A pregnant woman with quintuplets whose life was at risk was authorized by the São Paulo Court of Justice (TJ-SP) to undergo the embryonic reduction procedure. This process is characterized by reducing the number of fetuses in multifetal pregnancies to avoid complications that could pose a danger to the life of the pregnant woman or the other fetus.
The pregnancy, which was the result of artificial insemination, was high risk, according to the family's lawyer, Stéfano Cocenza. The process takes place in secret.
According to the lawyer, two embryos were implanted, which divided to form two gestational sacs, one for twins and the other for triplets. The situation is considered rare.
“The clinical opinion of the doctor who assisted the client, as well as that of the clinic where the procedure was carried out, was that due to her age and biological conditions, the client would not be able to bear the pregnancy of quintuplets, as well as that there were great possibilities of the embryos do not evolve well, posing great risks to the pregnant woman’s life”, says the defense.
Brazilian legislation allows abortion to be performed in cases of risk to the mother's life, as well as in cases of rape and fetal anencephaly. The Federal Council of Medicine (CFM), however, prohibits doctors from carrying out embryonic reduction in cases of assisted reproduction and, therefore, judicial authorization was required to carry out the procedure.
The court decision guarantees the rights of the patient and the doctor who performs the procedure, since, according to Cocenza, “the Regional Medicine Councils (CRM) are ethically prosecuting the doctors who perform the procedure”.
“[Se não houvesse a proibição do CFM]the procedure would be accepted by the medical community, which would be carried out without the risk of ethical and criminal proceedings and there would be no need for judicialization”, argues the family lawyer.
The gynecologist Helena Borges Paro, professor at the Federal University of Uberlândia and member of the International Federation of Gynecology and Obstetrics (FIGO), was an expert in the case – appointed by the TJ-SP himself – and recommended fetal reduction, with removal of the gestational sac that has three embryos, to ensure the health and possibility of survival of the fetuses.
In a study published by the doctor, she states that embryonic reduction should not be considered an induced abortion, “as the objective of the procedure is the opposite: to ensure the best pregnancy outcomes (both neonatal and maternal)”, she argues.
Journey through Justice
Before being authorized, the request was denied in the first instance. Then, habeas corpus was filed with the São Paulo Court of Justice (TJ-SP), which also denied the request, which is why the family's defense filed another habeas corpus with the Superior Court of Justice.
The rapporteur of the action at the Superior Court of Justice partially accepted the request for an injunction, ordering a hearing with a medical expert to clarify the real situation.
After that, the judge reporting the case at TJ-SP ordered the first instance judge to hold the hearing with a medical specialist in the area.
Even with the hearing, both the Public Prosecutor's Office and the judge of first instance maintained their refusal to proceed. According to the family's lawyer, in summary, the allegation was that it was not proven that the patient could not withstand the management of quintuplets nor that the babies would have difficulty developing and being born alive.
“Upon receiving the information, the judge reporting the case at TJ-SP urgently ordered the Public Prosecutor’s Office to comment. After the demonstration, the judge, in a memorable vote, ended up granting the order and authorizing the procedure to be carried out, determining that the permit be issued urgently by the judge of first instance”, says Concenza.
Source: CNN Brasil
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