Leo Pessini

Abortion among adolescents: a bioethical approach

OBJECTIVES: to describe the socio-demographic, behavioral, clinical and anatomical-pathological characteristics and the type of abortion in adolescents as a way of discussing the subject from a bio-ethical perspective. METHODS: a structured questionnaire was applied to 201 adolescent girls receiving treatment for incomplete abortion and being subjected to uterine curretage, at a public maternity unit in the Northeast region of Brazil. RESULTS: the mean age was 16.1 years; most girls had a stable partner, were of mixed race, and were not accustomed to using condoms during sexual intercourse. The mean age for initiation of sexual activity was 15 years. Most had not planned the pregnancy but wanted to get pregnant. The mean gestational age of the fetus was 13.2 weeks. With regard to the type of abortion, 1.99% were spontaneous and 81.59% were certainly provoked, according to data obtained using the World Health Organization classification. Fetal and maternal tissue were 88.56% and 11.44%, respectively. Of the abortions that were certainly provoked, there was one case of the use of a hydatidiform mole. CONCLUSIONS: it is recommended that strategic family planning programs be urgently introduced and that anatomical-pathological tests be carried out on the material resulting from an abortion. Proactive bioethical reflection seems to be the tool for providing minimal guidelines for the protection and care of adolescents and for assisting health professionals.

A interrupção da gravidez na adolescência: aspectos epidemiológicos numa maternidade pública no nordeste do Brasil

O abortamento provocado e praticado amplamente pelas mulheres, em contexto clandestino, no Brasil, sendo considerado uma questao de saude publica. Neste estudo, propoe-se a conhecer aspectos socio-demograficos, comportamentais, clinicos, complicacoes, e o tipo de abortamento praticado por adolescentes submetidas a curetagem uterina. Foi utilizada metodologia descritiva, atraves de entrevistas por meio de questionario estruturado no atendimento a 201 adolescentes com abortamento incompleto submetidas a curetagem uterina, em um hospital do Sistema Unico de Saude (SUS), em Maceio, Alagoas. Os principais determinantes para o abortamento foram: idade acima de dezesseis anos, com parceiro estavel; pardas; nao planejaram a gestacao; desejavam a gestacao, primigestas; idade gestacional menor que 15 semanas; raras complicacoes relacionadas ao abortamento, e utilizando a classificacao da Organizacao Mundial da Saude, observou-se abortamento provocado em 98,01% dos casos. Entre os casos de abortamentos certamente provocados, 89,19% reportaram o uso do misoprostol, o que reforca maior investimento publico na assistencia ao uso de metodos contraceptivos entre os adolescentes respeitando seus direitos sexuais e reprodutivos.

Envelhecimento e doença de Alzheimer: reflexões sobre autonomia e o desafio do cuidado

Este articulo propone una reflexion sobre la perdida de autonomia y, como consecuencia, la dependencia total de otros, en la desafiadora relacion de cuidado con la persona mayor afectada por la enfermedad de Alzheimer. Desde los albores de su historia, la bioetica provoca reflexiones sobre cuestiones complejas e instigadoras que surgen con en el avance de la tecnociencia. En materia de salud, la demografia y la epidemiologia demuestran el creciente numero de personas de edad avanzada debido al rapido progreso biotecnologico y mejores condiciones de vida. Sin embargo, hay evidencias de que el envejecimiento hace que el cuerpo sea mas susceptible a las enfermedades, y mas vulnerable a la aparicion de la enfermedad de Alzheimer. En este escenario, se investiga las posibilidades de la relacion de cuidado etico centrado en la reconstruccion de la autonomia de la persona mayor que se perdio en el curso de la enfermedad de Alzheimer. La ausencia de respuestas es un desafio a la geriatria y gerontologia para la busqueda de orientacion con base en referenciales bioeticos.This paper fosters a reflection on the loss of autonomy and the ensuing total dependence on the Other in the challenging care-provision interaction with the individual affected by Alzheimer’s disease. Since its inception, Bioethics instigates reflections on complex and intriguing issues stemmed from techno-science advancements. In health-related areas, demography and epidemiology indicate a growing increase of older persons, due to accelerated bio-technological developments and better living conditions. There are evidences, however, that aging makes the body prone to the development of diseases, and more vulnerable to Alzheimer’s disease. In this scenario, one should ponder on the possibilities of an ethical care aiming to reconstruct the autonomy of the older person that was lost in the tangles of Alzheimer’s disease. The lack of responses challenges Geriatrics and Gerontology to seek guidance from the referentials of Bioethics.

El envejecimiento y la enfermedad de Alzheimer: reflexiones sobre la pérdida de la autonomía y el desafío la atención

Este articulo propone una reflexion sobre la perdida de autonomia y, como consecuencia, la dependencia total de otros, en la desafiadora relacion de cuidado con la persona mayor afectada por la enfermedad de Alzheimer. Desde los albores de su historia, la bioetica provoca reflexiones sobre cuestiones complejas e instigadoras que surgen con en el avance de la tecnociencia. En materia de salud, la demografia y la epidemiologia demuestran el creciente numero de personas de edad avanzada debido al rapido progreso biotecnologico y mejores condiciones de vida. Sin embargo, hay evidencias de que el envejecimiento hace que el cuerpo sea mas susceptible a las enfermedades, y mas vulnerable a la aparicion de la enfermedad de Alzheimer. En este escenario, se investiga las posibilidades de la relacion de cuidado etico centrado en la reconstruccion de la autonomia de la persona mayor que se perdio en el curso de la enfermedad de Alzheimer. La ausencia de respuestas es un desafio a la geriatria y gerontologia para la busqueda de orientacion con base en referenciales bioeticos.This paper fosters a reflection on the loss of autonomy and the ensuing total dependence on the Other in the challenging care-provision interaction with the individual affected by Alzheimer’s disease. Since its inception, Bioethics instigates reflections on complex and intriguing issues stemmed from techno-science advancements. In health-related areas, demography and epidemiology indicate a growing increase of older persons, due to accelerated bio-technological developments and better living conditions. There are evidences, however, that aging makes the body prone to the development of diseases, and more vulnerable to Alzheimer’s disease. In this scenario, one should ponder on the possibilities of an ethical care aiming to reconstruct the autonomy of the older person that was lost in the tangles of Alzheimer’s disease. The lack of responses challenges Geriatrics and Gerontology to seek guidance from the referentials of Bioethics.

Aging and Alzheimer's Disease: reflections on the loss of autonomy and the challenges of care

Este articulo propone una reflexion sobre la perdida de autonomia y, como consecuencia, la dependencia total de otros, en la desafiadora relacion de cuidado con la persona mayor afectada por la enfermedad de Alzheimer. Desde los albores de su historia, la bioetica provoca reflexiones sobre cuestiones complejas e instigadoras que surgen con en el avance de la tecnociencia. En materia de salud, la demografia y la epidemiologia demuestran el creciente numero de personas de edad avanzada debido al rapido progreso biotecnologico y mejores condiciones de vida. Sin embargo, hay evidencias de que el envejecimiento hace que el cuerpo sea mas susceptible a las enfermedades, y mas vulnerable a la aparicion de la enfermedad de Alzheimer. En este escenario, se investiga las posibilidades de la relacion de cuidado etico centrado en la reconstruccion de la autonomia de la persona mayor que se perdio en el curso de la enfermedad de Alzheimer. La ausencia de respuestas es un desafio a la geriatria y gerontologia para la busqueda de orientacion con base en referenciales bioeticos.This paper fosters a reflection on the loss of autonomy and the ensuing total dependence on the Other in the challenging care-provision interaction with the individual affected by Alzheimer’s disease. Since its inception, Bioethics instigates reflections on complex and intriguing issues stemmed from techno-science advancements. In health-related areas, demography and epidemiology indicate a growing increase of older persons, due to accelerated bio-technological developments and better living conditions. There are evidences, however, that aging makes the body prone to the development of diseases, and more vulnerable to Alzheimer’s disease. In this scenario, one should ponder on the possibilities of an ethical care aiming to reconstruct the autonomy of the older person that was lost in the tangles of Alzheimer’s disease. The lack of responses challenges Geriatrics and Gerontology to seek guidance from the referentials of Bioethics.