Issues in Law & Medicine最新文献

When intrauterine infection develops prior to viability, prognosis for the fetus is guarded. Previable partuition can be pursued when infection is present, but physician must challenge themselves to do only what is indicated and avoid causing unnecessary effects by their methods of terminating pregnancy.

Background: Some women who take mifepristone, a progesterone receptor antagonist, in order to terminate their pregnancies, change their minds and desire to stop the medical abortion process. There are only two articles in the medical literature documenting the reversal of the effects of mifepristone.

Objective: We present and analyze a series of women who attempted to reverse the effects of mifepristone by taking supplemental progesterone to determine if the reversal of the effects mifepristone with progesterone is possible and safe. Additionally, we compare different progesterone regimens to determine relative efficacies.

Methods: This is an observational case series of 754 patients who decided to attempt to reverse the medical abortion process after taking mifepristone but before taking the second drug in the protocol, misoprostol. We followed the patients, who were given progesterone in an effort to reverse the effects of mifepristone, and conducted statistical analyses to determine the efficacies of different protocols compared to a control mifepristone embryo survival rate, derived from the literature.

Results: Intramuscular progesterone and high dose oral progesterone were the most effective with reversal rates of 64% (P < 0.001) and 68% (P < 0.001), respectively. There was no apparent increased risk of birth defects. Conclusions: The reversal of the effects of mifepristone using progesterone is safe and effective.

The evidence the fetuses feel pain at earlier gestational ages than previously thought prompts a call for universal management than individual practice. The purpose of this document is to present the available evidence for fetal pain, discuss implications for procedures in pregnancy, and to provide recommendations for situations requiring termination of pregnancy.

In 2016 a Parliamentary Committee in Victoria, Australia, recommended the legalization of physician-assisted suicide and voluntary euthanasia. Its report was deeply flawed. Its treatment of key objections to legalization, both principled and practical, was superficial and selective. The Voluntary Assisted Dying Act, passed by the Victorian Parliament in November 2017, is built on the report's shaky foundations.

Associations between several personal and contextual predic-tors of negative post-abortion mental health outcomes were explored using a large national sample of U.S. women who sought out post-abortion care from a crisis pregnancy center. The predictors examined included decisional regret, pregnancy wantedness, various forms of pressure, understanding of the procedure, and satisfaction with counseling provided by the abortion facility. Well-established measures of depression, anxiety, and substance abuse in addition to a newly developed assessment of abortion-related out-comes, the Post-Abortion Psychological and Relational Adjustment Scale (PAPRAS) were employed as the criteria in regression models. All analyses included controls for pre-abortion psychological adjustment and various forms of abuse in addition to a number of demographic variables. When the PAPRAS served as the outcome measure, the abortion context variables as a group accounted for 45.8% of the variance in women's post-abortion psychological and relational adjustment scores. Using the same sets of pre-dictors in a series of regression models and employing established measures of general anxiety, depression, PTSD, alcohol abuse, and substance abuse, 3.5% to 8.8% of the variance was explained. Based on psychometric analy-sis of the PAPRAS, there is evidence that this newly developed instrument holds promise for addressing the unique post-abortion mental health and relational concerns of women.

A Catholic hospital is decreasing the prevalence of disabilities in its Neonatal Intensive Care Unit [NICU] survivor. The hospital developed guidelines that encourage parents to allow their premature baby to die. Using extremely negative message framing, the physician guides the prospective parents to choose to forego an examination of their baby when it is born. Making this choice before birth ensure that no intervention or health care will be provided. The goal is to decrease the probability that the family will leave the hospital with a baby who will be disabled. The outcome is the death of a baby who may or may not have been disabled.

Recent legislation introduced in the United States, and abroad, to restrict "conversion" or "change" therapies for clients under the age of eighteen has brought upon increasing challenges for religious and/or rejecting families of children who identify as lesbian, gay, bisexual, transgender, questioning (LGBBTQ), or experience unwanted same-sex attractions or gender identity conflicts. Currently, fourteen states, the District of Columbia, and forty-four cities have based laws to prohibit such therapies, with ore legislation being introduced every year. While reports of abuse and/or forced therapy with licensed clinicians are hard to verify, outcomes studies on the effects of "conversion" or "change" therapy for minors have not been published in the scientific peer-reviewed literature, and even less is known about successful interventions for religious and/or rejecting families of such youth. With the increasing scrutiny brought about by such laws, licensed medical health practitioners should consider adopting innovative models of family systems therapy in order to safely and effectively work with sexual minority youth, and their families. This article presents one such family systems therapeutic model, while also addressing several important ethical considerations for working with religious and/or rejecting families of sexually minority youth.

Induced abortion is the most common surgical procedure performed on females of child-bearing age, including adolescent women. Consequently, pediatricians should be familiar with the short-term and long-term risks of induced abortion and also be able to compassionately discuss these risks with adolescents and involved family members. Some of the potential short- and long-term risks include increased mortality from suicide and other violence, as well as natural causes; increased risk of breast cancer; greater rates of substance abuse; and higher risk of morbidity and mortality for subsequent children due to premature births, especially very premature births. Patient education on the risks of induced abortion should be considered during anticipatory guidance discussions at well-child visits during the adolescent years.

This article aims to elucidate the position of Muslim Jurisprudence on the matter of Three-Parent in Vitro Fertilization (IVF) while linking it to the position of Arab laws-the Emirati Law-as a model. The present study adopted an inductive analytical method. Three Parent IVF takes place by injecting the nuclear deoxyribonucleic acid (DNA) from the ovum of the mother (wife) inserting this nuclear DNA in an ovum given by a female donor, from which the nucleus has been removed. This new ovum is then fertilized by sperm from the father (husband) by traditional methods inside the laboratory. The author concludes that Islamic Law is opposed to this practice, and that Emirati Law does not permit it in such form. Key words: Three-Parent in Vitro Fertilization (IVF), Muslim Jurisprudence (Fiqh), Emirati Law.