Pawlikowski Jakub, Sak Jarosław J, Marczewski Krzysztof
Zakład Etyki i Filozofii Człowieka, Uniwersytet Medyczny w Lublinie.
Wiad Lek. 2012;65(2):90-6.
Some lawful procedures are morally controversial and this situation can sometimes provoke conflicts between patients and physicians (conscience clause problem). The aim of our survey was to collect opinions about medical procedures that are accepted by Polish law and unaccepted by the Catholic Church--dominating denomination in Poland, and analyzing conditions determining these opinions.
Cross sectional study. An anonymous survey was distributed among 528 physicians who work in public hospitals in eastern Poland (turn = 61%). The sample consist of: 51% women, 49% men; 52% work AT surgical wards, 48% at non-surgical wards; average work period: 17.03 years (SD = 10.73; min. = 1, max. = 45); 93% Catholics; average religiosity (measured by the Scale of Religious Attitudes): M = 5.47 (SD = 1.01; min. = 1.60, max. = 6.80). The questionnaire contained questions about: hormonal contraceptives, artificial fertilization, abortion in the case of rape and fetus defect.
The majority of respondents accepts artificial fertilization (70%), about half accepts abortion in case of fetus defect (50%), almost half accepts abortion in case of rape (41%) and contraception for minors (43%). There was statistically significant differences between physicians with different religiosit--the lack of approval for above procedures correlates with increasing religiosity.
Individual religiosity (regardless of denomination) is the most important condition influencing Polish physician's opinions and attitudes concerning contraception, abortion and artificial fertilization. Physicians with higher religiosity (about 25%) in the situation of divergence between their moral beliefs and patient's demands will choose for their beliefs, which can cause conflicts. Physician-patient relationship's models should take into account physicians'cultural beliefs and not only the cultural beliefs of the patients.
一些合法程序在道德上存在争议，这种情况有时会引发患者与医生之间的冲突（良心条款问题）。我们此次调查的目的是收集关于波兰法律认可但波兰占主导地位的天主教会不认可的医疗程序的意见，并分析决定这些意见的条件。
横断面研究。一项匿名调查在波兰东部公立医院工作的528名医生中展开（回应率 = 61%）。样本构成如下：女性占51%，男性占49%；52%在外科病房工作，48%在非外科病房工作；平均工作年限：17.03年（标准差 = 10.73；最小值 = 1，最大值 = 45）；93%为天主教徒；平均宗教虔诚度（通过宗教态度量表测量）：M = 5.47（标准差 = 1.01；最小值 = 1.60，最大值 = 6.80）。问卷包含有关以下方面的问题：激素避孕、人工授精、强奸及胎儿缺陷情况下的堕胎。
大多数受访者接受人工授精（70%），约一半受访者接受胎儿缺陷情况下的堕胎（50%），近一半受访者接受强奸情况下的堕胎（41%）以及未成年人避孕（43%）。不同宗教虔诚度的医生之间存在统计学显著差异——对上述程序的不认可与宗教虔诚度的增加相关。
个人宗教信仰（无论教派）是影响波兰医生对避孕、堕胎和人工授精的意见及态度的最重要条件。在道德信仰与患者需求存在分歧的情况下，宗教虔诚度较高的医生（约25%）会选择坚持自己的信仰，这可能引发冲突。医患关系模式应考虑医生的文化信仰，而不仅仅是患者的文化信仰。
