{"title":"选择提供：爱尔兰的早期医学堕胎与临床医生的良知》（Early Medical Abortion and Clinician Conscience in Ireland）。","authors":"Mary Donnelly, Claire Murray","doi":"10.1007/s10728-024-00490-2","DOIUrl":null,"url":null,"abstract":"<p><p>Providers are essential to the delivery of abortion care. Yet, they often occupy an ambiguous space in political discourse around abortion. The introduction of a new abortion service in Ireland invites us to look afresh at providers. Since the Health (Regulation of Termination of Pregnancy) Act 2018 came into force, by far the most common form of abortion care has been early medical abortion (EMA). This is typically provided by General Practitioners (GPs), with approximately 10% of GPs having chosen to provide EMA. This article draws on an empirical study of providers to investigate their motivations for, and experiences of, provision and their views on colleagues who have not chosen to provide. The study shows that for many providers, the choice to provide was grounded in a moral commitment to protecting women's rights to autonomy and health and ensuring that the harms of the past were not repeated. The article argues that notwithstanding increased normalisation of EMA in Ireland, conscience still has a role to play in abortion care provision and it is important to reflect on the various aspects of this role.</p>","PeriodicalId":46740,"journal":{"name":"Health Care Analysis","volume":" ","pages":"165-183"},"PeriodicalIF":1.8000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390768/pdf/","citationCount":"0","resultStr":"{\"title\":\"Choosing to Provide: Early Medical Abortion and Clinician Conscience in Ireland.\",\"authors\":\"Mary Donnelly, Claire Murray\",\"doi\":\"10.1007/s10728-024-00490-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Providers are essential to the delivery of abortion care. Yet, they often occupy an ambiguous space in political discourse around abortion. The introduction of a new abortion service in Ireland invites us to look afresh at providers. Since the Health (Regulation of Termination of Pregnancy) Act 2018 came into force, by far the most common form of abortion care has been early medical abortion (EMA). This is typically provided by General Practitioners (GPs), with approximately 10% of GPs having chosen to provide EMA. This article draws on an empirical study of providers to investigate their motivations for, and experiences of, provision and their views on colleagues who have not chosen to provide. The study shows that for many providers, the choice to provide was grounded in a moral commitment to protecting women's rights to autonomy and health and ensuring that the harms of the past were not repeated. The article argues that notwithstanding increased normalisation of EMA in Ireland, conscience still has a role to play in abortion care provision and it is important to reflect on the various aspects of this role.</p>\",\"PeriodicalId\":46740,\"journal\":{\"name\":\"Health Care Analysis\",\"volume\":\" \",\"pages\":\"165-183\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11390768/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health Care Analysis\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10728-024-00490-2\",\"RegionNum\":3,\"RegionCategory\":\"哲学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ETHICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Care Analysis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10728-024-00490-2","RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ETHICS","Score":null,"Total":0}
引用次数: 0
摘要
提供者对于提供堕胎护理至关重要。然而，在有关堕胎的政治讨论中，她们往往占据着模糊的位置。爱尔兰引入新的堕胎服务，促使我们重新审视提供者。自 2018 年《健康（终止妊娠监管）法案》生效以来，迄今为止最常见的堕胎护理形式是早期药物流产（EMA）。这通常由全科医生（GP）提供，约有 10%的全科医生选择提供 EMA。本文通过对提供者的实证研究，调查他们提供服务的动机和经历，以及他们对未选择提供服务的同事的看法。研究表明，对许多提供者而言，选择提供是基于对保护妇女自主权和健康权以及确保过去的伤害不再重演的道德承诺。文章认为，尽管 EMA 在爱尔兰日趋正常化，但良知在提供堕胎护理方面仍可发挥作用，对这一作用的各个方面进行反思非常重要。
Choosing to Provide: Early Medical Abortion and Clinician Conscience in Ireland.
Providers are essential to the delivery of abortion care. Yet, they often occupy an ambiguous space in political discourse around abortion. The introduction of a new abortion service in Ireland invites us to look afresh at providers. Since the Health (Regulation of Termination of Pregnancy) Act 2018 came into force, by far the most common form of abortion care has been early medical abortion (EMA). This is typically provided by General Practitioners (GPs), with approximately 10% of GPs having chosen to provide EMA. This article draws on an empirical study of providers to investigate their motivations for, and experiences of, provision and their views on colleagues who have not chosen to provide. The study shows that for many providers, the choice to provide was grounded in a moral commitment to protecting women's rights to autonomy and health and ensuring that the harms of the past were not repeated. The article argues that notwithstanding increased normalisation of EMA in Ireland, conscience still has a role to play in abortion care provision and it is important to reflect on the various aspects of this role.
期刊介绍：
Health Care Analysis is a journal that promotes dialogue and debate about conceptual and normative issues related to health and health care, including health systems, healthcare provision, health law, public policy and health, professional health practice, health services organization and decision-making, and health-related education at all levels of clinical medicine, public health and global health. Health Care Analysis seeks to support the conversation between philosophy and policy, in particular illustrating the importance of conceptual and normative analysis to health policy, practice and research. As such, papers accepted for publication are likely to analyse philosophical questions related to health, health care or health policy that focus on one or more of the following: aims or ends, theories, frameworks, concepts, principles, values or ideology. All styles of theoretical analysis are welcome providing that they illuminate conceptual or normative issues and encourage debate between those interested in health, philosophy and policy. Papers must be rigorous, but should strive for accessibility – with care being taken to ensure that their arguments and implications are plain to a broad academic and international audience. In addition to purely theoretical papers, papers grounded in empirical research or case-studies are very welcome so long as they explore the conceptual or normative implications of such work. Authors are encouraged, where possible, to have regard to the social contexts of the issues they are discussing, and all authors should ensure that they indicate the ‘real world’ implications of their work. Health Care Analysis publishes contributions from philosophers, lawyers, social scientists, healthcare educators, healthcare professionals and administrators, and other health-related academics and policy analysts.
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