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7. Conflicting Values Encountered by Health Professionals
- Vanderbilt University Press
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63 7 Conflicting Values Encountered by Health Professionals When I (AF) was a medical intern, in the 1950s, I worked in the emergency department of a hospital in Chile. My schedule was Monday through Saturday from 6:30 to 9:00 p.m., in addition to one night in six and one full Sunday in six. Because the shift chief knew that I had already decided to specialize in obstetrics and gynecology, soon after my internship began, I was sent to work in the “curettage” room, where incomplete abortions were treated. There were so many that, I often spent the whole two and a half hours of my shift doing nothing but curettage, particularly on Friday and Saturday evenings. At the time, the prevailing culture in medicine was to treat women who had abortions as criminals. Members of the public health system staff felt that they had the authority to accuse, judge, and condemn every woman with abortion complications and make them all suffer the pain of the curettage without anesthesia of any kind. If a woman dared to complain, she was verbally abused: She had to pay for yielding to the pleasures of sex without assuming the responsibility of motherhood. The presumption was that (1) she had wanted to have sex, (2) she had enjoyed it, (3) she had not prevented the pregnancy because she was irresponsible, and (4) her reasons for not wanting to continue the pregnancy were selfish. At first I bought into this line of thought, but as I began to listen to the women’s stories, it become increasingly clear that in almost every case, some or all of of the four presumptions listed above were incorrect. My initial condemnation of these women shifted to understanding and compassion. I rebelled against a society that pushed women into a situation where they saw no other choice but 64 The Human Drama of Abortion to submit to the risk and pain of an unsafe abortion. I also came to realize that the abortion epidemic that was rapidly growing in the country at the time was just the sum of numerous examples of “exceptional circumstances” and that each woman had a valid justification for deciding to terminate her pregnancy. At the same time, I was under the illusion that it would be possible to prevent abortions if women knew about and had access to effective contraceptive methods. It took some time and accumulated experience to realize that some abortions will always occur. Health Professionals and the Value of Life For health care providers, saving lives is the primary goal, and for those who care for a pregnant woman, this goal includes both the life of the potential mother and that of her offspring. It is with this perspective in mind that we consider the reasons and circumstances under which health care providers reach the decision to accept or reject a woman’s request to terminate a pregnancy. Most young students are motivated to enter medical school by the desire to help people by means of curing diseases and saving lives. Many of them have witnessed the skillful and timely intervention of a physician who alleviated the suffering of a friend or relative. Therefore, right from the very beginning of a career in medicine, the main motivation of medical students is to acquire the power to save lives through the knowledge and experience gained during the training process. When the time comes to choose a specialty, those who choose obstetrics are typically motivated by the ability to contribute to the process of bringing new life into the world. The miracle of birth is the most positive experience any person can have, in contrast to the other extreme in a physician’s duties, that of helping a patient to die without pain and with the greatest possible dignity Obstetricians and the Fetus Obstetrics is an extremely rewarding medical specialty, and those who practice it feel most satisfied by the birth of a healthy infant. In difficult cases, particularly if the baby’s life was at considerable risk during labor and delivery, obstetricians are rewarded with the legitimate pride of having been instrumental in “giving” the mother a healthy child. This feeling of power and gratification is reinforced by the appreciation that [3.91.106.157] Project MUSE (2024-03-29 13:44 GMT) Conflicting Values Encountered by Health Professionals 65 mothers often express to their obstetricians weeks, months, or even years later. The obstetrician’s work is as dedicated to...