Escuela de Sociología, Universidad de Valparaíso, El Litre 1028, Valparaíso, Chile; Instituto de Investigación en Ciencias Sociales (ICSO), Universidad Diego Portales, Chile.
Centro de Derechos Humanos, Facultad de Derecho, Universidad Diego Portales, Chile.
Soc Sci Med. 2020 Sep;261:113220. doi: 10.1016/j.socscimed.2020.113220. Epub 2020 Jul 17.
While Chile recently decriminalized abortion in cases of rape, lethal fetal anomaly, and to save a woman's life, most abortions are still criminalized. We assessed medical and midwifery school faculty and students' views on punishing and reporting people involved in unlawful abortion, and their understanding of their obligation to protect patient confidentiality and to report unlawful abortions.
We interviewed 30 medical and midwifery school clinician faculty from seven public, private, secular and Catholic-affiliated universities, all located in the metropolitan region of Santiago, Chile. Medical (n = 239) and midwifery (n = 79) students at these same seven universities completed an online survey. We coded faculty interview transcripts, and analyzed codes related to maintaining patient confidentiality and reporting unlawful abortion. We summarized student views related to reporting and imprisoning people involved in unlawful abortion, and used general estimating equation (GEE) models to identify the factors associated with support for criminalization.
Faculty and students generally did not support reporting or imprisoning anyone involved in an unlawful abortion and believed that protecting patient information takes precedence over reporting. Yet, faculty described pressures to report in the public sector and several cases where they or their colleagues were involved in reports. Most students somewhat/strongly agreed (78%) that patient information concerning an unlawful abortion should be kept confidential; 35% strongly/somewhat agreed that a clinician involved in an unlawful surgical abortion should be imprisoned, and 18% agreed that the woman involved should be imprisoned, with students from secular universities being significantly less likely to support reporting and punishing people involved in unlawful abortion, than students from Catholic universities.
There is a need to clarify clinicians' ethical obligations in abortion care, in particular in Catholic universities, so that they can ensure that their patients have access to high quality confidential health care services.
尽管智利最近将因强奸、致命胎儿异常和挽救妇女生命而进行的堕胎合法化，但大多数堕胎仍属刑事犯罪。我们评估了医学和助产学校的教职员工和学生对惩罚和举报参与非法堕胎的人的看法，以及他们对保护患者隐私和报告非法堕胎的义务的理解。
我们采访了来自圣地亚哥大都会区的七所公立、私立、世俗和天主教附属大学的 30 名医学和助产学校临床教师。来自这七所大学的医学生（n=239）和助产士学生（n=79）完成了在线调查。我们对教师访谈记录进行了编码，并分析了与保护患者隐私和报告非法堕胎相关的代码。我们总结了学生对举报和监禁参与非法堕胎的人的看法，并使用广义估计方程（GEE）模型来确定支持刑事定罪的相关因素。
教职员工和学生普遍不支持举报或监禁任何参与非法堕胎的人，并认为保护患者信息优先于举报。然而，教师描述了在公共部门报告的压力，以及他们或同事参与报告的几个案例。大多数学生或多或少地（78%）同意（strongly agreed）有关非法堕胎的患者信息应保密；35%强烈/有些同意（strongly agreed）参与非法手术堕胎的临床医生应被监禁，18%同意参与非法堕胎的妇女应被监禁，而来自世俗大学的学生比来自天主教大学的学生更不可能支持举报和惩罚参与非法堕胎的人。
需要澄清临床医生在堕胎护理中的道德义务，特别是在天主教大学，以确保他们的患者能够获得高质量的保密医疗保健服务。
