REPROHEALTHLAW Updates – August 2018

August 15, 2018

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DEVELOPMENTS:

Argentina:  Abortion Bill approved by Chamber of Deputies June 14, 2018, and narrowly rejected by Senate (38 to 31) August 9, 2018.  26 speakers at hearings July 31, 2018, included Argentine lawyer Mercedes Cavallo, a doctoral student at the University of Toronto’s Faculty of Law.  Cavallo oral argument (video)Cavallo editorial.   New York Times article.

Brazil: Supreme Court Considers Decriminalizing Abortion.  Public Hearings held August 3-6, 2018.  New York Times article.

Mexico’s newly elected government announces plan to decriminalize abortion in first trimester, nationwide.   EFE News report.

CALL FOR PAPERS:

“The Impact of Politics on Sexual and Reproductive Health and Rights,” for publication in Reproductive Health Matters, May 2019.  Submissions due October 31, 2018.
RHM Call for papers

SCHOLARSHIP:

[abortion] “Access to knowledge and the Global Abortion  Policies Database,”  by Joanna N. Erdman and Brooke Ronald Johnson Jr.  International Journal of Gynecology and Obstetrics  2018; 142: 120–124   PDF – Wiley online.

[abortion law, Latin America] El aborto en América Latina: Estrategias jurídicas para luchar por su legalización y enfrentar las resistencias conservadoras, por Paola Bergallo, Isabel Cristina Jaramillo Sierra y Juan Marco Vaggione, compiladores,  Buenos Aires: Siglo Veintiuno y RED ALAS, 2018. Libro de 482-paginas en linea.

[abortion law] “From Ireland to Northern Ireland: campaigns for abortion law,” by Angel Li,  The Lancet 391 (10138), 16–22 June 2018, Pages 2403-2404.  Article online.

[abortion law] “Abortion law reform: Why ethical intractability and maternal morbidity are grounds for decriminalisation,” by Andrew McGee, Melanie Jansen and Sally Sheldon. ANZJOG,  Article early view online.

[abortion law] “The paradox of access – abortion law, policy and misoprostol” by Karen Marie Moland, Haldis Haukanes, Getnet Tadele, Astrid Blystad, Tidsskriftet den Norske Legeforening 2:23 January 2018, Article online.

[abortion law, Ireland] “Reproductive Justice in Ireland: A Feminist Analysis of the Neary and Halappanavar Cases,” by Joan McCarthy,  in: Mary Donnelly and Claire Murray, eds., Ethical and Legal Debates in Irish Healthcare: Confronting Complexities (Manchester, UK: Manchester University Press, 2016).  Book information.    Submitted Text online.

Abortion Law in Transnational Perspective: Cases and Controversies, ed. Rebecca Cook, Joanna Erdman and Bernard Dickens (Philadelphia: Univ. Pennsylvania Press, 2014) 20% discount code is PH70.  Abstracts of 16 chapters.   Spanish edition by FCE/CIDE – 16 abstractsAbortion Decisions: Table of Cases in English and Spanish.

[conscientious objection, Mexico] “Abortion and conscientious objection: rethinking conflicting rights in the Mexican context,” by  Gustavo Ortiz-Millán, Global Bioethics 29.1 (2018) 15 pages,  Early view online.

“The Right to Conscience” – An Annotated Bibliography.   (Toronto: International Reproductive and Sexual Health Law Program,
Faculty of Law, University of Toronto, 2018)  .Conscientious Objection bibliography:  The Right to Conscience

Indications for abortion: new annotated bibliographies:

  • Annotated Bibliography on legal aspects of fetal anomaly and their implications for counseling, service delivery and abortion laws and policies (Toronto: International Reproductive and Sexual Health Law Program, Faculty of Law, University of Toronto, 2018).  Fetal anomaly bibliography
  • Legal and policy dimensions of rape-related abortion services (Court decisions, Treaty resources, policy guidance and publications. ) (Toronto: International Reproductive and Sexual Health Law Program, Faculty of Law, University of Toronto, 2018).  Rape or Incest bibliography 
  • Selección de doctrina y jurisprudencia latinoamericanas sobre Causal violación y/o incesto en casos de aborto (Rape or Incest bibliography in Spanish)  (Toronto: El Programa Internacional de Derecho en Salud Sexual y Reproductivas Facultad de Derecho, Universidad de Toronto, 2018)

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


JOBS

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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.

 

 

 

 


Fetal anomaly as an indication for abortion – annotated bibliography

August 15, 2018

Today, our International Reproductive and Sexual Health Law Program is pleased to issue a new 25-page annotated bibliography on Fetal anomaly indication for abortion,  as the second installment of our selected resources on “Indications for Abortion.”  This includes special sections on rubella/measles, thalidomide and fatal fetal anomalies, including anencephaly.  We are immensely grateful to University of Toronto Law students Michelle Hayman and Saul Moshé-Steinberg for helping to develop this bibliography.

In addition, our previous bibliographies on the Indication for  Rape or Incest (English),   and  Rape or Incest (Spanish) are now updated, and our longstanding list of resources on conscientious objection has been updated and expanded into a 32-page annotated  bibliography on The Right to Conscience.

ANNOTATED BIBLIOGRAPHY ON LEGAL ASPECTS OF
FETAL ANOMALY AND THEIR IMPLICATIONS FOR COUNSELING,
SERVICE DELIVERY AND ABORTION LAWS AND POLICIES

TABLE OF CONTENTS
Court Decisions
Treaty Resources: Regional and International Treaty Bodies – Decisions, Comments and Observations
°    Regional
°    International
Policy Guidance
°    Domestic
°    International
Databases: legislation and countries that allow abortion in cases of rape
Publications
Articles and Book Chapters
Specific Conditions
°    Rubella/Measles
°    Thalidomide
Fatal Fetal Anomaly
Screening, Detection and Counseling
Portuguese Publications on Brazil
Reports and Resources
Governmental Bodies
Non-Governmental Organizations
Acknowledgments.

LINKS to new Annotated Bibliographies:
The Right to Conscience.
Fetal anomaly indication for abortion
Rape or Incest indication for abortion
Rape or Incest indication for abortion (Spanish, Latin America)

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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.


Ireland must comply with international human rights including HRC rulings in Whelan and Mellet cases

January 31, 2018

Many thanks to Mercedes Cavallo, a doctoral candidate in the University of Toronto’s Faculty of Law, and a Reproductive Health Law Fellow,  for analyzing these two key Irish cases for readers of this blog:

On October 18, 2017, the Irish Oireachtas (Parliamentary) Joint Committee on Abortion recommended 15-2-2 not to fully retain the Eighth Amendment restrictions on abortion.   Irish abortion laws are among the most restrictive in the world and have been condemned by the UN Human Rights Committee in the cases of Whelan v. Ireland and Mellet v. Ireland.  Under the Irish Constitution’s Eighth Amendment, as interpreted by the Supreme Court of Ireland in Attorney General v. X and Others, abortion is a crime and is only permissible when it is established, as a matter of probability, that there is a real and substantial risk to the life, as distinct from the health, of the pregnant woman.

In addition, the “Abortion Information Act” 1995 restricts circumstances in which individuals (including health professionals) can provide information about legal abortion services in Ireland or abroad, and criminalizes “advocating or promoting” the termination of pregnancy.  Due to the constraints of this legal framework, women who need abortions in Ireland usually travel to the United Kingdom, with little information and no financial or psychological support from the State.

In the Whelan and Mellet. cases, the UN’s Human Rights Committee found Ireland non-compliant in denying abortion services and grief counselling to two women who had each been pregnant with a doomed foetus.

Siobhán Whelan, at 20 weeks pregnant, was informed that her foetus had a congenital malformation and would likely die in utero, during labor, or soon after birth. Her obstetrician mentioned that “in another jurisdiction [she] would be offered a termination but obviously not in this country due to Irish law.” The obstetrician expected Ms. Whelan to “continue with the pregnancy, attend ante-natal appointments ‘as normal’ and wait for nature to take its course.” Another doctor gave her a report of the scan, “in case [she] wanted to travel.”  She sought further information about travel, but most agencies could only assist women who were less than 13 weeks pregnant, so she learned about the Liverpool Women’s Hospital through a friend. At significant expense, she arranged babysitting, leave from work and farm relief.  Afterwards, she felt very isolated, and suffers from complicated grief and trauma.

Amanda Jane Mellet was 21 weeks pregnant when she was told that her foetus had congenital defects and would die in utero or shortly after birth.  Hospital staff said only that abortions were not available in Ireland and that some people “choose to travel.” The midwife advised her to contact an Irish family planning organization for information and counseling. Her doctor attempted to dissuade her from travelling to the UK for abortion. Only 12 hours after the abortion, she travelled to Ireland because she could not afford a longer stay in the U.K.  Upon her return, she was denied access to grief counselling. She still suffers from complicated grief and unresolved trauma.

In both cases, the Committee ruled that Ireland had violated the women’s rights to privacy (article 17), equality/non discrimination (article 26) and freedom from cruel, inhuman and degrading treatment (article 7), under the International Covenant on Civil and Political Rights.  To make amends, the Committee required Ireland to pay full reparations to both women, make psychological treatment available to them, and take measures to prevent similar violations in the future.  According to the Committee, “the State party should amend its law on voluntary termination of pregnancy, including if necessary its Constitution, to ensure compliance with the Covenant, ensuring effective, timely and accessible procedures for pregnancy termination in Ireland, and take measures to ensure that health-care providers are in a position to supply full information on safe abortion services without fearing they will be subjected to criminal sanctions” (Mellet, para. 9).

In Mellet, Judge Nigel Rodley concurred that “the refusal of the State party to allow for terminations even in the case of fatal foetal abnormality cannot even be justified as being for the protection of the (potential) life of the foetus. In addition, not only has article 7 [prohibition of inhuman and degrading treatment under ICCPR] been violated cumulatively … but by the very requirement that a pregnant woman carrying a doomed foetus is subjected to the anguish of having to carry the pregnancy to term.”(Mellet p.25).

As human rights expert Christina Zampas testified (2:27-2:45) before an Irish  parliamentary committee, Ireland is obligated to comply with international human rights law, including these two decisions: “The urgency of the human rights concerns in Ireland is reflected in serious human rights violations amounting to cruel, inhuman and degrading treatment, as found in the Mellet and Whelan cases. The UN Human Rights Committee held in these two cases that prohibiting and criminalising abortion in situations of fatal foetal impairment subjected these women to conditions of intense physical and mental suffering, and that no justification could be invoked, nor were there extenuating circumstances to excuse such harm.”

 So far, these decisions only represent a victory for the two victims.  The Human Rights Committee ignored that the criminalization of abortion in Ireland discriminates against women on grounds of sex and gender. The Committee decided that the women’s right to equality was violated only because other women who had had spontaneous miscarriages in Ireland could access counselling services, but they could not.

Equal treatment on grounds of sex and gender demands accommodation of the biological differences between men and women in reproduction,2 not endorsement of a false legal equality created by men for men.  Both decisions overlooked that the criminalization of abortion discriminates against women because it is a medical procedure that only women need, whereas the Irish legal system does not criminalize any medical procedure that only men need. Fortunately, concurring opinions by Committee members Yadh Ben Achour and Sarah Cleveland exemplify jurisprudence that strives to understand the perspectives of women in difficult situations.

It remains to be seen whether Irish government initiatives and a referendum this year, will bring Irish law into compliance with international human rights law.

Related resources:

Ireland:  Irish Government announces referendum on abortion, by Christina Zampas, Reprohealthlaw Blog, January 31, 2017.  Commentary online.

These are #115 and #116 in our Reprohealthlaw Commentaries Series. online here.
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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.

 


Spain: Health Service held accountable for objectors’ abortion delays and loss of uterus

October 31, 2017

Many thanks to Francisca Fernández Guillén, a feminist lawyer who specialises in sexual and reproductive health. She collaborated as an expert with the Women’s Health Observatory (part of the Spain’s Ministry of Health) on the development of the “Strategy for Assistance at Normal Childbirth in the National Health System”. She also gives training and talks for professionals on health legislation and bioethics and contributes articles and opinion pieces to journals and specialist presses, some of which can be read here.    We thank her for commenting on this enlightening case and decision:

Zurich Insurance PLC, Sucursal en España v. Doña Encarnacion y don César y Servicio Galego de Saude, Sentencia 00392/2017, Apelación 43/17 (High Court of Galicia at Coruña, Spain)  Decision online in Spanish

The Health Service of the autonomous region of Galicia in Spain was recently found guilty of intentionally concealing from a pregnant mother, the fact that her child was suffering from severe life-limiting anomalies that included “cri du chat” syndrome, a severe mental disability. The Health Service also obliged her to travel 600 km to receive an abortion in a private clinic that was insufficiently prepared to deal with her clinical condition. As a consequence, her child was born alive after seven months in the womb and died shortly afterwards, while the woman, only 32 years old, lost her uterus.

During the High Court proceedings, it emerged that her doctors had deliberately delayed the protocoled prenatal diagnostic testing. Once she had a proper diagnosis, following a consultation with a private geneticist, the gynaecologist in the regional health service then delayed authorization for an abortion, maintaining that it was necessary to carry out further diagnostic tests.  However, the expert witness called by the woman’s defence team made it clear that the tests on which the gynaecologist had insisted were primarily of interest to establishing cause of death and implications for future pregnancies, and were by no means urgent, especially in a case of advanced gestation that required immediate termination.

The High Court’s ruling made it clear that what had occurred was a “severe failure of the health system.” The president of the regional government, Albert Nuñez Feijoo, resolved not to appeal the initial decision of the county court and apologized for what had happened, attributing blame to the fact that a very high proportion of doctors in the region are “conscientious objectors” to medical abortions.  Nevertheless, the Health Service’s insurance company, hoping to reduce their compensation to the victim, appealed to the High Court of Galicia, which subsequently ratified the county court’s sentence, along with particularly harsh criticism of the Health Service’s actions.

During the court proceedings, it was put forth that the birth of child with such a severe illness is an insurmountable burden for the mother, her family and society.  As a lawyer, I am concerned that this woman’s experience is not an isolated case.  During the proceedings, I learned of a number of women who have had similar experiences with the Health Service.

In one instance, a woman gave birth to a boy who suffers from severe disability and cardiopathy, including Golenhar syndrome and Tetralogy of Fallot. His mother, abandoned by the boy’s father during the pregnancy, is an immigrant from South America who works as a domestic assistant and has insufficient economic or social resources to bring up a child with such severe disabilities. Unfortunately, she doesn’t wish to take the case to court for fear of repercussions, since her child must receive care from the same hospital for the duration of his life.

Despite reporting this and other known cases to the appropriate authorities in the health service, I have never received any response and, to this day, no effective measures have been put in place to ensure that religious ideology and a lack of ethical commitment, inappropriately called “conscientious objection”, don’t put the lives and health of women in danger.

Decision:
Zurich Insurance PLC, Sucursal en España v. Doña Encarnacion y don César y Servicio Galego de Saude, Sentencia 00392/2017, Apelación 43/17 (High Court of Galicia at Coruña, Spain)  Decision in Spanish 

News reports:
El Pais (English):  “The doctors’ right to object nearly cost me my life” Health system ordered to compensate woman who lost uterus after hospital refused to carry out abortion

(Spanish)  Eldiario.es The Galician government found guilty and must pay 270.000 € to women who lost her uterus  See also: The President of the autonomous region of Galicia apologizes
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The REPROHEALTHLAW BLOG is managed by 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.

 

 


Chile: Constitutional Tribunal upholds constitutionality of new abortion law

September 21, 2017

Many thanks to Carlos Herrera Vacaflor, LL.M., for providing the following overview of this historic decision in Chile.

Tribunal Constitucional Chile, STC Rol N° 3729(3751)-17 CPT,  Requerimientos de inconstitucionalidad presentados por un grupo de Senadores y Diputados, respecto de normas del proyecto de ley que regula la despenalización de la interrupción voluntaria del embarazo en tres causales, correspondiente al boletín N° 9895-11.  Decision in Spanish: 295 pagesAccompanying documentsOther Submissions
New: English Decision: 149 pages includes a Table of Contents for both English and Spanish editions.

On August 21, 2017, the Constitutional Tribunal of Chile, in a 6 to 4 ruling, upheld the constitutionality of a Bill (now enacted into law) that decriminalizes abortion in three cases: rape, fatal fetal impairment and when a woman’s life is in danger.

The Tribunal based its ruling on the following guiding principles, among others. On the basis of international human rights treaties ratified by Chile and national legal developments on maternity, the Tribunal recognized that pregnancy affects the physical and psychological integrity of a woman, since a fetus occupying a woman’s body causes physical and physiological transformations.  Furthermore, the Tribunal stated that criminal law on abortion imposes severe restrictions on rights, and leads to social and legal condemnation of individuals. The Tribunal, given such punitive power, recognized that criminal law should only be considered as an instrument of last resort, in order to limit the restrictive effect the law has on rights.

The Tribunal interpreted “threat to the life of the woman” as a risk to her life (riesgo vital). Only the physician who provides the abortion is needed to diagnose the risk to the woman’s life; no further examinations are required, lest the provision of care be delayed. Abortion is also decriminalized when the fetus carries a fatal congenital or genetic impairment impeding its survival outside the womb. The Tribunal maintained that since the Bill requires that two specialist physicians diagnose the disease of the fetus, these professionals must avoid decisional paralysis that could put a woman in greater danger. In cases of rape, the Tribunal considered constitutional the limits on access to abortion: for girls under the age of 14, abortion must be performed before 14 weeks of gestation; if the victim is older than 14, before 12 weeks of gestation.

The Tribunal also recognized, by an 8 to 2 vote, the constitutionality of institutional conscientious objection. The Tribunal found institutional conscientious objection also constitutional. Given the lack of uniformity on whether artificial legal “persons” (such as hospitals or clinics) have a right to conscience and religion in the Inter-American System of Human Rights, the Tribunal decided to elaborate its own position. The Tribunal considered it arbitrary to limit the scope of conscientious objection only to professionals intervening in abortion care. It argued that freedom of conscience and religion is protected for all persons in the Constitution and that, under comparative case law, educational institutions and private associations have been recognized as conscientious objectors in the context of education.

Full texts of Decision and Submissions:  Decision in Spanish -295 pagesAccompanying documentsOther Submissions     New: English Decision: 149 pages includes a Table of Contents for both English and Spanish editions. 

Chilean law professors who addressed the Court included:
Prof. Veronica Undurraga  presentation  in Spanish.
Prof. Lidia Casas Becerra  
presentation in Spanish, at minute 42.

Amicus curiae brief re: International consensus on abortion law with respect to decriminalization, by Joanna Erdman and Rebecca Cook:
Spanish and English briefs in one PDF.

Amicus curiae brief re conscience and conscientious objection by Prof. Bernard M. Dickens:  English PDF    Spanish PDF.

“Chile Celebrates its First Steps Towards Fulfilling Abortion Rights,” by Lidia Casas and Lieta Vivaldi, on Health and Human Rights Journal website.   Blogpost in English

Press Release from Center for Reproductive Rights.  Online in English.

Newspaper report in English.

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REPROHEALTHLAW Updates – Nov. 2016

November 24, 2016

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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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