Physician Assistants in OB/GYN Field Want More Ethics Expertise
Physician assistants (PAs) in OB/GYN feel unprepared for ethically challenging situations, researchers from the University of Chicago found.1 “Programs are not sufficiently preparing them to address the specific issues we face on a daily basis in OB/GYN,” says Julie Chor, MD, MPH, one of the study’s authors and assistant director of the MacLean Center for Clinical Medical Ethics at the University of Chicago.
Chor and colleagues interviewed 11 PAs at a large urban academic medical center who described discomfort with ethically challenging cases. Many did not recall any details about ethics education during their training. In 2015, Chor and a different research group surveyed OB/GYN program directors about ethics education in residency training.2 Those responses identified multiple barriers to ethics education: lack of structured curricula, limited time, and inadequate faculty expertise. Although all programs are required to provide some type of medical ethics instruction, how much is provided varies widely depending on the institution. “The PAs perceived they didn’t have much ethics training — specifically, not much in reproductive ethics,” Chor says.
Chor and colleagues are taking action on these findings by creating a joint case-based ethics curriculum for both PAs and residents. “Because they work so closely together, the goal is to get them to do the ethics education activities together,” Chor says.
The surveyed PAs named many ethical challenges they faced: end-of-life care, complex pregnancies, risks and benefits to mother and fetus, and counseling adolescents. The first step is recognizing that an ethical issue exists. “Even just being able to identify issues that may warrant an ethics consult, and taking the time to ask for assistance, is important,” Chor says.
- Steenbergh K, Fess E, Dade A, et al. PA perspectives on interprofessional ethics education in obstetrics/gynecology. JAAPA 2021;34:1.
- Byrne J, Straub H, DiGiovanni L, Chor J. Evaluation of ethics education in obstetrics and gynecology residency programs. Am J Obstet Gynecol 2015;212:397.e1-8.
Survey respondents named many ethical challenges they faced: end-of-life care, complex pregnancies, risk and benefits to mother and fetus, and counseling adolescents.
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