Blomgren Michelle N, McCave Emily
Frank H. Netter MD School of Medicine, Quinnipiac University, 370 Bassett Road North Haven, North Haven, CT, 06473, USA.
Department of OB/GYN, Upstate Medical University, 750 E Adams Street, Syracuse, NY, 13210, USA.
J Relig Health. 2024 Aug;63(4):3190-3205. doi: 10.1007/s10943-024-02043-2. Epub 2024 Apr 21.
The ethics in Catholic hospitals are guided by the Ethical and Religious Directives for Catholic Health Care Services, which provide direction on many topics, including family planning. Previous research has demonstrated there is variability in the availability of prohibited family planning services at Catholic hospitals. This study aims to research a potential source of variability in interpretation and application of the directives through interviewing ethics committee members. Participants were recruited from two different hospitals on the east coast with a total sample size of eight. Ethics committee members were asked questions regarding their personal approach to ethics, their hospital's approach to ethics, and the permissibility of specific family planning methods at their hospital. Most ethics committee members stated that the Catholic faith and/or directives were important in their hospitals' approach to ethics. Most participants stated that they had instances in which their personal approach to ethics conflicted with their hospital's approach, citing women's health and end-of-life care as common causes of conflict. All but one ethics committee member stated that hormonal contraception was forbidden under the directives; however, many members stated that this was either a gray area or permissible under certain circumstances. Reproductive health issues rarely came before the ethics committee at either site with one participant referring to them as "black and white issues." This research suggests that ethics committee members did not see the directives governing family planning services to be ambiguous. However, given the low frequency in which these issues come to the attention of the ethics committee, it is difficult to determine whether the opinions expressed by our participants contribute to the variability between Catholic hospitals when it comes to reproductive healthcare provision. An interesting topic for future research would be interviewing executives at Catholic hospitals to determine where this variability arises.
天主教医院的伦理规范受《天主教医疗服务伦理与宗教指令》的指导，该指令就包括计划生育在内的诸多主题提供指导。先前的研究表明，天主教医院在禁止的计划生育服务的可及性方面存在差异。本研究旨在通过采访伦理委员会成员来探究指令解释和应用方面潜在的差异来源。参与者从东海岸的两家不同医院招募，总样本量为八人。向伦理委员会成员询问了有关他们个人的伦理方法、他们医院的伦理方法以及他们医院特定计划生育方法的可允许性的问题。大多数伦理委员会成员表示，天主教信仰和/或指令在他们医院的伦理方法中很重要。大多数参与者表示，他们有个人伦理方法与医院伦理方法冲突的情况，将妇女健康和临终关怀视为常见的冲突原因。除一名伦理委员会成员外，所有人都表示激素避孕在指令下是被禁止的；然而，许多成员表示这要么是个灰色地带，要么在某些情况下是允许的。在这两个地点，生殖健康问题很少提交给伦理委员会，有一名参与者将其称为“黑白分明的问题”。这项研究表明，伦理委员会成员并不认为管理计划生育服务的指令模棱两可。然而，鉴于这些问题引起伦理委员会关注的频率较低，很难确定我们的参与者所表达的意见是否导致天主教医院在生殖保健提供方面存在差异。未来研究的一个有趣话题将是采访天主教医院的管理人员，以确定这种差异出现在何处。
