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RESUMEN: Cuando un paciente se somete a cualquier tipo de intervención sobre su cuerpo tiene que tener en cuenta varios conceptos. Especialmente el del consentimiento informado. Los pacientes cuentan con el derecho a la autonomía de la voluntad para decidir qué actos pueden llevarse a cabo sobre su cuerpo y cuáles no. También tienen un trámite de información previo a cualquier intervención para tener toda la información necesaria y conocer los riesgos y los posibles resultados. Todo lo anterior nos lleva a hablar de nuevo del consentimiento informado, presente ya desde hace muchos años en los ordenamientos jurídicos sanitarios de todo el mundo. Se trata de un concepto que ha evolucionado mucho a lo largo de los años junto con los diferentes tipos de relación médico- paciente. Y además es una figura jurídica que puede sufrir intensificaciones en algunos supuestos. Son supuestos bien tasados y regulados en nuestros ordenamientos jurídicos. Y dentro de ellos, tenemos la cirugía estética. La especialidad que atribuimos a la cirugía estética procede de la falta de necesariedad en la intervención que vamos a realizar. Actualmente la cirugía estética es algo completamente normalizado en nuestra sociedad, que está al alcance de casi cualquiera. De ahí la importancia del estudio de esta figura. ABSTRACT: When a patient undergoes any kind of intervention on his or her body, he or she has to take into account several concepts. Especially that of informed consent. Patients have the right to the autonomy for deciding which acts can be carried out on their body and which cannot. They also have an information procedure prior to any intervention in order to have all the necessary information and to know the risks and possible results. All of the above leads us to speak once again of informed consent, which has been present for many years now in health legal systems all over the world. It is a concept that has evolved greatly over the years along with the different types of doctor-patient relationship. It is also a legal concept that can be intensified in certain cases. These cases are well defined and regulated in our legal systems. And among them, we have cosmetic surgery. The speciality that we attribute to cosmetic surgery comes from the lack of necessity in the intervention that we are going to carry out. Nowadays, cosmetic surgery is something completely normalised in our society, which is within the reach of almost anyone. Hence the importance of studying this figure. Grado en Derecho

Objective: The objective was to evaluate whether a targeted interrogation applied to a decision algorithm would allow the selection of patients eligible for medicated elective termination of pregnancy by teleconsultation without the need for ultrasound scan.Material and methods: Interrogation data were applied to an algorithm selecting eligible patients. Then the dates of pregnancies thanks to last menstrual period (DGDDR) were compared with dates of pregnancies thanks to ultrasound scan (DGecho).Results: Of the 305 requests for Voluntary Interruption of Pregnancy studied, 138 were eligible for medical abortion without prior ultrasound. Among them, 122 had a pregnacy less than or egal to 9 week’s gestation according to last menstrual period. According to the ultrasound scan, these 122 patients had all an intrauterine pregnancy, 92,62% of them had a pregnancy less than or equal to 9 week’s gestation, 7,38% of them had a pregnancy less greater than or equal to 10 week’s gestation, but only 40,16% of them had a correct dating of the pregnancy (+/- 5 days).Conclusion: Data from the initial preabortion medical interrogation is reliable to select patients who don’t require ultrasound scan before medical abortion at 92,62%.; Objectif : l’objectif est d’évaluer si un interrogatoire ciblé appliqué à un algorithme décisionnel permettrait de sélectionner les patientes éligibles à une IVG médicamenteuse par téléconsultation sans avoir recours à une échographie pelvienne.Matériel et méthodes : les données de l’interrogatoire ont été traitées par un algorithme sélectionnant les patientes éligibles à une IVG sans échographie préalable. Puis les dates de début de grossesse à partir des DDR (DGDDR) ont été comparées aux dates de début de grossesse déterminées à l’aide de l’échographie (DGecho).Résultats : Sur les 305 demandes d’IVG étudiées, 138 étaient sélectionnées pour effectuer une IVG sans échographie préalable. Parmi elles, 122 patientes avaient un âge gestationnel calculé à partir de la DDR (AGDDR) ≤9SA. D’après l’échographie, ces 122 patientes avaient toutes une grossesse intra-utérine, 92,62% d’entre elles avaient un AGecho≤9SA, donc 7,38% avaient un 10SA ≤AGecho, mais seules 40,16% d’entre elles avaient un DGDDR correct (+/- 5 jours).Conclusion : les données de l’interrogatoire associées à l’algorithme décisionnel permettent de sélectionner les patientes ne nécessitant pas d’échographie préalable à l’IVG médicamenteuse avec 92,62% de fiabilité.

Voluntary interruption of pregnancy (VIP) in Italy is regulated by Law no. 194/1978. Its monitoring is carried out by the VIP Epidemio-logical Surveillance System, which periodically analyses the results of questionnaires compiled by the territorial healthcare structures and sent by each Region. The latest report, covering the years 2019 and 2020, highlights the adequacy of preventive and proactive strategies, an improvement in the quality and effectiveness of the service offered. Furthermore, considering the COVID-19 pandemic, the reorganization of the IVG application guidelines showed a considerable adaptation to the emergency context through measures such as the increase in pharmacological procedures compared to surgical procedures. The interpretation of the data shows that in Italy there is one of the lowest VIP rates in Europe, reflecting the effectiveness of campaigns that promote responsible procreation. Further implementations should be extended to the foreign population, which still shows a medium-high VIP rate. The efficiency of the service offered resulted to be high. The latter was assessed considering the waiting period required for the performance of the VIP procedure. Furthermore, the high percentage of conscientious objectors does not harm the healthcare service. The estimates show an adequate territorial coverage by the authorized structures compared to the female population of fertile age. In conclusion, the central action of planning, organization, and monitoring finds a valid ally in the territorial management entrusted to the Regions. The analyzed report reflects even more margins of efficiency and adequacy when considered within the particular historical context of the pandemic by COVID-19.

Dissertação de Mestrado em Política Social Portugal é um dos países da Europa em que a descriminalização do aborto é realidade desde 2007, através do Lei nº 16/2007 de 17 de abril, através da qual se exclui a ilicitude nos casos de interrupção voluntária da gravidez. Mesmo com a descriminalização, os discursos tendencialmente inscritos num paradigma médico, que alimentaram o debate público, as iniquidades no Sistema Nacional de Saúde, estereótipos e tabus culturais, bem como a insuficiência de informação para a população em geral, justificam o tema desta dissertação. Para além da relevância social, cientificamente procura-se analisar o acesso ao direito de facto à Interrupção Voluntária da Gravidez, um direito de jure, sob determinadas condições estabelecidas na Lei. No domínio da Política Social estão envolvidos o direito à saúde, à autonomia, à igualdade, implicando um enquadramento teórico abrangente, envolvendo os direitos reprodutivos e questões éticas e morais do aborto. Com o objetivo de compreender a perspectiva das detentoras do direito, usuárias da política, desenvolveu-se um estudo qualitativo, através do relato das suas experiências,que conta com entrevistas semi-estruturadas com mulheres que realizaram o procedimento (entre 2016 e 2020) tornando-as sujeitos ativos da avaliação dos obstáculos que hipoteticamente colocam entre um direito de júri e de facto. A metodologia participativa sugere o recurso à análise temática. Os resultados demostram que permanecem limitações sustentando a necessidade de alterações legislativas, nas políticas públicas e na organização e funcionamento das instituições. Portugal is one of the countries in Europe where the decriminalization of abortion has been a reality since 2007, through Law nº 16/2007 of April 17th, which excludes illegality in cases of voluntary interruption of pregnancy. Even with decriminalization, discourses framed in a medical perspective, which fuelled public debate, inequities in the National Health System, cultural stereotypes, and taboos, as well as insufficient information for the general population, justify the chosen theme of this dissertation. In addition to social relevance, scientifically it seeks to analyse the access of de facto right to the Voluntary Interruption of Pregnancy, a de jure right, under certain conditions established in the Law. In the field of Social Policy, the right to health, autonomy and equality are involved, demanding an in-depth theoretical framework, including reproductive rights and the ethical and moral issues of abortion. To understand the rights holder’s perspective, users of the policy, a qualitative study was developed, through the report of their experiences,which includes semi-structured interviews with women who underwent the procedure (between 2016 and 2020) making them the active subjects of the evaluation of the obstacles that they hypothetically place between a jury's right and a factual one. The participatory methodology suggests the use of thematic analysis. The results show that limitations remain, sustaining the need for changes in legislation, in public policies and in the organization and functioning of institutions. N/A

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El camino para la despenalización total del aborto en Colombia ha sido toda una lucha independentista, esto resulta lógico, por cuanto su debate en una sociedad conservadora con una población de pensamientos religiosos arraigados genera polarizaciones y opiniones adversarias. Es conveniente reconocer que no han sido pocos los momentos en los que esta discusión se ha visto acordonada por la moral causando divisiones sociales; sin embargo, los movimientos que respaldan la lucha de la mujer para un ejercicio pleno y libre de sus derechos sexuales y reproductivos no cesa. Por ende, el presente artículo pretende dilucidar la historicidad de la penalización del aborto en Colombia, adentrarse en los fundamentos que han avalado el movimiento despenalizador para culminar con la descripción de los retos jurídicos – penales que han acontecido en los diversos proyectos de ley y estudios jurisprudenciales en el recorrido por la legalidad desde una perspectiva crítica, reflexiva y orientadora. The path to the total decriminalization of abortion in Colombia has been quite an independence struggle, this makes sense, because their debate in a conservative society with a population of entrenched religious thoughts generates polarizations and adverse opinions. It is desirable to recognize that there have been few occasions when this debate has been agreed, because of the morality caused by social divisions however, the movements that support woman’s struggle for a full and free exercise of her sexual and reproductive rights continue. Therefore, this article aims to elucidate the history of the criminalization of abortion in Colombia, to dely into the fundamentals that have endorsed the decriminalizing movement to culminate in the description of legal, criminal challenges that have taken place in the various bills and jurisprudence studies in the journey through legality from a critical, reflective and guiding perspective. Especialista en Derecho Penal y Procesal Penal Especialización

Viral infections are considered to be risk factors for spontaneous abortion (SA). Conflicting results have been reported on the association between Human Papillomavirus (HPV) and SA. HPV DNA was investigated in matched chorionic villi tissues and peripheral blood mononuclear cells (PBMCs) from women who experienced SA (n = 80, cases) and women who underwent a voluntary interruption of pregnancy (VI, n = 80, controls) by qualitative PCR and quantitative droplet digital PCR (ddPCR). Viral genotyping was performed using real-time PCR in HPV-positive samples. Specific IgG antibodies against HPV16 were investigated in sera from SA (n = 80) and VI (n = 80) females using indirect ELISA assays. None of the DNA samples from SA subjects was HPV-positive (0/80), whilst HPV DNA was detected in 2.5% of VI women (p &gt, 0.05), with a mean viral DNA load of 7.12 copy/cell. VI samples (n = 2) were found to be positive for the HPV45 genotype. The ddPCR assay revealed a higher number of HPV-positive samples. HPV DNA was detected in 3.7% and 5% of SA and VI chorionic tissues, respectively, with mean viral DNA loads of 0.13 copy/cell in SA and 1.79 copy/cell in VI (p &gt, 0.05) samples. All DNA samples from the PBMCs of SA and VI females tested HPV-negative by both PCR and ddPCR. The overall prevalence of serum anti-HPV16 IgG antibodies was 37.5% in SA and 30% in VI (p &gt, 0.05) women. For the first time, HPV DNA was detected and quantitatively analyzed using ddPCR in chorionic villi tissues and PBMCs from SA and VI women. Circulating IgG antibodies against HPV16 were detected in sera from SA and VI females. Our results suggest that HPV infection in chorionic villi may be a rare event. Accordingly, it is likely that HPV has no significant role in SA.

In Italy, the National Plan for the Elimination of Measles and Congenital Rubella 2010–15 suggests offering Measles, Mumps and Rubella (MMR) vaccination to susceptible women who underwent voluntary termination of pregnancy (VTP) In Rome, S. Eugenio Hospital is one of the structures where VTP is practised in an Operative Unit called “Family Planning” The primary goal of this study was to estimate the prevalence of susceptibility to rubella, using IgG and IgM immunoassays, among women accessing VTP and to offering MMR vaccination to susceptible women. Secondarily, this study evaluated acceptance of the vaccination offer From 2013 to 2015, data were collected from 1513 voluntary termination of pregnancy (VTP) cases The results show a significant increase of 5 percent in susceptibility prevalence in the target group from 13.6% in 2013 and 2014 to 18.4% in 2015 The association between rubella susceptibility and age was statistically significant (p

Introducción: frente al aborto inducido se han establecido diferentes posturas que muchas veces se basan en perspectivas morales, filosóficas y religiosas, cuando deberían estar centradas en lo que implica esta situación de salud en la vida de las mujeres Metodología: se desarrolló una investigación fenomenológica para establecer los diálogos desde la perspectiva de las propias protagonistas sobre el aborto inducido con una participación de siete mujeres, mayores de 18 años en Bogotá. Resultados: las experiencias de las mujeres son variadas, pero se identificaron algunos aspectos similares o comunes. Sin embargo, cada vivencia es particular y tiene como marco el contexto en el que cada una habitaba en el momento del aborto. Se identificaron las siguientes categorías de análisis: aborto como consecuencia de un embarazo no deseado, aborto como experiencia frente a una decisión autónoma, aborto, culpa y pecado, cambios asociados a la experiencia, maternidad, materialización del deseo y aborto no debe ser considerado como un delito. Conclusiones: la vivencia del aborto no puede ser generalizable, y para su entendimiento debe tenerse en cuenta aspectos que solo atañen a la mujer como experta en su vida y en su situación. El aporte de la presente investigación fue recuperar la vivencia de las mujeres sobre el aborto para contribuir al cuidado de la salud en la población femenina. Introduction: Regarding induced abortion, different positions have been adopted, often based on moral, philosophical, and religious perspectives, when they should be focused on what this health situation implies for women’s lives. Method: A phenomenological research was conducted to establish dialogues from the own protagonists’ perspective of induced abortion, where seven women over 18 years of age in Bogotá participated. Results: Women’s experiences are varied, but some similar or common aspects were identified. However, each experience is specific and is framed within the context where each woman lived at the time of the abortion. The following categories of analysis were identified: Abortion as a consequence of unwanted pregnancy, abortion as an experience versus an autonomous decision, abortion, guilt and sin, changes associated with the experience, maternity, desire materialization, and abortion should not be considered a crime. Conclusions: Abortion experience cannot be generalized, and for its understanding, aspects that only concern women as the experts on their lives and situations must be taken into account. This research contribution was to restore women’s abortion experiences to advance female population health care.

Trabajo fin de grado en Enfermería, Objetivo: conocer las percepciones y el papel que desarrolla el o la profesional de Enfermería durante la interrupción voluntaria del embarazo (IVE). Material y métodos: se llevó a cabo una búsqueda bibliográfica en las bases de datos Pubmed, Cinalh, Cuiden, Scielo, Lilacs y en el repositorio Dialnet. Para la estrategia de búsqueda se utilizó un lenguaje controlado mediante los tesauros MeSH y DeCS. También se utilizaron palabras clave y búsquedas en leguaje libre. Se limitó la búsqueda a material publicado en los últimos diez años, en idioma inglés y español y no se limitó la búsqueda según diseño de estudio. Resultados: se seleccionaron y revisaron un total de 20 artículos mediante un análisis temático del contenido y se establecieron tres unidades de análisis donde se encuentran los principales hallazgos obtenidos. Estas unidades son: actitudes y percepciones de las enfermeras ante la IVE, percepción y experiencias de las mujeres sobre el cuidado de la enfermera en el proceso de su IVE y rol de la enfermera en la IVE. Conclusiones: aunque la bibliografía es escasa, se ha comprobado que la IVE genera percepciones heterogéneas entre las mujeres y las enfermeras. El papel de la enfermera depende de la legislación y el Sistema Sanitario de cada país, aunque podríamos reconocer que la enfermera desempeña un papel importante en la acogida, cuidado, educación y seguimiento de la mujer en situación de aborto voluntario. Es necesario un cuidado integral, que contemple las necesidades psicológicas y sociales, y humanista, respetando su autonomía. En nuestro país, y a pesar de que la IVE se enmarca en la cartera de servicios del Sistema Nacional de Salud, es remarcable la escasez de documentos obtenidos., Objective: to know the scientific literature for the nurse’s role in voluntary induced abortion. Methodology: a narrative review was conducted with a bibliography search in Cinhal, Cuiden, Pubmed, Scielo, Lilacs data bases and Dialnet archive. Searches were made with and without any keywords from DecS and MeSH, specific words of each data base our free search, combined with AND, OR and NOT boolean operators. The search was limited to articles published during the past ten years and written in English or Spanish or Portuguese, making no differences about design of the study. Results: twenty articles were scrutinized through a thematic content analysis, and classified within three analysis categories: nurse’s perceptions and attitudes about induced abortion, women’s perceptions and experiences about induced abortion care and nurse’s role in induced abortion care. Conclusions: it has been found that the voluntary termination of pregnancy generates heterogeneous perceptions among women and nurses. The role of the nurse depends on the legislation and health system of each country, although we can recognize the important role in the reception, care, education and monitoring of women in the situation of induced abortion. It is necessary an integral and humanistic care that responds to the physical, psychic and social needs of women and respect their autonomy. In Spain, the literature is scarce even though the abortion service has included in the National Health System., Objetivo: conhecer o papel da enfermeira no cuidado à mulher no processo de interrupção voluntária da gravidez (IVG). Metodologia: foi realizada uma pesquisa bibliográfica nas bases de dados: Cinalh, Cuiden, Scielo, Lilacs e no repositório Dialnet. Para a busca de artigos e construção da pesquisa foram utilizados os descritores e palavras-chave padronizados pelos MeSH e DeCS. A pesquisa foi limitada ao material publicado nos últimos dez anos, em espanhol, português e inglês e não foi limitada pelo desenho do estudo. Resultados:foram revisados 20 artigos mediante análise temática de conteúdo, e estabelecidas três unidades de análise: atitudes e percepções das enfermeiras sobre a IVG, percepção e experiências das mulheres sobre o cuidado no processo de sua IVG e o papel da enfermeira na IVG. Conclusões: verificou-se que a IVG gera percepções heterogêneas entre as mulheres e as enfermeiras, embora a enfermeira tenha um papel importante no acolhimento, cuidado, educação e seguimento do tratamento da mulher em situação de aborto voluntário. Outro fator importante a se considerar é que o papel da enfermeira depende da legislação e do sistema sanitário de cada país. Essas mulheres necessitam de um cuidado integrale humanizado, com o objetivo de garantir sua autonomia, segurança e saúde além das necessidades físicas. Na Espanha, apesar da IVG ser um serviço incluído no Sistema Nacional de Saúde é considerável a escassez de bibliografia sobre o tema.

Este estudio se propuso analizar los conceptos, actitudes y prácticas de un grupo de profesionales de la salud, ante la interrupción voluntaria del embarazo e identificar las principales barreras en relación a la solicitud de este procedimiento médico. Se realizó un estudio cualitativo de corte transversal a través de una exploración documental y el análisis de diez entrevistas semiestructuradas con profesionales de la salud, especialistas en ginecología y obstetricia. Los resultados indican que la interrupción voluntaria del embarazo está ligada aspectos éticos, morales y religiosos que influyen en la decisión de practicar este procedimiento médico, pese a concebirse como un derecho fundamental. Aunado a esto, existe desconocimiento de los elementos legales y una concepción de que esta práctica constituye una salida a los embarazos en adolescentes. Estos aspectos configuran barreras de acceso de tipo cultural, personal y estructural. This study aimed to analyze the concepts, attitudes and practices of a group of health professionals, before the voluntary interruption of pregnancy and identify the main barriers in relation to the request of this medical procedure. A qualitative cross-sectional study was carried out through a documentary exploration and the analysis of ten semi-structured interviews with health professionals, specialists in gynecology and obstetrics. The results indicate that the voluntary interruption of pregnancy is linked to ethical, moral and religious aspects that influence the decision to practice this medical procedure, despite being conceived as a fundamental right. Added to this, there is ignorance of the legal elements and a conception that this practice constitutes an exit to adolescent pregnancies. These aspects configure access barriers of a cultural, personal and structural nature.

Objective: Young women, especially between the ages of 19 and 24, are affected by unplanned pregnancies despite high contraceptive coverage. The objective of the study was to explain how current knowledge of emergency contraception is not effective in preventing unplanned pregnancies.Methods: This was a descriptive epidemiological study of 223 students from 19 to 24 years of age at Versailles Saint Quentin University.Results and conclusion: The sample does not know the reproductive physiology: 49.3% of the sample knows that it is possible to become pregnant at any time of the cycle and almost 80% of the students think that ovulation occurs only in the middle of the cycle. The knowledge of the emergency contraception (EC) is partial with confusions on the period of use: 48% is that the EC can be used between 3 and 5 days after unsafe sex. They would be 92% going to the pharmacy if they needed the EC. School information is insufficient in terms of hours and quality: Current knowledge of emergency contraception is insufficient to effectively prevent unplanned pregnancies. There is a need to strengthen the training professionals to provide appropriate information in schools. There are also restraints linked to fear: About 40% are afraid of side effects and 20% are afraid of infertility.; Objectifs : Les femmes jeunes, notamment de 19 à 24 ans sont touchées par les grossesses non prévues malgré une forte couverture contraceptive. L’objectif de l’étude était d’expliquer en quoi la connaissance actuelle de la contraception d’urgence ne permet pas une prévention efficace des grossesses non prévues.Matériel et méthodes : Il s’agissait d’une étude épidémiologique descriptive, menée auprès 223 étudiantes de l’Université Versailles Saint Quentin, âgées de 19 à 24 ans. Résultats : L’échantillon méconnaît la physiologie de la reproduction : 49% savent qu’une grossesse est possible à tout moment du cycle et presque 80% pensent que l’ovulation intervient uniquement au milieu du cycle. La connaissance de la contraception d’urgence (CU) est partielle avec des confusions sur le délai d’utilisation : elles sont 48% à savoir que la CU peut s’utiliser entre 3 et 5 jours après un rapport à risque. L’information scolaire est insuffisante en termes de nombre d’heures dispensées et de qualité : les connaissances actuelles de la contraception d’urgence sont insuffisantes pour prévenir efficacement la survenue de grossesses non prévues. Il faut renforcer la formation des professionnels afin de délivrer une information adaptée notamment en milieu scolaire. Il existe aussi des réticences liées à la peur : environ 40% des répondantes ont peur des effets secondaire et 20% de la stérilité.

Resumen Objetivo.Comprender la percepción acerca de la interrupción voluntaria del embarazo (IVE), bajo las tres causales definidas en la Sentencia C-355 del 2006, en un grupo de médicos del Hospital de San José, Bogotá-Colombia. Metodología.Estudio cualitativo hermenéutico. La muestra se configuró con quince médicos del servicio de Ginecología y Obstetricia seleccionados por muestreo teórico y el tamaño de la muestra se determinó por saturación de la información. Los datos se obtuvieron mediante entrevistas a profundidad que fueron analizadas con la propuesta de Heidegger, Diekelman, Allen y Tanner. Resultados.La Sentencia C-355 de 2006, fue percibida como una disposición necesaria que le reconoce a la mujer el derecho a decidir sobre su vida y reproducción; además, ofrece una interrupción del embarazo segura. Asimismo, aporta a la disminución de problemáticas sociales, del sistema de salud y familiares; aunque en la sociedad colombiana persiste una percepción negativa de la IVE. No obstante, señalaron las falencias de la Sentencia: ausencia en las definiciones del concepto de salud y del límite de semanas de gestación para acceder a la IVE; y de atención psicológica y genética posterior a la interrupción. Discusión.La Sentencia es un avance significativo para Colombia. A pesar de aceptar la IVE, los participantes reconocen los cuestionamientos que nacen de esta práctica y que son producto de sus valores religiosos y familiares, y de la estigmatización social del aborto. Conclusiones Es inminente la revisión de la Sentencia y la participación de los médicos en este proceso. Abstract Objective:to understand the perception that a group of physicians at Hospital de San Jose (Bogota-Colombia) have regarding voluntary abortion (VA) under the three causes defined by Sentence C-355/2006. Methodology: a qualitative hermeneutic study with a sample of 15 doctors from the Gynecology & Obstetrics ward who were selected by theoretical sampling. Sample size was defined through information saturation. Data were obtained through in-depth interviews which were analyzed using the approaches proposed by Heidegger, Diekelman, Allen and Tanner. Results:Sentence C-355/2006 was perceived as a necessary concept to empower woman´s right to decide on her life and reproduction; besides, it offers a safe form of VA. Also, the sentence helps in reducing social, health system and family problems; although a negative view of VA persists in Colombian society in general. However, the physicians did point out the sentence´s limitations: the lack of a definition of health, the fact that there is not a defined limit of pregnancy weeks to apply for VA and no psychological or genetic care after the procedure. Discussion:the sentence is a significant advancement in Colombia. In spite of accepting VA, participants do recognize the questioning regarding VA, which are derived from their religious and family values and the social stigma around abortion. Conclusions it is highly necessary to review this sentence, and physicians should participate in this process. Resumo Objetivo:Compreender a percepção sobre a interrupção voluntária da gravidez (IVG), sob três as causais definidas na Sentença C-355 do ano 2006, em um grupo de médicos do Hospital de San José, Bogotá-Colômbia. Metodologia:Pesquisa qualitativa hermenêutica. A amostra configurou-se com quinze médicos do serviço de Ginecologia e Obstetrícia selecionados por amostragem teórica, e o tamanho da amostra determinou-se por saturação da informação. Os dados obtiveram-se por meio de entrevistas de profundidade que foram analisadas com a proposta de Heidegger, Diekelman, Allen e Tanner. Resultados:A Sentença C-355 de 2006 foi percebida como uma disposição necessária que reconhece às mulheres os direitos a decidir sobre a sua vida e reprodução; além disso, oferece uma segura interrupção da gravidez. Do mesmo modo, contribui com a diminuição de problemas sociais, do sistema de saúde e familiares, mesmo que a sociedade colombiana continua com uma percepção negativa da IVG. Contudo, indicam-se a falências da Sentença: ausência nas definições do conceito de saúde e do limite de semanas de gravidez para aplicar a IVG; e de atendimento psicológico e de genética posterior à interrupção. Discussão:A Sentença é um avanço significativo na Colômbia. Embora aceitem a IVG, os participantes reconhecem seus questionamentos a esta prática, consequência dos seus valores religiosos e familiares, também da estigmatizarão social do aborto. Conclusões:É necessarío revisar a Sentença e que os médicos participem neste processo.

En este trabajo se identifica el efecto de la despenalización del aborto en los tres casos excepcionales contemplados en la Sentencia C-355/06 de la Corte Constitucional, sobre la tasa de natalidad en Colombia. Para ello, se utiliza una aproximación de diferencia en diferencias en un panel de datos municipal que aprovecha la variación geográfica de las clínicas y hospitales en el país. Se encuentra que la despenalización del aborto influye en la reducción de la tasa de natalidad entre un 5 y 6%. El efecto se desvanece con la ausencia este tipo de instituciones y tiene variaciones importantes a nivel regional. This paper identifies the effect of abortion depenalization in the three exceptional cases, the violation, the malformation and the physical or mental health of the mother, contemplated in the Sentence C-355/06 of the Constitutional Court, on the birth rate in Colombia. For this, I used a model of difference in differences, using a municipal panel data taking advantage of the geographical variation of clinics and hospitals in the country. It is found that the abortion depenalization influences the reduction of the birth rate between 5 and 6%. The effect fades with the absence of this type of institutions and has important variations at the regional level.

When a woman aims to terminate an unplanned pregnancy, she must go to a specialized healthcare unit, such as Júlio Dinis Maternity Hospital. In this unit, the procedures of voluntary interruption of pregnancy are done by two kinds of drug administration: the first one is always done by a nursing team, the second one can be performed at home or by a nursing team, depending on patient features. It is important to give the best option to the pregnant. In this paper, it is proposed to predict whether the second drug phase is done at home or at the hospital. The use of Data Mining (DM) helps in performing this step. Throughout this study, DM models capable to make predictions in a real environment using real data were induced. It was adopted the Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology. Four distinct techniques were considered: Decision Tree (DT), Naïve Bayes (NB), Support Vector Machine (SVM) and Generalized Linear Models (GLM) to perform classification tasks. Using these techniques it was possible to obtain acceptable results for each model. A value greater than 89% of accuracy and 91% in sensibility was achieved in some models.

OBJETIVO: Desenvolver e validar o conteúdo do Mosaico de Opiniões Sobre o Aborto Induzido (Mosai), um questionário estruturado que se pretende utilizar como instrumento para coletar informações sobre as opiniões de profissionais da saúde acerca da moralidade do aborto induzido. MÉTODOS: O conteúdo da primeira versão do questionário foi desenvolvido com base na técnica de análise temática de conteúdo de livros, artigos, filmes, sites e jornais relatando casos de abortamento e argumentando sobre sua prática. O Mosai ficou composto por 6 dilemas morais (vinhetas) relacionados a casos de abortamento, cujos desfechos devem ser escolhidos pelos respondentes e podem ser justificados mediante a classificação de 15 padrões de argumentos sobre o tema. A fim de validar seu conteúdo, o questionário foi submetido ao crivo de um painel de 12 especialistas, uma amostra intencional constituída de médicos, juristas, bioeticistas, sociólogos, enfermeiros e estatísticos, que avaliaram os critérios de clareza da redação, pertinência, adequação à amostra e aos domínios. As notas atribuídas pelos especialistas foram submetidas ao método da taxa de concordância. Os comentários livres foram analisados mediante a técnica de análise de conteúdo RESULTADOS: Todos os dilemas e argumentos foram considerados válidos segundo a taxa de concordância, entretanto, alguns comentários motivaram a exclusão de um dilema sobre anticoncepção de emergência, dentre outras mudanças CONCLUSÃO: A validação do Mosai poderá contribuir para que as opiniões de profissionais da saúde com relação à moralidade do aborto possam ser avaliadas de maneira abrangente e com maior profundidade. OBJECTIVE: This study aimed to develop and validate the contents of the Mosaico de Opiniões Sobre o Aborto Induzido (Mosai), a structured questionnaire intended to be used as a tool to collect information about the views of health professionals about the morality of abortion. METHODS: The contents of the first version of the questionnaire was developed based on the technique of thematic content analysis of books, articles, films, websites and newspapers reporting cases of abortion and arguing about their practice. The Mosai was composed of 6 moral dilemmas (vignettes) related to induced abortion, whose outcomes should be chosen by the respondents and could be justified by the classification of 15 patterns of arguments about the morality of abortion. In order to validate its contents, the questionnaire was submitted to the scrutiny of a panel of 12 experts, an intentional sample consisted of doctors, lawyers, ethicists, sociologists, nurses and statisticians, who evaluated the criteria of clarity of writing, relevance, appropriateness to sample and suitability to the fields. These scores were analyzed by the method of concordance rate, while the free comments were analyzed using the analysis technique content. RESULTS: All the moral dilemmas and arguments were considered valid according to the rate of agreement, however, some comments led to the exclusion of a dilemma about emergency contraception, among other changes. CONCLUSION: The content of Mosai was considered valid to serve as a tool to collect the opinions of healthcare professionals regarding the morality of abortion.

Resumen:En el presente artículo se examinan los proyectos de ley referidos al aborto, los cuales actualmente cuentan con estado parlamentario en Argentina (país donde dicha práctica es un delito penado con la cárcel, salvo contadas causales de no punibilidad). El objetivo es indagar, analizar y describir las consideraciones referidas a losderechos humanos y la salud, en tanto constituyen dos aspectos que aparecen reiteradamente en los diferentes proyectos, que a su vez remiten a una disputa por los significados en los discursos sociales circulantes con respecto al aborto. A partir de un relevamiento y análisis de documentos de acceso público (proyectos de ley presentados en las distintas Cámaras del Congreso Nacional), pondremos en perspectiva cultural el debate sobre la penalización/despenalización, a fin de comparar los diferentes proyectos de ley, la mayoría de los cuales se centra en la despenalización total y en una menor medida solo en modificaciones a los abortos no punibles, aunque también hay proyectos orientados a reforzar las restricciones vigentes. A la luz de los documentos, nos proponemos analizar los discursos sociales circulantes con respecto al aborto, observando las condiciones para el ejercicio de los derechos sexuales y reproductivos en el país. Abstract:This article examines the Congress Bills referred to abortion that currently have parliamentary state in Argentina (a country in which this practice is punishable with imprisonment, barring a few grounds for exemption). The objective is to investigate, analyze and describe some considerations related to human rights and health, two aspects that appear repeatedly in the different projects, which also refer to a dispute over the meaning of current social discourses regarding abortion. From a survey and analysis of public access documents (Congress Bills) the purpose is to put the criminalization/decriminalization debate in a cultural perspective. In order to do that, we compare the different bills, most of which focus on total decriminalization and to a lesser extent in modifications to the current legal abortions. Although there are also projects that aim at strengthening existing restrictions. We analyze, by studying the Congress Bills, the current social discourses relative to abortion, having in mind the conditions for the exercise of sexual and reproductive rights in the country.

Woman willing to terminate pregnancy should in general use a specialized health unit, as it is the case of Maternidade Júlio Dinis in Porto, Portugal. One of the four stages comprising the process is evaluation. The purpose of this article is to evaluate the process of Voluntary Termination of Pregnancy and, consequently, identify the risk associated to the patients. Data Mining (DM) models were induced to predict the risk in a real environment. Three different techniques were considered: Decision Tree (DT), Support Vector Machine (SVM) and Generalized Linear Models (GLM) to perform the classification task. Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology was applied to drive this work. Very promising results were obtained, achieving a sensitivity of approximately 93%., This work is funded by National Funds through the FCT – Fundação para a Ciência e a Tecnologia (Portuguese Foundation for Science and Technology) within project PEstOE/EEI/UI0752/ 2014 and PEst-OE/EEI/UI0319/2014

This article analyse the underlying arguments in the debate of abortion and its regulation, focusing on the known as “Gallardón Proposal” for modification of the current law in Spain. From the perspective of respect for women's autonomy and their recognized rights, I argue against the different items of the reform bill, concerning the doctrine of the Spanish Constitutional Court, as well as various reports published in the field., El artículo analiza los argumentos que subyacen en el debate sobre el aborto y su regulación, centrándose en la llamada “propuesta Gallardón”, de modificación de la ley actualmente vigente en España. Se argumenta en contra de los distintos ítems del proyecto de reforma desde un marco de respeto a la autonomía de la mujer y a sus derechos reconocidos –ponderándolos en una pauta de gradualidad–, teniendo en cuenta la doctrina del Tribunal constitucional español, así como los distintos informes habidos en la materia.

El artículo pone de manifiesto los problemas inherentes a la regulación del aborto vigente en España y la necesidad de afrontar una reforma. La actual regulación no garantiza adecuadamente los derechos fundamentales de la mujer, ni ofrece seguridad jurídica a los profesionales sanitarios, ni posibilita la práctica del aborto en condiciones de igualdad. Ese estado de cosas propicia como reacción vulneraciones de la legalidad, que son, por lo demás, injustificables en un Estado de Derecho. En parte como consecuencia de lo anterior, el actual sistema tampoco es idóneo para tutelar eficazmente el bien jurídico que sirve de legitimación al castigo. El Anteproyecto de salud sexual y reproductiva y de la interrupción del embarazo recientemente aprobado por el Con- sejo de Ministros ofrece una nueva regulación que acoge el modelo del plazo con asesoramiento y aborda desde una perspectiva integral la problemática que rodea al aborto., This article illustrates the problems that are inherent in the current regulations on abortion in Spain and highlights the need for a reform. The legislation currently in force does not adequately guarantee women’s fundamental rights, does not offer legal security to health professionals and does not allow abortions to be done under equal conditions for everybody. This scenario gives rise to an infringement of law, which is not justifiable in a state under the rule of law. Partly as a result of this scenario, neither is the current system suitable when it comes to efficiently safeguarding the legal right that serves to legitimise punishment. The draft bill on sexual and reproductive health and on termination of pregnancy, which was recently passed by the Spanish Council of Ministers, provides us with a new regulation that considers free abortion over a period of time with counselling and tackles the abortion-related problems with a comprehensive approach.

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica. A interrupção voluntária da gravidez (IVG) tem vindo a ser realizada em outros países há alguns anos, dividindo a opinião dos investigadores no que se refere aos riscos para a saúde mental das mulheres. O objectivo geral deste trabalho é perceber até que ponto a IVG induz alterações psicológicas nas mulheres que recorrem a este processo, mais concretamente, verificar se existe variabilidade nos níveis de depressão, ansiedade e stress no pré e pós IVG. Questionaram-se 30 participantes do sexo feminino no Centro Hospitalar de Setúbal - Hospital de São Bernardo, com idades compreendidas entre os 17 e os 40 anos. Utilizouse como instrumentos um questionário Sócio-Demográfico e Clínico e uma Escala de Ansiedade, Depressão e Stress (EADS-21), aferida para população portuguesa por José L. Pais-Ribeiro, Ana Honrado e Isabel Leal (2004) a partir da Depression, Anxiety and Stress Scale (DASS) de Lovibond & Lovibond (1983). O nosso estudo mostrou que a IVG não “induz” alterações psicológicas que ultrapassem a fronteira dos estados reactivos “normais” face ao processo em causa. No entanto, verificou-se que variáveis como o estado civil, habilitações literárias, religião, factores sócio-económicos, experiências passadas de interrupções da gravidez, idade e duração da gravidez, influenciam a resposta emocional das mulheres que recorrem à IVG. The voluntary interruption of pregnancy (VIP) has been performed in several countries for many years, dividing the points of view of key opinion leaders, concerning the risks of mental health problems of women. The aim of the present work was to understand the extent of psychological changes induced by VIP in women that had gone through the procedure. Possible variations in the levels of depression, anxiety and stress, before and after VIP, were tested on 30 female subjects, aged between 17 and 40, from Centro Hospitalar de Setúbal – Hospital de São Bernando. The instruments used in this study were a Sociodemographic and Clinical questionnaire and a Scale of Anxiety, Depression and Stress (EADS-21), validated for the Portuguese population by José L. Pais-Ribeiro, Ana Honrado e Isabel Leal (2004), based on Depression, Anxiety and Stress Scale (DASS) from Lovibond & Lovibond (1983). Our study suggests that the VIP does not induce psychological changes beyond the border states of normal reaction to the concerned process. However, it was observed that factors such as marital status, education, religion, socioeconomic situation, past experience of pregnancy interruption, age and number of pregnancy weeks play an important role in the emotional response to a VIP.

A propósito de la reciente promulgación de la Resolución Ministerial N.º 4862014/Minsa, que aprueba la guía técnica nacional para el aborto terapéutico, se ha generado un gran debate al respecto. Como un aporte a la discusión, se presenta una revisión sobre las definiciones y tipos de aborto, para luego centrarse en el denominado ‘aborto terapéutico’ y explorar las dificultades que existen para definirlo. Finalmente, se presentan algunas observaciones a esta Guía técnica emitida por el Minsa. Se concluye que el término ‘aborto terapéutico’ es anacrónico y contradictorio porque el aborto no es un tratamiento que asegure mejorar la salud de la mujer ni la del niño. El término apropiado debería ser ‘interrupción del embarazo por razones médicas’. With regard to the recent enactment of the Peruvian Ministerial Resolution N.º 4862014/Minsa, which approves the national technical guide for therapeutic abortion, has generated considerable debate. A review of the definition and type of abortion and the focus on the socalled ‘therapeutic abortion’ is presented. This article explores the difficulties in defining it. Finally, some comments are presented to the Technical Guidance issued by the Minsa. We conclude that the term ‘therapeutic abortion’ is anachronistic and contradictory because abortion is not a treatment ensuring better health of the woman neither for the unborn child. The proper term should be ‘termination of pregnancy for medical reasons’.

En Colombia, la vida y la interrupción voluntaria del embarazo-IVE son derechos fundamentales que se desprenden del ámbito jurídico de protección constitucional a la vida y de las libertades sexuales y derechos reproductivos de la mujer. Las restricciones para el ejercicio de la interrupción voluntaria del embarazo-IVE, parecen estar resueltas con las causales planteadas en la sentencia C-355 de 2006 de la Corte Constitucional. Sin embargo, existen otras restricciones que se desprenden del estudio de la vida y del derecho fundamental a la interrupción voluntaria del embarazo-IVE, desde las líneas argumentativas trazadas por Robert Alexy y Martin Borownski (2003), las cuales no han sido abordadas por la Corte Constitucional. El presente texto identifica restricciones a la vida, como delimitaciones al ámbito de protección del mismo, las cuales ampliarían el ejercicio del derecho fundamental a la interrupción voluntaria del embarazo.AbstractIn Colombia, the life and abortion-IVE are fundamental rights arising from the legal scope of constitutional protection to the lives and liberties of sexual and reproductive rights of women. Restrictions on the exercise of abortion-IVE, seem to be resolved with the grounds raised in the judgment C-355 of 2006 CONSTITUTIONAL COURT. However, other constraints arising from the study of life and the fundamental right to abortion-IVE, from the argumentative lines drawn by ROBERT MARTIN ALEXY and BOROWNSKI, which have not been addressed by the CONSTITUTIONAL COURT. This paper identifies restrictions to life, as the scope of protection boundaries thereof, which would extend the exercise of the fundamental right to abortion.RésuméEn Colombie, la vie et l’avortement IVE sont des droits fondamentaux découlant de la portée juridique de la protection constitutionnelle de la vie et des libertés des droits sexuels et reproductifs des femmes. Restrictions à l’exercice de l’avortement-IVE, semblent être résolus avec les moyens soulevés dansl’arrêt C-355 de 2006, la Cour constitutionnelle. Cependant, d’autres contraintes liées à l’étude de la vie et le droit fondamental à l’avortement-IVE, des lignes argumentatives dessinés par Robert Martin ALEXY et BOROWNSKI, qui n’ont pas été abordées par la Cour constitutionnelle. Ce documentidentifie les restrictions à la vie, comme le champ d’application de limites de protection de celui-ci, qui étendrait l'exercice du droit fondamental à l’avortement.