关于产妇要求剖宫产的争论：瑞典媒体报道的伦理原则视角
The struggle over caesarean section on maternal request: an ethical principles approach to Swedish media portrayal.
作者信息
Fredriksson Mio, Mattebo Magdalena
机构信息
Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Box 564, Uppsala, 751 22, Sweden.
School of Health, Care and Social Welfare, Division of Caring Sciences and Health Care Pedagogics, Mälardalen University, Box 883, Västerås, 721 23, Sweden.
出版信息
Reprod Health. 2025 Jun 27;22(1):118. doi: 10.1186/s12978-025-02057-3.
BACKGROUND
Caesarean section on maternal request (CSMR) is a complex ethical issue. Sweden is an intriguing case for studying CSMR due to its restrictive policy that curtail women autonomous choice regarding the mode of birth, despite overall policy developments aiming to strengthen patients’ rights, promote person-centred care, and adopt a more individualized approach. This study aims to understand how the tension surrounding CSMR is manifested in Swedish media. An ethical principles approach is used to investigate what image of CSMR is created and conveyed to the public and what main arguments are used for and against CSMR.
METHODS
This study covers news media and specialist press material in Sweden between March 2019 and March 2024. Searches were carried out in Retriever Research and resulted in 188 search hits. The content analysis had both an inductive and a deductive approach based on Beauchamp and Childress’s four ethical principles: respect for autonomy, non-maleficence, beneficence, and justice.
RESULTS
The analysis reveals a struggle in Swedish media over how to approach CSMR, touching on all ethical principles. Regarding , the debate focuses on whether CSMR is a medical decision about non-indicated surgery or a private choice. In terms of —which is the health professionals’ main concern—the media highlights conflicts over interpreting risks associated with caesarean section and vaginal birth. involves a tension between portraying vaginal birth as healthy and normal versus caesarean section as a method to protect sexual and bodily function. As regards , CSMR is portrayed as a challenge to the fundamental needs-principle in the healthcare system.
CONCLUSIONS
Ultimately, the ethical principles approach to analyzing the media portrayal of CSMR in Sweden highlights the need for decision guidelines and practices that are more open to a woman’s own evaluation of different risks while also encouraging critical reflection on the underlying factors shaping treatment preferences for both women and healthcare professionals.
SUPPLEMENTARY INFORMATION
The online version contains supplementary material available at 10.1186/s12978-025-02057-3.
背景
应产妇要求剖宫产（CSMR）是一个复杂的伦理问题。瑞典是研究CSMR的一个有趣案例，因为尽管总体政策发展旨在加强患者权利、促进以患者为中心的护理并采取更个性化的方法，但其限制性政策限制了女性在分娩方式上的自主选择。本研究旨在了解围绕CSMR的紧张关系在瑞典媒体中是如何体现的。采用伦理原则方法来调查CSMR被塑造并传达给公众的形象，以及支持和反对CSMR的主要论点。
方法
本研究涵盖2019年3月至2024年3月期间瑞典的新闻媒体和专业新闻材料。在Retriever Research中进行了搜索，共获得188条搜索结果。内容分析基于博尚和奇尔德雷斯的四项伦理原则：尊重自主权、不伤害、有益和公正，采用归纳法和演绎法。
结果
分析揭示了瑞典媒体在如何处理CSMR问题上的挣扎，涉及所有伦理原则。关于自主权，辩论的焦点是CSMR是关于非必要手术的医疗决定还是个人选择。就不伤害而言（这是卫生专业人员主要关注的问题），媒体强调了在解释剖宫产和阴道分娩相关风险方面的冲突。有益涉及到将阴道分娩描绘为健康和正常与将剖宫产描绘为保护性和身体功能的方法之间的紧张关系。至于公正，CSMR被描绘为对医疗保健系统基本需求原则的挑战。
结论
最终，用伦理原则方法分析瑞典媒体对CSMR的描述凸显了需要有决策指南和实践，这些指南和实践要更开放地接受女性对不同风险的自身评估，同时也要鼓励对塑造女性和医疗保健专业人员治疗偏好的潜在因素进行批判性反思。
补充信息
在线版本包含可在10.1186/s12978 - 025 - 02057 - 3获取的补充材料。
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