RESUMO
Poor access to contraception can lead to several undesired health outcomes, including high rates of unintended pregnancy, high rates of teen pregnancy, spontaneous preterm delivery, preeclampsia and maternal death. Properly addressing these public health issues often require a coordinated response at the state government level. States with conservative legislatures have traditionally fought attempts to expand access to contraception. However, several of these states are now implementing policies that increase access to their citizens. While the motives for each state differ, the goals are the same: reduce poor health outcomes by increasing access to contraception.
Assuntos
Comportamento Contraceptivo , Anticoncepção , Eficácia de Contraceptivos , Acessibilidade aos Serviços de Saúde , Política , Adolescente , Anticoncepcionais , Feminino , Financiamento Governamental/legislação & jurisprudência , Humanos , Contracepção Reversível de Longo Prazo , Mortalidade Materna , Patient Protection and Affordable Care Act , Pré-Eclâmpsia , Gravidez , Gravidez na Adolescência , Gravidez não Planejada , Nascimento Prematuro , Estados UnidosRESUMO
In this case scenario, a medical student, Jenny, is conducting congenital heart disease research in a resource-limited setting faced with water insecurity. She has concerns about how ethical it is for her to conduct advanced clinical research in a region with more basic health needs. The first commentary argues that advanced clinical research in resource-limited settings follows the ethical principle of beneficence and interactional justice but violates the principle of distributive justice. The second commentary questions whether beneficence is enough, since the Belmont Report states that beneficence is the obligation to simultaneously reduce harm and increase benefit. It calls upon public health physician-scientists to think deeply about how to involve communities in their research-and how to insert themselves into health policy development processes.
Assuntos
Beneficência , Pesquisa Biomédica/ética , Países em Desenvolvimento , Recursos em Saúde , Obrigações Morais , Pobreza , Alocação de Recursos/ética , Ética Médica , Ética em Pesquisa , Política de Saúde , Humanos , Justiça Social , Água , Abastecimento de ÁguaRESUMO
Scottish obstetrician James Young Simpson first introduced the use of ether and chloroform anesthesia for labor in 1847, just 1 year after William Morton's first successful public demonstration of ether anesthesia at the Massachusetts General Hospital. The contemporaneous development of surgical anesthesia and obstetrics enabled obstetric anesthesia to address the pain of childbirth. Shortly after its introduction, obstetricians raised concerns regarding placental transport, or the idea that drugs not only crossed the placenta, but exerted detrimental effects on the neonate. The development of regional anesthesia and clinical work in obstetric anesthesia and perinatology addressed issues of the safety of the neonate, enabling obstetric anesthesia to safely and dramatically reduce the pain of childbirth.