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Still a moral dilemma: how Ethiopian professionals providing abortion come to terms with conflicting norms and demands.
BMC Medical Ethics ( IF 2.7 ) Pub Date : 2020-02-11 , DOI: 10.1186/s12910-020-0458-7
Demelash Bezabih Ewnetu 1, 2 , Viva Combs Thorsen 3 , Jan Helge Solbakk 2 , Morten Magelssen 2
Affiliation  

BACKGROUND The Ethiopian law on abortion was liberalized in 2005. However, as a strongly religious country, the new law has remained controversial from the outset. Many abortion providers have religious allegiances, which begs the question how to negotiate the conflicting demands of their jobs and their commitment to their patients on the one hand, and their religious convictions and moral values on the other. METHOD A qualitative study based on in-depth interviews with 30 healthcare professionals involved in abortion services in either private/non-governmental clinics or in public hospitals in Addis Ababa, Ethiopia. Transcripts were analyzed using systematic text condensation, a qualitative analysis framework. RESULTS For the participants, religious norms and the view that the early fetus has a moral right to life count against providing abortion; while the interests and needs of the pregnant woman supports providing abortion services. The professionals weighed these value considerations differently and reached different conclusions. One group appears to have experienced genuine conflicts of conscience, while another group attempted to reconcile religious norms and values with their work, especially through framing provision of abortion as helping and preventing harm and suffering. The professionals handle this moral balancing act on their own. In general, participants working in the private sector reported less moral dilemma with abortion than did their colleagues from public hospitals. CONCLUSIONS This study highlights the difficulties in reconciling tensions between religious convictions and moral norms and values, and professional duties. Such insights might inform guidelines and healthcare ethics education.

中文翻译:

仍然存在道德困境:提供堕胎的埃塞俄比亚专业人员如何以相互矛盾的规范和要求达成协议。

背景技术埃塞俄比亚的堕胎法在2005年得到了放宽。但是,作为一个虔诚的宗教国家,新法律从一开始就一直引起争议。许多堕胎提供者都有宗教信仰,一方面提出了一个问题,即如何就工作上相互矛盾的要求和对患者的承诺进行谈判,另一方面又提出了宗教信仰和道德价值观。方法一项定性研究,基于对埃塞俄比亚亚的斯亚贝巴的私人/非政府诊所或公立医院从事流产服务的30名医疗专业人员的深入访谈。使用系统的文本压缩(定性分析框架)分析成绩单。结果对于参与者,宗教规范以及认为早期胎儿具有生命的道德权利的观点不利于提供堕胎;孕妇的利益和需求支持提供堕胎服务。专业人士对这些价值考虑因素的权衡不同,得出不同的结论。一个小组似乎经历了真正的良心冲突,而另一小组则试图调和宗教准则和价值观与其工作,特别是通过将堕胎规定为帮助和预防伤害和痛苦的框架。专业人士自行处理这种道德平衡行为。一般而言,在私营部门工作的参与者报告的堕胎道德困境比公立医院的同事要少。结论本研究强调了调和宗教信仰与道德规范和价值观以及职业职责之间的紧张关系的困难。这些见解可能会为准则和医疗保健道德教育提供参考。
更新日期:2020-04-22
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