Background

The Ethical and Religious Directives (ERDs) guide the delivery of health care in Catholic hospitals across the United States.

Purpose

This study seeks to understand the perceptions and experiences of medical trainees in a Catholic health care system on key ethical issues pertaining to the ERDs.

Methods

Medical students from a Jesuit Catholic university were recruited via email to complete a self-administered online survey on seven contemporary ethical issues: Catholic Healthcare Systems as Safety Nets; Contraception and Sexually Transmitted Infection (STI) Prevention; Gender-Affirming Care; Fertility; Maternal Endangerment and Pregnancy Termination; Elderly Care; and Brain Death and Organ Donation. Each student ranked the seven issues in order of priority and responded to further questions for the top three issues ranked. Free responses were analyzed with reflexive thematic analysis with an interpretivist approach.

Results

Forty respondents (40/972; 4.12%) completed the entire survey. Maternal endangerment was the most commonly selected issue (N = 37). A statistically significant association was identified between religion (observance and self-identification) and the selection of Contraception and STI Prevention (p = 1.0 × 10⁻⁴; p = 0.011, respectively). In qualitative analysis, concern for patient welfare, navigation of value conflicts, and expression of uncertainty emerged across themes.

Conclusion

The findings of this study suggest that medical students’ ethical reasoning and experiences may be in tension with the ERDs. Recommendations include promotion of familiarity and alignment with the ERDs through the exploration of specific scenarios and exposure to ERD-coherent practices throughout medical training.

Non-Technical Summary

Medical students from a Jesuit Catholic university were surveyed for their opinions on seven contemporary issues related to the Ethical and Religious Directives, which guide Catholic healthcare provision in the United States. The issue of Maternal Endangerment and Pregnancy Termination was the most commonly chosen topic. An association between religion and selection of the topic of Contraception was detected. Free responses across topics demonstrated concern for patient welfare, navigation of value conflicts, and expressions of uncertainty.

Short Summary

Medical students from a Jesuit Catholic university were surveyed for their opinions on the Ethical and Religious Directives.