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"numChildren": 1 }, "data": { "key": "42TS6CET", "version": 87, "itemType": "journalArticle", "title": "Conscientious objection, barriers, and abortion in the case of rape: a study among physicians in Brazil", "creators": [ { "creatorType": "author", "firstName": "Debora", "lastName": "Diniz" }, { "creatorType": "author", "firstName": "Alberto", "lastName": "Madeiro" }, { "creatorType": "author", "firstName": "Cristião", "lastName": "Rosas" } ], "abstractNote": "In Brazil, to have a legal abortion in the case of rape, the woman’s statement that rape has occurred is considered sufficient to guarantee the right to abortion. The aim of this study was to understand the practice and opinions about providing abortion in the case of rape among obstetricians-gynecologists (OBGYNs) in Brazil. A mixed-method study was conducted from April to July 2012 with 1,690 OBGYNs who responded to a structured, electronic, self-completed questionnaire. In the quantitative phase, 81.6% of the physicians required police reports or judicial authorization to guarantee the care requested. In-depth telephone interviews with 50 of these physicians showed that they frequently tested women’s rape claim by making them repeat their story to several health professionals; 43.5% of these claimed conscientious objection when they were uncertain whether the woman was telling the truth. The moral environment of illegal abortion alters the purpose of listening to a patient − from providing care to passing judgement on her. The data suggest that women’s access to legal abortion is being blocked by these barriers in spite of the law. We recommend that FEBRASGO and the Ministry of Health work together to clarify to physicians that a woman’s statement that rape occurred should allow her to access a legal abortion.\nRésumé\nAu Brésil, pour avorter légalement en cas de viol, la déclaration de la femme affirmant que le viol s’est produit est considérée comme suffisante pour garantir le droit à l’avortement. L’objectif de cette étude était de comprendre la pratique et les opinions sur l’avortement en cas de viol parmi les gynécologues-obstétriciens brésiliens. Une étude à méthodologie mixte a été réalisée d’avril à juillet 2012 auprès de 1690 gynécologues-obstétriciens qui ont répondu à un autoquestionnaire électronique structuré. Dans la phase quantitative, 81,6% des médecins exigeaient des rapports de police ou une autorisation judiciaire pour assurer les soins demandés. Des entretiens téléphoniques approfondis avec 50 de ces médecins ont montré qu’ils vérifiaient fréquemment l’affirmation de viol des femmes en les faisant répéter leur histoire à plusieurs professionnels de santé ; 43,5% d’entre eux invoquaient l’objection de conscience quand ils n’étaient pas sûrs de la véracité des dires de la femme. L’environnement moral de l’avortement clandestin modifie le but de l’écoute d’une patiente : ce n’est plus de fournir des soins mais de la juger. Les données suggèrent que l’accès des femmes à l’avortement légal est bloqué par ces obstacles, en dépit de la loi. Nous recommandons que la FEBRASGO et le Ministère de la Santé collaborent pour faire comprendre aux médecins que la déclaration d’une femme affirmant qu’un viol s’est produit devrait lui donner accès à un avortement légal.\nResumen\nEn Brasil, para tener un aborto legal en el caso de una violación, la declaración de la mujer de que fue violada es suficiente para garantizar su derecho al aborto. El objetivo de este estudio fue entender la práctica y opiniones de gineco-obstetras en Brasil con relación a la prestación de servicios de aborto en el caso de violación. Desde abril hasta julio de 2012, se realizó un estudio de métodos combinados, con 1690 gineco-obstetras que respondieron a un cuestionario electrónico estructurado. En la fase cuantitativa, el 81.6% de los médicos requerían una denuncia policial o autorización judicial para garantizar los servicios solicitados. Las entrevistas telefónicas a profundidad con 50 de estos médicos mostraron que a menudo verificaban la declaración de violación por parte de las mujeres pidiéndoles que repitieran su historia a varios profesionales de la salud; el 43.5% de estos invocaron objeción de conciencia cuando no estaban seguros de que la mujer estuviera diciendo la verdad. El ambiente moral del aborto ilegal cambia el propósito de escuchar a una paciente: de brindarle atención a juzgarla. Los datos indican que el acceso de las mujeres a los servicios de aborto legal está siendo bloqueado por estas barreras a pesar de la ley. 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