Cargando…

Integration of Catholic Values and Professional Obligations in the Provision of Family Planning Services: A Qualitative Study

IMPORTANCE: Religious leaders of the Catholic church created guidelines for practicing medicine, that involve reproductive care restrictions that may conflict with professional obligations. OBJECTIVE: To explore how Catholic obstetrician-gynecologists integrate their religious values and professiona...

Descripción completa

Detalles Bibliográficos
Autores principales: Marchin, Angela, Seale, Rebecca, Sheeder, Jeanelle, Teal, Stephanie, Guiahi, Maryam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7550969/
https://www.ncbi.nlm.nih.gov/pubmed/33044549
http://dx.doi.org/10.1001/jamanetworkopen.2020.20297
_version_ 1783593078945218560
author Marchin, Angela
Seale, Rebecca
Sheeder, Jeanelle
Teal, Stephanie
Guiahi, Maryam
author_facet Marchin, Angela
Seale, Rebecca
Sheeder, Jeanelle
Teal, Stephanie
Guiahi, Maryam
author_sort Marchin, Angela
collection PubMed
description IMPORTANCE: Religious leaders of the Catholic church created guidelines for practicing medicine, that involve reproductive care restrictions that may conflict with professional obligations. OBJECTIVE: To explore how Catholic obstetrician-gynecologists integrate their religious values and professional obligations related to family planning services. DESIGN, SETTING, AND PARTICIPANTS: In this qualitative investigation, in 2018, US-based obstetrician-gynecologists were recruited through an online survey and were invited to participate in audio-recorded telephone interviews using a semistructured interview guide. Participants were obstetrician-gynecologists who self-identified as Catholic and reported providing reproductive health care as follows: (1) provide natural family planning only (low practitioners), (2) provide additional contraceptive methods (moderate practitioners), and (3) provide family planning services including abortion (high practitioners). The study purposively sampled those with higher self-reported religiosity. Data were analyzed from November 2018 to February 2019. MAIN OUTCOMES AND MEASURES: The primary outcome was understanding how participants describe integration of Catholic values with family planning service provision. The telephone interviews explored their integration of Catholic values and professional obligations, and 3 coders analyzed the responses using grounded theory. RESULTS: Among the 34 Catholic obstetrician-gynecologists interviewed (27 women [79.4%]), there were 10 low, 15 moderate, and 9 high practitioners from 19 states. Participants’ description of morality was consistent with Albert Bandura’s Social-Cognitive Theory of Moral Thought and Action. The findings were used to create a modified framework. Within each group of physicians, 3 themes demonstrating their reconciliations between Catholic values and professional obligations emerged; each of these themes reflected one of the medical ethical principles of autonomy, beneficence, nonmaleficence, or justice. All 10 low practitioners primarily promoted natural family planning approaches to avoid iatrogenic risks and none provided abortion, reflecting nonmaleficence. Alternatively, moderate practitioners focused on nonmaleficence by offering contraception to prevent abortions. High practitioners primarily promoted patient autonomy by separating religious doctrine from medical practice. All had concerns for beneficence. In each group, 1 of the 4 medical ethical principles was underrepresented. CONCLUSIONS AND RELEVANCE: In this qualitative analysis, Catholic obstetrician-gynecologists establish their family planning care provision practices by emphasizing certain moral and/or ethical principles over others. These findings highlight how physician morality in the realm of family planning service provision often involves certain religious and/or professional reconciliations. Understanding the dilemmas Catholic obstetrician-gynecologists face can guide professional development efforts and inform ongoing discussions about conscientious objection and provision.
format Online
Article
Text
id pubmed-7550969
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher American Medical Association
record_format MEDLINE/PubMed
spelling pubmed-75509692020-10-19 Integration of Catholic Values and Professional Obligations in the Provision of Family Planning Services: A Qualitative Study Marchin, Angela Seale, Rebecca Sheeder, Jeanelle Teal, Stephanie Guiahi, Maryam JAMA Netw Open Original Investigation IMPORTANCE: Religious leaders of the Catholic church created guidelines for practicing medicine, that involve reproductive care restrictions that may conflict with professional obligations. OBJECTIVE: To explore how Catholic obstetrician-gynecologists integrate their religious values and professional obligations related to family planning services. DESIGN, SETTING, AND PARTICIPANTS: In this qualitative investigation, in 2018, US-based obstetrician-gynecologists were recruited through an online survey and were invited to participate in audio-recorded telephone interviews using a semistructured interview guide. Participants were obstetrician-gynecologists who self-identified as Catholic and reported providing reproductive health care as follows: (1) provide natural family planning only (low practitioners), (2) provide additional contraceptive methods (moderate practitioners), and (3) provide family planning services including abortion (high practitioners). The study purposively sampled those with higher self-reported religiosity. Data were analyzed from November 2018 to February 2019. MAIN OUTCOMES AND MEASURES: The primary outcome was understanding how participants describe integration of Catholic values with family planning service provision. The telephone interviews explored their integration of Catholic values and professional obligations, and 3 coders analyzed the responses using grounded theory. RESULTS: Among the 34 Catholic obstetrician-gynecologists interviewed (27 women [79.4%]), there were 10 low, 15 moderate, and 9 high practitioners from 19 states. Participants’ description of morality was consistent with Albert Bandura’s Social-Cognitive Theory of Moral Thought and Action. The findings were used to create a modified framework. Within each group of physicians, 3 themes demonstrating their reconciliations between Catholic values and professional obligations emerged; each of these themes reflected one of the medical ethical principles of autonomy, beneficence, nonmaleficence, or justice. All 10 low practitioners primarily promoted natural family planning approaches to avoid iatrogenic risks and none provided abortion, reflecting nonmaleficence. Alternatively, moderate practitioners focused on nonmaleficence by offering contraception to prevent abortions. High practitioners primarily promoted patient autonomy by separating religious doctrine from medical practice. All had concerns for beneficence. In each group, 1 of the 4 medical ethical principles was underrepresented. CONCLUSIONS AND RELEVANCE: In this qualitative analysis, Catholic obstetrician-gynecologists establish their family planning care provision practices by emphasizing certain moral and/or ethical principles over others. These findings highlight how physician morality in the realm of family planning service provision often involves certain religious and/or professional reconciliations. Understanding the dilemmas Catholic obstetrician-gynecologists face can guide professional development efforts and inform ongoing discussions about conscientious objection and provision. American Medical Association 2020-10-12 /pmc/articles/PMC7550969/ /pubmed/33044549 http://dx.doi.org/10.1001/jamanetworkopen.2020.20297 Text en Copyright 2020 Marchin A et al. JAMA Network Open. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Marchin, Angela
Seale, Rebecca
Sheeder, Jeanelle
Teal, Stephanie
Guiahi, Maryam
Integration of Catholic Values and Professional Obligations in the Provision of Family Planning Services: A Qualitative Study
title Integration of Catholic Values and Professional Obligations in the Provision of Family Planning Services: A Qualitative Study
title_full Integration of Catholic Values and Professional Obligations in the Provision of Family Planning Services: A Qualitative Study
title_fullStr Integration of Catholic Values and Professional Obligations in the Provision of Family Planning Services: A Qualitative Study
title_full_unstemmed Integration of Catholic Values and Professional Obligations in the Provision of Family Planning Services: A Qualitative Study
title_short Integration of Catholic Values and Professional Obligations in the Provision of Family Planning Services: A Qualitative Study
title_sort integration of catholic values and professional obligations in the provision of family planning services: a qualitative study
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7550969/
https://www.ncbi.nlm.nih.gov/pubmed/33044549
http://dx.doi.org/10.1001/jamanetworkopen.2020.20297
work_keys_str_mv AT marchinangela integrationofcatholicvaluesandprofessionalobligationsintheprovisionoffamilyplanningservicesaqualitativestudy
AT sealerebecca integrationofcatholicvaluesandprofessionalobligationsintheprovisionoffamilyplanningservicesaqualitativestudy
AT sheederjeanelle integrationofcatholicvaluesandprofessionalobligationsintheprovisionoffamilyplanningservicesaqualitativestudy
AT tealstephanie integrationofcatholicvaluesandprofessionalobligationsintheprovisionoffamilyplanningservicesaqualitativestudy
AT guiahimaryam integrationofcatholicvaluesandprofessionalobligationsintheprovisionoffamilyplanningservicesaqualitativestudy