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INTERNATIONAL MEETING OF CATHOLIC
OBSTETRICIANS AND GYNAECOLOGISTS
Rome, June 17-20, 2001
IMPLICATIONS OF THE PRECEPTS OF THE CATHOLIC CHURCH
IN OB-GYN PRACTICE AT A CATHOLIC MEDICAL COLLEGE HOSPITAL
Rosily.I.K. (SR.Rose Jophy), Asst. Professor, OBG.
Mhaskar.A., Professor and head of the department of OBG.
Rev.Dr. Kalam.T, Director, St. John's Medical college and hospital.
Address: Dr. Sr. Rose Jophy, Asst. Professor, OBG, Department of Obstetrics and Gynaecology,
St. John's Medical College and Hospital, Bangalore 560034, India. <stjohnsblr@vsnl.net.in>

INTRODUCTION

The Church's teaching on the regulation of birth is clear. The church promotes responsible parenthood using methods which are in tune with the intention of the creator. The aim of this teaching is as given in St. John's Gospel, Chapter 10, Verses 10 "I came that they may have life, and have it abundantly". Joy and happiness are the expressions of life in it's fullness.
Only 1.6 % of the population in India, are Christians. The Government is promoting all the methods of contraception, and even abortions to bring down the population. We have about 3000 institutions taking part in health care ministry. St. John's is a Catholic Medical School which is officially owned by C.B.C.I. (Catholic Bishop's Conference of India). This institution tries at all levels to stand by the teachings of the church in the process of caring for and curing of the sick, inculcating our motto in our students, " He shall live because of me". The admission to St. John's is purely on merit basis giving preference to Catholics, 50% boys, 25% girls and 25% religious.

OBJECTIVES

This survey is made to assess whether the graduates and postgraduates of this institution (1) were at a disadvantage while imparting medical care when compared to their peers trained in other institutions (2) faced any discrimination during undergraduate examinations (3) had any problems for admission to postgraduate courses elsewhere or (4) faced any discrimination during the postgraduate course and examination because this institution imparts practical knowledge only in natural family planning methods.

MATERIALS AND METHODS

Appropriate open-ended, unstructured questionnaires (given in appendix), were developed and distributed by the first author personally to 54 interns, 24 postgraduates and 18 Johnite faculty members. The subjects documented their designation, sex and whether they belonged to a religious order. The responses were collected and analysed.

OBSERVATION AND DISCUSSION

Table I depicts the responses of the 54 interns who participated in the survey. There were 24 boys, 15 girls and 15 religious nuns, of whom 48 (88.9%) did not feel that they were at any disadvantage, while 6 (11.1%) , {4 girls and 2 boys} reported that they faced discrimination at the time of examination. No religious nuns reported that they were discriminated at the time of examination. Perhaps in their case the examiners knew that as Catholic nuns they would not advise the artificial methods of contraception or MTP. However, boys and girls though a very small number may have felt discriminated because of inadequate practical knowledge about contraception and MTP.

Table 2 depicts the postgraduate's impressions about their experiences in rural medical practice without practical skills in contraceptive methods during undergraduate training at St. John's. Majority did not feel any disadvantage, 21 (87.5%) said 'no' and only 3 (12.5%) said 'yes'.

Table 3(a) indicates how the patients who sought advice for contraception were managed. While 12 (50%) advised natural family planning methods, 8 (33.3%) explained all the methods and the teachings of the church and then left the option to the individuals. They referred those patients who opted for artificial methods of contraception to government hospitals. One doctor referred such patients straight away to government hospitals. Another doctor preferred to insert IUCD's to prevent illegal abortions that were prevalent in that area. Only 2 (8.2%) did not encounter such patients as the people knew that these methods were not practised in those hospitals.

Table 3(b) indicates how the respondents had dealt with the patients who approached them seeking MTP. While 11 (45.8%) discouraged the patients, motivating them to continue pregnancy, 6 (25%) did not encounter such patients as they worked in Catholic Hospitals where they do not entertain such patients and 7 (29.2%) tried to discourage such patients but referred them to government hospitals if they failed to convince them.

Table 4 indicates whether the respondents felt discriminated during their examinations. Only 4 (16.7%) felt uncomfortable at examinations, while 20 (83.3%) faced no problems during their examinations.

Table 5 depicts the evaluation of the Johnite faculty members while 5 (27.8%) felt that they were at a disadvantage because they were not trained in contraceptive methods, 13 (72.1%) did not feel so.

Table 6(a) depicts the experiences of the respondents in rural medical practice. Table 6(a) and 6(b) indicate that 11 were male faculty members to whom patients do not usually go for advice about contraception and MTP and hence the answer was "not applicable" and 7 (38.9%) advised against MTP and tried to promote natural family planning methods.

Table 7 indicates that 2 (11.1%) felt discriminated during their examination. Only one person (5.6%) faced problem at all levels, i.e. for admission to, during the course and during the postgraduate examination in Obstetrics & Gynaecology .

The course that I applied for was M.D. in Obstetrics & Gynaecology. I was asked by the Professor & Head, not to take up this subject because I would not perform MTP and contraception. The Dean involved and finally I was given admission to the Diploma Course.
During the course, I was posted only in MTP (Medical Termination of Pregnancy) and sterilization Unit, so that I would be forced to perform both MTP and sterilization. The Unit Chief with whom I was working, protected me and I did not have to do either of it.
During the examination, I was asked to come back after 6/12. After 6 months, she refused to conduct the examination. The University was contacted and they gave instructions to conduct the examination and then I passed.
To join as faculty member, I had to do the master's course. The course was in St. John's, so I had no problem. Again the examination was conducted in a different centre. The examiners failed me, because I said I will not terminate a pregnancy of 24 weeks with spina bifida diagnosed by ultrasound.
Now I am proud of teaching the graduates and postgraduates in Obstetric & Gynaecology promoting responsible parenthood, whereby they impart this knowledge to their patients and enable them to have life in its fullness.
The evaluation appears to indicate that majority of the interns, postgraduates and faculty members respect the precepts of the church and have tried to practise it in their daily medical practices, safe guarding life from its very inception.

CONCLUSION

In spite of a small minority felt that they are at a disadvantage not getting practical training in MTP and contraception, the institution upholds the teachings of the church throughout its curriculum and tries to inculcate into her students the value of human life and how to safeguard it from its beginning till its end.

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INTERNS
I. Do you feel discriminated at the time of examination just because you are from St. John's,
where only natural family planning methods are promoted ?

Table I: Interns distribution

Yes

No

Boys &endash; 24

2 ( 8.3%)

22 (91.7%)

Girls &endash; 15

4 ( 26.7%)

11 (73.3%)

Nuns &endash; 15

0

15 (100%)

TOTAL - 54

6 (11.1%)

48 (88.9%)

POSTGRADUATES THOSE WHO HAVE DONE RURAL POSTING (Total number - 24)
1. Do you feel that you are at a disadvantage because you are not trained in contraceptive methods during your undergraduate training at St. John's ?

Table 2

Number

Percentage

No

21

87.5

Yes

3

12.5

2. How did you manage the patients who came for
a) Contraception

Table 3 (a)

Number

Percentage

Patient’s do not come to our centers, because they know it is not done in Catholic Hospitals

2

8.2

Advised NFP methods

12

50

Referred to government hospitals

1

4.2

Explained all methods and gave freedom to choose and then referred to government hospitals, if needed

8

33.3

Inserted IUCD’s as it is found to be safer than illegal abortions that would takeplace otherwise

1

4.2

b) MTP

Table 3 (b)

Number

Percentage

Discouraged. Gave advise to continue pregnancy imparting knowledge how important is God given life

11

45.8

Patients did not come to our centers for MTP (Catholic hospital)

6

25

Discouraged, but if patient still insists referred to government hospitals

7

29.2

3. Did you feel discriminated at your exams because you are from St. John's
where only NFP is promoted?

Table 4

Number

Percentage

No

20

83.3

Yes

4

16.7

JOHNITE FACULTY (Interviewed number &endash; 18)
1. Do you feel that you are at a disadvantage because
you are not trained in contraceptive methods at St. John's ?

Table 5

Number

Percentage

No

13

72.1

Yes

5

27.8

2) In your rural practice how did you manage the patients who came for
a) Contraception

Table 6 (a)

Number

Percentage

Advised NFP and Barrier methods

2

11.1

Advised only NFP

2

11.1

Referred to other centers for IUCD

3

16.7

Is not applicable ( male faculty)

11

61.1

b) MTP

Table 6 (b)

Number

Percentage

Advised against MTP

7

38.9

Not applicable

11

61.1

3) Do you feel discriminated
(a) During your UG and PG exams
(b) At admission for postgraduate course elsewhere
(c) During your P.G. course elsewhere

Table 7

No

Yes

At your U.G. & P.G. exams

16 (88.9%)

2 (11.1%)

At admission for P.G. course elsewhere

17 ( 94.4%)

1 (5.6%)

During P.G. course elsewhere

17 (04.4%)

1 (5.6%)


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