Brošura u pdf. formatu - PALGO centar

se ne ispoljavaju na isti način kod žena i kod muškaraca; - neke
bolesti su isključivo vezane za ženski pol; - bolesti kod žena
često zahtevaju drugačiji pristup dijagnostici i lečenju nego
kod muškaraca; - faktori rizika po zdravlje nisu isti za oba pola,
pogotovo u pogledu nasilja na ženama; - dobra preventivna
zaštita može dovesti do smanjenja obolevanja i produženja
životnog veka žena. U razvijenim zemljama to je dovelo do
veće pažnje društva i stvaranja svojevrsnih pokreta za zdravlje
žena. Naročito su važni pravci razvoja i preporuke SZO u
pogledu otklanjanja nejednakosti među polovima, smanjenja
stope smrtnosti i invalidnosti porodilja, bezbednog abortusa,
smanjenja nasilja nad ženama i programa zdravstvene zaštite
žena na svim nivoima.
Stanje ljudskih prava žena u oblasti zaštite zdravlja je deo
šireg konteksta. Život i zdravlje svakog čoveka predstavljaju
pravom zaštićena lična dobra, a iz toga proizilazi niz bazičnih
i izvedenih prava iz korpusa tzv. pacijentovih prava. U osnovi
većine od tih prava jeste pravo na samoodređenje i kontrolu
vlastitog tela. Kod ženske populacije, u zavisnosti od konkretnih
okolnosti i životnog veka, ova pitanja se tipično aktuelizuju
kod: preventivne zaštite zdravlja žena, planiranja i kontrole
rađanja u pozitivnom i negativnom pravcu, trudnoće, porođaja i
materinstva, seksualne aktivnosti i rizika od prenosivih bolesti,
prelaznog doba i starosti.
Zaštita žena kroz zdravstveno zakonodavstvo Srbije danas
je praktično redukovana na reproduktivnu ulogu žene. Većinom
su to opšte odredbe o pojačanoj zaštiti žena, gde od posebnih
zakona koji bi obuhvatnije posmatrali celokupnu oblast medicine
rađanja, postoji samo Zakon o postupku prekida trudnoće u
zdravstvenoj ustanovi (1995). Inače ovaj zakon je restriktivniji
u propisivanju uslova za pobačaj po odobrenju u odnosu na
prethodno važeći istoimeni zakon, zbog čega predstavlja
korak unazad u pogledu slobode žene da odlučuje o pobačaju.
Kod zaštite reproduktivnog zdravlja od suštinske je važnosti
razumevanje tesne veze između ove zaštite i reproduktivnih
prava, čije se ostvarivanje uvek treba omogućiti i respektovati
od strane zdravstvenih službi, bez uticaja i pritisaka na slobodnu
volju žene. To dolazi u prvi plan naročito kod sledećih pitanja:
pravo na rađanje i mere potpomognutog oplođenja, pravo na
kontrolu rađanja u pogledu željenog i zdravog potomstva, pravo
na pobačaj uz specifičnosti ranog i kasnog pobačaja, pravo
na sterilizaciju, prava trudnice kao pacijenta uz specifičnosti
HiV-pozitivne trudnoće, prava porodilja, i prava vezana za
ginekološko-hirurške intervencije.
Potrebno je oblikovati koncept reprodukcije koji objašnjava
i potvrđuje ideju o pravu na reprodukciju kao bazičnom
ljudskom pravu. U većini liberalnih zapadnih demokratija
smatra se da ljudi moralno i legalno uživaju prokreativnu
slobodu ili prokreativnu autonomiju. Ona uključuje kako pravo
na reprodukciju, tako i pravo da se spreči reprodukcija. Tako
definisano pravo povlači za sobom niz spornih pitanja koja traže
svoje razrešenje. Na primer, ko ima pravo na reprodukciju; da
li njega uživaju samo venčani parovi ili i pojedinci; da li je ovo
pravo ograničeno na heteroseksualne parove; da li je limitirano
starosnom granicom titulara; da li mogu maloletne osobe ili
starije žene u postmenopauzi imati pravo na reprodukciju;
da li ovo pravo pripada samo fertilnim osobama koja mogu
da rađaju prirodno, via coitus, ili i sterilne osobe imaju pravo
na reprodukciju. Na ova pitanja ne može se dati odgovor bez
koherentne koncepcije prava na reprodukciju u kontekstu zaštite
reproduktivnog zdravlja. ■
- health risk factors are not the same for both sexes, especially
when it comes to violence against women; - good prevention can
lead to decrease of diseases and to a longer life span of women.
In developed countries, this has lead to greater attention of the
society, and to the formation of specific movements for women’s
health. Directions of development and WHO recommendations
are especially important when it comes to eliminating gender
inequality, reducing the level of mortality, and morbidity of new
mothers, safe abortion, decrease of violence against women, and
programs of health care for women at all levels.
The status of women’s rights in health care is part of a
broader context. The life and health of each individual are
personal assets protected by the law, forming a basis for a series
of basic and deduced rights belonging to the body of so called
rights of patients. The basis of most such rights is formed by the
right to self determination and to control over ones own body. In
the famale population, depending on concrete circumstances and
life span, such issues become typically current from the aspect
of: preventive protection of women’s health, planning and
control of reproduction in the positive or the negative direction,
pregnancy, parturition and maternity, sexual activity, and risk
from communicable diseases, menopause, and old age.
Today, health protection of women in the health care
legislation of Serbia is practically reduced to her reproductive
role. There are mostly general provisions on the intensified
protection for women, with only one specific law encompasing
in more detail the entire area of reproductive medicine, the
Law on Procedure for Termination of Pregnancy in a Health
Care Institution (1995). When prescribing conditions for
approved termination, this Law is in fact more restrictive than
the previous Law under the same name, thus representing a
retrograde step when it comes to the right of a woman to decide
about an abortion. From the aspect of protection of reproductive
health, it is very important to understand the close connection
between this type of protection and the right of reproduction,
which should always be enabled and respected by health care
services, without any influence or pressure against the free will
of the woman. This takes center stage especially in connection
with the following issues: the right to give birth, and to measures
of assisted ferilization, the right to birth control in the sense of
desired and healthy offspring, the right to an abortion with the
specificity of early and late abortion, the right to sterilization,
the rights of pregnant women as patients belonging to the
group of specific HIV-positivne pregnancies, the right of new
mothers, and rights in connection with gynecological surgical
interventions.
There is the need to shape a concept of reproduction which
explains and confirms the idea of the right to reproduction
as a basic human right. In most liberal western democracies
there is the view that people are morally and legally entitled
to the freedom to procreate or the autonomy to procreate.
This includes both the right to reproduce, and the right to
prevent reproduction. The right thus defined implies a series
of disputable issues demanding to be resolved. For example,
who has the right to reproduce; is this the right only of married
couples, or also of single individuals; is this right limited to
heterosexual couples; is it limited by the age of the individual;
can minors or older women during postmenopause have the
right to reproduce; is this the right only of fertile individuals
who can give birth naturally, via coitus, or do sterile persons also
have the right to reproduce. These questions can not be answered
without a coherent view of the right to reproduce in the context
of protection of reproductive health. ■
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