Evolving capacity and decision-making in practice: adolescents' access to legal abortion services in Mexico City
Evolving capacity and decision-making in practice: adolescents' access to legal abortion services in Mexico City
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DOI：
10.1016/s0968-8080(13)41708-1
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发表时间：
2013-05-01
影响因子：
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通讯作者：
Watson, Katherine
中科院分区：
文献类型：
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作者：
Clyde, Jessie;Bain, Jennifer;Watson, Katherine
国际法和协定中关于青少年和年轻人的权利的规定已从注重保护发展到承认“不断发展的能力”和决策能力。不明确的政策和法规以及实际实践中的变化可能使提供者不清楚如何支持青少年的决策，反而造成意想不到的障碍。2009年在墨西哥城进行的这项研究探讨了法规、临床态度和实践是支持还是阻碍了12-17岁少女获得有关堕胎的信息和堕胎服务。我们调查了堕胎诊所的主任和工作人员，以及准备堕胎或刚刚堕胎的青少年，并将神秘客户送到诊所询问信息。虽然提供者普遍对青少年决定堕胎的能力持积极态度，但他们对成年人陪伴的需要和成年人应该是谁有不同的理解，而寻求信息的神秘客户如果有成年人陪同，更有可能获得完整的信息。需要澄清同意和陪伴的要求，并且需要使提供者了解这些要求；青少年应在无人陪伴的情况下获得信息和咨询；此外，还需要改善公共部门诊所的隐私和保密性。这些都支持青少年堕胎决策中的保护和自主的互补概念。(C) 2013年生殖健康事项
The rights of adolescents and young people in international law and agreements have evolved significantly from a focus on protection to a recognition of "evolving capacities" and decision-making ability. Unclear policies and regulations and variations in actual practice may leave providers with little clarity on how to support adolescent decision-making and instead create unintended barriers. This study in Mexico City in 2009 explored whether regulations and clinical attitudes and practice were supporting or hindering the access of adolescent girls aged 12-17 to information regarding abortion and to abortion services. We surveyed abortion clinic directors and staff, and adolescents arranging or just having had an abortion, and sent mystery clients to clinics to ask for information. While providers were generally positive about adolescents' ability to decide on abortion, they had different understandings about the need for adult accompaniment and who that adult should be, and mystery clients seeking information were more likely to receive complete information if accompanied by an adult. Clarification of consent and accompaniment requirements is needed, and providers need to be made aware of them; adolescents should have access to information and counselling without accompaniment; and improvements in privacy and confidentiality in public sector clinics are also needed. These all support complementary concepts of protection and autonomy in adolescent decision-making on abortion. (C) 2013 Reproductive Health Matters