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Conflicts in Care for Obstetric Complications in Catholic Hospitals

机译：天主教医院产科并发症的护理冲突

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Background: A recent national survey revealed that over half of obstetrician-gynecologists working in Catholic hospitals have conflicts with religious policies, but the survey did not elucidate the nature of the conflicts. Our qualitative study examines the nature of physician conflicts with religious policies governing obstetriciangynecologist (ob-gyn) care. Results related to restrictions on the management of obstetric complications are reported here. Methods: In-depth interviews lasting about one hour were conducted with obstetrician-gynecologists throughout the United States. Questions focused on physicians' general satisfaction with their hospital work settings and specific experiences with religious doctrine-based ob-gyn policies in the various hospitals where they have worked. Results: Conflicts reported here include cases in which Catholic hospital religious policy (Ethical and Religious Directives for Catholic Health Care Services) impacted physicians' abilities to offer treatment to women experiencing certain obstetric emergencies, such as pregnancy-related health problems, molar pregnancy, miscarriage, or previable premature rupture of membranes (PPROM), because hospital authorities perceived treatment as equivalent to a prohibited abortion. Physicians were contractually obligated to follow doctrine-based policies while practicing in these Catholic hospitals. Conclusions: For some physicians, their hospital's prohibition on abortion initially seemed congruent with their own principles, but when applied to cases in which patients were already losing a desired pregnancy and/or the patient's health was at risk, some physicians found the institutional restrictions on care to be unacceptable.
机译：背景：最近的一项全国调查显示，在天主教医院工作的妇产科医生中，有一半以上与宗教政策存在冲突，但该调查并未阐明冲突的性质。我们的定性研究检查了医师与管理妇产科医生（ob-gyn）护理的宗教政策冲突的性质。此处报道了与限制产科并发症相关的结果。方法：在美国各地的妇产科医生进行了大约一小时的深度访谈。问题集中在医生对他们医院工作环境的总体满意度以及在他们所工作的各家医院中基于宗教教义的妇产科政策的具体经验方面。结果：此处报告的冲突包括天主教医院的宗教政策（《天主教健康护理服务的道德和宗教指示》）影响医生为遭受某些产科急症（例如与怀孕有关的健康问题，磨牙，磨牙，流产）的妇女提供治疗的能力的情况。或可避免的胎膜早破（PPROM），因为医院当局认为治疗等同于禁止流产。在这些天主教医院执业时，内科医师有合同义务遵守基于教义的政策。结论：对于一些医生来说，医院禁止流产起初看起来与他们自己的原则是一致的，但是当应用于已经失去期望怀孕和/或患者健康处于危险之中的情况时，一些医生发现医院的制度限制照顾得不能接受。

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