Ethical Issues during Zika Epidemic in Puerto Rico and the Americas.

The Zika virus epidemic and the possible devastating teratogenic effects of the virus represent a challenge. Health authorities have the responsibility to create programs that provide adequate preventive, medical and psychological services to the affected population. The estimated risk of microcephaly in infants of mothers infected with Zika virus is 1 to 13% when the infection occurs in the first trimester of pregnancy. There is insufficient data to estimate the risk of microcephaly when infection occurs in the second or third trimester. Pregnant women and those in reproductive age are advised to avoid traveling to places where there is local transmission of the Zika virus. Human rights advocates have requested, comprehensive sexual and reproductive health services that include expanded access to contraceptive methods including emergency contraception and safe abortion services. These strategies created a debate between the abortion rights and the right of the disabled. The discussion rests on the assumption that there are lives that are not worth living. Most people focus on the most severely affected patients, but few consider that the spectrum of disabilities associated with congenital Zika infection is broad. The rights of children with disabilities and their dignity as individuals should be respected.