Search Results (20)

Therapeutic termination of pregnancy (TToP) represents an intervention that is performed for medical reasons, such as risks to maternal health or severe fetal anomalies. Advances in prenatal screening and diagnostic tools—including serum markers, ultrasound, cell-free fetal DNA, chorionic villus sampling and amniocentesis—have significantly improved early detection and clinical decision-making. This narrative review synthesizes current knowledge on the genetic, environmental and psychosocial determinants that influence the decision of the patients to pursue TToP. The literature search was performed primarily using PubMed database, while Scopus and Google Scholar were used to identify additional relevant studies. Some of the selected studies, as well as certain sections of this review, address both therapeutic and voluntary termination of pregnancy, whereas others focus exclusively on TToP. Moreover, this review describes the types of abortion (medical or surgical/aspiration) along with their management strategies to prevent or address potential complications. It is well known that demographic, cultural and socio-economic factors continue to influence the access to TToP, as well as the perceptions of it. Psychiatric comorbidities (such as anxiety, affective and psychotic disorders) are observed with a higher prevalence among women undergoing TToP and may influence both the decision and psychological outcomes post-procedure. While most women report emotional relief after TToP, some of them experience depression, post-traumatic stress disorder or substance misuse. Legal and ethical considerations further complicate access to safe abortion, leading to situations where patients may resort to unsafe procedures, which result in higher rates of morbidity and mortality. Data from the EUROCAT network show rising trends in congenital anomalies like trisomy 13, trisomy 18 and caudal regression syndrome (conditions commonly associated with TToP). Therefore, it is mandatory to form a multidisciplinary team in these cases, integrating medical, psychological and ethical dimensions. Ensuring safe, evidence-based and compassionate access to TToP remains a critical component of reproductive healthcare. Full article

Background/Objectives: Abortion legislation represents a complex intersection of medical practice, ethical considerations, and legal frameworks that demonstrate significant legal heterogeneity across Europe. This study undertakes a comprehensive comparative assessment of the statutory schemes governing abortion across the European continent, examining gestational limits, exceptional circumstances, and regulatory requirements. Methods: A comparative legal analysis was conducted across 31 European jurisdictions. Primary legislative instruments were identified and authenticated through official governmental sources, parliamentary databases, and legal repositories to ensure analysis of current consolidated legislation. Data extraction focused on gestational limits, exceptional circumstances, procedural requirements, and constitutional provisions to categorize jurisdictions into regulatory models. Additionally, a structured literature search was performed in PubMed and Scopus (2015–2025) using the keywords “abortion,” “law,” and “Europe.” From 297 screened records, 30 articles were selected to contextualize legislative evolution and scholarly discourse. Results: The comparative analysis identified substantial heterogeneity in European abortion legislation, revealing four distinct regulatory models. Most jurisdictions establish a legal limit for elective abortion of approximately 12 weeks of gestation, with variations ranging from 10 weeks to 24 weeks. Exceptions to gestational limits are widely recognized for maternal life-threatening conditions, severe fetal anomalies and pregnancies resulting from sexual violence. Conclusions: European abortion legislation reflects persistent regulatory pluralism rather than convergence toward a unified model. While commonality exists regarding early gestational limits for elective abortion, significant variation remains in exceptional circumstances, procedural requirements, and underlying regulatory philosophies. This heterogeneity impacts healthcare provision, cross-border reproductive care, and medico-legal practice. The identified regulatory models illustrate diverse balances between reproductive autonomy and state interests. Future research should examine the practical consequences of these diverse schemes on health outcomes and cross-border patient mobility. Full article

While American magisterial teaching has continuously cast abortion as part of a consistent ethic covering a comprehensive and interrelated set of issues affecting human life and dignity, the teaching also entails a set of tensions between the single issue of abortion and the larger framework, and this has been resolved by insisting that the legality of abortion affects all other issues and so deserves special focus; this focus has played out in public policy with detrimental consequences. This essay argues that if the bishops’ goals truly are a reduction in abortions, the promotion of respect for life and human dignity, and the promulgation of a truly comprehensive and consistent ethic, then there must be a change in their approach. This change would consist of a focus on the unintended lethal impacts of illegality, more grassroots arguments aimed at changing cultural attitudes, and more support—in both rhetoric and action—for measures that work, including but not limited to the myriad levels of structural justice for the poor and women in particular. These actions would, in turn, reinforce the consistent ethic. Further, the bishops should disavow a single-issue approach and move toward an actually comprehensive approach to public policy. Full article

Introduction: Pharmacies are important points of access and information for women seeking medication abortion. In the context of the Democratic Republic of Congo [DRC], where the legal conditions for abortion have expanded in recent years and now allow pharmacies to dispense medication abortion with a prescription, little is known about medication abortion counseling and care offered by pharmacy staff. The aim of this study was to explore the quality of information provided by pharmacy staff to customers seeking medication abortion in Kinshasa. Methodology: A cross-sectional study using the mystery client (MC) approach was conducted in 480 pharmacies between April and May 2023. Trained female (n = 9) and male (n = 3) investigators played the role of mystery clients seeking abortion medication for themselves (or their partner or relative), and they asked questions to assess the performance of pharmacy staff and the quality of the provided information. The MCs recorded the results of their visits immediately after they left the pharmacy. Data were analyzed using Stata 17.0 and QGIS. The research protocol received ethical approval from the Kinshasa School of Public Health, and the need for informed consent was waived as pharmacy providers were being observed acting in their professional capacity. Results: Misoprostol was available at 40% of pharmacies visited, while mifepristone–misoprostol was available at less than 2%. Correct dosage information for misoprostol was provided by only 23% of the providers, with the lowest proportion observed in interactions involving male partners (2.4%). During discussions, only 10.6% of the providers explained what to expect during the abortion process. The quality of information differed according to the client profile, the district, and whether the client had a prescription. Conclusions: While medication abortion can provide a safe option for women seeking to manage their own abortion, the lack of adequate information on the correct dosage and administration can hinder the effectiveness of this regimen. To fully realize the potential of this medication for reducing unsafe abortion, it is essential that pharmacy staff are trained and supported to provide high-quality information and services, and that inequities in access to medications are addressed. Full article

Introduction: Globally, about half of all induced abortions have been estimated to be unsafe, which results in 13% of maternal deaths yearly. Of these induced abortions, 41% of unsafe abortions have been reported in young women who are dependent on their parents for their livelihood. They are often left in a vulnerable position and may have difficulty in making a decision regarding abortion. This study aimed to (1) characterize and map factors that influence abortion decision-making of adolescents and young women, and (2) identify the care and support that they need in their decision-making process. Methods: We conducted a scoping review following the JBI method and PRISMA-ScR checklist. We comprehensively searched MEDLINE (PubMed), Embase, Cochrane Library, CINAHL, and PsycInfo, and hand searched publications in the Google Scholar database between November 2021 and October 2023. The search included all English language qualitative and mixed methods research articles published on the database up to October 2023 that included participants aged 10–24 years. The CASP checklist was used as a guide for the qualitative analysis. NVivo was used to synthesize the findings. Results: There were 18 studies from 14 countries (N = 1543 young women) that met the inclusion criteria. Three domains and eleven categories were included as follows: personal (desire for self-realization and unwanted pregnancy), interpersonal (parental impact, reaction of partner, roles of peers and friends, existence of own child, and lack of support), and social circumstances (sexual crime, financial problem, limitation of choice, and underutilized healthcare services). Decision-making factors regarding abortions were also found across all three domains. Conclusion: The abortion decision-making of young women is influenced by various external factors regardless of country. Parents are especially influential and tend to force their daughters to make a decision. Young women experienced suffering, frustration, and lack of autonomy in making decisions based on their preference. This emphasizes the importance of autonomous decision-making. In this regard, healthcare services should be used. However, there are barriers to accessing these services. To improve such access, the following are required: staff training to provide adolescent and youth-friendly health services, counseling based on women’s needs, counseling including the parents or guardians that is confidential and ethical, promotion of decision aids, and affordable accessible care. Full article

Appeals to the moral value of nature and naturalness are commonly used in debates about technology and the environment and to inform our approach to the ethics of technology and the environment more generally. In this paper, I will argue, firstly, that arguments from nature, as they are used in debates about new technologies and about the environment, are misinterpreted when they are understood as attempting to put forward categorical objections to certain human activities and, consequently, their real significance is often overlooked. Secondly, arguments from nature, particularly as they are used in the context of debates over the use of new technologies, can be understood as appealing to human nature as a way to determine human limitations. Thirdly, arguments from nature can inform our discussion of what it is to be a human being or a person, and this kind of discussion can, in turn, inform our ethical deliberations in such areas of bioethics as euthanasia, abortion, etc. Finally, I conclude that a proper understanding of these arguments can help in establishing which virtues and which vices relate to our relationship with the non-human world—that is, which character dispositions are relevant to an environmental virtue ethics, with human nature as its foundation. A proper understanding of the argument from nature provides the basis for a ‘virtuously anthropocentric’ environmental ethics. Full article

Cancer during pregnancy, affecting 1 in 1000 pregnancies, is rising in incidence due to delayed childbearing and improved detection. Common types include breast cancer, melanoma and cervical cancer and Hodgkin’s Lymphoma. There are several physiological changes that occur during pregnancy that make its management a challenge to clinicians. Managing it requires multidisciplinary approaches and cautious test interpretation due to overlapping symptoms. To minimize fetal radiation exposure, non-ionizing imaging is preferred, and the interpretation of tumor markers is challenging due to inflammation and pregnancy effects. In terms of treatment, chemotherapy is avoided in the first trimester but may be considered later. Immunotherapy’s safety is under investigation, and surgery depends on gestational age and cancer type. Ethical and legal concerns are growing, especially with changes in U.S. abortion laws. Access to abortion for medical reasons is vital for pregnant cancer patients needing urgent treatment. Maternal outcomes may depend on the type of cancer as well as chemotherapy received but, in general, they are similar to the non-pregnant population. Fetal outcomes are usually the same as the general population with treatment exposure from the second trimester onwards. Fertility preservation may be an important component of the treatment discussion depending on the patient’s wishes, age and type of treatment. This article addresses the complicated nature of a diagnosis of cancer in pregnancy, touching upon the known medical literature as well as the ethical–legal implications of such a diagnosis, whose importance has increased in the light of recent judicial developments. Full article

The growing political influence of evangélico Christians in traditionally Catholic Brazil has caught the attention of social and political scientists as well as theologians. Among others, the reasons for two-thirds of the mainly Pentecostal and Neo-Pentecostal electorate voting for Jair Messias Bolsonaro include a moral agenda concerning human sexuality and the “traditional family,” namely the rejection of abortion under any circumstance and same-sex marriage. This conservative agenda is shared in other countries and churches and shows as “traditionalist” (Benjamin Teitelbaum), especially in Brazil, the USA under Trump, and Russia. At the same time, other, more social aspects of Christian diaconia in caring for the integrity of the body are left aside, although they are foreseen in those churches’ declarations of faith and ethical catechisms. The 2019–2022 government’s blatant failure to cope with the COVID-19 pandemic, the appalling rise of hunger, and the destruction of the Amazon rainforest should give rise to what I call an “evangélico sense of shame” as a consequence of the incompatibility of many of the faith convictions of that part of the electorate with Bolsonaro’s stances and actions, retrieving shame as an ethical category. To this end, I analyze biblical notions and theological reflections on shame, as well as publications of evangélico churches with a focus on the largest of its churches in Brazil, the Assemblies of God. Thus, I intend to reclaim an integral diaconia for evangélico churches. Full article

Japan, having had the longest isolationist policy in the world, is averse to options, such as migration to increase the population. What kinds of pronatalist policies to increase fertility and lower the population’s age are ethical? Two questions can be raised: is it ethical for the government to intercede, and is it ethical for individuals to exercise this choice? In addition to the gradually decreasing birth rate, Japan is faced with the challenge of a possible sharp decline in the birth rate in 5 years. Astrology and superstition have influenced the sex preference of a child in Japan, and in 1966, there was a 26% drop in the birth rate. It was the year of Hinoeuma, occurring at 60-year intervals, and women born that year are believed to have a potentially dangerous ‘headstrong temperament’ and murder their husbands. Abortion rates spiked that year, and many forged the birth date of their child. The next Hinoeuma is in 2026. Although the bioethical debate about pronatalism exists in the literature, there is no literature addressing the question of sex selection in the context of a decreasing population. This paper argues that even if the Japanese government’s current pronatalist approach is ethically warranted, it should not extend to sex selection since it would promote misogyny and stereotypical gender roles. Full article

The physician’s decision concerning pregnancy termination is influenced by a number of factors. The study aimed at obtaining the opinions of obstetricians and gynecologists with regard to the indications for pregnancy termination, the readiness to perform the procedure personally and the assessment of the determinants thereof. The survey study was conducted between 1 January 2020 and 31 December 2021 among physicians who performed diagnostic prenatal ultrasonography. A considerable majority of physicians participating in the study did not approve of termination without medical indications (62.5%). A marked majority of them considered the following cases as indications for pregnancy termination: severe fetal defects (90%), lethal defects (91.5%) and a disease threatening maternal life (91.5%). A small group of physicians declared that they were ready to perform a termination without medical indications (12.5%). However, they were ready to perform a pregnancy termination personally in cases of threat to maternal life (77.5%), severe fetal defects (75%), lethal fetal defects (75%) and a pregnancy being a result of rape (75%). No statistical significance was observed with regard to the influence of the respondents’ sex, the fact of having children or the workplace on the issue of indications for pregnancy termination. It seems justified to develop case-centered counseling concerning abortion, based on specialists in perinatology, law and ethics, especially in countries with more restrictive abortion law or strongly religious societies. Full article

The recent social and legal debate in several European countries on abortion, euthanasia, and assisted suicide has caused a strong resurgence of the concerns of healthcare personnel as to the real possibility of protecting their consciences in their professional sphere. Individual refusal for religious, moral, deontological, or ethical reasons to participate in activities that directly or indirectly could result in the termination of a human life constitutes the most extreme manifestation of the legal phenomenon of conscientious objection. Although the European Convention on Human Rights does not recognize a general right to conscientious objection, since Bayatyan v. Armenia, the case law of the European Court of Human Rights has identified a connection between conscience-related claims to compulsory military service and Article 9 of the Convention. However, to this date, this doctrine has not been applied to cases that affect health-sensitive areas like abortion and contraception. This article analyzes the activity of the European Court of Human Rights in relation to the right to freedom of conscience and to conscientious objection, particularly in healthcare, and offers several final observations projected to possible future conflicts. Full article

The onset of embryonic heart beating may be regarded as the defining feature for the beginning of personal human life. Clarifying the timing of the first human heartbeat, therefore, has religious, philosophical, ethical, and medicolegal implications. This article reviews the historical and contemporary sources of knowledge on the beginning of human heart activity. Special attention is given to the problem of the determination of the true age of human embryos and to the problem of visualization of the human embryonic heart activity. It is shown that historical and current textbook statements about the onset of blood circulation in man do not derive from observations on living human embryos but derive from the extrapolation of observations on animal embryos to the human species. This fact does not preclude the existence of documented observations on human embryonic heart activity: Modern diagnostic (ultrasound) and therapeutic (IVF) procedures facilitate the visualization of early embryonic heart activity in precisely dated pregnancies. Such studies showed that the human heart started its pumping action during the fourth post-fertilization week. A small number of direct observations on the heart activity of aborted human embryos were reported since the 19th century, but did not receive much recognition by embryologists. Full article

Background: Although undergoing an abortion is stressful for most women, little attention has been given to their psychological wellbeing. This protocol aims to assess the feasibility, acceptability, and primary effects of a complex intervention to promote positive coping behaviors and alleviate depression symptoms among Chinese women who have undergone an abortion. Methods: A two-arm randomized controlled trial design will be used. Participants will be recruited at their first appointment with the abortion clinic and randomly allocated to receive either the Stress-And-Coping suppoRT (START) intervention (in addition to standard abortion care) or standard care only. All participants will be followed-up at two- and six-weeks post-abortion. Approval has been granted by local and university ethics committees. This research was supported by an Australian Government Research Training Program Scholarship. Discussion: The results will assist refinement and further evaluations of the START intervention, contribute to improved abortion care practices in China, and enrich the evidence on improving women’s psychological well-being following abortion in China. Trial registration: Registered at the Chinese Clinical Trials.gov: ChiCTR2100046101. Date of registration: 4 May 2021. Full article

Neurodegenerative diseases are a group of debilitating pathologies in which neuronal tissue dies due to the buildup of neurotoxic plaques, resulting in detrimental effects on cognitive ability, motor control, and everyday function. Stem cell technology offers promise in addressing this problem on multiple fronts, but the conventional sourcing of pluripotent stem cells involves harvesting from aborted embryonic tissue, which comes with strong ethical and practical concerns. The keystone discovery of induced pluripotent stem cell (iPSC) technology provides an alternative and endless source, circumventing the unfavorable issues with embryonic stem cells, and yielding fundamental advantages. This review highlights iPSC technology, the pathophysiology of two major neurodegenerative diseases, Alzheimer’s and Parkinson’s, and then illustrates current state-of-the-art approaches towards the treatment of the diseases using iPSCs. The technologies discussed in the review emphasize in vitro therapeutic neural cell and organoid development for disease treatment, pathological modeling of neurodegenerative diseases, and 3D bioprinting as it applies to both. Full article

On 22 January 2019, New York state passed the Reproductive Health Act (RHA), which specifies three circumstances under which a healthcare provider may perform an abortion in New York: (1) the patient is within twenty-four weeks of pregnancy, (2) the fetus is non-viable, or (3) the abortion is necessary to protect the patient’s life or health. The first one, that of abortion being accessible within the first twenty-four weeks of pregnancy, is not unique to New York, as many other states allow medical professionals to provide abortions during this time. The latter two have caused significant controversy because they detail certain circumstances in which abortions would be accessible after twenty-four weeks. This paper will focus on these latter two circumstances. I will first argue that any debate or discussion about (2) must go beyond the conventional debate about the ethics of abortion and incorporate, more appropriately, a discussion on euthanasia and the ethics of end-of-life care for nascent human life. In particular, it requires us to consider the morality of non-voluntary active euthanasia for non-viable fetuses, rather than just a discussion of the ethics of late term abortions. When it comes to (3), I will argue that assessing its moral permissibility actually raises some legitimate moral concerns, even from a reproductive rights perspective. On certain readings, it seems as if condition (3) would allow for the termination of a healthy fetus for reasons not related to the mother’s physical health or life. If this is the case, I argue, the right to an abortion would be construed as a right to fetal termination, rather than just fetal evacuation. However, I will argue that there are good reasons that pro-choice advocates should interpret the right to an abortion as a right to fetal evacuation instead of termination, and if this is the case, a woman should not be able to demand the death of a healthy fetus if ending the pregnancy safely via fetal evacuation would suffice. Full article