Policy Tag: Nicaragua

Adopted by the 72nd WMA General Assembly (online), London, United Kingdom, October 2021

 

Nicaragua is currently in a phase of accelerated expansion and community transmission of Covid-19. It is urgent for health authorities to promote necessary and proportionate measures to contain the progress of the pandemic.

The exponential increase in Covid-19 cases has caused a collapse of Nicaragua’s public and private healthcare system. The lack of basic medical devices has contributed to dozens of doctors and healthcare professionals becoming infected and a large number who have died.

The Nicaraguan medical profession, through more than 30 medical societies and the Covid-19 citizen observatory, has been denouncing this situation for a long time. Nonetheless, the Special Cybercrime Act approved by the Government of Nicaragua, in force since 30 December 2020, establishes sentences of 1 to 10 years in prison for all those who spread news that produces fear or anxiety in the population.

This situation of persecution is compounded by the approach to the Covid-19 pandemic, as doctors in the public sector who demanded protective measures like masks, gloves or vaccines, were dismissed under the accusation that they disrupted the public peace. Private-sector physicians who cared for patients or guided the population on self-protection measures against the pandemic were called to stop those statements, under penalty of withdrawing their licence to practice medicine or the imposition of criminal penalties, among other terrorism-related charges.

The General Assembly of the World Medical Association (WMA) hereby ratifies the letter from its president, Dr Barbe, sent on 31 August to the president of the Republic of Nicaragua, Mr Daniel Ortega, which outlines the dramatic situation suffered by Nicaraguan medical professionals and offers its support to the Declarations of 25 June 2018 and 23 August 2021 from CONFEMEL (Latin American and Caribbean Medical Confederation).

The World Medical Association (WMA) opposes and observes with extreme concern any governmental interference that threatens the freedom of professional practice and freedom of expression of any doctor. It also urges the government of Nicaragua and the members of its National Assembly:

  • to protect all health professionals;
  • to avoid or modify any legal regulation that may harm the professional autonomy of physicians.

The World Medical Association (WMA) also wishes to highlight the extraordinary role of Nicaraguan doctors, which is inherent to our ancient profession. It actively supports and promotes the right of everyone to receive information and medical care based solely on their clinical needs.

 

Adopted by the 60th WMA General Assembly, New Delhi, India, October 2009,
and revised by the 70th WMA General Assembly, Tbilisi, Georgia, October 2019

 

WHEREAS,

In 2006, Nicaragua adopted a penal code that criminalises abortion in all circumstances, including any medical treatment of a pregnant woman which results in the death of or injury to an embryo or fetus.

According to the UN Population Fund (UNFPA), despite improvement of national sexual and reproductive health indicators, Nicaragua continues to have one of the highest teenage pregnancy and maternal mortality rates in the Americas region, in particular in lower income rural population groups.

This legislation:

  • Has a negative impact on the health of women in Nicaragua resulting in preventable deaths of women and the embryo or fetus they are carrying.
  • Places physicians at risk of imprisonment if they carry out abortions, even to save a pregnant woman’s life, unless they follow the Nicaraguan Ministry of Health’s (MINSA) 2006 Obstetric Protocols designed for high emergency care alone.
  • Requires physicians to report to police, women and girls for suspected abortions, in breach of their duty of confidentiality towards patients and placing them in a conflict between the law and medical ethics.

The WMA Statement on Medically-Indicated Termination of Pregnancy (October 2018) provides that: “National laws, norms, standards, and clinical practice related to termination of pregnancy should promote and protect women’s health, dignity and their human rights, voluntary informed consent, and autonomy in decision-making, confidentiality and privacy. National medical associations should advocate that national health policy upholds these principles.”

The WMA reiterates its Resolution on Criminalisation of Medical Practice (October 2013) recommending that its members “oppose government intrusions into the practice of medicine and in healthcare decision making, including the government’s ability to define appropriate medical practice through imposition of criminal penalties.”

THEREFORE, the World Medical Association and its constituent members urge the Nicaraguan government to repeal its penal code criminalizing abortion and develop in its place a legislation that promotes and protects women’s human rights, dignity and health, including adequate access to reproductive healthcare, and that allows physicians to perform their duties in line with medical ethics and particularly medical confidentiality.