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“Obviously there is a conflict between confidentiality and what you are required to do by law”: Chilean university faculty and student perspectives on reporting unlawful abortions
"بدیهی است که بین محرمانه بودن و آنچه که شما باید توسط قانون انجام دهید تضاد وجود دارد": دانشکده دانشگاه شیلی و دیدگاه دانشجویان در مورد گزارش سقط جنین غیرقانونی-2020 Background and objectives: While Chile recently decriminalized abortion in cases of rape, lethal fetal anomaly,
and to save a womans life, most abortions are still criminalized. We assessed medical and midwifery school
faculty and students views on punishing and reporting people involved in unlawful abortion, and their understanding
of their obligation to protect patient confidentiality and to report unlawful abortions.
Methods: We interviewed 30 medical and midwifery school clinician faculty from seven public, private, secular
and Catholic-affiliated universities, all located in the metropolitan region of Santiago, Chile. Medical (n = 239)
and midwifery (n = 79) students at these same seven universities completed an online survey. We coded faculty
interview transcripts, and analyzed codes related to maintaining patient confidentiality and reporting unlawful
abortion. We summarized student views related to reporting and imprisoning people involved in unlawful
abortion, and used general estimating equation (GEE) models to identify the factors associated with support for
criminalization.
Results: Faculty and students generally did not support reporting or imprisoning anyone involved in an unlawful
abortion and believed that protecting patient information takes precedence over reporting. Yet, faculty described
pressures to report in the public sector and several cases where they or their colleagues were involved in reports.
Most students somewhat/strongly agreed (78%) that patient information concerning an unlawful abortion
should be kept confidential; 35% strongly/somewhat agreed that a clinician involved in an unlawful surgical
abortion should be imprisoned, and 18% agreed that the woman involved should be imprisoned, with students
from secular universities being significantly less likely to support reporting and punishing people involved in
unlawful abortion, than students from Catholic universities.
Discussion: There is a need to clarify clinicians ethical obligations in abortion care, in particular in Catholic
universities, so that they can ensure that their patients have access to high quality confidential health care
services. Keywords: Abortion | Confidentiality | Healthcare systems | Higher education | Religion | Neoliberalism | Chile | Latin America |
مقاله انگلیسی |
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Alcohol and the Law
الکل و قانون-2019 It is important for physicians to be aware of the local procedures for reporting alcohol use
and related impairment and to have some knowledge of the law applicable in the jurisdiction
where they practice.
The physician’s duty is patient education with an ethical and legal duty to warn the patient
of the adverse personal and societal effects of alcohol. If possible, family support should
be enlisted and alcohol rehabilitation efforts pursued.
The physician should explicitly document all good faith efforts to accomplish these
initiatives.
Warning third parties of the potential for harm related to an individual patient’s alcoholrelated
impairment may involve a breach of patient confidentiality.
Disclosure to a third party should be undertaken only if the risk of significant harm exceeds
the burden that will result to the patient from warning others. Although specific laws, KEYWORDS : Alcohol | Law | Public safety | Alcohol-related impairment | Patient confidentiality |
مقاله انگلیسی |