Should there be mandatory testing for HIV prior to marriage in India?

The National AIDS Prevention and Control Policy of the government of India states that testing for HIV infection should be voluntary in nature. But from time to time various state governments and the central government have announced their intent of introducing mandatory premarital testing. Though this intent has not yet been translated into action, we present our case against the adoption of such a policy by discussing various social and medical issues. These include the limited population that such a policy would target given the early age of marriage in India; issues related to its implementation considering the low marriage registration rates in India; potential of stigma and discrimination associated with it; issues with defining boundaries and the role of the state; limitations related to the HIV test itself in context of the policy, including the window period and the positive predictive value of the test; its limited impact in population groups at a high risk for HIV infection; its limited role in changing unsafe behaviours; its limited potential to enhance the empowerment of women; its conflict with existing human rights; and the adverse experience of other countries with a similar policy.

[Autohemotherapy, state intervention and bioethics]. / Auto-hemoterapia, intervenção do estado e bioética.

The increasingly frequent practice of autohemotherapy entails a potential risk to the health of individuals since it is scientifically unproven. There are practically no clinical studies showing the efficacy and safety of this procedure; only experimental research with questionable results from studies on human beings and animals. Over the last years, the sanitary surveillance area has expanded its preventive and risk control actions based upon a precautionary philosophy in the private as well as the public sphere. By observing the theoretical and practical reference points of the "four Ps" (prevention, protection, precaution and prudence), in accordance with the epistemology developed within Intervention Bioethics, sanitary surveillance actions are based upon legal administrative policing powers. These powers are understood to be the Public Administration's competence to set conditions on and restrict the use and benefit of goods, activities and individual rights, on behalf of the common well being of people or the State itself. The Brazilian State, through its sanitary surveillance policing powers at the three levels of government, has intervened in the practice of autohemotherapy. Considering the responsible State intervention in situations of collective interest, vulnerability and susceptibility, the present study proposed to analyze the practice of autohemotherapy in the light of sanitary surveillance actions and their relationship with the "four Ps" of Intervention Bioethics.

A parteira leiga no atendimento à mulher no parto e nascimento do seu filho / The lay midwife care to woman upon delivery and her childbirth

Trata-se de uma pesquisa que teve como objetivo conhecer as práticas de parteiras leigas durante o acompanhamento às mulheres no parto e nascimento de seus filhos. A metodologia apoiou-se na história oral de parteiras, com análise temática de Bardin. Os achados referentes às atividades das parteiras revelam o caráter doméstico de suas práticas, constituindo-se elas próprias em um dos recursos desta prática, além de outros que adotavam na execução de suas atividades. O resgate destas práticas poderá servir de reflexão para os profissionais da saúde, em um momento em que se discutem propostas de humanização do parto e do nascimento