Case-Based Ethics Education for Medical Students: Discussing Reproductive Health Ethics in a Changing Landscape

AbstractBackground: Discussing reproductive health ethics in education settings can be challenging given personal views that students and educators may have related to reproductive healthcare, specifically regarding abortion access. Although this can be sensitive to discuss, it is important to engage with these topics in medical education so that students are prepared to take care of pregnant patients, especially given changes in the reproductive healthcare landscape since Roe v. Wade was overturned in 2022. Currently, however, there are limited curricula available focused on teaching reproductive health ethics in this environment.

We designed an active-learning small-group session for medical students as part of their bioethics pre-clerkship curriculum. Students participated in a session to review important ethical dilemmas in the context of authentic cases related to caring for pregnant patients facilitated by interdisciplinary faculty. Following the session, students evaluated the session using a retrospective pre-post survey to collect quantitative and qualitative data.

178 students participated in the curriculum, and 128 completed the survey. Students demonstrated a stronger understanding of the ethical dilemmas related to providing reproductive healthcare following this session (p < .0001). They also described the session as engaging and relevant. Thematic analysis of narrative responses showed that students appreciated the opportunity to better understand a physician's responsibility in these challenging situations.

Students valued this novel curriculum and recommended that it be repeated in future years. They also appreciated having a discussion space to consider the ethical dilemmas that clinicians may face in practice related to reproductive health.