CFM vetoes injection in legal abortions over 22 weeks – 04/03/2024 – Health

The resolution of the CFM (Federal Council of Medicine) that prohibits doctors from carrying out a procedure that causes the death of the fetus in cases of termination of pregnancy above 22 weeks, published this Wednesday (3), will make legal abortion unfeasible in these cases, according to doctors and lawyers consulted by the Sheet.

The standard prohibits fetal asystole, which involves the injection of chemicals that interrupt the fetal heartbeat. After that, a procedure similar to childbirth is carried out to remove the baby.

Asystole is a technical recommendation from the WHO (World Health Organization) in cases of legal abortion above 20 weeks. Among other reasons, it is indicated to prevent the fetus from being expelled with vital signs before it is removed from the uterus, in addition to preventing emotional and psychological stress on patients and medical teams.

The CFM’s decision comes just over a month after the Ministry of Health suspended a technical note that established that there should be no time limit for the termination of pregnancy in the cases provided for by law — the Penal Code does not establish a time limit. The retreat took place after pressure from Bolsonarists.

The ministry’s note annulled a previous decision by Jair Bolsonaro’s (PL) government that imposed a time limit of 21 weeks and six days for legal abortion.

For Henderson Fürst, president of the Special Commission on Bioethics and Biolaw of the OAB (Brazilian Bar Association), the ministry’s retreat opened a loophole for the CFM’s current resolution. “Now we have a certain restriction on legal abortion.”

According to him, rape victims who have passed the gestational age of 22 weeks and want to have access to termination will need to seek judicial support, for example, a request for habeas corpus or a court order.

“Doctors will refuse to perform it for fear of both criminal prosecution and persecution within the ethical-professional scope in CRMs [Conselhos Regionais de Medicina].”

For doctor and gynecologist Raphael Câmara, rapporteur of the CFM resolution, the measure does not prohibit doctors from bringing forward childbirth in the cases provided for by law, but, in practice, there will be fear in carrying it out.

“Many won’t do it. No doctor will have the courage to anticipate the birth at 22, 23, 24 weeks, because the chances of being injured are very high. Those who are against the resolution have to make it clear that they are in favor of killing nine-month-old babies in the womb”, says he, former secretary of Primary Health Care at the Ministry of Health during the government of Jair Bolsonaro (PL).

In Henderson Fürst’s opinion, the CFM resolution is unconstitutional because the law that regulated legal abortion, at no time, establishes a temporal restriction for its performance.

“This restriction of rights is unconstitutional. The Constitution says that you can only have restricted rights based on law, not a resolution,” says Fürst.

According to gynecologist and obstetrician Cristião Rosas, coordinator in Brazil of the Medical Network for the Right to Decide (Global Doctors For Choice – GDC), the resolution is a huge mistake and, in practice, will make legal abortions over 20 weeks unfeasible.

“It attacks the legal, constitutional and human rights of the most vulnerable and marginalized girls and women in Brazilian society. The rights of fetuses are not above the rights of women and girls”, he states.

Füsrt has the same assessment. “No matter how much they say that it is a child capable of extrauterine life, we have to consider that we are facing a victim of rape, who becomes pregnant against her will, in a country with countless barriers to carrying out the procedure.”

Among the obstacles are the emotional disorders caused by rape that “paralyze” the victim, delaying decision-making, the lack of information from hospitals that perform legal abortions and the insufficient number, which forces women to travel long distances to perform abortions. lo, in addition to the alleged conscientious objection of medical teams who refuse to carry out the interruption.

“Often, the 22-week gestational period is exceeded, not by the will of these women, but, due to these barriers, the time passes”, he says.

Raphael Câmara disagrees with the thesis of unconstitutionality and says that the resolution was discussed for more than a year, by three technical chambers (bioethics, obstetrics and pediatrics) and was evaluated in three plenary sessions at the CFM.

Among the arguments in favor of the rule, he mentions that it was already provided for in the manual published during his tenure at the Ministry of Health, in the Bolsonaro government, and that, even after being questioned in the STF (Supreme Federal Court), it was not overturned.

“Legal abortion is a medical procedure and it is up to the CFM to decide which procedures the doctor can or cannot perform based on bioethical principles. [A assistolia] It is a procedure with zero benefit for the woman and total harm for the baby.”

When asked about the impact that the resolution could have on legal abortion procedures, the Ministry of Health did not respond until the publication of this report.

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