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Este artículo analiza el discurso bioético y su propuesta de mediación en los conflictos morales en el terreno de la salud. Defiende la importancia de las teorías bioéticas reconocieren los principios de la incertidumbre y de la suficiencia de lo real como forma de promoción de la tolerancia moralEste artigo analisa o discurso bioético e sua proposta de mediação dos conflitos morais em saúde. Defende a importância das teorias bioéticas reconhecerem os princípios da incerteza e da suficiência do real como forma de promoção da tolerância moralThis article analyses bioethics and its philosophical perspectives to moral conflicts on health matters. It argues for the relevance of working with the principles of uncertainty and sufficiency of the real in bioethical theories as a way to promote moral tolerance

Living in a forensic hospital for the last 38 years, Josefa da Silva is the longest female inhabitant surviving the penal and psychiatric regime in Brazil. This paper analyses dossier, judicial proceedings, interviews and photographs about her. The psychiatric report is the key component of the medical and penal doubling of criminal insanity. Twelve psychiatric reports illustrate three time frames of the court files: abnormality, danger, and abandonment. The psychiatric authority over confinement has moved from discipline to security, and from disciplinary security to social assistance. In the arrangement between the penal and psychiatric powers, the judge recognizes the medical authority over the truth of insanity. It is the medicine of the reasons for Zefinha's internment that altered over the decades.

Este artigo analisa como se constrói a verdade do estupro para que a mulher que se apresenta como vítima tenha acesso ao aborto legal no Brasil. Foram entrevistados 82 profissionais de saúde de cinco serviços de referência para aborto legal, um de cada região do país, entre médicos, enfermeiros, técnicos em enfermagem, assistentes sociais e psicólogos. As entrevistas buscaram compreender procedimentos e práticas a que a mulher é submetida para ter acesso ao aborto legal. Apesar de particularidades na organização e no funcionamento dos serviços, identificamos um regime compartilhado de suspeição à narrativa da mulher que se expressa por práticas periciais de inquérito em torno do acontecimento da violência e da subjetividade da vítima. A verdade do estupro para o aborto legal não se resume à narrativa íntima e com presunção de veracidade, mas é uma construção moral e discursiva produzida pela submissão da mulher aos regimes periciais dos serviços. Este artículo analiza cómo se construye la verdad de la violación sexual para que la mujer que se presenta como víctima de violación tenga acceso al aborto legal en Brasil. Fueron entrevistados 82 profesionales de salud de cinco servicios de referencia para el aborto legal, uno de cada región del país, entre médicos, enfermeros, técnicos en enfermería, trabajadores sociales y psicólogos. Las entrevistas buscaban comprender los procedimientos y prácticas a que la mujer se somete para tener acceso al aborto legal. A pesar de las particularidades en la organización y funcionamiento de los servicios, identificamos un régimen compartido de sospecha a la narrativa de la mujer que se expresa por prácticas periciales de investigación en torno al acontecimiento de la violencia y de la subjetividad de la víctima. La verdad de la violación sexual para el aborto legal no se resume a la narrativa íntima y presunción de veracidad, sino es una construcción moral y discursiva producida por la sumisión de la mujer a los regímenes periciales de los servicios. This paper analyzes how the truth of the rape is constructed in order to authorize a woman victim of rape to have a legal abortion. We have interviewed 82 health care professionals (physicians, nurses and technicians, social workers and psychologists) at five reference facilities for legal abortion in Brazil. The interviews aimed to understand the procedures and practices imposed on a woman in order to be allowed to have the legal abortion. In spite of the particularities of each facility, we have identified a shared regime of suspicion of the woman's narrative, which investigates the fact of the violence and the victim's subjectivity. The truth of the rape for the legal abortion is not a woman's narrative with a status of veracity, but it is a moral and discursive construction shaped by the victims' submission to the forensic regimes of the services.

In Brazil, to have a legal abortion in the case of rape, the woman's statement that rape has occurred is considered sufficient to guarantee the right to abortion. The aim of this study was to understand the practice and opinions about providing abortion in the case of rape among obstetricians-gynecologists (OBGYNs) in Brazil. A mixed-method study was conducted from April to July 2012 with 1,690 OBGYNs who responded to a structured, electronic, self-completed questionnaire. In the quantitative phase, 81.6% of the physicians required police reports or judicial authorization to guarantee the care requested. In-depth telephone interviews with 50 of these physicians showed that they frequently tested women's rape claim by making them repeat their story to several health professionals; 43.5% of these claimed conscientious objection when they were uncertain whether the woman was telling the truth. The moral environment of illegal abortion alters the purpose of listening to a patient - from providing care to passing judgement on her. The data suggest that women's access to legal abortion is being blocked by these barriers in spite of the law. We recommend that FEBRASGO and the Ministry of Health work together to clarify to physicians that a woman's statement that rape occurred should allow her to access a legal abortion.

As questões de gênero e sexualidade são pautasoficiais das políticas de educação em direitos humanos do Ministério da Educação. Implementar nas escolas públicas uma educação em direitos humanosrequer a criação de condições para que as pessoas que não se enquadram nos marcos normativos de gênero e sexualidade possam viver livres da violência e da injúria. Uma transformação nos modos de representaçãoe figuração sobre gênero e sexualidade é fundamental para a promoção da igualdade, sendo o principal desafio ético a desconstrução do marco da heteronormatividade, um registro discriminatório presente nas iniciativas pedagógicas do MEC, em particular nos livros e filmes didáticos. Neste artigo,a discussão desenvolve-se a partir da apresentação de duas pesquisas sobre os materiais didáticos distribuídos pelo MEC, livros e filmes, em que a heteronorma é um marco epistêmico., Gender and sexuality are official curriculum at the nationalagenda in human rights for the Ministry of Education. To implement a human rights perspective to education requires new conditions to allow people who are out of the hegemonic sexual frame to express themselves free of violence and injury. As a consequence, to transform the ways of represent and figurate gender and sexuality is essential to promote equality. This is the main ethical challenge to the heteronormative frame of the pedagogicalinitiatives of the Ministry of Education, mainly in the books and films distributed by the federal public policy. In this article the analysis is conducted from two different approaches on didactic materials distributed by the Ministry of Education, books and films, in which heteronormativityis the dominant episteme.

The aim of this chapter is to describe how the visual narrative, more specifically the ethnographic documentary, can be an instrument of ethical approach to social questions relating to issues where there is a strong moral prejudice, as is the case of madness and crime. The images do not have the power to change reality or to directly alter oppressive regimes, but they can become indelible images in the mind of those who watch a film and they offer new understandings of criminal madness, and may (in turn) stimulate political action. The images from this documentary ‘The House of the Dead’ are of unknown men, who do ‘not exist’ in ordinary social life: people without personal bonds or biographies. The documentary brings them ‘to life’ and ‘re-members’ them. I believe that “remembering is an ethical act” of nearing others’ pain, afflictions, and sufferings. In the first section of this chapter, I present the film and the main ethical and aesthetic decisions involved in the production of an activist documentary. The section is organised in three acts around three characters, mirroring characters in the poem ‘The House of the Dead.’ In the second section, I discuss some characteristics of the activist documentary, especially the ethnographic roots and the concept of a ‘call for action,’ and then some of the ethical and political tensions involved in this type of visual narrative. I believe that political documentaries—and art in general—can be tools to improve our sense of humanity in response to pain and human affliction, as the field of the visible and the intelligible is broadened.

A Declaração de Helsinki representou um marco fundamental para a pesquisa clínica envolvendo seres humanos. Desde a promulgação da Declaração, uma série de revisões e modificações foram feitas ao texto original, mas nenhuma delas modificou seu espírito humanista ou diminuiu sua força como instância reguladora da pesquisa clínica. Nos últimos quatro anos, no entanto, vem sendo debatida uma proposta de modificação dos princípios éticos da Declaração. No caso desta proposta ser aprovada, a pesquisa clínica internacional com seres humanos será radicalmente modificada, aumentando a vulnerabilidade de certos grupos sociais. Neste artigo, apresentamos o processo histórico de promulgação da Declaração de Helsinki e os mais recentes debates em torno da proposta de modificação. Trata-se de uma análise das implicações do novo texto para os países subdesenvolvidos e da defesa da necessidade de uma consideração política do conceito de vulnerabilidade.

Para este artigo, foram analisadas trezentas matérias extraídas dos principais jornais da mídia impressa brasileira sobre o tema da clonagem, em um período de dezoito meses, a contar do anúncio de Dolly, feito em fevereiro de 1997. A análise do material teve dois grandes objetivos: mapear os constantes morais a que a possibilidade da clonagem de seres humanos esteve associada e identificar alguns dos pressupostos morais da pesquisa científica com animais não-humanos e que foram reproduzidos irrefletidamente pela mídia. Além do reconhecimento de que houve antes uma difusão irrefletida do medo da clonagem em seres humanos que mesmo um debate ético frente à questão, a conclusão a que os autores chegaram com este estudo foi que há um sério descompasso entre as reflexões bioéticas e a mídia brasileira. This article was based on an analysis of three hundred articles from mainstream Brazilian periodicals over a period of eighteen months, beginning with the announcement of the Dolly case in February 1997. There were two main objectives: to outline the moral constants in the press associated with the possibility of cloning human beings and to identify some of the moral assumptions concerning scientific research with non-human animals that were published carelessly by the media. The authors conclude that there was a haphazard spread of fear concerning the cloning of human beings rather than an ethical debate on the issue, and that there is a serious gap between bioethical reflections and the Brazilian media.

Este artigo analisa os métodos, os percursos e as redes de apoio utilizados por adolescentes para o aborto clandestino. O estudo, transversal e descritivo, entrevistou 30 adolescentes internadas após a curetagem uterina por aborto em dois hospitais públicos de Teresina, de junho a novembro de 2011. O consentimento livre e esclarecido foi oral e as entrevistas foram gravadas após a confirmação do aborto induzido. Majoritariamente, as adolescentes tinham entre 14 e 17 anos, eram solteiras, urbanas, moravam com os pais, tinham baixa escolaridade e registravam idade gestacional de 12 semanas. O Cytotec foi usado isoladamente por 28 (94%) adolescentes – de 3 a 6 comprimidos, vaginal e/ou oralmente, que procuraram o hospital após sangramento vaginal e/ou cólicas intensas. Elas compraram o Cytotec sozinhas (43%, 13) ou com ajuda de amigo ou companheiro (40%, 12), em farmácias comuns. O medicamento foi vendido pelo proprietário (45%, 13) ou pelo balconista (55%, 16), que deu as orientações de uso. O apoio para as adolescentes irem ao hospital foi dado pela mãe (40%, 12) ou por amiga (30%, 9). Houve 3 (10%) complicações graves, resultando em internação de até 20 dias. O estudo demonstra a predominância do Cytotec como método abortivo entre adolescentes. _________________________________________________________________________________ ABSTRACT This paper analyses the methods, techniques and support networks taken by adolescents to perform illegal abortions. It is a descriptive and cross-sectional study involving interviews with 30 adolescents who had been hospitalized for uterine curettage in two public hospitals in Teresina between June and November 2011. Informed consent was given orally, and the interviews were recorded after the confirmation of the induced abortion. The adolescents were between 14 and 17 years old, single, and predominantly lived with their parents in urban areas, had little schooling and recorded a gestational age of 12 weeks. Between 3 and 6 tablets of Cytotec were taken orally and/or vaginally by 28 (94%) adolescents, and they were rushed to the hospital due to severe cramping, vaginal bleeding or both. They either bought Cytotec alone (43%, 13), or with the help of a friend or partner (40%, 12). Cytotec was sold to them in ordinary pharmacies, by the owner (45%, 13) or clerk (55%, 55), who provided instructions for use. They went to the hospital with their mother (40%, 12) or a girl friend (30%, 9). Three (10%) adolescents developed serious complications. The study revealed that Cytotec is the main method used to perform illegal abortions among adolescents.

O censo dos Estabelecimentos de Custódia e Tratamento Psiquiátrico é um retrato da população dos ECTPs no ano de 2011. O levantamento, inédito no Brasil, possibilitará o conhecimento de uma das populações mais vulneráveis que vive em instituições de custódia no país. Por outro lado, o ineditismo do estudo não permite comparações longitudinais sobre particularidades da população, mas apenas do perfil da população que vivia nessas unidades no ano estudado. Serão apresentados dados que traçam um desenho da realidade nacional e das realidades locais e até mesmo comparações entre o perfil nacional e os perfis locais dos ECTPs. Espera-se que a divulgação deste estudo censitário desperte o interesse da sociedade, da administração pública e da academia no sentido de aprofundar o conhecimento sobre a realidade apresentada aqui.

O artigo é um estudo antropológico que aborda os pressupostos éticos do tratamento médico ministrado em crianças portadoras de paralisia cerebral grave. A pesquisa foi realizada a partir de um trabalho etnográfico de oito meses, com pacientes em tratamento no Centro de Paralisia Cerebral do Hospital Sarah, Salvador. A observação da terapêutica ministrada a estas crianças, que apresentam pouquíssimas mudanças do quadro clínico, levou ao questionamento já bastante sugerido em discussões relativas à deontologia médica: Qual o objetivo do tratamento médico empregado nestas crianças? Na verdade, os resultados desta pesquisa indicaram a existência de explicações sócio-humanistas que estariam além da explicação médico-científica oficial, a qual resumiria a terapêutica a um fisicalismo corporal. _______________________________________________________________________________ ABSTRACT This study deals with the ethical premises of medical treatment for children with serious cerebral palsy. Eight months of ethnographic research were carried out with patients at the Cerebral Palsy Center in the Sarah Hospital in Salvador, Bahia, Brazil. Observation of treatment for these children, who displayed limited clinical change, led to the following question, as suggested by discussions from medical deontology: What is the purpose of medical treatment for children with serious cerebral palsy? The results of our research point to social and humanist explanations going beyond the official medical scientific explanation, which limits treatment to corporal mechanicism.

We describe the epidemic of microcephaly in Brazil, its detection and attempts to control it, the suspected causal link with Zika virus infection during pregnancy, and possible scenarios for the future. In October 2015, in Pernambuco, Brazil, an increase in the number of newborns with microcephaly was reported. Mothers of the affected newborns reported rashes during pregnancy and no exposure to other potentially teratogenic agents. Women delivering in October would have been in the first trimester of pregnancy during the peak of a Zika epidemic in March. By the end of 2015, 4180 cases of suspected microcephaly had been reported. Zika spread to other American countries and, in February 2016, the World Health Organization declared the Zika epidemic a public health emergency of international concern. This unprecedented situation underscores the urgent need to establish the evidence of congenital infection risk by gestational week and accrue knowledge. There is an urgent call for a Zika vaccine, better diagnostic tests, effective treatment, and improved mosquito-control methods.

This paper seeks to analyze the Judiciary's approach with respect to demands for the judicialization of the right to health by means of a case study of civil lawsuits for access to health care in Brazil's Federal District. Judicialization of the right to health signifies the judicialization of various of the health services provided. This is a descriptive and exploratory case study that covers the Federal District and uses mixed techniques to gather and analyze data. This study analyzed 385 lawsuits (87% of the total number of cases of judicialization of health for the period from 2005 to 2010 that reached the Appellate court). The results indicate that the most judicialized service is access to intensive care unit, followed by drugs and health care. Almost all lawsuits are filed by public defenders, with medical prescriptions and recommendations from the public health service. The results of this study challenge some dominant themes in the national debate, particularly the claim that judicialization is a phenomenon of the elites and that the services judicialized are drugs. The study does not seek to make generalizations, but highlights the fact that the phenomenon of judicialization of health has different aspects encompassed under the same concept.

This paper analyses the methods, techniques and support networks taken by adolescents to perform illegal abortions. It is a descriptive and cross-sectional study involving interviews with 30 adolescents who had been hospitalized for uterine curettage in two public hospitals in Teresina between June and November 2011. Informed consent was given orally, and the interviews were recorded after the confirmation of the induced abortion. The adolescents were between 14 and 17 years old, single, and predominantly lived with their parents in urban areas, had little schooling and recorded a gestational age of 12 weeks. Between 3 and 6 tablets of Cytotec were taken orally and/or vaginally by 28 (94%) adolescents, and they were rushed to the hospital due to severe cramping, vaginal bleeding or both. They either bought Cytotec alone (43%, 13), or with the help of a friend or partner (40%, 12). Cytotec was sold to them in ordinary pharmacies, by the owner (45%, 13) or clerk (55%, 55), who provided instructions for use. They went to the hospital with their mother (40%, 12) or a girl friend (30%, 9). Three (10%) adolescents developed serious complications. The study revealed that Cytotec is the main method used to perform illegal abortions among adolescents.

This paper presents the results of the structured interview phase of the National Abortion Survey (PNA-interviews), describing the itineraries, methods and social and demographic profile of women who had at least one illegal abortion. Structured interviews were conducted during the years 2010 and 2011 in five state capitals (Belem, Brasilia, Porto Alegre, Rio de Janeiro and Salvador) with 122 women aged between 18 and 39 who had abortions. It is a non-probabilistic sample controlled by six parameters in accordance with level of education and age to reflect the social and demographic structure found in the PNA ballot-box questionnaire phase. The majority of women interviewed had had only one abortion, but 1 in every 4 had two abortions and 1 in every 17 had a third one. The majority of abortions are among women under 19 years of age who already had children and a higher incidence is found among black women. The most common test for pregnancy is beta-HCG blood test, the pharmacy urine test and ultrassound. The prevailing method for induction is a combination of teas and misoprostol (called Cytotec in Brazil), followed by hospital assistance after induction. Women are usually helped by a relative or their partners and several women reported helping other women to have abortions.

The article lists recommendations for dealing with methodological aspects of an abortion survey and makes suggestions for testing and validating the survey questionnaire. The recommendations are based on the experience of the Brazilian Abortion Survey (PNA), a random sample household survey that used the ballot-box technique and covered adult women in all urban areas of the country. O artigo lista recomendações para lidar com aspectos metodológicos de um inquérito sobre aborto e faz sugestões para testar e validar o questionário do levantamento. As recomendações baseiam-se na experiência da Pesquisa Nacional de Aborto (PNA), uma pesquisa domiciliar baseada em amostra aleatória da população urbana do Brasil que utilizou a técnica de urna.

This paper evaluates the hypothesis that the judicialization of medicine for mucopolysaccharidosis in Brazil is an action promoted by economic elites. Previous studies upholding the thesis of judicialization by elites in the case of other types of medication that are more costly for the Unified Health Service are discussed. An analysis of all 196 processes containing information about judicial processes brought to court between February 2006 and December 2010 that ended by determining that the State should provide such medication free of charge to patients was conducted. There is evidence that attorneys' fees were covered by entities interested in the results of judicialization, such as the distributors or pharmaceutical industries. Patients may also be migrating for diagnosis and treatment to university centers that are a benchmark for medical innovation in the country, as the option for public health services is related to their higher technical and scientific capacity. Therefore, the resort to private lawyers, indicators of social exclusion based on the address of patients and the use of public health services, are not adequate class information to corroborate or refute the thesis of judicialization by the elites.

A comunicação científica em humanidades enfrenta uma mudança no formato das publicações e no volume da produção editorial no Brasil. Houve um crescimento significativo no número de autores e um maior fluxo de produção em periódicos científicos em formato digital. Este artigo explora um aspecto central da ética na comunicação científica – o plágio. O plágio define-se como uma apropriação indevida de criação literária, que viola o direito de reconhecimento do autor e a expectativa de ineditismo do leitor. Como regra, o plágio é uma infração ética que desrespeita a norma de atribuição de autoria na comunicação científica. O artigo analisa duas estratégias comuns de plágio: a cópia e o pastiche. Em casos de criação literária protegida por direitos autorais, o plágio pode também ser crime.

O tema do plágio suscita reações intensas. Seja no ambiente restrito da sala de aula, seja no contexto amplo da comunicação científica, não se fica indiferente ao flagrante de um caso de plágio, que gera desde a frustração e indignação até o mais grave sentimento de ultraje. Talvez por isso o discurso sobre essa prática se mostre tão rico em metáforas e analogias: nos artigos deste debate, assinados por Newton Narciso Gomes Junior, Hélder Boska de Moraes Sarmento e Paulo Rogério Meira Menandro, o plágio é tratado como “ato de vilania”, “golpe de estelionato”, “falsificação de autoria”, “rapinagem”, “usurpação”, “mecanismos de corrupção”, “ardis”, “dissimulação”, “soluções ilícitas” e “fraude intelectual”. Esses são termos também encontrados na literatura sobre o tema e, não raro, o campo semântico dos adjetivos que qualificam o plágio é o mesmo daqueles que descrevem o crime, embora nossa aposta seja a de tratá-lo não como objeto de sanções penais, mas como infração ética.

This paper analyzes the illegal trade in misoprostol, the medication predominantly used for abortion in Brazil. The study analyzed ten cases that came to the attention of the Public Prosecution Service for the Federal District between 2004 and 2010. The cases were organized into three categories: 1. women's stories; 2. profile of the vendors; 3. maternal mortality cases. The research was reviewed by an ethics committee. The main outcomes were: 1. young women in steady relationships use misoprostol in the home or with the assistance of drug vendors. Of the seven women indicted, three were reported on arrival at the public hospital to finalize abortion; 2. the drug vendors work at the community drugstore and are local agents for the sale of misoprostol. They instruct women on how to use the drug and how to prevent infections, but refuse to provide them with care in case of emergency. Traffickers operate via the internet and have a larger inventory of drugs; 3. there were two cases of maternal mortality due to the combination of high risk methods, such as a vaginal probe and misoprostol. The main causes for maternal mortality are the delay in seeking medical care, as the women fear criminal prosecution, and the combined use of misoprostol with high risk methods.

Este artigo analisa como a mídia impressa brasileira noticia o comércio clandestino do misoprostol, o principal medicamento para aborto. Foram recuperadas 1.429 notícias, de 220 veículos de informação impressos e eletrônicos, entre 2004 e 2009. A análise foi realizada em 524 notícias de 62 veículos impressos regionais e nacionais. O misoprostol é pauta permanente, mas o enquadramento das notícias é policial, diverso do aborto como uma questão religiosa, política e de saúde pública que domina a mídia brasileira. O misoprostol está inserido no mercado ilegal de medicamentos de gênero, tais como os para emagrecimento, disfunção erétil ou anabolizantes. Sessenta e quatro (12%) notícias impressas apresentam histórias de vida de mulheres que abortaram com o misoprostol. As mulheres têm de 13 a 46 anos e sua inserção de classe demarca diferentes experiências de aborto. Três personagens foram identificados nos itinerários de aborto: amigas, intermediários e médicos. As histórias de aborto tardio são confundidas com a tipificação penal do infanticídio e são casos-limite para a narrativa midiática. ________________________________________________________________________________ ABSTRACT This article analyzes how the Brazilian news media covers the illegal market for misoprostol, the main drug used to induce abortion. A total of 1,429 news stories were retrieved from 220 print and electronic media channels from 2004 to 2009. The analysis included 524 stories from 62 regional and national newspapers. Misoprostol appeared repeatedly in the news, but was usually approached from a criminal perspective, unlike abortion as a whole, which the Brazilian media routinely covers as a religious, political, and public health issue. Misoprostol is part of the illegal gender-related drug market, along with drugs for weight loss and erectile dysfunction and anabolic steroids. Sixty-four (12%) of the news stories told life histories of women who had aborted with misoprostol. The women’s ages ranged from 13 to 46 years, and socioeconomic status was associated with different experiences with abortion. Three characters appeared in the women’s abortion itineraries: girlfriends (confidantes), go-betweens, and physicians. Stories of late-stage abortion are confused with the criminal characterization of infanticide and provide the extreme cases in the media’s narrative on abortion.

The paper analyzes conscientious objection by physicians, through the concrete situation of legal abortion in Brazil. It reviews the two main ethical frameworks about conscientious objection in public health, the incompatibility thesis and the integrity thesis, to analyze the reality of legal abortion services in the referral services of the Brazilian public health care system. From these two perspectives, a third perspective is proposed - the justification thesis, to manage the right to conscientious objection among physicians in referral services. This analysis may contribute to the organization of services for legal abortion and to the education of future physicians working in emergency obstetric care.

O artigo apresenta os primeiros resultados da Pesquisa Nacional de Aborto (PNA), um levantamento por amostragem aleatória de domicílios, realizado em 2010, cuja cobertura abrangeu as mulheres com idades entre 18 e 39 anos em todo o Brasil urbano. A PNA combinou duas técnicas de sondagem: a técnica de urna e questionários preenchidos por entrevistadoras. Seus resultados indicam que, ao final da vida reprodutiva, mais de uma em cada cinco mulheres já fez aborto, ocorrendo os abortos em geral nas idades que compõem o centro do período reprodutivo das mulheres, isto é, entre 18 e 29 anos. Não se observou diferenciação relevante na prática em função de crença religiosa, mas o aborto se mostrou mais comum entre mulheres de menor escolaridade. O uso de medicamentos para a indução do último aborto ocorreu em metade dos casos e a internação pós-aborto foi observada em cerca de metade dos abortos. Tais resultados levam a concluir que o aborto deve ser prioridade na agenda de saúde pública nacional. _______________________________________________________________________________ ABSTRACT This study presents the first results of the National Abortion Survey (PNA, Pesquisa Nacional de Aborto), a household random sample survey fielded in 2010 covering urban women in Brazil aged 18 to 39 years. The PNA combined two techniques, interviewer-administered questionnaires and self-administered ballot box questionnaires. The results of PNA show that at the end of their reproductive health one in five women has performed an abortion, with abortions being more frequent in the main reproductive ages, that is, from 18 to 29 years old. No relevant differentiation was observed in the practice of abortion among religious groups, but abortion was found to be more common among people with lower education. The use of medical drugs to induce abortion occurred in half of the abortions, and post-abortion hospitalization was observed among approximately half of the women who aborted. Such results lead to conclude that abortion is a priority in the Brazilian public health agenda.

This article analyzes how the Brazilian news media covers the illegal market for misoprostol, the main drug used to induce abortion. A total of 1,429 news stories were retrieved from 220 print and electronic media channels from 2004 to 2009. The analysis included 524 stories from 62 regional and national newspapers. Misoprostol appeared repeatedly in the news, but was usually approached from a criminal perspective, unlike abortion as a whole, which the Brazilian media routinely covers as a religious, political, and public health issue. Misoprostol is part of the illegal gender-related drug market, along with drugs for weight loss and erectile dysfunction and anabolic steroids. Sixty-four (12%) of the news stories told life histories of women who had aborted with misoprostol. The women's ages ranged from 13 to 46 years, and socioeconomic status was associated with different experiences with abortion. Three characters appeared in the women's abortion itineraries: girlfriends (confidantes), go-betweens, and physicians. Stories of late-stage abortion are confused with the criminal characterization of infanticide and provide the extreme cases in the media's narrative on abortion.

Este artigo analisa um conjunto de decisões do Supremo Tribunal Federal (STF) relativas ao Benefício de Prestação Continuada (BPC), um benefício assistencial de transferência de renda para idosos ou pessoas com deficiência incapacitadas para o trabalho e a vida independente, cuja renda familiar per capita seja inferior a um quarto do salário mínimo. A judicialização das políticas sociais é um fenômeno crescente à Suprema Corte brasileira e o caso do BPC é paradigmático. O artigo discute os argumentos de cunho orçamentário que prevaleceram nas recentes decisões do STF e contesta a adequação do recorte de renda estabelecido pela Lei Orgânica de Assistência Social (Loas) como critério de elegibilidade ao benefício. Por fim, o artigo avalia os impactos orçamentários de uma elevação do critério de elegibilidade para meio salário mínimo. A principal conclusão do artigo é de que uma elevação do critério de renda será acompanhada por um aumento da população legalmente elegível para o BPC, mas, devido a atuais erros de focalização da política, a expansão de custos será inferior ao aumento no tamanho da população legalmente elegível. _______________________________________________________________________________ ABSTRACT This paper analyses decisions of the Brazilian Supreme Court regarding the Beneficio de Prestacao Continuada (BPC, Continuous Cash Benefit), a regular income transfer to the elderly and persons with disability not capable of working or living an independent life whose family per capita income is lower than a quarter of the minimum wage. The litigation of social policies before the Brazilian Supreme Court is a growing phenomena and the case of BPC is paradigmatic. The paper examines the budgetary arguments prevailing in recent Supreme Court decisions, and challenges the appropriateness of the income eligibility threshold set by the Lei Organica da Assistencia Social (Social Assistance Act). In addition, the paper evaluates the fiscal impact of raising the threshold to half minimum wage. The main conclusion of the study is that an increase in the threshold would be followed by an increase in the number of beneficiaries but, due to the existing targeting errors, the raise in costs would be lower than the growth of the eligible population.

This study presents the first results of the National Abortion Survey (PNA, Pesquisa Nacional de Aborto), a household random sample survey fielded in 2010 covering urban women in Brazil aged 18 to 39 years. The PNA combined two techniques, interviewer-administered questionnaires and self-administered ballot box questionnaires. The results of PNA show that at the end of their reproductive health one in five women has performed an abortion, with abortions being more frequent in the main reproductive ages, that is, from 18 to 29 years old. No relevant differentiation was observed in the practice of abortion among religious groups, but abortion was found to be more common among people with lower education. The use of medical drugs to induce abortion occurred in half of the abortions, and post-abortion hospitalization was observed among approximately half of the women who aborted. Such results lead to conclude that abortion is a priority in the Brazilian public health agenda.

O objetivo deste artigo é demonstrar como o campo dos estudos sobre deficiência consolidou o conceito de deficiência como desvantagem social. Por meio de uma revisão das principais ideias do modelo social da deficiência, o artigo traça uma gênese do conceito de deficiência como restrição de participação ao corpo com impedimentos, tal como adotado pela Convenção sobre os Direitos das Pessoas com Deficiência da Organização das Nações Unidas, ratificada pelo Brasil em 2008. This paper aims to demonstrate how the field of disability studies consolidated the concept of disability as social oppression. By reviewing the main ideas of the social model of disability, this article presents the genesis of the concept of disability as a restriction of participation for disabled people, as adopted by the United Nations Convention on the Rights of Persons with Disabilities, which Brazil ratified in 2008. El objetivo de este artículo es demostrar cómo el campo de los estudios sobre discapacidad ha consolidado el concepto de discapacidad como desventaja social. Por medio de una revisión de las principales ideas del modelo social de la discapacidad, el artículo traza una génesis del concepto de discapacidad como restricción de participación al cuerpo con deficiencias, tal como adoptado por la Convención sobre los Derechos de las Personas con Discapacidad de la Organización de las Naciones Unidas, ratificada por Brasil en 2008.

Bioethics consolidated in Brazil at the end of the 1990s. A similar phenomenon occurred in other Latin American countries, especially in Argentina, Chile, and Mexico, where the introduction of bioethics to academics was a notable occurrence (Diniz et al. 1999, pp. 244-248; Organizacion Panamericana de la Salud 2006; United Nations and Scientific and Cultural Organization 2006; Velasco-Suarez 2001). In this consolidation process, women assumed different roles: sometimes as academic protagonists and sometimes as interlocutors in the public sphere. This dual insertion is the trademark of women in Latin American bioethics and is part of the biography of this essay, a biographical and genealogical narrative of Latin American and especially Brazilian bioethics. The common thread of this narrative is our experience in this dual role as academic protagonists and as bioethical political speakers. Other women’s reports about this process of the academic consolidation of bioethics in Latin America support the narrative; however, the authors assume total responsibility for the interpretation of the facts.1

This article analyses how biomedicine evaluates the disabled body in determining the inclusion of a person with disabilities in Brazilian social protection system. An empirical research was conducted with 58 people who tried to have access to Continuous Cash Benefit Program (BPC), a social protection policy for impoverished disabled people. In order to have access to BPC, a disabled person undergoes a medical examination by physicians from Social Security National Institute (INSS), in which labor incapacity and the dependency are attested. Based on the cases that had or did not have access to BPC, this article explores the thin line between biomedical knowledge and moral beliefs about the normal and productive body. Este artigo analisa como o discurso biomédico avalia o corpo deficiente para fins de inclusão de uma pessoa com deficiência no sistema de proteção social no Brasil. Foi realizada uma pesquisa empírica com 58 pessoas que buscaram ter acesso ao Benefício de Prestação Continuada (BPC), programa de proteção social às pessoas com deficiência pobres. Para ter acesso ao BPC, a pessoa com deficiência se submete a uma perícia do corpo realizada por peritos médicos do Instituto Nacional do Seguro Social a fim de atestar sua incapacidade para o trabalho e a condição incapacitante. A partir dos casos que tiveram acesso ao benefício e daqueles recusados, o artigo explora as tênues fronteiras entre o saber biomédico e as concepções morais sobre o corpo normal e produtivo.

This article analyses how biomedicine evaluates the disabled body in determining the inclusion of a person with disabilities in Brazilian social protection system. An empirical research was conducted with 58 people who tried to have access to Continuous Cash Benefit Program (BPC), a social protection policy for impoverished disabled people. In order to have access to BPC, a disabled person undergoes a medical examination by physicians from Social Security National Institute (INSS), in which labor incapacity and the dependency are attested. Based on the cases that had or did not have access to BPC, this article explores the thin line between biomedical knowledge and moral beliefs about the normal and productive body.

O aconselhamento genético é uma prática que surgiu nos Estados Unidos na década de 1940 e tem se difundido ao redor do mundo com a crescente popularização da informação genética e a profissionalização da genética na saúde pública. É por meio de sessões de aconselhamento que as pessoas são informadas sobre os resultados de testes genéticos e recebem orientações sobre probabilidades, riscos e possibilidades de doenças genéticas. Trata-se de uma prática profissional que combina saúde, assistência e educação. Este ensaio descreve o surgimento e o desenvolvimento da prática de aconselhamento genético e apresenta alguns de seus desafios éticos. _______________________________________________________________________________ ABSTRACT Genetic counseling is a biomedical practice that appeared in the United States in the 1940s and spread elsewhere in the world with the popularization of genetic information and the new genetics in public health. A genetic counseling session aims to inform and orient individuals on their genetic tests, presenting notions of probabilities, risks, and genetic diseases. Thus, this biomedical practice combines health care, social assistance, and education. This paper describes the emergence and development of genetic counseling and discusses some of its ethical challenges

The aim of this paper is to discuss the main characteristics of the scientific literature on abortion in Brazil. Data were collected from 88 literature bases, and 2,109 documents from 1987 to 2008 were retrieved. Based on the findings, the field of abortion in Brazil is dominated by female researchers affiliated with public universities and nongovernmental organizations from the Southeast, with training in health sciences. There is no research on abortion in the North, while 14% of the studies were conducted in the Northeast and 4% in the Central-West. Abortion has been a constant theme in the scientific literature in Brazil, increasing in the mid-20th century.

O objetivo deste artigo é apresentar as principais características do campo de pesquisas sobre aborto no Brasil entre 1987 e 2007. Foram pesquisadas 88 bases bibliográficas de dados e recuperadas 2.109 fontes de informação. Os resultados mostram que o campo de estudos sobre aborto é dominado por mulheres pesquisadoras, sediadas em universidades públicas e organizações não governamentais da Região Sudeste, com formação em Ciências da Saúde. Não há pesquisas sobre o aborto na Região Norte; 14% das pesquisas foram realizadas sobre o Nordeste, e 4% sobre o Centro-Oeste. O tema do aborto se manteve ativo na comunicação científica no período pesquisado, havendo um crescimento em meados dos anos 2000. _______________________________________________________________________________ ABSTRACT The aim of this paper is to discuss the main characteristics of the scientific literature on abortion in Brazil. Data were collected from 88 literature bases, and 2,109 documents from 1987 to 2008 were retrieved. Based on the findings, the field of abortion in Brazil is dominated by female researchers affiliated with public universities and nongovernmental organizations from the Southeast, with training in health sciences. There is no research on abortion in the North, while 14% of the studies were conducted in the Northeast and 4% in the Central-West. Abortion has been a constant theme in the scientific literature in Brazil, increasing in the mid-20th century.

Este artigo analisa os principais desafios envolvidos na revisão ética de projetos de pesquisa social com técnicas qualitativas de levantamento de dados. O sistema de revisão ética brasileiro foi idealizado tendo as ciências biomédicas como referência de campo disciplinar e técnicas de pesquisa. Por meio da discussão de cinco casos clássicos às ciências humanas e sociais, o artigo percorre alguns dos principais pontos de tensão ética na pesquisa social. Sustenta-se a possibilidade de esse tipo de pesquisa ser acolhido pelo atual sistema de revisão ética, desde que haja uma sensibilização dos comitês para as particularidades metodológicas impostas pelas técnicas qualitativas. Por fim, a necessidade de diretrizes éticas específicas para a pesquisa social também é considerada.

To comparatively analyze governmental regulations on embryonic stem cell research among countries.The study was performed between March and May 2008, using a direct electronic search through official databases of legislative documents from 25 selected countries, confirmed by email consultation with researchers and authorities from these countries, when necessary.Results showed a trend to allow the practice of embryonic stem cell research, though with strict ethical restrictions. Among the countries analyzed, only Italy and Germany explicitly condemned the extraction of stem cells and only Italy prohibits their subsequent use. Recent judicial decisions in Brazil are in accordance with the international regulatory context of embryo research.The trend observed represents freedom of research to promote knowledge as a public good, emphasized by the expectation of therapeutic potentiality of embryonic stem cell research to treat and cure diseases without any medical care.

O objetivo deste artigo é discutir como princípios já consolidados da ética em pesquisa podem ser incorporados à prática de revisão ética de pesquisas em Ciências Humanas, em particular etnografias ou pesquisas que utilizem as técnicas de observação participantes e entrevista aberta. Para a discussão, o fio condutor será a análise dos procedimentos metodológicos e éticos utilizados na produção do documentário etnográfico "Uma História Severina". A análise do filme sugere como ampliar os horizontes do debate sobre ética em pesquisa para além dos fundamentos biomédicos do campo é uma tarefa urgente. _______________________________________________________________________________ ABSTRACT This paper aims to discuss how already established principles of research ethics can be incorporated to the ethical review of research projects in Social Sciences, particularly ethnographic studies or studies using the techniques of participant observation and open interviews. The discussion is guided by an analysis of the methodological and ethical procedures used in the production of the ethnographic documentary "Severina's Story". The analysis of the film shows the urgent need to expand the horizons of the debate around research ethics beyond the biomedical fundaments of this field.

To determine the prevalence of sickle cell trait and sickle cell anemia among newborns in the Federal District, Brazil, a cross-sectional prevalence study covering the years 2004 to 2006 was conducted. Test results reported from the Neonatal Screening Program in the Federal District Health Department from 2004 to 2006 were analyzed, and prevalence rates were calculated. Neonatal blood samples were tested by isoelectric focalization. From January 2004 to December 2006, 116,271 newborns were tested for hemoglobinopathies, corresponding to 85% of all live births from mothers residing in the Federal District. The study identified 3,760 newborns with sickle cell trait (Hb AS) and 109 with sickle cell anemia (Hb SS). The prevalence rates were 323 (Hb AS) and 9 (Hb SS) per 10,000 live births. The high prevalence of sickle cell trait highlights the importance of neonatal screening in the Federal District to support work by health managers and professionals for planning educational measures and reducing the morbidity associated with sickle cell disease.

A bioética se consolidou no Brasil em finais dos anos 1990. Um fenômeno semelhante ocorreu em outros países da América Latina, em especial na Argentina, no Chile e no México. Nesse processo de consolidação, as mulheres assumiram diferentes papéis: ora de protagonistas acadêmicas da bioética, ora de interlocutoras da bioética no espaço público. Essa dupla inserção é marca registrada das mulheres na bioética latino-americana e é parte da biografia das autoras deste ensaio. Este ensaio é uma peça biográfica e genealógica da bioética latino-americana e brasileira em particular. O fio condutor da narrativa são experiências vividas pelas autoras nesse duplo papel de protagonismo acadêmico e de interlocução política da bioética.