ASOCIACION MEDICA MUNDIAL
Original:
Inglés
Documento no:
SMAC 192/Forced Sterilisation COM REV/Oct2012
Título:
PROYECTO DE DECLARACION SOBRE LA
ESTERILIZACION FORZADA
Destinación:
Comité de Asuntos Médico-Sociales
192ª Sesión del Consejo
Asamblea General de la AMM, Bangkok 2012
Centara Grand Hotel
Bangkok, Tailandia
10 al 13 de octubre de 2012
Nota:
Esta propuesta fue presentada por la Asociación Médica Británica (BMA). En abril de 2012 el Consejo
decidió enviar este proyecto de Declaración a los miembros constituyentes para comentarios. Se
incluyen los comentarios recibidos y la versión propuesta por la BMA.
Abreviaturas:
AMA
CMA
CNOM
IMO
IsMA
KMA
NMA
NeMA
NZMA
SwMA
American Medical Association
Canadian Medical Association
Conseil national de l’Ordre des médecins (France)
Irish Medical Organisation
Israel Medical Association
Korean Medical Association
Norwegian Medical Association
Nepal Medical Association
New Zealand Medical Association
Swedish Medical Association
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Medidas necesarias:
Para consideración
July 2012
SMAC 192/Forced Sterilisation COM REV/Oct2012
GENERAL COMMENTS
The statement might be best framed in terms of the role of government in reproduction, and the relationship to social policy. Decisions
AMA
about sterilization (and contraception) would ideally happen at the individual level by families and sexual partners with the expert advice
of physicians using their medical judgment, rather than by governments with an interest in social outcomes. Such a statement needs to be
carefully crafted- as currently framed the policy may not get to the heart of the issue, and may fail to address a variety of problematic
practices more broadly related to government control of reproduction.
Forced and coerced sterilization is not specific to women. It has relevance for men as well because not only can they be victims of the
practice, but also because the procreative options for their partners are affected. The policy should broadly address efforts against both
sexes.
Specifically, the AMA suggests that the scope of the statement be broadened to include other motives besides discrimination for states to
sterilize people. There are a variety of reasons states or other entities may seek to control who procreates. For example:
Social Policy/Social Engineering: This category includes eugenics and population control.
Punitive: Includes procedures performed on criminals to limit perceived public threats (e.g. sex offenders receiving chemical castration)
IMO
The IMO is happy to support this paper as drafted.
IsMA
This is a well written statement.
The IsMA would like to raise a question regarding an issue that is related to sterilization though was not raised in this statement – that of
sterilization of those who do not or cannot make an informed choice.
Perhaps a line could be added after paragraph 3 dealing with this issue.
KMA
KMA fully supports the proposed statement.
NMA
The Norwegian Medical Association supports this document.
NeMA
The NeMA has no further suggestion; the document is good enough.
NZMA The NZMA agrees with the sentiment, but believes that the document should also address and/or acknowledge the situation where the
individual is incapable of making their own decision. It should acknowledge the role of their advocate or legal representative.
SwMA
The Swedish Medical Association fully supports this proposed statement.
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July 2012
SMAC 192/Forced Sterilisation COM REV/Oct2012
* Numbering will be deleted (or adjusted) when the revised text is adopted.
No
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Texto propuesto
SMAC 191/Forced
Sterilisation/Apr2012
INTRODUCCION
La AMM reconoce que ninguna
persona, sin consideración de su sexo,
etnia, nivel socio-económico,
condición médica, como el VIH/Sida o
discapacidad, debe ser sometida a una
esterilización forzada.
Comentarios específicos
Agregado: negritas/subrayado
Eliminado: tachado
Comentarios: [cursiva]
Texto propuesto por la BMA
The WMA recognises that no person, regardless of
gender, ethnicity, socio-economic status, medical
condition, such as suffering from HIV/Aids or disability,
should be subjected to forced or coerced sterilisation.
[CNOM]
La AMM reconoce que ninguna
persona, sin consideración de su sexo,
etnia, nivel socio-económico, condición
médica o discapacidad, debe ser
sometida a una esterilización forzada
permanente.
SMAC 192/Forced Sterilisation
REV/Oct2012
The WMA recognises that no person, regardless of
gender, ethnicity, socio-economic status, or medical
condition [CMA; SwMA], such as suffering from
HIV/Aids or disability, should be subjected to forced or
coerced sterilisation. [CMA]
[CMA: We suggest omitting this for the usual reason –
lists of this type can never be comprehensive and so lose
their intended effect]
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[AMA: The terms “forced” and “coerced” need to be
better defined. Reproductive choices may be coerced in
more indirect, less covert ways. For example, is an
individual “forced” if they consent to a procedure in order
to receive benefits such as welfare or a reduced prison
sentence?
“Sterilization” also needs further definition: does it mean
only permanent procedures or also less permanent ones,
such as injections of Norplant or chemical castration ?]
La esterilización debe estar disponible, As a part of contraception, sterilisation should be
accesible y económicamente abordable available, accessible and affordable for every individual
para cada persona como parte de la
as part of the full range of contraceptive methods. The
amplia variedad de métodos
decision to undergo a selected sterilisation must depend
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Una amplia variedad de métodos
anticonceptivos, incluida la
esterilización, deben estar accesibles y
ser económicamente abordables para
July 2012
anticonceptivos. La decisión de
someterse a una esterilización debe ser
tomada únicamente por el interesado.
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new
SMAC 192/Forced Sterilisation COM REV/Oct2012
exclusively on be the sole decision of the individual
concerned. [CNOM]
[AMA: The first sentence suggests that there is a place
for government in this matter, in helping to make
contraception accessible to all, and moreover it suggests
that there is an appropriate time and place for
sterilization (where the patient wants it). This is an
important concept generally. However, its inclusion here
is confusing because of the way the policy is currently
written. If such language were to be included, it should be
included in an initial preamble that captures the broader
issues of procreative liberty such as the proper role of
government and the importance of patient choice in
reproductive matters.]
Al igual que otros tratamientos
As with all other medical treatments, sterilisation should
médicos, la esterilización sólo debe ser only be performed after an informed choice has been
realizada después de una elección
made and the free, unequivocal and valid consent of the
informada y de haber obtenido de la
individual or of her/his legal representative has been
persona su consentimiento libre y
obtained. [CNOM]
válido.
Move from paragraph 6:
Wherever possible, such consent should be obtained
when the patient is not facing a medical emergency, or
other major stressor. [CMA]
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cada persona. El Estado puede cumplir
una función para asegurar que estos
servicios estén disponibles, junto a
organizaciones privadas, caritativas y de
terceros. La decisión de someterse a una
esterilización debe ser tomada
únicamente por el interesado.
Al igual que otros tratamientos médicos,
la esterilización sólo debe ser realizada
en un paciente competente después de
una elección informada y de haber
obtenido de la persona su
consentimiento libre y válido. Cuando
un paciente no es competente, la
decisión válida sobre el tratamiento
debe tomarse en conformidad con los
requerimientos legales pertinentes, antes
de llevar a cabo el procedimiento.
Cada vez que sea posible, el
consentimiento se debe obtener cuando
el paciente no enfrente una urgencia
médica u otro elemento principal de
estrés, ya que esto puede significar que
el paciente es temporalmente
incompetente y por lo tanto no es capaz
de entregar un consentimiento válido.
July 2012
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La AMM condena las prácticas en las
que un Estado o cualquier otro actor
intente pasar por alto los requisitos
éticos normales relacionados con
dicho tratamiento.
SMAC 192/Forced Sterilisation COM REV/Oct2012
The WMA condemns practices where a state or any other
actor attempts to bypass normal ethical requirements in
relation to such treatment. necessary for informed
consent. [AMA]
La AMM condena las prácticas en las
que un Estado o cualquier otro actor
intente pasar por alto los requisitos
éticos necesarios para obtener un
consentimiento libre y válido.
The WMA condemns practices where a state or any other
actor attempts to bypass normal ethical requirements in
relation to such treatment act. [CNOM]
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El consentimiento a la esterilización
debe estar libre de incentivos
materiales o sociales que puedan
alterar la libertad de elección y no
debe ser condición para otra atención
médica (incluido el aborto seguro),
beneficios sociales, seguros,
institucionales u otros.
Cada vez que sea posible, el
consentimiento se debe obtener
cuando el paciente no enfrente una
urgencia médica u otro elemento
principal de estrés.
RECOMENDACIONES
La AMM llama a las asociaciones
médicas nacionales a manifestarse en
contra de la esterilización forzada en
sus propios países.
El consentimiento a la esterilización
debe estar libre de incentivos materiales
o sociales que puedan alterar la libertad
de elección y no debe ser condición
para otra atención médica (incluido el
aborto seguro), beneficios sociales,
seguros, institucionales u otros.
Move at the end of paragraph 3 [CMA]
Delete paragraph [AMA, CNOM]
[AMA: The language implies that consent is not
necessary in situations where a patient is facing a
medical emergency. The term “major stressor” is vague
and could be used as an excuse to avoid obtaining
informed consent.]
[CNOM : it refers to the free consent in paragraph 3]
The WMA calls on national medical associations to
advocate against forced and coerced sterilisation in their
own countries and globally. [CMA]

21.08.12
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RECOMENDACIONES
La AMM llama a las asociaciones
médicas nacionales a manifestarse en
contra de la esterilización forzada en sus
propios países y a nivel mundial.