Abstract
Objective
In obstetrical and gynaecological healthcare, patients often find themselves in a
vulnerable position. Sensitive issues such as sexual and reproductive health are addressed
and certain procedures can be experienced as abusive. According to research a lifetime
prevalence of abuse in healthcare (AHC) can be assumed for 13–28% of female patients
in the Nordic countries. In the present study we analyse the content of ethical documents
for healthcare professionals within obstetrics and gynaecology in Sweden, in order
to find out to what extent ethical guidelines consider issues that have shown to be
related to the occurrence of AHC.
Study design
We searched the literature to find empirical data on AHC. Guidelines for nurses, midwives
and physicians were selected. After developing an analytical framework based on the
empirical data the content of the ethical guidelines was analysed.
Results
The various ethical guidelines for staff working within obstetrics and gynaecology
differ distinctively from each other regarding their content of issues that are related
to AHC. Issues that were mostly disregarded were: considering the patient's perspective
and the patients’ possible experience of violence, considering power imbalances within
healthcare, sexual misconduct, how to deal with other professional's ethical misconduct
and how professionals relate to each other. We found the ethical guidelines of the
International Federation of Gynecology and Obstetrics (FIGO) and of the International
Confederation of Midwives to be those which contained most of the issues that have
empirically shown to be important in regard to AHC.
Conclusion
While staff members from different professions may share responsibility for the same
patient, their ethical guidelines vary considerably. To become a possible resource
for prevention of AHC, we suggest that ethical guidelines in healthcare should be
revised following empirical research on ethical conduct. As ethical guidelines cannot
be effective by their existence only, we would like to initiate a discussion on the
function and use of ethical guidelines in general and regarding AHC in particular.
Being aware that ethical guidelines are only a part of ethics in healthcare, however,
we envision a broader approach to the aim of preventing AHC, where research is encouraged
on how a virtue ethics approach could be applied.
Keywords
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Article info
Publication history
Published online: August 08, 2012
Accepted:
July 24,
2012
Received in revised form:
May 28,
2012
Received:
December 31,
2011
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
