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. 2018 Oct;40(10):599-605.
doi: 10.1055/s-0038-1673367. Epub 2018 Oct 23.

Prevalence, Attitudes, and Factors Motivating Conscientious Objection toward Reproductive Health among Medical Students

Omar Ismail Santos Pereira Darzé  1 , Ubirajara Barroso Júnior  1
Affiliations

Prevalence, Attitudes, and Factors Motivating Conscientious Objection toward Reproductive Health among Medical Students

Omar Ismail Santos Pereira Darzé et al. Rev Bras Ginecol Obstet. 2018 Oct.

Abstract
in English, Portuguese

Objective: We have evaluated the prevalence of and the motivating factors behind the refusal to provide reproductive health services and the ethical knowledge of the subject among medical students from the Escola Bahiana de Medicina e Saúde Pública, in the state of Bahia, Brazil.

Methods: The present cross-sectional study involved 120 medical students. A questionnaire was utilized. The dependent variables were students' objections (or not) regarding three clinical reproductive health cases: abortion provided by law, contraceptive guidance to an adolescent without parental consent, and prescription of emergency contraception. The independent variables were age, gender, religion, ethical value, degree of religiosity, and attendance at worship services. Ethical knowledge comprised an obligation to state the reasons for the objection, report possible alternatives, and referral to another professional. Data were analyzed with χ2 tests and t-tests with a significance level of 5%.

Results: Abortion, contraception to adolescents, and emergency contraception were refused by 35.8%, 17.5%, and 5.8% of the students, respectively. High religiosity (p < 0.001) and higher attendance at worship services (p = 0.034) were predictors of refusing abortion. Refusal to provide contraception to adolescents was significantly higher among women than men (p = 0.037). Furthermore, 25% would not explain the reason for the refusal, 15% would not describe all the procedures used, and 25% would not refer the patient to another professional.

Conclusion: Abortion provided by law was the most objectionable situation. The motivating factors for this refusal were high commitment and religiosity. A reasonable portion of the students did not demonstrate ethical knowledge about the subject.

Objetivo: Avaliar a prevalência e os fatores motivadores da recusa em prestar serviços de saúde reprodutiva, bem como o conhecimento ético do tema, entre estudantes de medicina. MéTODOS: Estudo transversal, envolvendo 120 estudantes de medicina. Aplicou-se um questionário cujas variáveis dependentes foram a existência ou não de objeções quanto à condução de três casos clínicos sobre saúde reprodutiva: o abortamento previsto em lei, a orientação contraceptiva a uma adolescente sem consentimento dos pais, e a prescrição de contracepção de emergência. As varáveis independentes foram: idade, gênero, religião, valor ético, grau de religiosidade e frequência a cultos religiosos. Os conhecimentos éticos pesquisados foram a obrigação de expor os motivos da objeção, relatar as alternativas possíveis e encaminhar a paciente a outro profissional. Os dados foram analisados pelo teste do χ2 e pelo teste-t, com nível de significância de 5%.

Resultados: O abortamento foi recusado por 35,8% dos estudantes, a contracepção aos adolescentes por 17,5%, e a contracepção de emergência por 5,8%. A alta religiosidade (p < 0,001) e uma maior frequência a cultos (p = 0,034) foram os preditores identificados no caso do abortamento previsto em lei. A recusa da contracepção aos adolescentes foi significativamente maior entre as mulheres (p = 0,037). Entre os estudantes, 25% não explicariam o motivo da recusa, 15% não descreveriam todos os procedimentos e 25% não fariam o encaminhamento da paciente para outro profissional. CONCLUSãO: O abortamento previsto em lei, foi a situação mais objetada. Os fatores motivadores a esta recusa foram o alto comprometimento e maior religiosidade. Uma parcela razoável dos alunos não demonstrou ter conhecimentos éticos sobre o tema.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

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References

    1. Chavkin W, Leitman L, Polin K. for Global Doctors for Choice. Conscientious objection and refusal to provide reproductive healthcare: a White Paper examining prevalence, health consequences, and policy responses Int J Gynecol Obstet 2013123S41–S56.. Doi: 10.1016/S0020-7292(13)60002-8 - PubMed
    1. American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 385 November 2007: the limits of conscientious refusal in reproductive medicine Obstet Gynecol 2007110051203–1208.. Doi: 10.1097/01.AOG.0000291561.48203.27 - PubMed
    1. Nordberg E M, Skirbekk H, Magelssen M.Conscientious objection to referrals for abortion: pragmatic solution or threat to women's rights? BMC Med Ethics 20141515. Doi: 10.1186/1472-6939-15-15 - PMC - PubMed
    1. World Health Organization. Safe Abortion: Technical and Policy Guidance for Health Systems. 2nd ed Geneva: WHO; 2012 - PubMed
    1. Zampas C.Legal and ethical standards for protecting women's human rights and the practice of conscientious objection in reproductive healthcare settings Int J Gynaecol Obstet 201312303S63–S65.. Doi: 10.1016/S0020-7292(13)60005-3 - PubMed

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