rules and the resolution of abortion disputes by reference to national constitutions. For such purpose, the main legal changes of abortion laws in the last decade are first surveyed. Landmark decisions of the high courts of Argentina, Bolivia, Colombia, and Mexico are then analyzed. It is shown that courts have accepted the need to balance interests and competing rights to ground less restrictive laws. In doing so, they have articulated limits to protection of fetal interests, and basic ideas of women’s dignity, autonomy, and equality. The process of constitutionalization has only just begun. Constitutional judgments are not the last word, but they are important contributions in reinforcing the legality of abortion.   Full text online through SSRN

Further reading
(English):

“Abortion,” by Paola Bergallo & Agustina Ramón Michel, Chapter 3 in  The Latin American casebook: Courts, constitutions and rights, ed. Juan F. Gonzalez-Bertomeu and Roberto Gargarella (Routledge, 2016).  Latin American casebook .

“The Constititutionalization of Abortion,” by Reva Siegel, in Abortion Law in Transnational Perspective: Cases and Controversies (University of Pennsylvania Press, 2014) 13-35.  English bookLibro en español.

(Spanish):
La constitucionalización del aborto y sus encuadres en las altas cortes de América Latina,por Paola Bergallo & Agustina Ramón Michel, “constitucionalización,” Academia.edu.

“Interpretando derechos: La otra legalización del aborto en América Latina.” por Paola Bergallo, Capitulo 7 en Debates y Reflexiones en torno a la despenalización del aborto en Chile, Lidia Casas y Delfina Lawson. Ediciones Lon, Santiago de Chile, 2016. “Interpretando”, Academia.edu.    Debates y Reflexiones – PDF Book .

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Forced sterilization case against Bolivia: expert testimony by Christina Zampas

June 15, 2016

 

I.V. v Bolivia is the first case the Inter-American Court of Human Rights has heard on informed consent to medical treatment and the first case alleging forced sterilization. It is only the second reproductive rights case considered by this Court.

This case concerned the involuntary sterilization in 2000 of an immigrant woman from Peru in a public hospital in Bolivia during a caesarean section.  The doctors decided that a future pregnancy would be dangerous for I.V. and performed a tubal ligation, claiming that this was necessary in order to prevent a future pregnancy. They also noted that they had obtained I.V.’s consent while on the operating table. When I.V. learned that she had been sterilized she felt devastated, and has been seeking justice ever since.

In 2015, the Inter-American Commission on Human Rights referred this case to the Inter-American Court for a decision, after having concluded that Bolivia was responsible for the violation of Articles 5.1, 8.1, 11.2, 13, 17, and 25 of the American Convention on Human Rights, and Article 7 of the Inter-American Convention on the Prevention, Punishment, and Eradication of Violence against Women (Convention of Belém do Pará). The Commission’s report is online here.

Christina Zampas, a Reproductive and Sexual Health Law Fellow at the University of Toronto’s International Reproductive and Sexual Health Law Program, presented oral expert testimony before the Court during its hearing on 2 May 2016 in San Jose, Costa Rica. Christina Zampas has studied forced sterilization issues since 2002, when at the Center for Reproductive Rights, she worked with the Center for Civil and Human Rights (Poradňa), Slovakia, to document the forced sterilization of Roma women in Slovakia, and co-authored Body and Soul: forced sterilization and other assaults on Roma reproductive freedom in Slovakia, online here.   Since then, she has engaged in advocacy and litigation before UN and regional human rights and intergovernmental bodies, calling for accountability on the issue. She has also co-chaired Open Society Foundation’s Working Group on Sterilization and has been instrumental in the development of health and medical association standards on the topic, including the World Health Organization (WHO) UN Inter Agency statement on forced and coerced sterilization (2014) online here, and the International Federation of Gynecology and Obstetrics’  guidelines on female sterilization (2011), pages 122-126.

In her recent testimony before the Inter-American Court of Human Rights, Zampas focused on international and regional human rights standards in relation to informed consent to medical care generally, and to sterilization specifically.  In her presentation, she explained United Nations and European Court of Human Rights standards and case law on the subject, including on the numerous cases against Slovakia concerning forced sterilization of Roma women, as well as international health and ethical standards.  She emphasized that international and regional health and human rights standards are clear: sterilization for prevention of future pregnancy cannot be justified on grounds of medical emergency, which would permit departure from the general principle of informed consent.  Even if a future pregnancy might endanger a person’s life or health, alternative contraceptive methods can be used to ensure that the individual does not become pregnant immediately. The individual must be given the time and information needed to make an informed choice about sterilization. The provision of information, counseling and sterilization under the stressful conditions of childbirth are not only a violation of the right to information but also violate the right to privacy, physical integrity and human dignity and are a gross disregard for an individual’s autonomy, rising to the level of inhuman and degrading treatment.

Zampas’s testimony also urged the Court to address the gender stereotypes and the intersectionality of gender with other characteristics, such as race and ethnicity, disability, HIV and migrant status, often underlying the practice. These stereotypes deem women incapable of making rational decisions about their reproductive capacity, stripping them of decision-making regarding their own bodies and lives. They assume that men and people in positions of authority—such as doctors who perform medical procedures, male family members, or society at large—are better positioned to make decisions for women. Human rights bodies have recognized the power imbalances in doctor-patient relationships and how this can lead to serious abuses, including in the use of the medical necessity doctrine. She noted that such notions, prevalent in society, can lead to violations of the right to be free from discrimination.

Zampas’s testimony set forth potential individual and structural (general) remedies, including compensation and an apology, law and policy reform that is in line with human rights standards, training and education of all health care staff, adoption of ethical guidelines to address informed consent and gender stereotyping, and monitoring of public and private health centers to ensure accountability, and guarantee an effective remedy when violations do occur.

Amicus briefs in this case were filed by Women’s Link Worldwide and the Allard K. Lowenstein International Human Rights Clinic, Yale Law School, Ciara O’Connell and Diana Guarinzo-Peralata at University of Sussex, and the Human Rights and Gender Justice Clinic at CUNY Law School and Women Enabled International. Expert written testimony was provided by Luisa Cabal, in her capacity as a lawyer and expert on sexual and reproductive health and rights, and Ana G. Cepin, MD, Fellow of the American College of Obstetricians and Gynecologists.

The decision is expected within the next year.

Relevant publications:

Christina Zampas is co-author with Adriana Lamačková, a former LLM student in the program, of “Forced and Coerced Sterilization of Women in Europe,” International Journal of Gynecology and Obstetrics (2011), Forced and Coerced Sterilization.

Sterilization: list of program resources, including articles, theses, and further reading .   Sterilization resources.

Ethical and Legal Issues in Reproductive and Sexual Health, written or edited by Rebecca Cook and Bernard Dickens, published in the International Journal of Gynecology and Obstetrics – Ethical/Legal articles  online.


Uterus transplants: Legal and Ethical Issues

June 14, 2016

Congratulations to Bernard M. Dickens, Professor Emeritus of Health Law and Policy and Co-Director of the International Reproductive and Sexual Health Law Program at University of Toronto’s Faculty of Law, who recently published the following article:

Bernard M. Dickens, “Legal and Ethical Issues of Uterus Transplantation,” International Journal of Gynecology and Obstetrics 133.1(2016): 125-128.

Abstract:
The clinically detailed report of a successful uterus transplantation and live birth in Sweden, in which a family friend donated her uterus, provides a basis for expanded practice. Family members and friends can serve as living donors without offending legal or ethical prohibitions of paid organ donation, even though family members and friends often engage in reciprocal gift exchanges. Donations from living unrelated sources are more problematic, and there is a need to monitor donors’ genuine altruism and motivation. Donation by deceased women – i.e. cadaveric donation – raises issues of uterus suitability for transplantation, and how death is diagnosed. Organs’ suitability for donation is often achieved by ventilation to maintain cardiac function for blood circulation, but laws and cultures could deem that a heartbeat indicates donors’ live status. Issues could arise concerning ownership and control of organs between recovery from donors and implantation into recipients, and on removal following childbirth, that require legal resolution.

Keywords: Altruistic uterus donation, Brain death, Cadaveric uterus donation, Ethics in uterus donation, Legality of uterus donation, Organ transplantation, Uterus donation.

The entire article is online here.

72 other IJGO articles on “Ethical and Legal Issues in Reproductive and Sexual Health” are online here.


REPROHEALTHLAW Updates

May 12, 2016

SUBSCRIBE TO REPROHEALTHLAW: To receive these updates monthly by email, enter your address in upper right corner of this webpage, then check your email to confirm the subscription.

DEVELOPMENTS

GENDER JUSTICE UNCOVERED AWARDS – Vote on the Best and Worst judgments of 2015, gathered by Women’s Link Worldwide.  Decisions are attached!  Vote by May 30, 2016.  To review this year’s nominees, click on “Cases”.

PERU: re the historic case of  K.L. v. Peru: As a teenager in 2001, K.L.was denied abortion of an anencephalic fetus who died soon after birth. The UN CEDAW Committee stated that her human rights had been violated.   In 2016, she has received financial compensation.   News report.

RWANDA – access to legal abortion for raped 13-year-old denied by first court, then allowed on appeal.    Judgment of October 30 2015, official English translation, redacted to preserve privacy. Rwandan juvenile abortion decision.

UGANDA – Preventable Maternal Deaths – 3 decisions Overview on Reprohealthlaw Blog.

Center for Health Human Rights and Development (CEHURD) and 3 Others v Attorney General [2012], Constitutional Petition No. 16 of 2011 (Constitutional Court of Uganda at Kampala). Preventable maternal deaths were dismissed as a “political” matter.  Decision online.  Case Summary and Analysis by Nthabiseng Lelisa and Godfrey Kangaude.

Center for Health, Human Rights and Development & 3 Others  v Attorney General.  [2015], Constitutional Appeal No. 01 of 2013 (Supreme Court of Uganda at Kampala) [Uganda Supreme Court orders Constitutional Court to hear a petition on maternal health rights violations.]  Decision online.  Case summary and analysis by Godfrey Kangaude. 

Center for Health, Human Rights and Development & 4 Others  v Nakaseke District Local Administration [2015], Civil Suit No. 111 of 2012 (High Court of Uganda at Kampala). [Ugandan High Court finds human rights violations where a pregnant woman died of a ruptured uterus and blood loss while in labour.] Decision online. Case summary and Analysis by Godfrey Kangaude 

EDUCATIONAL FUNDING

Comparative Program on Health and Society at the University of Toronto, Canada, invites applications for 2016-2017.  Complete applications due May 30, 2016.    Doctoral fellowships on “Health and human rights” and “Social determinants of health”: Doctoral fellowships.   Research Associate fellowship

O’Neill Institute for National and Global Health Law, Georgetown University Law Center in Washington, DC.   – Associate position for law graduates, to work on domestic and global health law and policy projects. Apply by May 31, 2016  Associate position for law graduates

RESOURCES

[abortion – anti-choice strategy, United Kingdom]”A guerrilla strategy for a pro-life England,” by Sheelagh Mcguinness, 7.2 Law, Innovation and Technology 283-314. [how anti-abortion “guerrilla” strategies undermine reproductive rights]  Abstract and article.

[abortion and police]  Practical Guide for Partnering with Police on Abortion. The guide is for trainers and advocates, by Ipas, 2016.  Ipas Guide.

[abortion, zika virus – Brazil]  “Threats of retrocession in sexual and reproductive health policies in Brazil during the Zika epidemic,” [Ameaças de retrocesso nas políticas de saúde
sexual e reprodutiva no Brasil em tempos de epidemia de Zika] by Beatriz Galli and Suely Deslandes,   32.4 (2016) Cad. Saúde Pública (Rio de Janeiro)  Epub 19-Abr-2016  Portuguese original.  English translation.

[abortion, zika] “Using a Human Rights Accountability Framework to Respond to Zika,” by Beatriz Galli.  Health and Human Rights Journal blog, May 2, 2016.  Blog online.

[Conscientious objection by hospitals – new report] “Health Care Denied: Patients and Physicians Speak Out about Catholic Hospitals and the Threat to Women’s Health and Lives,” American Civil Liberties Union (ACLU and Merger Watch, 2016)  40-page report.   Faith-based restrictions at 550 US hospitals go far beyond abortion: news article.

[Conscientious objection by hospitals prohibited] “Healthcare responsibilities and Conscientious Objection”  by R. J. Cook, M. Arango Olaya and B.M. Dickens,  International Journal of Gynecology and Obstetrics 104 (2009): 249-252.  English abstract and article. Spanish translation.

[Conscientious objection] “The Right to Conscience,” by Bernard M. Dickens in Abortion Law in Transnational Perspective: Cases and Controversies, ed. Rebecca J. Cook, Joanna N. Erdman and Bernard M. Dickens (University of Pennsylvania Press, 2014), 210-238. Book in EnglishSpanish translation.

Conscientious Objection: articles and projects related to the Reproductive and Sexual Health Law Programme of the University of Toronto  Updated List.

[forced treatment during pregnancy, e.g. caesarean births] New book: Autonomy and pregnancy: A comparative analysis of compelled obstetric intervention (2016), Samantha Halliday. Table of contents and excerpts at Googlebooks

US-focused news, resources, and legal developments are available on Repro Rights Prof Blog.  View or subscribe.

JOBS

Program Manager, Women’s Health and Equality in Latin America, Wyss Foundation, Washington DC,  Apply by May 31, 2016.  Job details.

Links to other employers in the field of Reproductive and Sexual Health Law are online here

______________
Compiled by the Coordinator of the International Reproductive and Sexual Health Law Program, reprohealth*law at utoronto.ca For Program publications and resources, see our website, online here. TO JOIN THIS BLOG: enter your email address in upper right corner of this webpage, then check your email to confirm the subscription.