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改变堕胎立法对一个有堕胎权保护的州的急诊医学住院医师的影响。

The Impact of Changing Abortion Legislation on Emergency Medicine Residents in a State With Protected Abortion Rights.

机构信息

is a Medical Education Scholarship Fellow and Clinical Instructor, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.

is Clinical Assistant Professor, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA; and.

出版信息

J Grad Med Educ. 2024 Aug;16(4):445-452. doi: 10.4300/JGME-D-23-00891.1. Epub 2024 Aug 15.

Abstract

The US Supreme Court's 2022 ruling in overturned , allowing individual states to determine abortion restrictions, significantly impacting graduate medical education (GME). While focus has been on states enacting restrictions, the impacts in states where abortion rights are safeguarded are equally important. Emergency medicine (EM) serves as a safety net within the health care system, making it ideal for understanding the broader implications of these legal changes on GME. To explore the experiences and perspectives of EM residents regarding changing abortion legislation in California, an abortion-protective state. We conducted a qualitative study using transcendental phenomenology. Thirteen postgraduate year 4 EM residents from a single large university-based program in California participated in semistructured interviews in 2023. Data were analyzed using thematic analysis. Four themes were identified: (1) impact of changing abortion legislation on practice; (2) personal and professional decisions influenced by legislation; (3) navigating legal uncertainties in practice; and (4) advocacy and engagement beyond clinical practice. Residents reported varying levels of awareness and concern about the implications of abortion laws on EM practice, the influence of these laws on their career decisions, the need for legal guidance, and a commitment to advocacy. These themes highlight a complex interplay between legal changes, personal values, and professional responsibilities. This study highlights the significant impact of the decision on EM residents in California, revealing that residents face unique ethical, legal, and advocacy challenges that may affect their professional identity formation.

摘要

美国最高法院 2022 年的裁决推翻了这一先例,允许各州自行决定堕胎限制,这对研究生医学教育(GME)产生了重大影响。虽然人们关注的是各州实施的限制,但在堕胎权得到保障的州,其影响同样重要。急诊医学(EM)在医疗保健系统中充当着安全网,使其成为了解这些法律变化对 GME 更广泛影响的理想选择。为了探讨加利福尼亚州(一个保护堕胎权的州)的 EM 住院医师对不断变化的堕胎立法的经验和看法,我们采用了超越现象学的定性研究方法。2023 年,我们从加利福尼亚州一个大型大学附属医院的项目中招募了 13 名四年级的 EM 住院医师,他们参加了半结构化访谈。采用主题分析法对数据进行分析。确定了四个主题:(1)堕胎立法变化对实践的影响;(2)立法对个人和职业决策的影响;(3)在实践中应对法律不确定性;(4)超越临床实践的倡导和参与。住院医师报告了对堕胎法对 EM 实践的影响的不同程度的认识和关注、这些法律对其职业决策的影响、对法律指导的需求以及对倡导的承诺。这些主题突出了法律变化、个人价值观和职业责任之间的复杂相互作用。这项研究强调了 裁决对加利福尼亚州 EM 住院医师的重大影响,揭示了住院医师面临独特的伦理、法律和倡导挑战,这些挑战可能影响他们的职业身份形成。

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