| BMC Medical Ethics | |
| Opinions on conscientious objection to induced abortion among Finnish medical and nursing students and professionals | |
| Anne-Mari Mustonen2  Markku Myllykangas3  Pauliina Ristimäki1  Saara Lappalainen3  Petteri Nieminen1  | |
| [1] University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Institute of Biomedicine/Anatomy, Kuopio, FI-70211, Finland;University of Eastern Finland, Faculty of Science and Forestry, Department of Biology, Joensuu, FI-80101, Finland;University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Institute of Public Health and Clinical Nutrition, Kuopio, FI-70211, Finland | |
| 关键词: Survey; Reproductive health; Induced abortion; Conscientious objection; | |
| Others : 1144803 DOI : 10.1186/s12910-015-0012-1 |
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| received in 2014-10-14, accepted in 2015-03-04, 发布年份 2015 | |
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【 摘 要 】
Background
Conscientious objection (CO) to participating in induced abortion is not present in the Finnish health care system or legislation unlike in many other European countries.
Methods
We conducted a questionnaire survey with the 1st- and the last-year medical and nursing students and professionals (548 respondents; response rate 66–100%) including several aspects of the abortion process and their relation to CO in 2013.
Results
The male medical respondents chose later time points of pregnancy than the nursing respondents when considering when the embryo/fetus “becomes a person”. Of all respondents, 3.5–14.1% expressed a personal wish to CO. The medical professionals supported the right to CO more often (34.2%) than the nursing professionals (21.4%), while ≥62.4% could work with someone expressing CO. Yet ≥57.9% of the respondents anticipated social problems at work communities caused by CO. Most respondents considered self-reported religious/ethical conviction to be adequate for CO but, at the same time, 30.1–50.7% considered that no conviction would be sufficient. The respondents most commonly included the medical doctor conducting surgical or medical abortion to be eligible to CO. The nursing respondents considered that vacuum suction would be a better justification for CO than medical abortion. The indications most commonly included to potential CO were second-trimester abortions and social reasons. Among the medical respondents, the men were more willing to grant CO also in case of a life-threatening emergency of the pregnant woman.
Conclusions
While the respondents mostly seemed to consider the continuation of adequate services important if CO is introduced, the viewpoint was often focused on the staff and surgical abortion procedure instead of the patients. The issue proved to be complex, which should be taken into consideration for legislation.
【 授权许可】
2015 Nieminen et al.; licensee BioMed Central.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150331021312526.pdf | 427KB | ||
| Figure 1. | 19KB | Image |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Tiitinen A (2014): Raskauden keskeytys (Induced termination of pregnancy). Duodecim Terveyskirjasto. [http://www.terveyskirjasto.fi/terveysportti/tk.koti?p_artikkeli=dlk00166]. In Finnish.
- [2]Heino A, Gissler M, Soimula A: Induced Abortions 2010. National Institute for Health and Welfare, Official Statistics of Finland, Helsinki; 2011.
- [3]Lawrence RE, Curlin FA: Physicians’ beliefs about conscience in medicine: A national survey. Acad Med 2009, 84:1276-82.
- [4]Strickland SLM: Conscientious objection in medical students: a questionnaire survey. J Med Ethics 2012, 38:22-5.
- [5]Díaz-Olavarrieta C, Cravioto VM, Villalobos A, Deeb-Sossa N, García L, García SG: El programa de interrupción legal del embarazo en la Ciudad de México: experiencias del personal de salud (Mexico City’s Legal Abortion Program: health workers’ experiences). Rev Panam Salud Publica 2012, 32:399-404. In Spanish with an English abstract
- [6]Wheeler SB, Zullig LL, Reeve BB, Buga GA, Morroni C: Attitudes and intentions regarding abortion provision among medical school students in South Africa. Int Perspect Sex Reprod Health 2012, 38:154-63.
- [7]Frank JE: Conscientious refusal in family medicine residency training. Fam Med 2011, 43:330-3.
- [8]Heino A, Gissler M, Apter D, Fiala C: Conscientious objection and induced abortion in Europe. Eur J Contracept Reprod Health Care 2013, 18:231-3.
- [9]Chavkin W, Leitman L, Polin K: (For Global Doctors for Choice): Conscientious objection and refusal to provide reproductive healthcare: A White Paper examining prevalence, health consequences, and policy responses. Int J Gynecol Obstet 2013, 123:S41-56.
- [10]Fiala C, Arthur JH: “Dishonourable disobedience” — Why refusal to treat in reproductive healthcare is not conscientious objection. Woman - Psychosom Gynaecol Obstet 2014, 1:12-23.
- [11]Minerva F: Conscientious objection in Italy. J Med Ethics. 2015, 41:170-3.
- [12]Savolainen J. Räsänen: Hoitohenkilöstölle oikeus kieltäytyä abortista. Sisäministeri Päivi Räsänen luki kirkolliskokouksessa kätilön kirjeen, joka hämmensi kuulijoita (Räsänen: Health care personnel should have the right for conscientious objection to abortion. A letter of a midwife read by Minister of the Interior Päivi Räsänen at the Assembly of the Church of Finland caused confusion among the listeners). Helsingin Sanomat. 2012;Nov 9. In Finnish.
- [13]Heikkilä M. Aborttilaki (The law on the termination of pregnancy). Mediuutiset. 2011;Oct 21. In Finnish.
- [14]Stephens M, Jordens CFC, Kerridge IH, Ankeny RA: Religious perspectives on abortion and a secular response. J Relig Health 2010, 49:513-35.
- [15]Kaposy C: Two stalemates in the philosophical debate about abortion and why they cannot be resolved using analogical arguments. Bioethics 2012, 26:84-92.
- [16]Johnson BR Jr, Kismödi E, Dragoman MV, Temmerman M: Conscientious objection to provision of legal abortion care. Int J Gynecol Obstet 2013, 123:S60-2.
- [17]Kantymir L, McLeod C: Justification for conscience exemptions in health care. Bioethics 2014, 28:16-23.
- [18]Meyers C, Woods RD: Conscientious objection? Yes, but make sure it is genuine. Am J Bioethics 2007, 7:19-20.
- [19]Dorfman SF, Peterson H, Rashbaum W, Romney SL, Rosenfield A, Vaughan HG Jr, et al.: The Facts Speak Louder than “The Silent Scream”. Planned Parenthood® Federation of America, New York; 1985.
- [20]FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health: Ethical guidelines on conscientious objection Int J Gynecol Obstet 2006, 92:333-4.
- [21]WHO: Safe Abortion: Technical and Policy Guidance for Health Systems, Second edition. World Health Organization, Geneva; 2012.
- [22]Singh A, Wulf D, Hussain R, Bankole A, Sedgh G: Abortion Worldwide: A Decade of Uneven Progress. Guttmacher Institute, New York; 2009.
- [23]Wen D, Ma X, Li H, Liu Z, Xian B, Liu Y: Empathy in Chinese medical students: psychometric characteristics and differences by gender and year of medical education. BMC Med Educ 2013, 13:130. BioMed Central Full Text
- [24]Hojat M, Gonnella JS, Nasca TJ, Mangione S, Vergare M, Magee M: Physician empathy: Definition, components, measurement, and relationship to gender and specialty. Am J Psychiat 2002, 159:1563-9.
- [25]Lee SJ, Ralston HJP, Drey EA, Partridge JC, Rosen MA: Fetal pain: A systematic multidisciplinary review of the evidence. JAMA 2005, 294:947-54.
- [26]University of Eastern Finland (2012): Opinto-opas 2013–2014 (Curriculum 2013–2014) [www.uef.fi/documents/12848/1944186/UEF_L%C3%A4%C3%A4ketieteen_opinto_opas_sisluet.pdf/1108ae50-d0d8-415d-84e5-8b0962b4c675]. In Finnish.
- [27][http:/ / portal.savonia.fi/ amk/ fi/ opiskelijalle/ opetussuunnitelmat?yks=KS&krtid=421 &tab=6] webcite Savonia University of Applied Sciences (2014): Opetussuunnitelmat. Sosiaali- ja terveysala (Curriculum for midwives) []; (Curriculum for nurses) [http://portal.savonia.fi/amk/fi/opiskelijalle/opetussuunnitelmat?yks=KS&krtid=771&tab=6 webcite]. In Finnish.
- [28]Sivin I: IUDs are contraceptives, not abortifacients: a comment on research and belief. Stud Family Plann 1989, 20:355-9.
- [29]Westeson J: Reproductive health information and abortion services: Standards developed by the European Court of Human Rights. Int J Gynecol Obstet 2013, 122:173-6.
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