Conscientious refusal in reproductive medicine: an educational intervention

Am J Obstet Gynecol. 2009 Nov;201(5):502.e1-7. doi: 10.1016/j.ajog.2009.05.056. Epub 2009 Aug 7.

Abstract

Objective: This study evaluates an educational intervention focusing on the ethical reasoning and communication skills necessary in counseling patients about morally objectionable medical interventions.

Study design: All students on the core clerkship in obstetrics and gynecology at the University of Miami Miller School of Medicine participated in a structured workshop. Students completed anonymous surveys before and after the workshop. Associations between the participants' change in comfort level in providing nondirective counseling and measured demographic variables were analyzed.

Results: Of 140 students, 37% (n = 52) positively changed their comfort level with nondirective options counseling; 10% (n = 14) negatively changed. Change in understanding of the physician's role was reported by 60% (n = 84). The exercise was rated as educationally valuable by 95% (n = 128), with 84% (n = 115) attesting that the workshop would help them "approach things differently."

Conclusion: Evaluation of multiple parameters demonstrated that this workshop heightened student awareness of the ethical and communications skills challenges posed by this clinical situation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Communication
  • Education, Medical*
  • Female
  • Humans
  • Male
  • Refusal to Treat / ethics*
  • Reproductive Medicine / ethics*
  • Surveys and Questionnaires