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Case Studies in Prenatal Diagnosis and Access to
AbortionJoanna Erdman
Schulich School of Law, Dalhousie University Nova Scotia, Canada
15 October 2012III Latin American Legal Conference on Reproductive
Rights
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Rethinking Abortion and the Law: Transnational Perspectives
(UPenn Press 2014)
• How we advocate, regulate & adjudicate on abortion
• Ideas that influence, underlie & give meaning to legal reforms
• Relevant questions, persuasive arguments & foreseeable answers
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Rethinking Abortion and the Law: Transnational Perspectives
(UPenn Press 2014)
• Luís Roberto Barroso, Legal Strategies Involving Anencephalic Fetuses
• Paola Bergallo, The Indications Model in Argentina
• Lisa Kelly, Innocent Suffering in Abortion Law • Julieta Lemaitre, Catholic Constitutionalism on
Sex, Women and Life • Alejandro Madrazo, Prenatal Life: Narrative
and Strategy• Verónica Undurraga, Proportionality in
Constitutional Review
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The relationship in human rights law between:
Prenatal or fetal diagnostic technology&
Access to safe and lawful abortion
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Case Studies
Brazilian Supreme Court: ADPF (2012)• Lawful access to termination for
anencephalic pregnancies
European Court of HR: RR v. Poland (2011)
• Access to prenatal testing to confirm fetal diagnosis
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Case Studies
Traditional Reading
• Exception and Hierarchy • Vulnerability, Suffering and Mercy
Progressive Reading
• Women’s agency and capacity • Rights in Reproductive Decision-Making
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Brazil: ADPF 54
• Abstract Constitutional Review: National Confederation of Health Workers & ANIS
• Anencephaly: fatal fetal neural tube defect
• Exceptions: Rape & Life
• Implied Exception? – Judicial Interpretation
• Varied Outcomes
• Physical, Financial and Psychological Burdens
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Brazil: ADPF 54
Asserted a woman’s right to terminate an anencephalic
pregnancy
As a general legal rule, requiring no prior authorization
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Brazil: ADPF 54
Factual Findings
• Fatal & untreatable (distinct from disability)
• Certain diagnosis on objective medical criteria
• Brain activity: consistent legal standard
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Brazil: ADPF 54
Legal Argument
1. Premature Delivery v. Abortion
Not human intervention, but congenital deformity
2. No Prenatal Life = No Right to Life
No justification for state intervention
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Brazil: ADPF 54
“Because it is absolutely unviable, the anencephalic fetus cannot be entitled to a right to life. The conflict between fundamental rights
is only apparent.
Strictly speaking, at the other side of the scale, as opposed to women's rights, is not the
right to life and human dignity of the those who are to come, precisely because there is no one to
come, there is no viable life.”
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Brazil: ADPF 54
Supreme Court Judgment
• Therapeutic Premature Delivery (vs. abortion)
• Lawful under Penal Code & Constitutionally Required
• BUT – No Exception to General Prohibition
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Brazil: ADPF 54Broader Social Impact
•Ignite Debate on Decriminalization •Recognize Concept of Reproductive Rights
Constitutional Principle of Dignity
•Focus and Justify Women’s Experience & Suffering •No Countervailing Value/Justification in Right to Life
Avenue to Reproductive Freedom/Decision-Making
… within tragic circumstances
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ECHR: RR v. PolandNarrow & Particular
•Prenatal Diagnosis of Severe Fetal Condition
Broad & Strategic
•Women’s Decision-Making in Pregnancy and Reproduction
Channels Vulnerability and Agency
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ECHR: RR v. Poland
• Indication: severe or fatal condition, until viability
• Prenatal tests by ordinance until 22 weeks
• Ultrasounds & blood tests indicate fetal condition
• Amniocentesis: recommended, delayed & refused
• 23rd week: Turner’s syndrome confirmed
• Past gestational limit
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ECHR: RR v. PolandViolation: Free from inhuman/degrading treatment
Conduct: Manipulation and Procrastination …
•Harm: Causing Suffering in Uncertainty
Conduct: Deliberate Intention …
•Harm: To Frustrate exercise of legal right
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ECHR: RR v. PolandViolation: Respect for physical and psychological integrity
Denied access to diagnostic services v. abortion …
•Harm: Denied Right to Access Health Information
Right to Information = Right to Autonomy …
•Harm: Denied right to Reproductive Freedom
•In decision-making about pregnancy, treatment, future plans
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Case Studies
Rather than access to abortion … granted in mercy and compassion
Recognize and respect women … as decision makers in pregnancy &
reproduction