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A Journal on Forensic Medicine
Minerva Medicolegale 2015 December;135(3-4):47-60
Medical abortion and conscientious objection
Giammaria M., Santurro A., Reveruzzi A., Marinelli E., Zaami S.
Dipartimento di Scienze Anatomiche, Istologiche, Medico Legali e dell’Apparato Locomotore Sapienza, Università di Roma, Roma, Italia
Medical abortion consists in interrupting pregnancy using specific drugs. It’s an important alternative to the surgical abortion, the only one used in Italy until a few years ago, that involves performing surgical evacuation of the contents of the uterus under general anesthesia, usually after the seventh week of pregnancy. Although there are several drugs suitable for the purpose, used alone or in combination, the gold standard of medical abortion involves the administration of mifepristone (RU486) followed by a prostaglandin, usually misoprostol. The introduction of RU486 has recently opened new scenarios, especially about conscientious objection of health workers: in fact, the use of medical methods of abortion, such as combination regimens of mifepristone and misoprostol, requires the back-up of vacuum aspiration, in case of failed or incomplete abortion, because these drugs are not directly feticidal. Some health professionals, according to conscientious objection, refuse to assist in such procedures. The paper analyzes, therefore, legal and ethical aspects of the protocol RU486, also in the light of a recent Italian sentence (Corte di Cassazione, sez. VI penale 02.04.2013 n. 14979), confirming a conviction for omission of official acts, against a doctor who had refused to lend assistance to a patient hospitalized for medical abortion.