Although abortion has been the most debated of all issues analyzed in bioethics, no moral consensus has been achieved. The problem of abortion exemplifies the difficulty of establishing social dialogue in the face of distinct moral positions, and of creating an independent academic discussion based on writings that are passionately argumentative. The greatest difficulty posed by the abortion literature is to identify consistent philosophical and scientific arguments amid the rhetorical manipulation. A few illustrative texts were selected to characterize the contemporary debate. The terms used to describe abortion are full of moral meaning and must be analyzed for their underlying assumptions. Of the four main types of abortion, only 'eugenic abortion', as exemplified by the Nazis, does not consider the wishes of the woman or couple--a fundamental difference for most bioethicists. The terms 'selective abortion' and 'therapeutic abortion' are often confused, and selective abortion is often called eugenic abortion by opponents. The terms used to describe abortion practitioners, abortion opponents, and the 'product' are also of interest in determining the style of the article. The video entitled "The Silent Scream" was a classic example of violent and seductive rhetoric. Its type of discourse, freely mixing scientific arguments and moral beliefs, hinders analysis. Within writings about abortion three extreme positions may be identified: heteronomy (the belief that life is a gift that does not belong to one) versus reproductive autonomy; sanctity of life versus tangibility of life; and abortion as a crime versus abortion as morally neutral. Most individuals show an inconsistent array of beliefs, and few groups or individuals identify with the extreme positions. The principal argument of proponents of legalization is respect for the reproductive autonomy of the woman or couple based on the principle of individual liberty, while heteronomy is the main principle of opponents. Opponents have taken an active approach in decomposing their beliefs into different strands to be argued. Their assertions that the fetus is a person from conception or a person in potential have forced proponents of legalized abortion to argue in a largely reactive mode.
Demography, which should be the basis for planning of any program or project, has traditionally been ignored by Colombian governments. No population statistics are available for the pre-Conquest period in Colombia. Statistics during the Colonial era were based on population counts for division of lands, taxation, and similar considerations. The first census was undertaken around 1770. Colombia's most recent census was in 1993, and another is being prepared for 2000. The censuses have been useful for development purposes despite their significant limitations of completeness and accuracy. Colombia's population in 1997 was estimated at 40,300,000, making it the third most populous country of Latin America after Brazil and Mexico. Fertility has declined considerably since 1965. Colombia's crude birth rate is believed to have exceeded 50/1000 in the 18th and 19th centuries and was estimated at 45/1000 by the Latin American Demographic Center for the first half of the 20th century. The crude birth rate was 41.3/1000 in 1968, 33.1/1000 in 1973, 30/1000 in 1980, and around 26/1000 in 1990 and 1995. The total fertility rate was estimated at 7.0 in 1960-65, 6.7 in 1969, 4.5 in 1973, 3.2 in 1985, and 2.9 in 1995. Fertility declined most appreciably before 1975, but rates continue to drop in rural as well as urban areas and in all geographic zones. For Colombia as a whole the total fertility rate is 4.8 for women with less than 5 years of schooling and 2.4 for those with 8 or more years. It is 2.7 in urban and 4.4 in rural areas.
Different forms of violence against women and girls reflect existing inequalities between men and women and between adults and children, as well as concepts of masculinity based on aggressiveness and exercise of force as means of affirming virility. Such forms of masculinity manifest themselves through sexual violence. Women who remain in violent relationships are paralyzed by the lack of a self-defense mechanism, by economic and psychic dependence, and by low self-esteem resulting from a long history of submission. Violence against women and girls consists in a series of behaviors, beliefs, and practices aimed at compromising the full exercise of their rights, often with societal tolerance. Sexual violence represents an assault on basic human rights and on the victims' personality, body, and conscience, and on the conscience of their families and even their communities. A number of measures should be taken to eliminate sexual violence, including sex education within the family, school, and elsewhere.
The Chamber of Commerce of Bogota conducted a study of prostitution in the city with the participation of prostitutes themselves. In 1990, around 14,000 women were found to be working as prostitutes in the city's center, with 44% concentrated in the barrios of La Alameda, Las Nieves, and San Bernardo. Over 70% of the women were born outside of Bogota. 82% were aged 15-40 years; the age range was 9-60 years. 1200 minors were counted. A 1992 study in the sector of Chapinero revealed 3480 women working as prostitutes. 81% had migrated to the city and 96% were aged 15-40 years. Visible street prostitution was infrequent. A 1993 study of child prostitution in a smaller area than the 1990 center-city study revealed 2959 minors, suggesting that the number had nearly tripled. 60% were natives of the city. A 1994 study of 200 male prostitutes in the center-city found that 24% were natives of Bogota. 32% had left home before the age of 10. 89% had become prostitutes before their 16th birthday. 17% were HIV-seropositive; most of their clients were married men. In all cases, the factors leading to prostitution originated within the family and included physical mistreatment, sexual abuse by parents or stepparents, rejection and abandonment, as well as lack of income, unemployment, and lack of skills. Information on HIV infection was incomplete and ineffective. The number of indigent and homeless persons and that of drug addicts living on the streets of Bogota is not known. A large number of governmental and nongovernmental organizations attempt to provide help, but their efforts are not guided by any coherent plan of action.
In late 1997, PROFAMILIA began a study of the role of male sexual and reproductive rights as part of the construction of new masculine identities. The work was approached from the disciplines of law and sociology. Patriarchy, as a system of domination, permeated most cultures, giving men a position of power in relation to women and leading to a series of violent and self-destructive male behaviors. The patriarchal system imposed aggressive, promiscuous, risky, and irresponsible behaviors on men, which created a climate for sexual abuse, unwanted pregnancy, propagation of sexually transmitted diseases, and violence against women. Changes in female roles have created the need for changes in male roles. The most visible sexual and reproductive needs of men were studied through literature reviews and semistructured questionnaires with PROFAMILIA clients. Among the needs identified were a new type of male participation in family and domestic life, a new content for male sexual freedom, greater participation of men in reproductive decisions and in raising their children, and new ways of relating to others and sharing feelings and emotions. The need to avoid behaviors that put health at risk was also identified. A review of the evolution of existing sexual and reproductive rights and of the documents that constitute their ethical and juridical framework led to the conclusion that the construction of new rights specifically for men is not necessary, or juridically possible, in the current historical context.
