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Ethical considerations on the beginning of life

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Journal of Medicine and the Person

Abstract

This article was prepared by a working group of paediatricians and gynaecologists belonging to the Association of Medicine and the Person as a proposal to be discussed at the Bioethical Commission of the National Federation of Italian Chambers of Physicians which took place in Ferrara on 24–25 October 2008. The document addressed four key aspects of the bioethics of the beginning of life: (1) a responsible sexuality under the aspect of prevention and contraception with particular attention to the crucial aspects of adolescence and emergency contraception; (2) medically assisted procreation starting from scientific studies and the evaluation of risks/benefits for individuals born from this practice, with special attention to genetic diagnosis prior to implant, in view of the substantial negative effects on the embryo and on the introduction of eugenic selection; (3) a responsible procreation, the protection of maternity and the voluntary interruption of pregnancy: what significance does each of these elements carry? What is the role of doctors in all this? What are the proposals to protect motherhood nowadays? What is the role of the doctors in pre-natal diagnosis and what information is provided to parents on the actual usefulness of these tests? (4) the decision not to resuscitate extremely premature babies, which has been discussed by the Italian Scientific Society of Neonatology, by the Italian National Commission of Bioethics and by the Italian High Council of Health Services. Some positions still emerge in regards to assistance of prematures which are at variance with the position of the three above mentioned organisations and of a great part of the scientific world.

Riassunto

Questo documento è stato preparato da un gruppo di lavoro composto da pediatri e ginecologi appartenenti all’Associazione Medicina e Persona come proposta per la Commissione di Bioetica della Federazione Nazionale degli Ordini dei Medici, riunitasi a Ferra ra il 24–25 ottobre scorso. Il documento tratta quattro punti relativi alla bioetica di inizio vita: (1) la sessualità responsabile sotto il profilo della prevenzione e della contraccezione con particolare riguardo a due aspetti cruciali riguardanti l’età adolescenziale e la contraccezione d’emergenza; (2) la procreazione medicalmente assistita affrontata a partire dalla valutazione della letteratura scientifica e quindi della valutazione rischi/benefici sulla popolazione nata da tale pratica di fecondazione; un cenno particolare alla diagnosi genetica pre-impianto in riferimento agli effetti negativi, non trascurabili, sull’embrione e sull’introduzione con essa della pratica della selezione eugenetica; (3) la procreazione cosciente e responsabile, la tutela della maternità e l’interruzione volontaria di gravidanza: che significato ha oggi ciascuno di questi termini? Che ruolo ha il medico in tutto questo? Quali sono le proposte per tutelare oggi la maternità? Che ruolo ha il medico nella diagnosi prenatale e quale informazione a riguardo è data ai genitori circa la reale utilità dell’indagine? Senza un’educazione l’esito è il consumismo prenatale; (4) la rianimazione del neonato estremamente pretermine. Quest’ultimo tema è stato recentemente affrontato dalla Società Scientifica di Neonatologia, dal Comitato Nazionale di Bioetica e dal Consiglio Superiore di Sanità. Continuano a permanere posizioni selettive riguardo all’assistenza neonatale non condivise dai tre organismi citati e da gran parte della letteratura scientifica che viene qui considerate.

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Authors and Affiliations

  1. UO Pediatria, Ospedale di Merate AO Lecco, Merate, Italy

    C. Isimbaldi

  2. Ospedale San Gerardo Vecchio, Clinica Ostetrico-Ginecologica, Via Solferino 16, 20052, Monza, Italy

    P. Vergani & A. Locatelli

  3. EO Ospedali Galliera, Genoa, Italy

    G. Migliaro

  4. UO Terapia Intensiva Neonatale Ospedale Le Scotte, Siena, Italy

    C. V. Bellieni

  5. Dipartimento Materno Infantile, AO San Gerardo, Monza, Italy

    G. Paterlini

  6. Presidio Ospedaliero M. Melloni Fatebenefratelli, Milan, Italy

    A. Natale

  7. Divisione Ostetrico-Ginecologica, AO Lecco, Lecco, Italy

    P. Greppi

  8. Divisione Ostetrico-Ginecologica, Ospedale Vimercate, Vimercate, Italy

    M. Barbato

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  1. C. Isimbaldi
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  2. P. Vergani
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  4. C. V. Bellieni
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Correspondence to P. Vergani.

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Isimbaldi, C., Vergani, P., Migliaro, G. et al. Ethical considerations on the beginning of life. J Med Pers 7, 91–100 (2009). https://doi.org/10.1007/s12682-009-0021-2

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