RESUMO
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.
Assuntos
Catolicismo , Anticoncepcionais Pós-Coito , Serviço Hospitalar de Emergência , Tratamento de Emergência/estatística & dados numéricos , Hospitais Religiosos , Consentimento Livre e Esclarecido/estatística & dados numéricos , Educação de Pacientes como Assunto/estatística & dados numéricos , Estupro/estatística & dados numéricos , Consciência , Serviço Hospitalar de Emergência/organização & administração , Tratamento de Emergência/métodos , Ética Médica , Feminino , Hospitais Urbanos , Humanos , Consentimento Livre e Esclarecido/legislação & jurisprudência , Política Organizacional , Educação de Pacientes como Assunto/legislação & jurisprudência , Educação de Pacientes como Assunto/métodos , Recursos Humanos em Hospital , Serviço de Farmácia Hospitalar/organização & administração , Projetos Piloto , Gravidez , Gravidez não Desejada , Estupro/legislação & jurisprudência , Encaminhamento e Consulta/estatística & dados numéricos , Religião e Medicina , Inquéritos e Questionários , Estados UnidosRESUMO
The disclosure of sensitive information concerning mental health, drug and alcohol use, and communicable diseases requires express patient consent under federal and state laws. This paper presents the results of a retrospective medical record abstraction of hospital consent-to-treatment and release-of-information forms, examining whether the forms are present in the records, and, if so, whether they are signed by patients. The results suggest that patients who have sensitive information in their medical records or pay out of pocket for their care are less likely to consent to disclosure of their records. We discuss the implications of these results and recommend further research to understand patients' perceptions of medical confidentiality and the processes used for securing consent to hospital treatment.