Informed consent for emergency contraception: variability in hospital care of rape victims.
There is growing concern that rape victims are not provided with emergency contraceptives in many hospital emergency rooms, particularly in Catholic hospitals. In a small pilot study, we examined policies and practices relating to providing information, prescriptions, and pregnancy prophylaxis in emergency rooms. We held structured telephone interviews with emergency department personnel in 58 large urban hospitals, including 28 Catholic hospitals, from across the United States. Our results showed that some Catholic hospitals have policies that prohibit the discussion of emergency contraceptives with rape victims, and in some of these hospitals, a victim would learn about the treatment only by asking. Such policies and practices are contrary to Catholic teaching. More seriously, they undermine a victim's right to information about her treatment options and jeopardize physicians' fiduciary responsibility to act in their patients' best interests. We suggest that institutions must reevaluate their restrictive policies. If they fail to do so, we believe that state legislation requiring hospitals to meet the standard of care for treatment of rape victims is appropriate.
Smugar
S S
SS
Medical Center, Philadelphia, USA.
Spina
B J
BJ
Merz
J F
JF
D002410:Catholicism; D003242:Conscience; D003281:Contraceptives, Postcoital; D004636:Emergency Service, Hospital / Q000458:organization & administration; D004638:Emergency Treatment / Q000379:methods / Q000706:statistics & numerical data*; D004992:Ethics, Medical; D005260:Female; D016519:Hospitals, Religious; D006786:Hospitals, Urban; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D016134:Organizational Policy; D010353:Patient Education as Topic / Q000331:legislation & jurisprudence / Q000379:methods / Q000706:statistics & numerical data*; D010564:Personnel, Hospital; D010607:Pharmacy Service, Hospital / Q000458:organization & administration; D010865:Pilot Projects; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D011902:Rape / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012068:Religion and Medicine; D011795:Surveys and Questionnaires; D014481:United States
D003281:Contraceptives, Postcoital