Casas Lidia, Freedman Lori, Ramm Alejandra, Correa Sara, Baba C Finley, Biggs M Antonia
Director, Centro de Derechos Humanos, Facultad de Derecho, Universidad Diego Portales, Santiago, Chile.
Associate professor, Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, University of California, San Francisco, Oakland, CA, USA.
Int Perspect Sex Reprod Health. 2020 Dec 14;46(Suppl 1):25-34. doi: 10.1363/46e0620.
In 2017, Chile reformed its abortion law to allow the procedure under limited circumstances. Exploring the views of Chilean medical and midwifery faculty regarding abortion and the use of conscientious objection (CO) at the time of reform can inform how these topics are being taught to the country's future health care providers.
Between March and September 2017, 30 medical and midwifery school faculty from universities in Santiago, Chile were interviewed; 20 of the faculty taught at secular universities and 10 taught at religiously affiliated universities. Faculty perspectives on CO and abortion, the scope of CO, and teaching about CO and abortion were analyzed using a grounded theory approach.
Most faculty at secular and religiously affiliated universities supported the rights of clinicians to refuse to provide abortion care. Secular-university faculty generally thought that CO should be limited to specific providers and rejected the idea of institutional CO, whereas religious-university faculty strongly supported the use of CO by a broad range of providers and at the institutional level. Only secular-university faculty endorsed the idea that CO should be regulated so that it does not hinder access to abortion care.
The broader support for CO in abortion among religious-university faculty raises concerns about whether students are being taught their ethical responsibility to put the needs of their patients above their own. Future research should monitor whether Chile's CO regulations and practices are guaranteeing people's access to abortion care.
2017年，智利改革了堕胎法，允许在有限情况下进行堕胎手术。探讨智利医学和助产专业教师在改革时对堕胎及出于良心拒行（CO）的看法，有助于了解这些主题是如何传授给该国未来的医疗服务提供者的。
2017年3月至9月，对智利圣地亚哥各大学的30名医学和助产学校教师进行了访谈；其中20名教师在世俗大学任教，10名在宗教附属大学任教。采用扎根理论方法分析了教师对出于良心拒行和堕胎的看法、出于良心拒行的范围以及关于出于良心拒行和堕胎的教学情况。
世俗大学和宗教附属大学的大多数教师支持临床医生拒绝提供堕胎护理的权利。世俗大学教师普遍认为，出于良心拒行应限于特定提供者，并反对机构层面的出于良心拒行，而宗教大学教师则强烈支持广泛提供者在机构层面使用出于良心拒行。只有世俗大学教师认可应对出于良心拒行进行规范，使其不妨碍堕胎护理的获取。
宗教大学教师对堕胎中出于良心拒行的更广泛支持引发了人们对是否向学生传授将患者需求置于自身需求之上的道德责任的担忧。未来的研究应监测智利的出于良心拒行规定和做法是否能保障人们获得堕胎护理。
