因违规人工终止妊娠引起医疗纠纷1例

案例王某,女,32岁,干部。预产期:2003年11月9日。于2003年11月4日因计划外怀孕被强迫入院施行人工终止妊娠术。孕39 2W,孕2产1,体查:T 36.5℃,P 72次/min,R 18次/min,BP 118/70mmHg,孕期检查正常,无高血压及心脏病史,既往及孕期无异常病史。腹部检查:怀孕9个月,宫高脐上4指,经产妇。B超检查:胎儿双顶径93 mm,胸径85 mm,股骨70 mm,胎心( );胎盘前宫壁,厚度33 mm,胎盘Ⅲ±级;羊水42 mm。B超提示:足月妊娠单胎头位(COA)。2003年11月4日6:00施行宫腔穿刺2次,未抽出羊水,没有注射利凡诺尔,采用米索前列醇刺激宫缩终止妊娠。6:05Pm含服米索…     

因违规人工终止妊娠引起医疗纠纷1例

王某，女，32岁，干部。预产期：2003年11月9日。于2003年11月4日因计划外怀孕被强迫入院施行人工终止妊娠术。孕39^＋2W，孕。产1，体查：T36．5℃，P72次／min，R18次／min，BP118／70mmHg，孕期检查正常，无高血压及心脏病史，既往及孕期无异常病史。腹部检查：怀孕9个月，宫高脐上4指，经产妇。B超检查：胎儿双顶径93mm，胸径85mm，股骨70mm，胎心（＋）；胎盘前宫壁，厚度33mm，胎盘Ⅲ±级；羊水42mm。B超提示：足月妊娠单胎头位（COA）。     

Value of fetal autopsy after medical termination of pregnancy

We carried out a retrospective study of 352 medical terminations of pregnancy (MTP) carried out in a large French administrative region over two consecutive years. We analysed the indications for MTP and then compared the prenatal ultrasound diagnosis with fetal autopsy findings in order to demonstrate the value of pathological examination of the fetus in prenatal diagnosis and genetic counselling as well as the need to check by autopsy the quality of ultrasound screening. Preliminary analysis of the indication for these MTP showed that in 69.9% ultrasound screening had been carried out, revealing mainly brain abnormalities (22.2%) and heart defects generally associated with chromosomal abnormalities (32.1%). Prenatal findings were in agreement with autopsy results, showing no false-positive prenatal diagnoses. However, in 7.9% of cases in which brain abnormalities were detected, confirmation was not possible at autopsy because of tissue autolysis, showing the need for optimal conditions of expulsion. In 35.8% of cases, confirmation of the diagnosis by autopsy was not useful for management but still added to medical knowledge and demonstrated to the mother the reality of the defects. In 50.9%, the autopsy findings were decisive for genetic counselling.     

Chorionic villus sampling prior to pregnancy termination, a tool for forensic paternity testing.

Chorionic villus sampling (CVS), prior to pregnancy termination (pre-termination CVS), is suggested as a tool for forensic paternity testing. Unlike the abortion material, which consists of ruptured tissues of fetal and maternal origin, extra-embryonic membranes obtained through CVS can provide an uncontaminated source of fetal tissue for genotyping. We discuss the possibility of confined placental mosaicism (CPM) and its implications on the polymerase chain reaction (PCR) based analyses of short tandem repeats (STRs) and the D1S80 loci.     

一起非医学需要鉴定胎儿性别及终止妊娠手术案引发的思考

笔者通过对一起非医学需要鉴定胎儿性别及终止妊娠手术案件的评析,提出在卫生行政处罚案件的处理过程中涉及到多个行政执法部门、多部法律竞合的问题并阐述了自己的看法,旨在探讨通过部门联动、无缝隙的行刑对接,对各种形式的非法行医行为进行严厉的打击,维护法律的尊严。     

Conscientious objection and equality laws: Why the content of the conscience matters

Law and Philosophy - By enacting equality laws the liberal state decides the limits of liberal tolerance by relying on content-based rather than content-neutral considerations. Equality laws are...     

Conscientious objection in reproductive health care: Analysis of Pichon and Sajous v. France

This article explores the issue of conscientious objection invoked by health professionals in the reproductive and sexual health care context and its impact on women's ability to access health services. The right to exercise conscientious objection has been recognized by many international and European scholars as being derived from the right to freedom of thought, conscience and religion. It is not, however, an absolute right. When the exercise of conscientious objection conflicts with other human rights and fundamental freedoms, a balance must be struck between the right to conscientious objection and other affected rights such as the right to respect for private life, the right to equality and non-discrimination, and the right to receive and impart information. Particularly in the reproductive health care context, states that allow health professionals to exercise conscientious objection must accommodate this in such a way that its exercise does not compromise women's access to health services. This article analyses the European Court of Human Rights' decision on admissibility in Pichon and Sajous v. France (2001) and argues that a balancing approach should be applied in cases of conscientious objection in the sexual and reproductive health care context.     

Medicare program; grace period and termination for nonpayment of Supplementary Medical Insurance (Part B) premiums for insured and uninsured persons--HCFA. Final rule

This final rule changes the termination date for Supplementary Medical Insurance (SMI) (Part B) enrollees who fail to pay their Medicare Part B premiums. Presently, there is a 90 day grace period for the enrollee during which he or she may pay all overdue premiums and continue Part B coverage uninterrupted. The grace period begins at different times depending on whether the individual is or is not eligible for monthly social security, railroad retirement or civil service retirement benefits. This final rule establishes a uniform timeframe for determining the 90 day grace period which precedes the termination of SMI enrollees who fail to pay their Medicare Part B premiums.     

Fatalities associated with the termination of electrical services

The worldwide dependence on electricity to support the needs of today's society is often taken for granted and, as such, the hazards associated with the termination of electrical services are often neglected. Whether electrical services are unintentionally terminated as the result of severe weather or intentionally terminated as the result of nonpayment of utility bills, the ensuing conditions may lead to injury or death in affected individuals. We performed a retrospective review of all deaths investigated by the Onondaga County Medical Examiner's Office between 1999 and 2004. Our case database was searched for causes of death that included hypothermia, hyperthermia, carbon monoxide, fire, electrocution, and/or electricity. Further review of these cases was undertaken to determine the potential relationship between the death and the termination of electrical services. Seven fatalities were found to be associated with the termination of electrical services. Four fatalities resulted from its unintentional termination and 3 were a consequence of intentional termination. In reporting these deaths, we hope to emphasize the potential dangers associated with the termination of electrical services and explore the informational programs and public health laws that are in place to limit the associated potential negative outcomes.     

Order authorizing termination of certain life support systems

An elderly, severely brain-damaged patient was being ventilated and given nutrition and antibiotics intravenously in a medical center's critical care unit. Her legal guardian requested authorization to order that the respirator be withdrawn and the administration of nutrition and antibiotics be stopped. A Missouri circuit court ruled that, while public policy, as evidenced in the state's living will statute, permitted withdrawing the respirator, it apparently precluded withholding or withdrawing nutrition, hydration, or antibiotics.