In our country, it was not until 1985 that the first legal norm on the decriminalization of abortion was adopted. This norm was preceded by an intense and tense political and ideological debate, to which the medical profession has not remained a stranger. More than 2 decades have passed and a large part of the political groups and citizens are proposing a reform of the legal norm to meet the new social requirements. This circumstance has reopened the debate and the confrontation between unfortunately very opposing positions on the moral consideration of abortion and the formulas for regulating it. Even those who govern health facilities must ensure that conscientious objection is respected and that work is redistributed so that there are no situations unfair to opponents or non-objectors, punishment or privileges. It would be cynical to invoke conscientious objection to avoid some of the workload he has to bear. The good objector gladly compensates with a work of equal value, in intensity, duration, anger and schedule, which he stops by moral repulsion. As in civilian life with an alternative social service for those who oppose military service, the moral integrity of the objector will lead him to accept work that will equitably compensate for the one he no longer opposed. The fourth socio-economic reference to decriminalized abortion is known to be the most important innovation. We are no longer talking about abortion. There is some success of a voluntary termination of pregnancy to imply that the free choice of the woman is a decisive and sufficient reason to end the life of the unborn child. The decision to treat a woman`s illness without resorting to the destruction of the unborn human being represents a deeply professional attitude that is scientifically and ethically superior to its opposite. Faced with the mother-fetus dyad, the good doctor also owes himself to his two patients: the pregnant woman and the unborn child.
Today, given the considerable progress in the clinical management of diseases that can expose pregnant women to a serious risk to life, no doctor truly competent according to scientific criteria is obliged to accept that abortion is the treatment of choice for any disease of the mother, that is, it is such a superior and beneficial intervention compared to other therapeutic alternatives, that it would mean not practicing them, intentionally causing harm. to the surrogate mother and therefore seriously violate the medical imperative not to rape. Without needing to raise moral objections, the doctor, on the basis of the medical art of the moment, can reject the so-called therapeutic abortion for strictly scientific reasons, since it can offer valid treatment alternatives that also respect the life of the unborn child. In recent monographs on the treatment of diseases of pregnant women or critical obstetric situations, either no indication of therapeutic abortion appears, or it is cited as a possible alternative to a unique and extraordinary circumstance: the risk of rupture of the aortic ornamental aneurysm in Marfan syndrome, which can be avoided by appropriate treatment in the early stages of pregnancy. The problem, in addition to the theoretical interest of determining whether this is possible and to what extent a hospital is constituted as a legal entity capable of making decisions that influence the behaviour of all its members, involves immediate practical consequences for health policy, public information, industrial relations or the services and services offered. The doctor`s refusal to abort fetuses with malformations or defects that seriously disrupt their subsequent physical or mental development is justified by the specifically medical respect for deficient life. Article 25.2 of the Code of Ethics and Medical Ethics grants the unborn sick child the full status of a patient. In health care facilities, conscientious objection can be a source of serious conflict. The relationship between ideologically indifferent or pro-abortion health managers and opponents is very complex.
Administrators are often fascinated by two projects: the machine efficiency of their management and the submissive desire to please the hierarchs. It is not easy for them to see with sympathy those who cross the regular rhythm of uniform and planned work. Managers of hospitals or health care sectors obsessed with reducing the economic cost of medical care and maintaining the optimal functioning of the health care system tend to view any exception or exception as a troubling inconvenience. I do not want to get into an analysis of the counselling and information requirements for the woman who intends to have an abortion and the serious responsibilities that come with it. The experience of other countries shows how quickly the task of sensitizing women to what abortion is, who is the child they are carrying, is becoming an irrelevant bureaucratic procedure. The Supreme Court of the United States, a country where the theory and practice of informed and free consent was born and developed, prohibited, considering as an infringement of women`s right to privacy and a parade of atrocities, that the doctor had informed the pregnant woman that the unborn child was a human being from the moment of fertilization or described the anatomical or physiological characteristics of the fetus, including their appearance and ability to perceive and react.