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The Situation in Switzerland in General and a Casuistic Report
THE FUTURE OF OBSTETRICS AND GYNAECOLOGY: The Fundamental Right To Practice and be Trained According to Conscience
An International Meeting of Catholic Obstetricians and Gynaecologist
Organised by the World Federation of Catholic Medical Associations (FIAMC) and by MaterCare International (MCI)
Sponsored by the Pontifical Council for the Health Pastoral Care ROME, June 17th-20th, 2001
(Reproduced with permission)

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The Training of
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by Rudolf Ehmann
Director of the Department of Obstetrics and Gynaecology,
Government Hospital, Stans, Switzerland

In March 2001 the Swiss National Assembly decided to allow the termination of pregnancy within the first 12 weeks which means the legal abortion within this period. Immediately after this decision was published the referendum was taken, which means that the Swiss people have the opportunity to publicly vote in order to achieve the final decision.

As there are no official abortion clinics in Switzerland the argument in past years manifested itself in the idea, that abortions should be treated actually as "order of service" (In German: Leistungsauftrag). Therefore the study and professional work of colleagues who do not wish to terminate pregnancies or contribute to abortions is already nowadays continually growing difficult. Almost impossible is the study however, if such colleagues should refuse the involvement at contraception and technical-assisted reproduction and operations of sterilization. Although the Commission of Justice of the National Assembly have asked the Federal Government to take measures to allow doctors and nurses to refuse involvement without being discriminated, it remains to be seen how far these these admonitions will improve the situation of ethical-minded gynaecologists, midwives, nurses, ethicists and psychiatrists. The casuistic report of a then young doctor is not very encouraging in view of a real respect of Swiss Authorities regarding colleagues who want to work according to the Magisterium.

Already, the Swiss constitution clearly defines the right of freedom of conscience. In real life this right is not respected, as there are always reasons for the refusal of a candidate, as, for example, that positions have been filled for years to come, as Dr. Waldis will explain later.

Even if a colleague will obtain an opportunity to study, obstacles will be placed in the path of his training, especially if he does not participate in contraception, including sterilization or other medicinal reproductional techniques. As an example, he will not be allowed to perform his required surgical procedures without problems, meaning that he can pass his practical exam - if at all - only after a delay, or he will be treated badly by colleagues.

Positions as a registrar are practically impossible to obtain, let alone positions as a consultant. It is unfortunate that I am the only consultant in Switzerland, who can work in the sense of the "Magisterium", even though with difficulty, as I am being attacked by politicians, colleagues and the media.

It is always demanded from me that I resign from my office, as my attitude unsettles my colleagues and female patients. The government has, as a result of my attitude, appointed a registrar who is obliged to perform sterilizations and administer the pill and IUD's. Abortions are at the moment not yet performed. The government intends to introduce this procedure shortly, at the latest when the solution of delay (Fristenlösung) becomes effective.

There are an increasing number of young colleagues who are applying for an (internship) (practicum) position with us. We accept a two-year training period at the hospital.

There is an increasing number of women, who are looking for gynaecologists and hospitals with this attitude; they come to us from the whole of Switzerland and partly from outside the country - for giving birth or other treatment.

If we do not create more educational facilities within the sense of the "Magisterium" we will clear the field for the life threatening forces, which will have a negative selective effect on gynaecology. Unfortunately, the majority of the (intern- practicum) gynaecologists belong to this category today. I do hope we can slow down their development somehow soon. Since gynaecologists in the sense of the "Magisterium" are increasingly in demand, they are a veritable niche market.

 

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