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29 judgments found.
Country:
Canada Year: 2020
Court: Ontario Superior Court of Justice
Citation: 2020 ONSC 6398
Health Topics:
Chronic and noncommunicable diseases,
Sexual and reproductive health,
Water, sanitation and hygiene Facts: A motion for an interlocutory injunction was brought to prevent the City of Toronto from enforcing its By-law that prohibited camping and erecting tents, structures, and shelters in City parks, City of Toronto Municipal Code, c. 608. The applicants did not challenge the validity of the By-law but sought an order to have it suspended …Read more
Tags: Access to healthcare,
Access to treatment,
Addiction,
Chronic and noncommunicable diseases,
Cleanliness,
Depression,
Diabetes,
Disabled,
Drug abuse,
drug users,
Health care and health services,
Infectious diseases,
Influenza,
Mental health,
Noncommunicable diseases,
Opioids,
People who use drugs,
Poverty,
Public safety,
Pulmonary diseases,
Respiratory diseases,
Safe drinking water,
Sexual and reproductive health,
Sexual harassment,
Substance abuse,
violence,
water sanitation and hygiene
Country:
Canada Year: 2016
Court: Ontario Court of Appeal
Citation: 2016 ONCA 676
Facts: The applicants appealed a decision affirming the constitutionality of Brian’s Law (Mental Health Legislative Reform), 2000, S.O. 2000, c. 9. (“Brian’s Law”), which was enacted by the Ontario legislature in 2000. Brian’s Law amended the Mental Health Act (“MHA”), adding provisions that expanded criteria for involuntary committal in a psychiatric hospital and introduced community treatment …Read more
Tags: Community-based care,
Compulsory commitment,
Compulsory examination,
Compulsory treatment,
Forced examination,
Forced treatment,
Health care and health services,
Incapacity,
Informed choice,
Informed consent,
Involuntary examination,
Mental competence,
Mental disability,
Mental disorder,
Mental health,
Mental institution,
Psychiatry,
Public safety,
Schizophrenia
Country:
South Africa Year: 2019
Court: HIGH COURT OF SOUTH AFRICA KWAZULU-NATAL DIVISION, PIETERMARITZBURG
Citation: [2019] 4 All SA 469 (KZP)
Facts: The applicants’ claim was based on s. 27(1)(b) of the Constitution – the right to sufficient food and water, which they submitted found further expression in the provisions of the Water Services Act 108 of 1997 (“WSA”). Their complaint argued that farm occupiers and labour tenants, especially the applicants, lacked “access to sufficient water, basic …Read more
Tags: Clean water,
Cleanliness,
Indigent,
Potable water,
Safe drinking water,
Sewage,
Waste,
Waste management
Country:
Slovenia Year: 2018
Court: European Court of Human Rights
Citation: no. 38775/14, § 2, ECHR 2018
Human Rights: Right to property,
Right to social security Facts: The applicant, Mr. Slavko Krajnc, was a professional truck driver in Celje, Slovenia. On September 29, 2003, Krajnc was deemed to have “category III work-related disability” as a result of his epilepsy, which rendered him unable to work as a truck driver. Accordingly, he had the right to be assigned to a different, more suitable …Read more
Tags: Disabilities,
Health systems and financing
Country:
Spain Year: 2011
Court: Supreme Court
Health Topics:
Child and adolescent health,
HIV/AIDS,
Infectious diseases,
Sexual and reproductive health Facts: Appellee was diagnosed with HIV in 1994. In 1996, he began a relationship with appellant, during which time he used condoms but did not inform appellant of his HIV-positive status. The condom broke on several occasions, and ultimately appellant became pregnant and HIV-positive, and when she gave birth to their daughter, the daughter also was …Read more
Tags: AIDS,
Childbirth,
Children,
Condoms,
HIV,
HIV positive,
HIV status,
Infant health,
Minor,
Pediatric health,
People living with HIV/AIDS,
PLHIV,
Pregnancy,
Sexually transmitted diseases,
Sexually transmitted infections,
STDs,
STIs,
Transmission
Country:
Spain Year: 2011
Court: Supreme Court
Citation: STS 3153/2011
Health Topics:
Infectious diseases,
Occupational health Facts: The appellant claimed to have been infected by the Hepatitis C virus (HCV) which the appellant received during his duties as dissection technician in the Forensic Anatomical Institute in Barcelona. He was diagnosed on July 4, 1997, took sick leave in August 19, 1999, and lodged a claim for financial liability of EUR 600,000, along …Read more
Tags: Hepatitis,
Job safety,
Occupational accident,
Occupational hazards,
Workers' compensation
Country:
Spain Year: 2011
Court: Supreme Court
Citation: STS 451/2011
Health Topics:
Infectious diseases,
Medical malpractice,
Medicines Facts: In 1982, a child was given aspirin in the hospital to fight against a respiratory disease with fever. Afterward, he developed Reye’s syndrome, a kind of mental retardation. Attributing the disease to the administration of the aspirin, his parents brought a claim for financial liability from the Administration for a poor sanitary conditions. Their claim …Read more
Tags: Compensation,
Damages,
Drug safety,
Negligence,
Pharmaceuticals,
Remedies,
Tort
Country:
Spain Year: 2010
Court: Administrative Litigation Chamber of Granada
Health Topics:
Child and adolescent health,
Disasters and emergencies,
Infectious diseases,
Informed consent,
Medicines,
Public safety Human Rights: Freedom from torture and cruel, inhuman or degrading treatment,
Right to bodily integrity Facts: An outbreak of measles occurred in the city of Granada, beginning on October 9, 2010, with two children in the neighborhood of Albaycín. Due to low vaccination coverage among children in the neighborhood, especially those attending the public school Colegio Público Gómez Moreno, the disease spread. By November 18th, 36 cases had been reported. In …Read more
Tags: Children,
Compulsory treatment,
Immunization,
Involuntary treatment,
Mandatory treatment,
Measles,
Minor,
Non-consensual testing and treatment,
Patient choice,
Pediatric health,
Unauthorized treatment,
Vaccination,
Vaccines
Country:
Spain Year: 2010
Court: Constitutional Court
Health Topics:
Child and adolescent health,
Disabilities,
Mental health Human Rights: Right to due process/fair trial,
Right to liberty and security of person Facts: A citizen appeared in the court of first instance, asking for judicial authorization to commit her uncle to a psychiatric hospital due to his mental disorders and alcoholism, in accordance with the first and second paragraphs of Article 763.1 of Law 1/2000 of the civil procedure code (“Art. 763.1”). The court of first instance remanded …Read more
Tags: Children,
Compulsory commitment,
Involuntary commitment,
Mandatory commitment,
Mental disorder,
Mental illness,
Mental institution
Country:
Spain Year: 2010
Court: Supreme Court
Health Topics:
Controlled substances,
Prisons,
Sexual and reproductive health Human Rights: Freedom from discrimination,
Freedom of expression,
Freedom of religion Facts: The applicants, Mr. Eulalio and Mrs. Ariadna worked as nurses at the Prison of Albacete. The prison had, allegedly, implemented the so-called Syringe Exchange Program (“Program”), a public health program developed by the Penitentiary Health General Sub-Directorate. The experimental Program was launched with the objective of preventing the transmission of diseases between inmates by, among …Read more
Tags: Abortion,
Addiction,
Conscientious objection,
Custody,
Drug abuse,
Drug use,
Harm reduction,
Health care professionals,
Health care workers,
IDUs,
Imprisonment,
Incarceration,
Injecting drug users,
Inmate,
Jail,
People who use drugs,
Rehabilitation,
Substance abuse,
Termination of pregnancy
Country:
Spain Year: 2010
Court: Supreme Court
Health Topics:
Child and adolescent health,
Chronic and noncommunicable diseases,
Health care and health services,
Hospitals,
Medical malpractice,
Medicines Human Rights: Right of access to information Facts: The child of Mr. Florentino and Mrs. Mercedes, Jesus, was diagnosed with drug-resistant epilepsy after suffering reoccurring, frequent seizures since about two years of age, which persisted in spite of numerous drugs being tried to treat it in public hospitals. Finally, in 2003, when the child was about six years old, he had surgery in …Read more
Tags: Access to treatment,
Child development,
Children,
Epilepsy,
Health care professionals,
Health care workers,
Inadequate treatment,
Inappropriate treatment,
Informed choice,
Minor,
Negligence,
Neurological diseases,
Noncommunicable diseases,
Patient choice,
Pediatric health,
Private hospitals,
Public hospitals
Country:
Spain Year: 2010
Court: Supreme Court
Citation: STS 3364/2010
Health Topics:
Child and adolescent health,
Disabilities,
Health care and health services,
Hospitals,
Medical malpractice,
Sexual and reproductive health Facts: Plaintiff went to the hospital to obtain an amniocentesis, which reported a karyotype of 46, XY normal. Upon plaintiff’s son’s birth, 6 months later, doctors suspected the child suffered from Down syndrome. Testing of the child’s blood revealed a karyotype of 47 XY +21. Rechecking the original amniotic fluid also found an abnormality. The error …Read more
Tags: Abortion,
Abortion counseling,
Child development,
Compensation,
Damages,
Differently abled,
Disabled,
Family planning,
Negligence,
Public hospital,
Termination of pregnancy,
Testing
Country:
Spain Year: 2010
Court: Supreme Court
Citation: STS 5551/2010
Health Topics:
Hospitals,
Informed consent,
Medical malpractice,
Sexual and reproductive health Facts: The appellant, a welder and a machine technician, went to the health care facility of Mutua Asepeyo for lumbosciatic pain caused by lifting a machine that day. He was treated with medication and rest, but did not improve. He was then diagnosed with degenerative disc disease and disc herniation, which was confirmed elsewhere. He consented …Read more
Tags: Compensation,
Damages,
Fertility,
Inappropriate treatment,
Informed choice,
Negligence,
Patient choice,
Public hospitals,
Remedies,
Tort
Country:
Spain Year: 2010
Court: Supreme Court
Citation: STS 7026/2010
Health Topics:
Child and adolescent health,
Chronic and noncommunicable diseases,
Informed consent,
Medical malpractice,
Sexual and reproductive health Facts: The petitioner’s childbirth resulted in a child with disability. The petitioner had diabetes, a history of intravenous drug use, hepatitis B and C, and an obstetric history that included two abortions and two previous eutocic (vaginal) deliveries. When in the 35th week of her pregnancy, the petitioner went into preterm labor. The next day the …Read more
Tags: Caesarean,
Childbirth,
Children,
Compensation,
Damages,
Diabetes,
Health care professionals,
Health care workers,
Inadequate treatment,
Infant health,
Informed choice,
Maternal health,
Patient choice,
Pediatric health
Country:
Spain Year: 2010
Court: Supreme Court of Justice of Castilla-Leon
Citation: STSJCL 5299/2010
Health Topics:
Child and adolescent health,
Health care and health services,
Informed consent,
Medical malpractice,
Sexual and reproductive health Human Rights: Right of access to information,
Right to bodily integrity Facts: The appellant gave birth in the Hospital Universitario of Salamanca to a child born with shoulder dystocia. She brought an administrative claim against the relevant insurance company, requesting compensation in the amount of 140,036.65 Euros. She based her claim on the facts that (a) her baby’s medical history was not completed but only included gynecologist …Read more
Tags: Caesarean,
Childbirth,
Compensation,
Compulsory treatment,
Damages,
Diagnostics,
Emergency care,
Forced treatment,
Health care professionals,
Health care workers,
Inappropriate treatment,
Infant health,
Informed choice,
Involuntary treatment,
Maternal health,
Midwifery,
Patient choice,
Pregnancy,
Remedies,
Standard of care
Country:
Spain Year: 2010
Court: Supreme Court of Justice of Castilla-La Mancha
Citation: STSJCM 247/2010
Health Topics:
Informed consent Human Rights: Right of access to information Facts: Jose Pablo underwent surgery to correct his atlantoaxial luxation, a disorder that impairs rotation of the neck. He and his family believed that he was undergoing a simple and routine procedure, although this turned out not to be the case. Jose Pablo suffered quadriplegia as a result of the surgery, due to the misplacement of …Read more
Tags: Informed choice,
Patient choice
Country:
Spain Year: 2009
Court: Supreme Court
Citation: STS 16-11-2009 Appeal No. 4426/2008
Health Topics:
Chronic and noncommunicable diseases,
Health care and health services,
Health systems and financing,
Hospitals,
Sexual and reproductive health Human Rights: Right to health,
Right to social security Facts: The plaintiff sued the defendant, Regional Healthcare Department of the Generalitat Valenciana (RHD) for a refund of medical expenses following its denial of fertilization treatment. The plaintiff was carrying a genetic illness multiple endocrine neoplasia type II (MEN II). She had surgery after being diagnosed with the disease. Subsequently, the plaintiff decided she wanted to …Read more
Tags: Access to health care,
Access to treatment,
Assisted reproductive technology,
Emergency care,
Fertility,
Health funding,
Health insurance,
In vitro fertilization,
Infertility,
Out-of-pocket expenditures,
Pregnancy,
Private hospitals,
Public hospitals,
Reimbursement,
Social security,
Tertiary care
Country:
Spain Year: 2009
Court: Supreme Court
Citation: STS 4866/2009
Health Topics:
Child and adolescent health,
Health care and health services,
Hospitals,
Medical malpractice,
Sexual and reproductive health Human Rights: Right to health Facts: Appeals were filed by both parties to a decision in a case involving health damages sustained by a child as a result of a delay of the mother’s cesarean during childbirth. The child in the case suffered damages when, as a result of the lack of appropriate staff on-site, there was a delay in performing …Read more
Tags: Access to treatment,
Caesarean,
Childbirth,
Children,
Compensation,
Damages,
Duty of care,
Emergency care,
Health care professionals,
Health care workers,
Health facilities,
Inadequate treatment,
Infant health,
Maternal health,
Minor,
Negligence,
Pediatric health,
Pregnancy,
Remedies,
Standard of care,
Tort
Country:
Spain Year: 2009
Court: Supreme Court
Citation: No. 3404/2008
Health Topics:
Health care and health services,
Health systems and financing,
Hospitals,
Informed consent Human Rights: Freedom of religion,
Right to health Facts: Mr. Domingo was involved in an accident where he fractured his right femur. The Hospital of Bellvitge, where he was admitted, required patients to consent to a blood transfusion due to the risk of hemorrhage during surgery. Mr. Domingo refused a possible blood transfusion due to his religious beliefs as a Jehovah’s witness. Therefore, Mr. …Read more
Tags: Access to treatment,
Blood transfusion,
Conscientious objection,
Emergency care,
Health care technology,
Inadequate treatment,
Inappropriate treatment,
Informed choice,
Out-of-pocket expenditures,
Patient choice,
Private hospitals,
Public hospitals,
Reimbursement
Country:
Spain Year: 2009
Court: Supreme Court
Citation: STS 6895/2009
Health Topics:
Chronic and noncommunicable diseases,
Disabilities,
Health care and health services,
Health information,
Informed consent,
Medical malpractice Human Rights: Right of access to information,
Right to bodily integrity Facts: Plaintiff sued the Catalonian Institute of Health for alleged medical malpractice and lack of informed consent relating to an electrophysiological study that he underwent when he arrived at the hospital with severe arrhythmia and in an emergency condition. Plaintiff was a high-risk patient due to his past medical history, which included prior heart attacks and …Read more
Tags: Compensation,
Damages,
Disclosure,
Emergency care,
Health care professionals,
Heart disease,
Inappropriate treatment,
Informed choice,
Negligence,
Patient choice,
Remedies,
Standard of care,
Tort,
Unauthorized treatment
Country:
Spain Year: 2009
Court: Supreme Court of Justice of Cataluña
Citation: STSJC 723/2009 (Ángel and Others v. Servei Català de la Salut and Consorci Sanitari Integral)
Health Topics:
Child and adolescent health,
Health care and health services,
Informed consent,
Medical malpractice,
Sexual and reproductive health Human Rights: Right of access to information Facts: The appellants, parents of a child with microephaly disorder, alleged medical malpractice in that the failure of medical services to identify and inform them of their daughter’s condition during the pregnancy denied them the choice to terminate that pregnancy. In July of 2001, the appellants’ daughter was born and the appellants were informed that she …Read more
Tags: Abortion,
Child development,
Children,
Compensation,
Damages,
Diagnostics,
Examination,
Inadequate treatment,
Infant health,
Informed choice,
Misdiagnosis,
Patient choice,
Pediatric health,
Pregnancy,
Termination of pregnancy
Country:
Spain Year: 2009
Court: Supreme Court of Justice of Castilla-Leon
Citation: STSJCL 660/2009. Almudena v. Health Managing Area of the Primary Health Care of Burgos
Health Topics:
Health care and health services,
Health systems and financing Human Rights: Right to health,
Right to social security Facts: This case concerned social security reimbursement for private health care in Spain. The plaintiff suffered from an eating disorder, a personality disorder, and alcoholism. She sought treatment through Spain’s public health service for years. She was eventually discharged and referred to a public hospital, where she spent a year. She then sought reimbursement for the …Read more
Tags: Access to healthcare,
Access to treatment,
Health expenditures,
Health funding,
Health spending,
Out-of-pocket expenditures,
Reimbursement,
Social security,
Subsidies
Country:
Spain Year: 2009
Court: Supreme Court of Justice of Castilla-La Mancha
Citation: STSJCM 12-3-2009
Health Topics:
Health care and health services,
Health systems and financing,
Sexual and reproductive health Human Rights: Right to social security Facts: The appellant, a beneficiary of defendant public health institution Health Service of Castilla-La Mancha (“SESCAM”), received three fertility treatment cycles (two in a private institution and one in a public health institution) with negative results. The appellant then sought new fertility treatments from SESCAM, arguing that she was entitled to funding for three treatments of …Read more
Tags: Access to treatment,
Assisted reproductive technology,
Fertility,
Health care technology,
Health insurance,
Health regulation,
Health spending,
In vitro fertilization,
Infertility,
Social security
Country:
Spain Year: 2007
Court: Supreme Court
Citation: S.T.S. 6501, July 17, 2007.
Health Topics:
Chronic and noncommunicable diseases,
Health care and health services,
Health systems and financing,
Hospitals Facts: In 2002, Jose Maria was diagnosed with cancerous enlargements and was admitted to the Virgen de las Nievas Hospital, where he was treated with four cycles of chemotherapy and radiotherapy. One year later, he needed a surgery that public health services were unable to provide. As such, he went to the Teknon Clinic of Barcelona …Read more
Tags: Access to health care,
Access to treatment,
Cancer,
Clinics,
Emergency care,
Health expenditures,
Health funding,
Health insurance,
Health spending,
Lung disease,
Neurological diseases,
Out-of-pocket expenditures,
Private hospitals,
Public hospitals,
Reimbursement,
Secondary care,
Social security,
Subsidies,
Tertiary care
Country:
Spain Year: 2006
Court: Supreme Court
Citation: STS 3015/2006
Health Topics:
Health systems and financing,
Infectious diseases,
Medicines Human Rights: Right to health Facts: Appellant alleged that a resolution issued by the General Directorate of Pharmacy and Chemical Products (GDPCP) violated provisions in Spain’s Law of Medicines and General Law of Health by restricting the distribution of the pharmaceutical Rebetol for reasons other than objective reasons of health. When new pharmaceutical drugs were developed in Spain, owners of the …Read more
Tags: Access to drugs,
Access to medicines,
Essential medicines,
Health insurance,
Health regulation,
Health spending,
Hepatitis,
Pharmaceuticals,
Pricing,
Social security,
Subsidies
Country:
Spain Year: 2004
Court: European Court of Human Rights
Citation: App. No. 4143/02, 41 Eur. H.R. Rep. 40 (2005).
Health Topics:
Environmental health,
Health care and health services Human Rights: Right to privacy Facts: The applicant, a Spanish national, complained of noise disturbances at night bars, pubs and discotheques near her home in Valencia. An expert report confirmed that the noise levels were unacceptably high. The City Council designated her area an “acoustically saturated zone”, thereby imposing a ban on new noisy activities. Despite the ban, the City Council …Read more
Tags: Pollution
Country:
Spain Year: 2003
Court: Tribunal Supremo. Sala de lo Social (Supreme Court)
Citation: STS 7474/2003
Health Topics:
Health care and health services,
Health systems and financing,
Hospitals Human Rights: Right to health Facts: In the summer of 2000, the appellant suffered an injury while walking in the subway. She went to the public Hospital Severo Ochoa in Leganés where she was erroneously diagnosed with a sprained ankle. She was treated and had three additional examinations but continued to feel pain even after various treatments. She then went to …Read more
Tags: Diagnostics,
Emergency care,
Health expenditures,
Health spending,
Out-of-pocket expenditures,
Private hospitals,
Public hospitals,
Reimbursement
Country:
Spain Year: 1995
Court: United Nations Human Rights Committee
Citation: U.N. H.R. Comm., U.N. Doc. CCPR/C/53/D/493/1992 (Apr. 5, 1995).
Health Topics:
Controlled substances,
Mental health,
Prisons Human Rights: Freedom from discrimination,
Freedom from torture and cruel, inhuman or degrading treatment,
Right to bodily integrity,
Right to due process/fair trial,
Right to liberty and security of person,
Right to privacy Facts: The petitioner, a Canadian citizen, was arrested along with two acquaintances when the group attempted to enter Spain with large quantities of hashish concealed in their vehicle. The petitioner claimed to have no knowledge of the contraband, and his acquaintances also told police that he was innocent of any wrongdoing. Nevertheless, the examining magistrate incarcerated …Read more
Tags: Abuse,
Cruel and unusual punishment,
Cruel treatment,
Custody,
Degrading treatment,
Detainee,
Detention,
Drug use,
Humiliating treatment,
Imprisonment,
Incarceration,
Inhuman treatment,
Inmate,
Jail,
People who use drugs,
Police,
Prison conditions,
Torture
Country:
Spain Year: 1994
Court: European Court of Human Rights
Citation: Application No. 16798/90; (1995) 20 EHRR 277; [1994] ECHR 46; (1994) 303-C Eur. Ct. H.R. (ser A)
Health Topics:
Environmental health,
Water, sanitation and hygiene Human Rights: Freedom from torture and cruel, inhuman or degrading treatment,
Right to health,
Right to privacy Facts: Mrs. López Ostra brought an action against Spain due to environmental pollution from a nearby waste treatment plant. López Ostra lived adjacent to the plant, which was operating without a license. The plant malfunctioned on start-up, and released gas fumes and unpleasant smells. These caused health problems and were a nuisance to the local people. …Read more
Tags: Cleanliness,
Contamination,
Cruel treatment,
Degrading treatment,
Industrial waste,
Inhuman treatment,
Pollution,
Torture,
Waste,
Waste management,
Water pollution
Country:
Spain Year: 1994
Court: Constitutional Court
Health Topics:
Infectious diseases,
Mental health,
Sexual and reproductive health Human Rights: Freedom from discrimination,
Freedom from torture and cruel, inhuman or degrading treatment,
Right to bodily integrity,
Right to life Facts: The parents of a mentally-disabled woman requested that the court authorize the sterilization of their daughter. According to the Article 428 of the Criminal Code made in accordance with Article 6 LO 3/89 of 21 June (the “challenged provision”), sterilization of a disabled person who suffered from serious psychological deficiency would not be unlawful if the …Read more
Tags: Abortion,
Birth control,
Childbirth,
Compulsory sterilization,
Degrading treatment,
Forced abortion,
Forced sterilization,
Humiliating treatment,
Incapacity,
Incompetence,
Inhuman treatment,
Involuntary sterilization,
Mandatory sterilization,
Mental competence,
Mental disability,
Mental disorder,
Mental illness,
Mental retardation,
Pregnancy,
Sexually transmitted diseases,
Sexually transmitted infections,
STDs,
Sterilization,
STIs
Country:
Spain Year: 1989
Court: Supreme Court
Citation: Spanish Constitutional Court Courtroom 1st, S 15-2-1989, No.37/1989, Spanish Official Bulletin 52/1989, March 2, 1989, rec 235/1989
Health Topics:
Health information,
Hospitals,
Informed consent,
Sexual and reproductive health Human Rights: Right to bodily integrity,
Right to due process/fair trial,
Right to privacy Facts: On November 5 1986, the Court of First Instance and Preliminary Investigations No. 10 of Malaga ordered the search of a medical clinic where criminal actions (specifically, the administration of abortions) were allegedly taking place. In so doing, information regarding the medical history of Ms. Ximena’s (the appellant) was recorded. On November 21, 1986, the …Read more
Tags: Abortion,
Clinics,
Compulsory examination,
Compulsory testing,
Confidentiality,
Criminalization,
Degrading treatment,
Disclosure,
Forced examination,
Health facilities,
Health records,
Humiliating treatment,
Inhuman treatment,
Involuntary examination,
Involuntary testing,
Mandatory examination,
Mandatory testing,
Medical records,
Non-disclosure,
Pregnancy,
Secrecy,
Termination of pregnancy