Professional Norms, Personal Attitudes, and Medical Practice: The Case of Abortion

Abstract

The structural conditions under which obstetricians personally opposed to abortion will provide abortion services were examined. The data were obtained during the winter of 1975-1976 as part of a survey of abortion practices among private obstetricians in Maryland. Of the 473 physicians identified as eligible for inclusion in this study, 443 completed a telephone interview, and 318 of those interviewed returned a mail questionnaire. It was hypothesized that personally conservative obstetricians would provide abortion services if these services were supported by prevailing professional norms, whereas personally liberal obstetricians would provide these services irrespective of prevailing professional norms. The data strongly supported the hypotheses. Uniformly, conservative obstetricians were more likely to perform abortions and to demonstrate high levels of commitment to abortion services if they were in a favorable, in contrast to an unfavorable, normative climate. Of 6 comparisons between the abortion activities of conservative obstetricians in conservative versus liberal environments, 4 were significant at greater than the .05 level, all in the direction of greater activity in the more liberal climate. In contrast, the liberal obstetricians were more resistant to the potentially modifying effects on their behavior of an opposing normative climate (as was predicted). With only 1 exception (number of abortions), obstetricians with attitudes favorable to abortion appeared to resolve conflict between their own attitudes and prevailing norms in favor of the former, choosing to provide, rather than to withhold, abortion services. The data suggest that attitudes, as well as religious beliefs, have their greatest effects on the initial decision to perform abortions.