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DOI: 10.1055/s-0040-1721684
The Role of Medicine in Protecting the Vulnerable: between Sexual Violence and Conscientious Objection
O papel da Medicina na proteção de vulneráveis: entre violência sexual e objeção de consciência![](https://www.thieme-connect.de/media/10.1055-s-00030576/202011/lookinside/thumbnails/10-1055-s-0040-1721684_v42n11ed-1.jpg)
There are situations that cannot and should not be overlooked. Some situations must always be remembered so mistakes are not repeated and we seek to be better as people, professionals and citizens.
In August of this year, the case of a ten-year-old child in the southeastern region of Brazil that became pregnant with her uncle who had abused her since she was six was widely reported in the media. A child who lived in the company of her grandparents, and could say nothing about the rapes she suffered, given the risk of losing those who raised her. If she said anything, he [the uncle] would kill her grandfather. Four years of violence and silence. Four years of stolen childhood, until the symptom of abdominal pain caused her grandmother to take her to the hospital, where the pregnancy was revealed. What to do?
In Brazil, abortion is allowed by the legal system when there is no other way to save the pregnant woman's life; when the pregnancy results from rape; and in case of an anencephalic fetus pregnancy. These three cases do not require a court order, although an order to terminate the pregnancy had been issued by the Judge of the local Child and Youth Court after a request from the Public Ministry. However, the hospital, an accredited center for providing abortion care provided for by law in the region where the child lived, did not comply with the sentence under the allegation of “technical issues.”
This child and her grandmother were quickly taken to another referral center, this time in the northeast region, and finally, amid a great turmoil caused by pro-life and pro-choice movements, the abortion was performed by the hands of a competent and dedicated professional.
As a doctor, I do not have the knowledge to analyze legal issues, although it was clear that the Judiciary was present in this case and acted quickly to guarantee the dignity of life, paying attention to a basic principle of the Statute of the Child and Adolescent, which is their best interest, and protecting the right to health as well as the physical and psychological wellbeing.
While voices argued that pregnancy should be continued as if by a child's “moral obligation,” even though she had been abused and raped, others took the opposite position by defending her life in a broader sense: the biological and biographical life of a weeping girl in fear and pain while clung to a teddy bear. Fear and pain that would never be understood by police, judges, prosecutors, doctors, family members and an entire angry population.
Note the teachings of legal experts on this issue: “Childhood pregnancy, by itself, would already constitute a violation of a child's right. Would not the imposition of continuing this pregnancy be a further violation of her rights [...]?” We are talking about the pregnancy of “a ten-year-old girl, raped by someone from whom is expected care and protection.”[1]
Publication History
Article published online:
30 November 2020
© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Lima TMM, Sá MFF. Gravidez na infância e na adolescência. In: Lima TMM, Sá MFF. editores. Ensaios sobre a infância e a adolescência. 2a ed.. Belo Horizonte: Arraes; 2019: 15-26
- 2 Mendes RWM, Francisco AMC, Tostes CBS, Reis J, Atzingen AC. Conscientious objection to legal abortion in Minas Gerais State. Rev Bras Ginecol Obstet 2020; 42 (11) xxxxxx – Colocar as pags da RBGO
- 3 Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Ações Programáticas Estratégicas. Prevenção e tratamento das lesões decorrentes da violência sexual contra mulheres e adolescentes: norma técnica [Internet]. 3a ed.. Brasília (DF): Ministério da Saúde; 2012. [cited 2020 Oct 14]. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/prevencao_agravo_violencia_sexual_mulheres_3ed.pdf
- 4 Sá MFF, Naves BTO. Bioética e biodireito. 5a ed.. Indaiatuba: Foco; 2021. ; In press
- 5 Ministério da Saúde. Portaria no. 2.561, de 23 de setembro de 2020. Dispõe sobre o procedimento de justificação e autorização da interrupção da gravidez nos casos previstos em lei, no âmbito do Sistema Único de Saúde-SUS. Diário Oficial da União [Internet], 2020 Sep 24 [cited 2020 Oct 20]. Available from: https://www.in.gov.br/en/web/dou/-/portaria-n-2.561-de-23-de-setembro-de-2020-279185796