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机构对应对肺部和重症监护领域堕胎禁令的支持:一项多州定性研究。

Institutional support for navigating abortion bans in pulmonary and critical care: a multistate qualitative study.

作者信息

Hauschildt Katrina E, Kumar Avnee J, Viglianti Elizabeth M, Vranas Kelly C, Bernstein Taylor, Moroz Leslie, Iwashyna Theodore J

机构信息

Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, United States.

Department of Medicine, University of California, San Diego, School of Medicine, San Diego, CA 92093, United States.

出版信息

Health Aff Sch. 2025 May 2;3(5):qxaf095. doi: 10.1093/haschl/qxaf095. eCollection 2025 May.

Abstract

Abortion bans enacted by numerous US states between 2022 and 2024 offered little guidance to health care systems on pragmatic implementation. Early studies identified meaningful impacts to obstetric and gynecological patients and clinicians and strategies for institutions to support clinicians in these specialties. There is widespread concern regarding the legal implications of these bans on all specialties, and the impact of institutional responses to abortion bans on clinicians outside of obstetrics and gynecology is unknown. We conducted semi-structured interviews with 29 physicians in pulmonary and/or critical care medicine-another specialty whose patients have acute, life-threatening conditions precipitated or complicated by reduced access to reproductive care-about institutional responses to abortion restrictions. Physicians reported 5 areas in which institutional responses varied: legal interpretation of bans, policy and procedural changes, communication with physicians about changes, public statements about bans, and harm-mitigation strategies. Health care organization responses to abortion bans considered most helpful shared key features, including unambiguous guidance, institutional support for physicians, and demonstrated commitment to patient-first care. Our findings suggest promising potential strategies for health care organizations to minimize impacts of abortion restrictions on clinicians and support them in providing the highest level of patient-centered care possible in the post-Dobbs era.

摘要

2022年至2024年间,美国众多州颁布的堕胎禁令在实际实施方面几乎没有为医疗保健系统提供指导。早期研究确定了对妇产科患者和临床医生的重大影响,以及机构支持这些专业临床医生的策略。人们普遍担心这些禁令对所有专业的法律影响,而机构对堕胎禁令的应对措施对妇产科以外临床医生的影响尚不清楚。我们对29名肺科和/或重症医学医生进行了半结构化访谈——这是另一个其患者患有因生殖保健服务获取减少而引发或复杂化的急性、危及生命疾病的专业——了解机构对堕胎限制的应对情况。医生们报告了机构应对措施存在差异的5个领域:禁令的法律解释、政策和程序变化、与医生就变化进行沟通、关于禁令的公开声明以及减轻伤害策略。医疗保健组织对堕胎禁令的应对措施被认为最有帮助,这些措施具有共同的关键特征,包括明确的指导、对医生的机构支持以及对以患者为中心的护理作出承诺。我们的研究结果表明,医疗保健组织有一些有前景的潜在策略,可将堕胎限制对临床医生的影响降至最低,并支持他们在多布斯时代之后尽可能提供最高水平的以患者为中心的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d65/12089030/5b65139e5742/qxaf095f1.jpg

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