Name:
Publisher version
View Source
Access full-text PDFOpen Access
View Source
Check access options
Check access options
Average rating
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Star rating
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Journal title
European journal of obstetrics, gynecology, and reproductive biologyDate Published
2016-08-31Publication Volume
206Publication Begin page
36Publication End page
40
Metadata
Show full item recordAbstract
Objective: Given the same set of "facts" (e.g. fetal prognosis) different physicians may not give the same advice to patients. Studies have shown that people differ in how they prioritize moral domains, but how those domains influence counseling and management has not been assessed among obstetricians. Our objective was to see if, given the same set of facts, obstetricians' counseling would vary depending on their prioritization of moral domains.Design: Obstetricians completed questionnaires that included validated scales of moral domains (e.g. autonomy, community, divinity), demographic data, and hypothetical scenarios (e.g. how aggressively they would pursue the interests of a potentially compromised child, the degree of deference they gave to parents' choices, and their relative valuation of fetal rights and women's rights). Multivariate logistic regression using backwards conditional selection was used to explore how participants responded to the moral dilemma scenarios.
Results: Among the 249 participating obstetricians there was wide variation in counseling, much of which reflected differences in prioritization of moral domains. For example, requiring a higher likelihood of neonatal survival before recommending a cesarean section with cord prolapse was associated with Fairness/Reciprocity, an autonomy domain which emphasizes treating individuals equally (OR=1.42, 90% CI=1.06-1.89, p=0.05). Honoring parents' request to wait longer to suspend attempts to resuscitate an infant with no heart rate or pulse was associated with the community domains (involving concepts of loyalty and hierarchy) of In-Group/Loyalty; OR 1.30, 90% CI=1.04-1.62, p=0.05 and Authority/Respect (OR=1.34, 90% CI=1.06-1.34, p=0.045). Carrying out an unconsented cesarean section was associated with In-Group Loyalty (OR=1.26, 90% CI=1.01-1.56, p=0.08) and religiosity (OR=1.08, 90% CI=1.00-1.16, p=0.08).
Conclusion: The advice that patients receive may vary widely depending on the underlying moral values of obstetricians. Physicians should be aware of their "biases" in order to provide the most objective counseling possible.
Citation
Minkoff H, Zafra K, Amrita S, Wilson TE, Homel P. Physician morality and perinatal decisions. Eur J Obstet Gynecol Reprod Biol. 2016 Nov;206:36-40. doi: 10.1016/j.ejogrb.2016.08.042. Epub 2016 Aug 31. PMID: 27614269.DOI
10.1016/j.ejogrb.2016.08.042ae974a485f413a2113503eed53cd6c53
10.1016/j.ejogrb.2016.08.042
Scopus Count
Collections
The following license files are associated with this item:
- Creative Commons
Except where otherwise noted, this item's license is described as Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.