Conscientious objections in medicine for abortions among the undergraduate medical students: a questionnaire-based survey

Authors

  • Oliver Dsouza Department of Community Medicine, Fr. Muller Medical College, Mangalore, Karnataka, India
  • Keerthi S. Yalaburgi Department of Community Medicine, USM-KLE International Medical Programme, Belgaum, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20221769

Keywords:

Abortion, Conscientious objection, Religion, Referral

Abstract

Background: Conscientious objection (CO) in medicine is less a focused area of research in India.

Methods: In this questionnaire-based survey, responses from the students undergoing M.B.B.S./undergraduate training program from two medical colleges on voluntary abortion in general, and pertaining to the rape victims was obtained. We assessed the prevalence, influence of various factors and preference for referrals in CO towards abortion among the participants.

Results: Of the 900 students approached, 765 (85.0%) (females 68%) completed and returned the questionnaire, of whom 63.5% had an urban background, 48.0% were Christians and 52.0% were non-Christians (Muslim-5.4%; Hindu-46.5%). Only 9.7% had CO (p=0.000). There was a greater acceptance to abortion irrespective of gender and area of residence, except for gestational age beyond 20 weeks. Non-Christians were likely to have no objections towards abortion (p<005). Christians did not have CO for congenital abnormalities in pregnancy <20 weeks (60%), raped minor, (<20 weeks, 74%; beyond 20 weeks, 61%). Among the students who had CO, irrespective of religion majority had no issues with referring the woman to another doctor. The only exception to this norm was among the non-Christian students, who in case of raped minor <20 weeks were more likely (60%) to not refer.

Conclusions: CO is less prevalent among the Indian medical students and is towards voluntary termination of pregnancy, pregnancy beyond 20 weeks, when existed. Medical students were considerate towards rape victims. Religion plays a significant influential role in shaping the beliefs.

References

Savulescu J, Schuklenk U. Doctors Have no Right to Refuse Medical Assistance in Dying, Abortion or Contraception. Bioethics. 2017;31:162-10.

Fiala C, Gemzell Danielsson K, Heikinheimo O, Guðmundsson JA, Arthur J. Yes we can! Successful examples of disallowing 'conscientious objection' in reproductive health care. Eur J Contracept Reprod Health Care. 2016;21:201-6.

Harries J, Constant D. Providing safe abortion services: Experiences and perspectives of providers in South Africa. Best Pract Res Clin Obstet Gynaecol. 2019;62.

Ballantyne A, Gavaghan C, Snelling J. Doctors' rights to conscientiously object to refer patients to abortion service providers. N Z Med J. 2019;132:64-71.

Fiala C, Arthur JH. There is no defence for 'Conscientious objection' in reproductive health care. Eur J Obstet Gynecol Reprod Biol. 2017;216:254-8.

Heino A, Gissler M, Apter D, Fiala C. Conscientious objection and induced abortion in Europe. Eur J Contracept Reprod Health Care. 2013;18:231-3.

Bo M, Zotti CM, Charrier L. Conscientious objection and waiting time for voluntary abortion in Italy. Eur J Contracept Reprod Health Care. 2015;20:272-82.

Shahvisi A. Conscientious objection: a morally insupportable misuse of authority. Clin Ethics. 2018;13:82-7.

Harter TD. Why Tolerate Conscientious Objections in Medicine. HEC Forum. 2019;33(3):175-188.

Nieminen P, Lappalainen S, Ristimäki P, Myllykangas M, Mustonen AM. Opinions on conscientious objection to induced abortion among Finnish medical and nursing students and professionals. BMC Med Ethics. 2015;16:17.

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. 2013;123(3):41-56.

Singh S, Shekhar C, Acharya R, Moore AM, Stillman M, Pradhan MR, et al. The incidence of abortion and unintended pregnancy in India, 2015. Lancet Glob Health. 2018;6:e111-20.

Yokoe R, Rowe R, Choudhury SS, Rani R, Zahir F, Nair M. Unsafe abortion and abortion-related death among 1.8 million women in India. BMJ Glob Health. 2019;4:e001491.

Ayyavoo C, Kannan J, Ayyavoo A. Would abortion services in India benefit from lesser hurdles? J Evid Based Med Healthcare. 2018;5:2890-4.

Stulberg DB, Dude AM, Dahlquist I, Curlin FA. Abortion provision among practicing obstetrician-gynecologists. Obstet Gynecol. 2011;118:609-14.

Zareba K, Ciebiera M, Gierus J, Jakiel G. Perceptions of attending medical staff by women accessing pregnancy termination in Poland: a qualitative study. Eur J Contracept Reprod Health Care. 2019;24:124-9.

Strickland SL. Conscientious objection in medical students: a questionnaire survey. J Med Ethics. 2012;3822-5.

Hagen GH, Hage CØ, Magelssen M, Nortvedt P. Attitudes of medical students towards abortion. Tidsskr Nor Laegeforen. 2011;131:1768-71.

Moure Soengas A, Cernadas Ramos A. Perception of medical students in Galicia (Spain) regarding conscientious objection to the voluntary termination of pregnancy. Gac Sanit. 2020;34:150-6.

Macfarlane E, Paterson H. A survey of the views and practices of abortion of the New Zealand Fellows and trainees of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Aust N Z J Obstet Gynaecol. 2020;60:296-301.

Green J. Ethics and late termination of pregnancy. Lancet. 1993;342:1179.

Savulescu J. Is current practice around late termination of pregnancy eugenic and discriminatory? Maternal interests and abortion. J Med Ethics. 2001;27:165-71.

Darzé OISP, Barroso Júnior U. Prevalence, Attitudes, and Factors Motivating Conscientious Objection toward Reproductive Health among Medical Students. Rev Bras Ginecol Obstet. 2018;40:599-605.

Nordstrand S, Nordstrand M, Nortvedt P, Magelssen M. Medical students’ attitudes towards conscientious objection: a survey. J Med Ethics. 2013;40:609-12.

Catechism of the Catholic Church – IntraText. Vatican.va. 2020. Available at: https://www.vatican.va/archive/ENG0015/__P7Z.HTM#-2C5. Accessed on 11 January 2020.

Nordstrand S, Nordstrand M, Nortvedt P, Magelssen M. Medical students’ attitudes towards conscientious objection: a survey. J Med Ethics. 2013;40:609-12.

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Published

2022-06-28

How to Cite

Dsouza, O., & Yalaburgi, K. S. (2022). Conscientious objections in medicine for abortions among the undergraduate medical students: a questionnaire-based survey. International Journal Of Community Medicine And Public Health, 9(7), 2974–2980. https://doi.org/10.18203/2394-6040.ijcmph20221769

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Original Research Articles