Koch Mikaela, Wohlars Kirsten, Lazarov Victoria, Ablove Tova
From the David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
South Med J. 2025 Jan;118(1):26-30. doi: 10.14423/SMJ.0000000000001773.
The 2022 US Supreme Court decision dramatically shifted the legal landscape in health care, leaving state legislatures to redefine the ethics of medical practice. As gold-standard medical procedures become banned and criminalized, physicians are facing heightened legal uncertainty and grappling with moral dilemmas of where and how to practice. This study aimed to quantitatively assess trends in legal concern among medical students and identify correlations with decision making regarding future medical training.
To assess the impact of the Dobbs decision on trainees, a 24-item RedCAP survey was distributed to 72 medical schools assessing both geographic residency preferences and level of legal concern surrounding 10 abortion provision scenarios. Level of concern was assessed on a 3-point Likert scale from "not at all concerned" to "very concerned." To observe overall trends, an average level of concern score was computed by assigning numeric values to responses and averaging the scores for each respondent.
In total, 2298 medical students completed the survey and were included in the analysis. Students identifying with she/her pronouns and as Asian or studying in abortion-protected states had significantly higher levels of concern. Moreover, respondents located in abortion-restricted states with high levels of legal concern were more likely than their peers to indicate wanting to move to abortion-protected states for residency.
Individuals with heightened proximity to reproductive healthcare may face greater ethical and moral dilemmas as they seek future career opportunities in a post- world. These data suggest that they seem highly responsive to moving out of abortion-restricted states, indicating that the decision, and the legal landscape it has created, may further exacerbate disparities in reproductive health care.
2022年美国最高法院的裁决极大地改变了医疗保健领域的法律格局，让州立法机构重新界定医疗实践的伦理规范。随着金标准医疗程序被禁止并被定为刑事犯罪，医生面临着更高的法律不确定性，并在纠结于在哪里以及如何行医的道德困境。本研究旨在定量评估医学生对法律问题的关注趋势，并确定与未来医学培训决策的相关性。
为评估多布斯裁决对实习生的影响，向72所医学院校发放了一份包含24个条目的RedCAP调查问卷，评估地理居住偏好以及围绕10种堕胎提供情形的法律关注程度。关注程度采用从“完全不关注”到“非常关注”的3点李克特量表进行评估。为观察总体趋势，通过为回答赋值并计算每个受访者的得分平均值，得出平均关注程度得分。
共有2298名医学生完成了调查并被纳入分析。认同使用她/她代词、为亚洲人或在有堕胎保护法律的州学习的学生，关注程度显著更高。此外，位于堕胎受限州且法律关注程度高的受访者比同龄人更有可能表示想搬到有堕胎保护法律的州进行住院医师培训。
在一个新的环境中寻求未来职业机会时，与生殖健康护理联系更紧密的个人可能面临更大的伦理和道德困境。这些数据表明，他们似乎对搬离堕胎受限州反应强烈，这表明该裁决及其所造成的法律格局可能会进一步加剧生殖健康护理方面的差距。
