Desai Alisha, Holliday Ryan, Wallis Marianne, Thornewill Alice, Bahraini Nazanin H, Borges Lauren M
Department of Psychiatry and the Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, and the Department of Emergency Medicine and the Department of Anesthesiology Critical Care Medicine, University of Colorado School of Medicine, Aurora, Colorado; and the Center for Cognitive Behavioral Therapy and Mindfulness, Philadelphia, Pennsylvania.
Obstet Gynecol. 2023 Jan 1;141(1):15-21. doi: 10.1097/AOG.0000000000005009. Epub 2022 Nov 30.
The U.S. Supreme Court's 2022 ruling in Dobbs v Jackson Women's Health Organization held that the U.S. Constitution does not confer the right to an abortion, which set into motion an overhaul of reproductive health care services in certain states. Health care professionals are now operating within a rapidly changing landscape of clinical practice in which they may experience conflict between personal and professional morals (eg, bodily autonomy, patient advocacy), uncertainty regarding allowable practices, and fear of prosecution (eg, loss of medical license) related to reproductive health care services. The ethical dilemmas stemming from Dobbs create a context for exposure to potentially morally injurious events, moral distress, and moral injury (ie, functional impairment stemming from exposure to moral violations) among health care professionals. Considerations related to clinical intervention and approaches to policy are reviewed. Early identification of health care professionals' potentially morally injurious event exposure related to restricted reproductive services is critical for preventing and intervening on moral injury, with implications for improving functioning and retention within the medical field.
美国最高法院2022年对多布斯诉杰克逊妇女健康组织案的裁决认为,美国宪法并未赋予堕胎权,这引发了某些州对生殖保健服务的全面改革。医疗保健专业人员如今在迅速变化的临床实践环境中工作,在这种环境下,他们可能会在个人道德与职业道德(如身体自主权、患者权益倡导)之间经历冲突,对可允许的做法存在不确定性,并且担心因生殖保健服务而受到起诉(如失去行医执照)。多布斯案引发的伦理困境为医疗保健专业人员接触潜在的道德伤害事件、道德困扰和道德损伤(即因接触道德违规行为而导致的功能损害)创造了条件。本文回顾了与临床干预和政策制定方法相关的考量因素。早期识别医疗保健专业人员因生殖服务受限而可能遭受的道德伤害事件,对于预防和干预道德损伤至关重要,这对改善医疗领域的功能和人员留存具有重要意义。