Can I refuse to give out contraceptives as a Medical Student?

[Miami_med]

---

Members do not see this ad.

I'm sorry but I cannot force my personal views on a Patient and never will.

If a patient has a belief that Abortion is OK I can explore alternatives with them but in the end if they are dead set on the abortion, I will refer them, Patients have the right of choice of legal and accepted medical practices and as a Caregiver I should honor that.

We all seem to have no problem forcing our personal views onto fellow professionals though?

 

[Pharmavixen]

We all seem to have no problem forcing our personal views onto fellow professionals though?

When you're arguing with a colleague, it's all fair, as you're equals. But we are in a position of power with respect to patients.

As a pharmacist, I'm a gatekeeper, controlling access to drugs. If someone presents me with a prescription for an OC and I refuse to fill it because it's against my personal beliefs, and I refuse to even tell the person where she can get the prescription filled, that's an abuse of the power I have. Not a big deal where I live, in Canada's largest city with drugstores on every corner, but in small, rural communities, having a fundamentalist Christian running the only pharmacy for miles could result in an increase in teen pregnancies, and women seeking abortions, for that matter.

 

[oldpro]

We all seem to have no problem forcing our personal views onto fellow professionals though?

Why is it wrong to debate and

Topics in Healthcare A place to discuss, discourse, hold forth, and maybe, just maybe, have your mind changed.

I guess I'm wrong for feeling strong on the issue myself?😕

 

[Tired]

. . . but in small, rural communities, having a fundamentalist Christian running the only pharmacy for miles could result in an increase in teen pregnancies, and women seeking abortions, for that matter.

I have never quite understood this argument.

Essentially, you are arguing that people should do something they consider morally wrong in order to prevent other things from happening that they consider morally wrong? The same argument is used all the time in the debate on torture, where it is equally specious. You're just retreading "The Ends Justify The Means".

Shall we also forcibly sterilize the mentally ******ed to prevent unwanted pregnancies as well? Oh wait, that's already been done . . .

 

[psy]

If they can't get contraceptive, would you prefer them using abortion medication instead? Look at this article on women using the web for abortions. Since they couldn't order the drugs in the pharmacy near their home, they go online and have it delivered to them.

 

[Tired]

If they can't get contraceptive, would you prefer them using abortion medication instead? Look at this article on women using the web for abortions. Since they couldn't order the drugs in the pharmacy near their home, they go online and have it delivered to them.

With all due respect, step back from your knee-jerk self righteousness and read my post again.

The point is that for people who believe it is immoral to use or promote contraceptives, neither option is acceptable, nor will they participate in either.

Let's try another analogy that may resonate a little better with you: I don't believe that my 12yo daughter should have sex. However, I will not sew her vagina shut and cut off her clitoris to prevent it. I also will not refer her to someone who will.

Get it now?

 

[ForbiddenComma]

Are you saying that you feel it should be malpractice? Or do you actually believe that refusal to refer constitutes malpractice under the legal definition?

I meant in the more informal sense.

I have worked under some serious right-wing Christian FP and OB/GYN docs, and even they will prescribe the pill because a) it's standard practice in America, like it or not, and b) they don't want their patients going to Planned Parenthood instead.

Of course, they'll still mount the pulpit if the topic of abortion comes up. This seems ok to me. As I said, the topic of abortion is far from settled, and therefore the individual doctor has leeway to express their personal viewpoint. Regular birth control, on the other hand, has become part of the modern standard of care, and it represents a significant deviation if a doctor or pharmacist refuses to even refer a patient who wants Yaz. (i'm pro-choice if it makes a difference)

 

[psy]

With all due respect, step back from your knee-jerk self righteousness and read my post again.

The point is that for people who believe it is immoral to use or promote contraceptives, neither option is acceptable, nor will they participate in either.

Let's try another analogy that may resonate a little better with you: I don't believe that my 12yo daughter should have sex. However, I will not sew her vagina shut and cut off her clitoris to prevent it. I also will not refer her to someone who will.

Get it now?

My response wasn't to your post. It was a response to the OP. I was merely showing the possibilities out there.

 

[Tired]

Regular birth control, on the other hand, has become part of the modern standard of care, and it represents a significant deviation if a doctor or pharmacist refuses to even refer a patient who wants Yaz. (i'm pro-choice if it makes a difference)

It doesn't. This is an abstract discussion.

I personally know two interns who refuse to give out contraceptives. Also, consider the recent efforts to legally protect pharmacists who refuse to give out contraceptives. I don't think this is quite as settled as you depict.

But regardless, I continue to believe that physicians have the right to refuse to perform procedures and give out medications as their conscience dictates. I also understand the argument of those who say that referring patients to those who will also violates the tenets of their beliefs.

Fortunately the law the continues to support our rights as well.

 

[Miami_med]

Why is it wrong to debate and
I guess I'm wrong for feeling strong on the issue myself?😕

I think you misinterpereted me. As far as the OP is concerned, you are very clear that his beliefs about being a physician that doesn't involve himself with contraceptives are wrong. I did not say that you couldn't hold your opinion or even argue it. I haven't censored anyone in this thread. In fact, in this forum, I have deleted approximately 2 posts in the entire year I've been moderating it, and both were spam.

In this case, I personally disagree with all of these arguments that the OPs failure to comply with other people's standards of medical ethics (that are diametrically opposed to his personal ethics) is wrong. As a pack, we all have some power over each other when it comes to licensing and credentialing, as well as our ability to argue the "standard of care" to the legal system. Many people are arguing that the OP is abusing his power or being a bad physician because he doesn't want to involve himself in birth control. I'm arguing that what everyone else is doing is amounting to a similar "abuse of power" that everyone is accusing the OP of.

Now feel free to post a counterargument 😉

 

[oldpro]

It doesn't. This is an abstract discussion.

I personally know two interns who refuse to give out contraceptives. Also, consider the recent efforts to legally protect pharmacists who refuse to give out contraceptives. I don't think this is quite as settled as you depict.

But regardless, I continue to believe that physicians have the right to refuse to perform procedures and give out medications as their conscience dictates. I also understand the argument of those who say that referring patients to those who will also violates the tenets of their beliefs.

Fortunately the law the continues to support our rights as well.

Yet contraceptives are used to treat other problems besides birth control.

What if in the future we find even more uses for what we consider contraceptives, Oh Oh can't prescribe treatment because it is a contraceptive?

We cannot terminate a pregnancy for any reason? Not to save the mother's life?, even if they want to live, even if at the same time the fetus is not viable?

so its ok to condemn two lives to death in some cases?
Or condemn one to death while the other is already beyond living or dead?

I have not gone to medical school to do that and thought that others are the same.

I also have religious reasons for my beliefs but I will not bore you with my convictions.

 

[Tired]

Yet contraceptives are used to treat other problems besides birth control.

What if in the future we find even more uses for what we consider contraceptives, Oh Oh can't prescribe treatment because it is a contraceptive?

We cannot terminate a pregnancy for any reason? Not to save the mother's life?, even if they want to live, even if at the same time the fetus is not viable?

so its ok to condemn two lives to death in some cases?
Or condemn one to death while the other is already beyond living or dead?

I have not gone to medical school to do that and thought that others are the same.

I also have religious reasons for my beliefs but I will not bore you with my convictions.

I don't really care how you practice or what your rationale is for your actions. I also don't really care about your opinion of others' practice.

All I'm saying is that no practitioner should ever be told they have to carry out interventions they object to.

Even the doctors at Guantanimo aren't forced to carry out actions they object to.

 

[oldpro]

I don't really care how you practice or what your rationale is for your actions. I also don't really care about your opinion of others' practice.

All I'm saying is that no practitioner should ever be told they have to carry out interventions they object to.

Even the doctors at Guantanimo aren't forced to carry out actions they object to.

There are standards of care you may disagree with and yet have to follow or you pay the price of malpractice.

 

[Tired]

There are standards of care you may disagree with and yet have to follow or you pay the price of malpractice.

Look, I understand there's a bit of a language barrier here, so I've been trying to use simple sentences and not be a jerk, but for the last f-ing time:

Physicians do not have to hand out contraceptives. They can refuse to give out contraceptives and that is not malpractice and they will not face sanctions.

I mean, for the love of God, you're not a nurse anymore. You can't just make crap up and have everyone believe you. It may suprise you to learn that, for people like me who are actually involved in these situations, we've taken the time to look into the legalities involved here.

Seriously, check things out before you before you start talking about things you obviously know nothing about.

 

[oldpro]

Look, I understand there's a bit of a language barrier here, so I've been trying to use simple sentences and not be a jerk, but for the last f-ing time:

Physicians do not have to hand out contraceptives. They can refuse to give out contraceptives and that is not malpractice and they will not face sanctions.

I mean, for the love of God, you're not a nurse anymore. You can't just make crap up and have everyone believe you. It may suprise you to learn that, for people like me who are actually involved in these situations, we've taken the time to look into the legalities involved here.

Seriously, check things out before you before you start talking about things you obviously know nothing about.

Look part of this is belief, and what I believe should be ( Just like the OP) and I posted the fact that we have OTHER things we have to do even if we do not agree with them for our patients ( sorry its missunderstood, It was not meant to be "Physicians do not have to hand out contraceptives. They can refuse to give out contraceptives and that is not malpractice and they will not face sanctions.[/I]" ) I think not referring patients to a physician who will treat them as they request when it is lawful treatment is a problem. And because I posted something days or weeks ago does not mean I didn't change my mind some. Why does so many here have to be so rigid?

 

[Tired]

Look part of this is belief, and what I believe should be ( Just like the OP) and I posted the fact that we have OTHER things we have to do even if we do not agree with them for our patients ( sorry its missunderstood, It was not meant to be "Physicians do not have to hand out contraceptives. They can refuse to give out contraceptives and that is not malpractice and they will not face sanctions.[/I]" ) I think not referring patients to a physician who will treat them as they request when it is lawful treatment is a problem. And because I posted something days or weeks ago does not mean I didn't change my mind some. Why does so many here have to be so rigid?

Do you understand that there is a difference between these two statements?

(1) "It is wrong to refuse to hand out contraception or refer patients to physicians who will."

versus

(2) "If you refuse to hand out contraception or refer patients to someone who will, it is malpractice."


The first is a statement of belief. Fine.

The second is a factually incorrect statement, not a statement of belief.

 

[oldpro]

Do you understand that there is a difference between these two statements?

(1) "It is wrong to refuse to hand out contraception or refer patients to physicians who will."

versus

(2) "If you refuse to hand out contraception or refer patients to someone who will, it is malpractice."


The first is a statement of belief. Fine.

The second is a factually incorrect statement, not a statement of belief.

people are charged with malpractice on belief. Many cases have gone to litigation where technically the physician was not at fault yet the insurance company or the jury awarded the other party.

something may not be malpractice by definition but it may be by belief and perception.

hypothetical:

pt A begs the physician over a few visits for birth control because family has history of genetic diseases, physician refuses several times, patient in later months becomes pregnant trying to avoid it using rhythm method, patient dies in child birth and child dies of genetic disease at the same time. Family is so upset that they sue the doctor for malpractice. Do not think this can happen? I do

 

[cpants]

people are charged with malpractice on belief. Many cases have gone to litigation where technically the physician was not at fault yet the insurance company or the jury awarded the other party.

something may not be malpractice by definition but it may be by belief and perception.

hypothetical:

pt A begs the physician over a few visits for birth control because family has history of genetic diseases, physician refuses several times, patient in later months becomes pregnant trying to avoid it using rhythm method, patient dies in child birth and child dies of genetic disease at the same time. Family is so upset that they sue the doctor for malpractice. Do not think this can happen? I do

Of course it can happen. A doc can be sued for any reason. It doesn't mean he committed malpractice. This is why 99% of malpractice cases end up dropped or dismissed.

I pose the question to those who would find it against their morals to even discuss or refer for birth control: If a teenage patient approaches you regarding contraception to prevent disease and pregnancy, what is the appropriate response?

 

[Miami_med]

people are charged with malpractice on belief. Many cases have gone to litigation where technically the physician was not at fault yet the insurance company or the jury awarded the other party.

something may not be malpractice by definition but it may be by belief and perception.

hypothetical:

pt A begs the physician over a few visits for birth control because family has history of genetic diseases, physician refuses several times, patient in later months becomes pregnant trying to avoid it using rhythm method, patient dies in child birth and child dies of genetic disease at the same time. Family is so upset that they sue the doctor for malpractice. Do not think this can happen? I do

You know. If a patient wants OCPs, and you don't want to prescribe them, the patient can go to another doctor. We act as though the patient is somehow enslaved to us. We provide a service. If it is not the service that the patient wants, they are welcome to go elsewhere. To say that any person can't find another doctor in the US is ludicrous. Even the rural nowhere, we can travel. The patient isn't entitled to convenient services that you choose not to provide. We are not slaves to our patients (atleast not yet).

Lots of people don't provide lots of services. I had people go to my preceptor in my FP clerkship requesting diet pills. He didn't prescribe them. He said, "I do not prescribe diet pills." When asked where diet pills could be gotten, he replied that there are specialized clinics but never made a specific referral to any clinic. This was something he CHOSE not to do. The poster on this thread is CHOOSING not to offer OCPs as part of his services. We should actually encourage physicians having some control over their scope, whether the motivation is morals, money, altruism, whatever.

No one is up in arms about the diet pills. It's sort of like how abortion and birth control for some reason have magic fairy power in terms of how we try and promote their use. I remember being told on the OB/GYN clerkship how it was great that a Psychiatrist had learned to do D&Cs, increasing access to abortion. I thought to myself that this was strange. We normally try to keep people from practicing outside of their respective scopes of practice. The hammer of political correctness makes everyone try and push these two specific modalities in ways that violate all other rules of ethical conduct in medicine, and frankly, all common sense.

And I'll remind everyone to keep it civil.

 

[oldpro]

You know. If a patient wants OCPs, and you don't want to prescribe them, the patient can go to another doctor. We act as though the patient is somehow enslaved to us. We provide a service. If it is not the service that the patient wants, they are welcome to go elsewhere. To say that any person can't find another doctor in the US is ludicrous. Even the rural nowhere, we can travel. The patient isn't entitled to convenient services that you choose not to provide. We are not slaves to our patients (atleast not yet).

.

With Medicaid there is no choice, in some areas there are no other Doctors.

I know I'm in one of those areas. 50 to even 100 square miles? is a large area is it not?
So many practices are "Closed practices" and then some do not accept Medicaid. With the price of Gas how do you expect for these people to drive this far to see another Doctor who will prescribe the care they seek? (Of course we are talking about the subject here)

I'm not making this up.

But I agree with your point for the most part. I think again I get misunderstood, I'm presenting a view, possible things that can happen.

No I will not touch abortion
I do not agree with the practice personally ( not the birth control part of it)
I however think even Condoms can prevent the need for this, Depo, BC's, IUD's .....

 

[oldpro]

How about Hystroectomies in Younger patients? Does the OP think this is OK or should not be done because it causes the Loss of the ability to concieve?

Or tubes tied..... this is also Birth control.

As I said religion? I have known 1000's of Catholics have had tubes tied, ( I'm originally from a "Catholic state") Its interesting how some claim its religion and yet it is not held so sacred by those who practice that religion, if it was then there would be few that break these held beliefs.

 

[docB]

How about Hystroectomies in Younger patients? Does the OP think this is OK or should not be done because it causes the Loss of the ability to concieve?

Or tubes tied..... this is also Birth control.

As I said religion? I have known 1000's of Catholics have had tubes tied, ( I'm originally from a "Catholic state") Its interesting how some claim its religion and yet it is not held so sacred by those who practice that religion, if it was then there would be few that break these held beliefs.

I don't think the OP has presented an opinion on tubal ligation. I don't speak for him but I think it's likely that his main issue would be that he wouldn't want to be forced to perform them himself.

Your avatar grows more apropos with each post.

 

[oldpro]

I don't think the OP has presented an opinion on tubal ligation. I don't speak for him but I think it's likely that his main issue would be that he wouldn't want to be forced to perform them himself.

Your avatar grows more apropos with each post.

Yea amazing how I'm wrong on SDN for having opposing opinions and my own take on things. IS it not?

I have always questioned motives and thoughts, I'm not alone, many do not want to discuss these things, I want to learn this is one way to learn what others really think.

 

[nzik]

I just wanted to make a brief comment on this issue. I may find myself struggling with the same dilemma.

I think Catholics, and even other religious conservatives, face some discrimination amongst their peers with regard to these kinds of reproductive issues. We are often ridiculed for holding views that contradict the overwhelming majority of the population and find it disillusioning. I aggree with the attending physician that no one should give up their beliefs just because everyone else is forcing you to conform. Some sort of dialogue, possibly compromise, might be appropriate.

I am somewhat alarmed by eyesarecool's reasoning, though. Just because the issue of contraception arises does not necessarily mean that physicians do have a right to choose which patients to treat. We must remember that ethics transcends legal and institutional policies, especially when we are faced with circumstances in which such policies become unjust. [Just what sort of ethics these are are openly debated among physicians and ethicists, though.]

If you have any questions about how to approach this, I would recommend reading up on Edmund Pellegrino. He is chairman of the President's Council on Bioethics, a devout Catholic, and respectable even among his most liberal critics. If you find something on it, hit me up on it because I'm still researching this stuff.

Anyway, I apologize for lying - I was not brief as I said I would be.

 

[Miami_med]

With Medicaid there is no choice, in some areas there are no other Doctors.

I know I'm in one of those areas. 50 to even 100 square miles? is a large area is it not?
So many practices are "Closed practices" and then some do not accept Medicaid. With the price of Gas how do you expect for these people to drive this far to see another Doctor who will prescribe the care they seek? (Of course we are talking about the subject here)

I'm not making this up.

But I agree with your point for the most part. I think again I get misunderstood, I'm presenting a view, possible things that can happen.

No I will not touch abortion
I do not agree with the practice personally ( not the birth control part of it)
I however think even Condoms can prevent the need for this, Depo, BC's, IUD's .....

Unless you're really in the middle of nowhere, I suspect that "access" to condoms is comprised of driving to the local drugstore and paying $1 😉

 

[oldpro]

Unless you're really in the middle of nowhere, I suspect that "access" to condoms is comprised of driving to the local drugstore and paying $1 😉

Yes I agree condoms do not need prescriptions.

The McDonalds hot coffee should not need a label.

Guns should always be assumed loaded with bullets and can kill.

Some people need us to help them understand the actions and what could happen though.

 

[docB]

Yea amazing how I'm wrong on SDN for having opposing opinions and my own take on things. IS it not?

😕Huh?

 

[Nasrudin]

I believe that as a Christian, Christ would not want people handing out contraceptives.

Christ the hero perhaps not. Jesus of Nazareth, it is likely, never was asked about the merits of covering one's penis with latex before penetration. It seems to me a family of dirt poor bastard jewish kids in a Roman era ghetto would not mind one less mouth at the table, but that's just me. But you seem pretty familiar with the guy so I leave that to you.

You should by all means abide your conviction. It's just a shame there's not transparency in medicine. I mean as a patient it would be nice to know if my doc just stepped off the golf course with the Zoloft rep before I take his/her recommendation to consume it regularly. Or in your case I would just like to know your views before I agree to bypass the sacrilege of spilling my sperm without the intent of procreation, which if true, I'm hellbound as a mf'er.

 

[Nasrudin]

Do you understand that there is a difference between these two statements?

(1) "It is wrong to refuse to hand out contraception or refer patients to physicians who will."

versus

(2) "If you refuse to hand out contraception or refer patients to someone who will, it is malpractice."


The first is a statement of belief. Fine.

The second is a factually incorrect statement, not a statement of belief.

I understand your point of view. I think it is thoughtful and convincing. Practically speaking however, I wonder if it is not at least ethically responsible if not legally to explain to the patient how the decision was made.

So that the patient's own interests from their perspective is not contingent upon the ontological dilemma of the physician. In the same way that a doctor explains the clinical facts in a patients history lead him/her to conclude a certain diagnosis is likely, shouldn't the doctor also explain something like this: Mrs. X, I cannot recommend contraceptives to you because it is against my religion to do so, you will have to seek specific advice along these lines from a different clinician.

 

[Miami_med]

I understand your point of view. I think it is thoughtful and convincing. Practically speaking however, I wonder if it is not at least ethically responsible if not legally to explain to the patient how the decision was made.

So that the patient's own interests from their perspective is not contingent upon the ontological dilemma of the physician. In the same way that a doctor explains the clinical facts in a patients history lead him/her to conclude a certain diagnosis is likely, shouldn't the doctor also explain something like this: Mrs. X, I cannot recommend contraceptives to you because it is against my religion to do so, you will have to seek specific advice along these lines from a different clinician.

I'm pretty sure that no one here is arguing that the OP should be allowed to lie to his patients. The OP seems to mostly not want to deal in contraception. My real issue is that he should have the right to say that he doesn't provide contraception and have the right to refuse services surrounding it. I don't think that saying why he doesn't is even relevant, though he very well might be happy to say it violates his religious beliefs. I think this would be a different argument if he tried to claim to his patients that contraception didn't exist or intentionally made false statements..

 

[Nasrudin]

I'm pretty sure that no one here is arguing that the OP should be allowed to lie to his patients. The OP seems to mostly not want to deal in contraception. My real issue is that he should have the right to say that he doesn't provide contraception and have the right to refuse services surrounding it. I don't think that saying why he doesn't is even relevant, though he very well might be happy to say it violates his religious beliefs. I think this would be a different argument if he tried to claim to his patients that contraception didn't exist or intentionally made false statements..

On the contrary, it is quite relevant as long as you all are extending hypothetical scenarios. To not indicate a rationale is to mislead the patient into thinking that the decision was a clinical one and not an ethical/moral one.


If it is an ethical/moral one fine. Identify your reasoning to the patient. That is your right. But if you blur the line and the patient walks away thinking they have received a clinical evaluation instead of a moral statement that is a deliberate disservice to the patient.

 

[Tired]

I understand your point of view. I think it is thoughtful and convincing. Practically speaking however, I wonder if it is not at least ethically responsible if not legally to explain to the patient how the decision was made.

Well of course you explain yourself. My colleagues say this:

"I'm sorry, I don't give out birth control."

If asked, they basically say what you suggested, along the lines of, "My conscience doesn't permit it."

Shockingly, most people outside SDN are reasonable, and respect the provider's standpoint.

 

[Nasrudin]

Well of course you explain yourself. My colleagues say this:

"I'm sorry, I don't give out birth control."

If asked, they basically say what you suggested, along the lines of, "My conscience doesn't permit it."

Shockingly, most people outside SDN are reasonable, and respect the provider's standpoint.

Fair enough then. That is perfectly admirable of them.

And it is interesting as you note the higher concentration of a certain co-dependent liberalism or moral marginalizing of differing views inside heath care fields than outside of it.

 

[Tired]

And it is interesting as you note the higher concentration of a certain co-dependent liberalism or moral marginalizing of differing views inside heath care fields than outside of it.

I also enjoy how we will forgive our patients for any "life choice" they make, but will excuse no deviation from the "professional norms" for our colleagues.

 

[Nasrudin]

I also enjoy how we will forgive our patients for any "life choice" they make, but will excuse no deviation from the "professional norms" for our colleagues.

I have never thought of that double standard. I'll have to tuck that away as I seek to enter this profession to make sure I don't just mindlessly go along with ostracizing someone.

 

[Pharmavixen]

I also enjoy how we will forgive our patients for any "life choice" they make, but will excuse no deviation from the "professional norms" for our colleagues.

Well, we don't really "forgive" the lifestyle choices of patients; we tolerate them. But being licensed and paid as a professional entails certain responsibilities, no?

What I'm taking from this thread is, if I have a choice, I'm better off going to an atheist doctor, because I know his/her decisions are not being influenced by beliefs I don't share, that have nothing to do with my health.

 

[Nasrudin]

What I'm taking from this thread is, if I have a choice, I'm better off going to an atheist doctor, because I know his/her decisions are not being influenced by beliefs I don't share, that have nothing to do with my health.

Agreed. This is but one example of how a the cultural orientation of a physician can effect the care s/he gives and how it is delivered. In my opinion there are many.

The fact that physicians for the most part have sold the story of a supposedly contaminate-free product to the public is amazing to me. It's as if all of the sudden the white coat confers some sort of superhero powers of discernment and infallibility. And while wearing one the normal social and cultural pressures that apply to other humans cannot assail its gleaming whiteness.

 

[docB]

Well, we don't really "forgive" the lifestyle choices of patients; we tolerate them. But being licensed and paid as a professional entails certain responsibilities, no?

What I'm taking from this thread is, if I have a choice, I'm better off going to an atheist doctor, because I know his/her decisions are not being influenced by beliefs I don't share, that have nothing to do with my health.

That statement is just way off. You are supposing that only religious people could have any principles that impact their clinical judgements. Your atheist doctor could have plenty of beliefs in various things you don't share that contribute to the way they function.

Don't worry though. All the religious doctors are easily identified as they are all bitterly clinging to their guns and Bibles.

 

[Nasrudin]

That statement is just way off. You are supposing that only religious people could have any principles that impact their clinical judgements. Your atheist doctor could have plenty of beliefs in various things you don't share that contribute to the way they function.

Don't worry though. All the religious doctors are easily identified as they are all bitterly clinging to their guns and Bibles.

Interesting and astute point.

This is exactly how I see doctors. As human beings. The trick is to find one you can afford who is the closest equivalent to your personal criminal defense lawyer. People who pay a high retainer in cash have an easier time getting a doc to look for every angle to increase your chances for success in the bureaucratic mess that is the modern hospital or health care system.

For the rest of us its luck, with a still decent prabability given the last bastion of professional ethics still holds, and people's differences can usually be navigated well enough.

These facts are not what bothers me. What bothers me is the leaps of ego that suggest some sort of infallibility such that any implication of natural human prejudice is appalling.

 

[Miami_med]

Interesting and astute point.

This is exactly how I see doctors. As human beings. The trick is to find one you can afford who is the closest equivalent to your personal criminal defense lawyer. People who pay a high retainer in cash have an easier time getting a doc to look for every angle to increase your chances for success in the bureaucratic mess that is the modern hospital or health care system.

For the rest of us its luck, with a still decent prabability given the last bastion of professional ethics still holds, and people's differences can usually be navigated well enough.

These facts are not what bothers me. What bothers me is the leaps of ego that suggest some sort of infallibility such that any implication of natural human prejudice is appalling.

I pretty much agree with all of that. The exception is that I don't think most people really see us as all that superhuman any longer.

 

[eyesarecool]

I thank everyone for their responses to this topic. Different people have made some excellent points. To answer somebody's question, I am conciously against all forms of contraception. The reasons for this are religious, but that is besides the point. I was wondering if anybody has a link showing the legality surrounding a medical student's right of concious?

 

[psy]

Even though you are against all forms of contraception, would you still refer your patients to another doctor who does provide contraceptives?

 

[eyesarecool]

In my practice, I will not lie or misrepresent information concerning contraceptives. I will have advertised in my office some of the services that I do not offer. One of these will be the prescribing of contraceptives. The reasons for this could be numerous.

For example, a general surgeon does not have to offer hernia repairs as one of his services. This could be for many different reasons, such as financial. Maybe, the surgeon does not offer hernia repairs simply because they are bored of the procedure. The surgeon does not have to disclose the reason why he does not offer hernia repairs.

If a patient asks me to refer them to someone else, I will, but I'm not guaranteening that the physician I refer them to will provide the services that they want either. Since I have no control over what services another physician provides, I cannot be liable for his services.

Please do not give me stuff concerning ethics and what not. I believe that offering contraceptives is unethical. Therefore, since we disagree on ethics, and since there is nobody with true definitive authority to decide what is ethical or not, the only thing we are left with is the law of the land. I challenge anybody to show me an actual law, which disagrees with what I have said.

Thanks

 

[Tired]

I challenge anybody to show me an actual law, which disagrees with what I have said.

Far from it. The law supports you.

 

[Sunfire]

So, denying an abortion is selfish? What's selfish is killing an innocent human. It's also selfish to go around having sex when there is a reason you should not.

What I find interestingly relative to this point is that the majority of pregnancies end in natural spontaneous abortion anyways. That's right, and most of the time before the woman has any chance of getting an idea that conception and on had even taken place. Sort of puts the whole "killing an innocent human" concept into a different light, wouldn't you agree? At least in so far as any theosophical discussion is involved.

"Should" is an extremely precarious word to use here, in my opinion, because according to the science of Human Physiology, "reason you should" holds very specific connotations according to development and production (hormonal, etc.), which are certainly more seemingly relative than "reason you should not". Not to mention the additionally involved science of attraction. Still, I tend to detest the laziness of many people who seem to feel that abortion (D & C, anyhow) is a form of birth control, if only for the reason that it puts unnecessary physical (and often related mental and emotional) strains on the female. But the fact is that people do have sex, they have been having sex for a very, very long time, and they will continue to have sex long after we here have expired. Anyone can attempt to change the behavioral and sociological aspects of human biology, but I am 99.9999999999999999% sure that will end in anything but success.

 

[MOHS_01]

You probably can refuse to give out contraceptives. I just hope somebody uses it against you in your evaluation. You would deserve it.

Old, dead thread.... I know... but I could not let this slide. It is nothing short of a crying shame that many good people far too often have to deal with the pompous, self righteous, morally conflicted that can reside within the halls of academia. I have watched it for years, and when going through the ranks, merely considered it as part of the game. Now that I am older, more experienced, and not beholden, I see it for what it is -- mostly a power trip, but also a futile attempt at political indoctrination.

The short of it is that NO ONE has to do anything that they consider morally objectionable. There exists choice -- choice of provider, choice of treatment, etc. The patient can go to someone else for their OCP's. I find it incredibly convenient how the socially progressive find it acceptable to force their views upon others, all the while screaming from the top of their airwaves how the religious conservatives are destroying the country by doing the same.

 

[Tired]

The short of it is that NO ONE has to do anything that they consider morally objectionable. There exists choice -- choice of provider, choice of treatment, etc. The patient can go to someone else for their OCP's. I find it incredibly convenient how the socially progressive find it acceptable to force their views upon others, all the while screaming from the top of their airwaves how the religious conservatives are destroying the country by doing the same.

It's not a systemic probelm. Law and ethics both support what you have said; providers may choose not to provide services they morally object to. It is telling that the poster you quoted has no weapon left to wield except "somebody giving a negative eval". It's a non-issue.

 

[eyesarecool]

It's not a systemic probelm. Law and ethics both support what you have said; providers may choose not to provide services they morally object to. It is telling that the poster you quoted has no weapon left to wield except "somebody giving a negative eval". It's a non-issue.

Couldn't agree more.

 

[KempDrumsalot]

In my practice, I will not lie or misrepresent information concerning contraceptives. I will have advertised in my office some of the services that I do not offer. One of these will be the prescribing of contraceptives. The reasons for this could be numerous.

For example, a general surgeon does not have to offer hernia repairs as one of his services. This could be for many different reasons, such as financial. Maybe, the surgeon does not offer hernia repairs simply because they are bored of the procedure. The surgeon does not have to disclose the reason why he does not offer hernia repairs.

If a patient asks me to refer them to someone else, I will, but I'm not guaranteening that the physician I refer them to will provide the services that they want either. Since I have no control over what services another physician provides, I cannot be liable for his services.

Please do not give me stuff concerning ethics and what not. I believe that offering contraceptives is unethical. Therefore, since we disagree on ethics, and since there is nobody with true definitive authority to decide what is ethical or not, the only thing we are left with is the law of the land. I challenge anybody to show me an actual law, which disagrees with what I have said.

Thanks

Well there we go! Looks like you finally get what the posters have been saying, besides those who were saying "You must give them contreceptives." The truth of the matter is you have no ethical or legal obliagtion to do so. You must, however, provide them with a physician that can talk to them about their options or give them what they need. Otherwise, this would be a breach of ethical codes and are means for terrible things. Just remember, while those of us who are religious may be so, we can not force our beliefs on others. If someone wants to know something that you don't believe is right, then you are obligated to recommend them to a physician with the information needed. This topic was covered in another thread about abortions. While the doctor may not agree or believe it is ethical to provide abortions, if a patient asks or requires one, he/she must refer them to someone who can help.

 

[Miami_med]

Well there we go! Looks like you finally get what the posters have been saying, besides those who were saying "You must give them contreceptives." The truth of the matter is you have no ethical or legal obliagtion to do so. You must, however, provide them with a physician that can talk to them about their options or give them what they need. Otherwise, this would be a breach of ethical codes and are means for terrible things. Just remember, while those of us who are religious may be so, we can not force our beliefs on others. If someone wants to know something that you don't believe is right, then you are obligated to recommend them to a physician with the information needed. This topic was covered in another thread about abortions. While the doctor may not agree or believe it is ethical to provide abortions, if a patient asks or requires one, he/she must refer them to someone who can help.

Not providing a service and not referring for a service is not forcing anything on anyone. Do we no longer live in a world where we can say, "I'm sorry, I don't do that here, you'll have to go somewhere else." Everyone is in love with making up obligations for people to do things. There is nothing unethical about not handling an issue outside of your practice and letting the patient find a provider who handles it.