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CC BY 4.0 · Rev Bras Ginecol Obstet 2018; 40(10): 599-605
DOI: 10.1055/s-0038-1673367
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

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

Prevalência, atitudes e fatores motivadores à objeção consciente com relação à saúde reprodutiva entre estudantes de medicina
Omar Ismail Santos Pereira Darzé
1   Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
,
Ubirajara Barroso Júnior
1   Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil
› Author Affiliations
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Publication History

19 March 2018

07 July 2018

Publication Date:
23 October 2018 (online)

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Abstract

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.

Resumo

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.

Keywords

legal abortion - adolescence - reproductive rights - medical education - women's health

Descritores

aborto legal - adolescência - direito reprodutivo - educação médica - saúde da mulher

Contributors

Darzé O. I. S. P. and Barroso Júnior U. contributed with the project and the interpretation of data, the writing of the article, the critical review of the intellectual content, and the final approval of the version to be published.


 

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