国家堕胎政策和在多布斯决定后,提供堕胎的临床医生之间的道德痛苦
Katherine Rivlin1, Marta Bornstein2, Jocelyn Wascher1
1Department of Obstetrics and Gynecology, University of Chicago Medicine, Chicago, Illinois.
JAMA network open
|August 1, 2024
概括
提供堕胎护理的临床医生经历了显著的道德困扰,与保护性州相比,限制性州的医生是限制性州的两倍多. 这凸显了政策变革的必要性,以支持医疗保健提供者.
科学领域:
- 医学伦理 医学伦理
- 公共卫生政策 公共卫生政策
- 生殖健康 生殖健康
背景情况:
- 当医疗保健专业人员无法提供符合其道德判断的护理时,就会出现道德困扰,通常是由于外部约束.
- 通过多布斯决定推翻联邦堕胎保护可能会增加堕胎提供者面临潜在法律和民事后果的道德困境.
研究的目的:
- 评估在提供堕胎的临床医生中自我报告的道德痛苦水平.
- 为了根据多布斯决定后的州级堕胎政策来比较道德困扰得分.
主要方法:
- 从5月到2023年12月进行了一项全国性调查,针对美国医生,高级实践临床医生和提供堕胎护理的护士.
- 用道德痛苦温度计 (MDT) 来评估道德痛苦,这是一个经过验证的工具,可以从0到10进行痛苦评分.
- 包括负二项式回归在内的统计分析检查了MDT得分与国家堕胎政策 (限制性与保护性) 之间的关联.
主要成果:
- 310名临床医生完成了352个MDT; 41.5%在限制性状态下进行实践.
- 限制性状态的临床医生报告道德痛苦得分 (中位数8) 超过保护性状态 (中位数3) 的两倍.
- 在医生,独立诊所的医生,不再提供堕胎的医生,以及在Dobbs后堕胎量有显著转变的州的医生中观察到更高的痛苦.
结论:
- 堕胎提供者经历了高度的道德痛苦,特别是在限制堕胎政策的州.
- 调查结果强调,迫切需要进行结构性和政策层面的干预,包括联邦保护,以减轻临床医生的道德困境.
- 解决这些问题对于保持医疗保健道德标准和提供者福祉至关重要.
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