Controversial

[Rugger81]

I had a conversation about this a few months ago and it was brought up again recently with one of my friends. I want to preface this by saying I am in no way trying to push a view onto anyone. I am just curious about this issue:

Is there a conflict of interest (so to speak) when a doctor is staunchly Pro-Life? What kind of obligations does the physician have in terms of offering potential procedures/treatments to a patient?


Not trying to incite an argument, just curious as to other pre-meds' feelings on the subject.

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[MoosePilot]

I had a conversation about this a few months ago and it was brought up again recently with one of my friends. I want to preface this by saying I am in no way trying to push a view onto anyone. I am just curious about this issue:

Is there a conflict of interest (so to speak) when a doctor is staunchly Pro-Life? What kind of obligations does the physician have in terms of offering potential procedures/treatments to a patient?


Not trying to incite an argument, just curious as to other pre-meds' feelings on the subject.

I don't see a conflict. As for obligations, I have no idea what might be required, but I wouldn't do any procedure I wasn't morally comfortable with.

Seems like a doctor should be pro-life (not strictly in an anti-abortion sense). Isn't that a doctor's focus?

 

[Rugger81]

I meant the political connotation.

I'll rephrase - "anti-abortion"

 

[MoosePilot]

I meant the political connotation.

I'll rephrase - "anti-abortion"

What I meant was that being pro-life in an anti-abortion sense is ok. If a patient wants a procedure, doesn't mean you have to be the one to provide it. My other comment was that, to me, being pro-life in an anti-abortion sense is consistent with being pro-life in a general sense. Others feel differently and I understand some of their reasoning, but don't agree with the conclusion.

 

[stoic]

Part of the obligation of a prolife physician who is approached about abortion is to not only provide aftercare, but also to provide the patient information as to where she could get the procedure performed by a competent practitioner.

As a side note to this topic, the hosiptal where my Dad works has a Pharmacist who is a strict catholic and will not fill scripts for emergency contraception. The solution? It was put into the Pixis system .

 

[Rugger81]

what's the Pixis system?

 

[principessa]

As far as I know, physicians can decide whether or not to perform abortions, and medical students are not required to observe them or assist with them.

 

[Psycho Doctor]

I don't think any good doctor would perform any procedure that was against his/her religious or moral beliefs, no matter what. I know i never would.

 

[electric]

I guess that gets trickier when you're the only game in town. For example, if you didn't wish to perscribe the morning after pill and you are the only physician in town. Where do your rights end and those of your patients begin?

 

[Psycho Doctor]

when your integrity takes over.

tell her your pov and send her else where

i wouldn't compromise my integrity

 

[stoic]

Pixis is an automated drug dispensing machine that contains commonly used drugs. They are stocked by and located away from the hospital pharmacy (ICU, med/surg floor, ER, etc) so that nurses can get perscriped meds w/o having to go to the pharmacy.




As for writing an emergency contraception script when you're the only game in town? That really is a toughy. A Doc could probably do a phone consult with another provider in a different location who could then call the script in.

 

[Psycho Doctor]

somehow if you consult with anothe rMD and sugges the prescribe a drug to abort a baby, isn't that sort of going against your conscince if you are opposed to abortion? i think it would effect me if i felt iwas an instrument towards the abortion

 

[stoic]

So... you're gonna let one of your patients who insist on getting an abortion do it in an ally with a coat hanger?

 

[MoosePilot]

I guess that gets trickier when you're the only game in town. For example, if you didn't wish to perscribe the morning after pill and you are the only physician in town. Where do your rights end and those of your patients begin?

Car + phonebook = options

A patient's rights end when they try to force me to do something against my moral code.

 

[MoosePilot]

So... you're gonna let one of your patients who insist on getting an abortion do it in an ally with a coat hanger?

What, they don't know how to use a phonebook?

The options often come down to a pro-life doc or a back alley appointment with a coathanger? I agree that giving a specific referral feels too much like being an active part of something I find morally abhorrent. I might mention agencies such as planned parenthood which are more likely to have more info, but I don't want to have anything to do with actually expediting this procedure.

 

[stoic]

I agree that giving a specific referral feels too much like being an active part of something I find morally abhorrent. I might mention agencies such as planned parenthood which are more likely to have more info, but I don't want to have anything to do with actually expediting this procedure.

I disagree strongly. I feel it is the medical responsability of a physician to help a patient who insist on a procedure they do not perfrom to refer the patient to the most competent practitioner available. This holds true for ANY procedure the physician doesn't perform - regardless of the reason they don't perform it. A family practice doc who doesn't do derm procedures would never say "well, you need a dermatologist... here's a phonebook."

 

[Zweihander]

What, they don't know how to use a phonebook?

The options often come down to a pro-life doc or a back alley appointment with a coathanger? I agree that giving a specific referral feels too much like being an active part of something I find morally abhorrent. I might mention agencies such as planned parenthood which are more likely to have more info, but I don't want to have anything to do with actually expediting this procedure.

Careful there. Legally, that is bordering on patient abandonment, if not outright so. Once you assume care of a patient, you are required either to continue providing care or to make sure that the patient transfers care to another physician if you are unable or unwilling to continue being the provider.

 

[MoosePilot]

I disagree strongly. I feel it is the medical responsability of a physician to help a patient who insist on a procedure they do not perfrom to refer the patient to the most competent practitioner available. This holds true for ANY procedure the physician doesn't perform - regardless of the reason they don't perform it. A family practice doc who doesn't do derm procedures would never say "well, you need a dermatologist... here's a phonebook."

Well, there aren't many derm procedures that people find morally wrong, are there?

Look, I don't want to take this poor guys thread way off topic, but I understand what you're saying and still lean towards not giving a specific referral. I'll learn more about the topic in medical ethics courses or self-study before it becomes a factor, but right now I just can't see doing that.

 

[Rugger81]

When I posted the original question, I wasn't even thinking about a physician actually performing an abortion (esp. if s/he were morally opposed). I was thinking of the conflict of interest that could arise if a physician was so morally opposed to abortion that it would not even be discussed with a patient. If we start to scale back our "involvement", suggesting that even a referral is too akin to performing the abortion itself, doesn't that physician run into really bad territory? In other words, what's worse: seemingly compromising your integrity/ethics? Or using integrity as the reason you did not disclose all available courses of action, and perhaps jeopardizing the patient's life?

AGAIN, I am not criticizing either viewpoint. This is a really tough area for physicians, but I think it's something that needs more thought.

 

[stoic]

Moose -

I respect your views and I particuarly respect your willingness to stand up for them. BUT as Zweihander points out, it's an issue of professional responsability to make sure your patient is being provided care by the best possbile practitioner.

 

[MoosePilot]

I can understand where you are coming from, but I think that most moral physicians, regardless of their beliefs, want their patients to have the most competent caregiver possible. Can you honestly imagine telling your patient to just look in the phone book for a random abortion provider? Not all doctors are good ones, and your patient could suffer needlessly.

I am not trying to judge you at all; in fact, I admire people with strong, well thought-out principles.

Well right now I imagine every doctor who is licensed in the United States is competent until proven otherwise. I don't think these are the days when back alley abortionists exist. Like I said, I expect more specific training in ethics before I have to worry about this actively.

 

[Zweihander]

When I posted the original question, I wasn't even thinking about a physician actually performing an abortion (esp. if s/he were morally opposed). I was thinking of the conflict of interest that could arise if a physician was so morally opposed to abortion that it would not even be discussed with a patient. If we start to scale back our "involvement", suggesting that even a referral is too akin to performing the abortion itself, doesn't that physician run into really bad territory? In other words, what's worse: seemingly compromising your integrity/ethics? Or using integrity as the reason you did not disclose all available courses of action, and perhaps jeopardizing the patient's life?

AGAIN, I am not criticizing either viewpoint. This is a really tough area for physicians, but I think it's something that needs more thought.

Rugger, part of the moral AND LEGAL contract you make with society and with all your potential patients when you agree to become a physician is to give them sound medical advice. Patient abandonment is a real principle, and you must respect it. If you do not want to be involved in the care of a patient for whatever reason, you must transfer care. Period. At the very least, you say: "I feel ethically unable to give you help in pursuing your abortion, so I am going to suggest that you transfer care to a colleague of mine who is also a primary care provider and who can give you better advice than I can." At minimum, this is your responsibility.

And mind you, this is coming from someone who doesn't believe in and would NEVER perform an abortion (with the three classic exceptions, of course).


peace

 

[Noeljan]

Wow, patient abandonment? Life threatening if not treated? I don't know I was under the impression that an abortion is an elective procedure that must be paid out of pocket and in MOST cases is not required to save the patient's life. I wouldn't mind advising the the pt to a more pro abortion establishment, and would rather have them discuss such issues with someone who will provide them with the treatment they are seeking. I do not think anyone should be required to offer abortion (minus emergency life threatening situations). I also wanted to point out that when I worked in a OB clinic, most women in such situations were considered high risk, and once considered in a certain category were treated elsewhere (I don't rem exactly where though). So in most cases if you were the GP would you even be routinely seeing a woman who may have a known life threatening pregnancy often? I don't know maybe it was just this facility that had such a policy.

 

[MoosePilot]

I have to second the comment about abortion being an elective procedure. I doubt that it would be patient abandonment if I didn't give a specific referral, but rather a general idea of where to find someone who might do that procedure. I'm unlikely to know who is good at the procedure, so except in general referring someone to a board certified OB/GYN, I'm don't know who's the best doctor. That's really what credentials are for. I would definitely be open to discussing how to find a good doctor in any field, such as board certifications and databases with complaints.

In the event of a life threatening complication, I would be more willing to give a specific reference or consult. I think that would be the area where abandonment is a worry.

 

[Zweihander]

Patient abandonment doesn't only come into play in emergency situations. If you have been seeing a patient for routine primary care and decide you simply don't want to see her anymore (maybe you find her annoying, or she never pays, or whatever), you are required to oversee a transfer of care. The situation the OP describes is similar. You are not REQUIRED to perform an abortion at all, but if you do not want to you can't simply tell your patient "Tough luck, there's a copy of the yellow pages in the waiting room." There is more to this issue than simply what you as a practitioner find morally palatable; you also have to consider issues of liability and what the law holds you responsible for.

Here's what the AMA has to say on the issue:

Regardless of the situation, to avoid a claim of "patient abandonment," a physician must follow appropriate steps to terminate the patient-physician relationship. Abandonment is defined as the termination of a professional relationship between physician and patient at an unreasonable time and without giving the patient the chance to find an equally qualified replacement. To prove abandonment, the patient must show more than a simple termination of a patient-physician relationship. The plaintiff must prove that the physician ended the relationship at a critical stage of the patient's treatment without good reason or sufficient notice to allow the patient to find another physician, and the patient was injured as a result. Usually, expert evidence is required to establish whether termination in fact happened at a critical stage of treatment.

 

[LiNk]

if the law says "abortions are legal", and you try to advise someone not to have one only because of your morals, then you are not fit to be a doctor. you just denied someone a treatment opportunity at a personal whim.
look at it this way, if you're morally opposed to chemotherapy and denied someone that treatment, would you be fit to be a doctor?
if you are "incapable" of treating someone who wants an abortion, then you better REFER them to someone who will help them. and that DOESN'T include the phone book. I'm sorry, but saying that all doctors in the phone book are "good" would be like saying that all lawyers are trustworthy. And what if the doctor you refer them to is booked for the next few months, or isn't covered by your health insurance? then what do you do? wait a few months for another doctor to fit you in? by then it's too late.

this is all a bit exteme by the way, and I respect all points of view. Heck, I'm not even stating whether I'm pro-life or pro-choice.

 

[Noeljan]

but Zweihander
an abortion is not usually a procedure that a patients needs. What I mean is, it is not medically required to improve their health or to decrease physical demise. There are all kinds of procedures that pts could request that are elective. Is a physician legally required to offer breast enhancement transfer of sort, I mean the pt wants it but are you really required to transfer such care? As for the Doctor being required to always care for the pt...well what about when certain health insurances are no longer covered at certain places. I know for a fact people that have been turned away. Isint that a reason that the poor and uninsured most commonly go to the emergency room for care that could have been treated my a primary care physician? I am not saying a pt should ever be turned away when needed, but I have to say I have seen it happen. Also, personally I would offer my pts places they could go for a more accurate decision making process about abortion but don't think I should be required to go beyond that. I have no desire to ever perform a medically elected abortion, and like I said before if a pt was in a threatening situation they would already be seeing a more accurate provider that obviously went into their field knowing what they wanted to do.
Also, do you really think let us say a rather healthy woman who is deciding to terminate a otherwise healthy fetus at a critical stage in ones treatment? Obviously chemo is a very good example of critical stage treatment (in which d/c without any warning or follow up care could result with severe damage and spread of the cancer) but sorry I don't see abortion as one in the case I described. But I would refer the pt

 

[MoosePilot]

this is all a bit exteme by the way, and I respect all points of view. Heck, I'm not even stating whether I'm pro-life or pro-choice.

No, you just took a perfectly reasonable thread and added the first heat. Congrats. Why don't you tone it down and come talk, like the rest of us.

 

[MoosePilot]

Here's what the AMA has to say on the issue:

Regardless of the situation, to avoid a claim of "patient abandonment," a physician must follow appropriate steps to terminate the patient-physician relationship. Abandonment is defined as the termination of a professional relationship between physician and patient at an unreasonable time and without giving the patient the chance to find an equally qualified replacement. To prove abandonment, the patient must show more than a simple termination of a patient-physician relationship. The plaintiff must prove that the physician ended the relationship at a critical stage of the patient's treatment without good reason or sufficient notice to allow the patient to find another physician, and the patient was injured as a result. Usually, expert evidence is required to establish whether termination in fact happened at a critical stage of treatment.

The AMA quote is helpful. Abandonment is termination at an unreasonable time and without giving the patient a chance to find an equally qualified replacement. In the field of abortion, any doc will be at least equally qualified to me, as I will have no training in it, so that's not tough. The termination must be at a critical stage and without good reason. There has to be an injury resulting.

I'm more than happy to help the patient with the underlying condition (pregnancy). I'll do everything I can within the best standards of care for the pregnancy.

 

[LiNk]

No, you just took a perfectly reasonable thread and added the first heat. Congrats. Why don't you tone it down and come talk, like the rest of us.

I am sorry about that. I did get a bit carried away. I am too used to forums like Penny Arcade.

 

[stoic]

To me the AMA statement does seem to error on the side of letting a physician terminate the relationship w/o providing a refferal.

The problem with the AMA statement is that it leaves quite open the definition of "critical stage of treatment" and "ample time to find a new physician." Imagine a teary eyed woman telling a jury about how her physician "abandoned" her at the most difficult stage of her life- after she'd decided to have an abortion. Because of this, she was forced to find a new physician and the search for another OB/GYN took her from the 1st trimester to the 2nd. In the end, she decided to go ahead with a 2nd trimester abortion, but doing so has caused her great grief and psychological harm.

It's a completely hypothetical, extreme situation, but that's what ethical debates are all about, right? In any case, physicians have been hit hard for doing less wrong than the hypothetical physician above.

So I have two questions:

1) It can be really tough to get in with an OB/GYN. Because of the highly litigious nature of the field, many OB/GYN's run from new, unrefered pregnant patients like they're the plauge. I've seen it happen several times. So it really could take months for a pregnant women to get in for an abortion without a referal. What if this took from the end of the first trimester to the beginning of the third and the method of abortion had to be changed from aspiration to partial birth? IF you knew this would happen (which realistically you couldn't), would you make a direct referal to avoid the partial birth abortion?

2) Would you be willing, in a situation like I started the post with, to risk the chance of something similar happening? Physicians have been reamed hardcore for doing a lot less than this. Is it worth a huge jump in your premiums? What about your practice? Your license (ok, again we're at extrememes... but it's all in good fun, ya know?)

 

[matthew45]

This is responding to something a bit farther back in the thread, but could the whole reference to "back alley coathanger appointments" maybe be toned down?

Basically to me this is just another example of vitriolic socio-political rhetoric that obscures the truth more than it hides it. As people aspiring to be doctors I would hope that we would be capable of expressing ourselves without automatic regression to slogans and party lines.

With that out, let me just say that this is one future M.D. that is 100% pro-life. If I had a patient that "needed" an abortion I would explain to her that I had serious moral issues with the procedure and attempt to dissuade her from having it done.

Happy 4th of July.

 

[Noeljan]

You know what the strange thing is, I have said before that I know quite a few women/girls who have had abortions. I don't even think any of them went through their GPs or OBs. They usually just sought out a clinic on their own or went to planned parenthood. I also have heard from them that tx at planned parenthood is rather cheap (they ask the girls how much they can afford). Something to that nature.
To the topic though, I would personally refer but I don't think I should have to go beyond that. I really don't agree with abortion as birth control so I don't think I should have to care for the pt in terms of abortion care. Also, abortion is such a sticky issue for the fact that no lines can be set. Regardless of sides, a 100% guaranteed line cannot be set about the whole when does human life start. Because of this, you have to realize that many people do consider abortion murder. When you have an issue sooo shaky like this I don't think it is fair to say someone does not deserve to practice medicine bc of this. This is why health insurance usually does not cover this procedure, and why all physicians are currently not required to perform abortions. This is not your oh this tx is better tha this, etc. This is an issue that some believe is an ultimate right, and others consider murder. I am not saying one is more right than the other to have (but people do have such strong beliefs in this)
haha I dont know exactly what I am trying to say right now but I am thinking it

 

[stoic]

This is responding to something a bit farther back in the thread, but could the whole reference to "back alley coathanger appointments" maybe be toned down?

No, it can't. I'm sorry that it offends you, particuarly because you're a fellow jayhawk, but there are some patients out there who are going to have abortions whether doctors help them or not. It's an extreme example, yes, but it is a consequence of inadequate access (for whatever reason) to abortion providers. I believe that we must provide options to woman who are pregrant and who are going to terminate their pregnancy. I would be eccstatic if no one wanted abortions because every pregnancy was planned, but that is simply not the case right now in our society.

I have personal experiences involving a friend and lack of abortion access that color my view somewhat. Needless to say, no one should ever have to go through what she did.

 

[Noeljan]

well Stoic I have had a bunch of friends (one in particular with 4 abortions and one child) that seem to have an abundance of abortion of access, with little or no blame placed on their shoulders so it seems to shape my experiences in the matter as well.

 

[stoic]

well Stoic I have had a bunch of friends (one in particular with 4 abortions and one child) that seem to have an abundance of abortion of access, with little or no blame placed on their shoulders so it seems to shape my experiences in the matter as well.

Yes, but you're in New York and I'm in Kansas. I assure that things are not equal in these locations.

As I said earlier, I would be extremely happy if nobody wanted abortions... but that's not happening right now. We digress from the original post, anyway.

I posted a hypothetical a few post ago... what are your thoughts regarding it?

 

[kiki the alto]

Doctors do indeed have the right to refuse business, just like any other business does. Most situations make it pretty unethical to refuse business, but an abortion is 99.99% never a life-or-death situation. Care that must be rendered to keep a patient alive is ethically obligatory, but it generally doesn't come to that in the case of an abortion. If a girl comes in having tried to abort her child herself, that's something a doctor must do something about. I don't, however, buy that too many women would be so desperate, in times like these where not every doctor has qualms about doing a standard scrape job.

 

[MoosePilot]

I am sorry about that. I did get a bit carried away. I am too used to forums like Penny Arcade.

Definitely not a problem, just wanted to keep the thread cool

 

[MoosePilot]

So I have two questions:

1) It can be really tough to get in with an OB/GYN. Because of the highly litigious nature of the field, many OB/GYN's run from new, unrefered pregnant patients like they're the plauge. I've seen it happen several times. So it really could take months for a pregnant women to get in for an abortion without a referal. What if this took from the end of the first trimester to the beginning of the third and the method of abortion had to be changed from aspiration to partial birth? IF you knew this would happen (which realistically you couldn't), would you make a direct referal to avoid the partial birth abortion?

2) Would you be willing, in a situation like I started the post with, to risk the chance of something similar happening? Physicians have been reamed hardcore for doing a lot less than this. Is it worth a huge jump in your premiums? What about your practice? Your license (ok, again we're at extrememes... but it's all in good fun, ya know?)

1. No, I wouldn't, because my hopes would be that the patient decides not to go ahead with the abortion. The longer I have to present that alternative the better. If there was some really hypothetical world where I knew the end result before the whole thing started, that might be different, but is also unrealistic.

2. Yes. I'd be willing to lose my license or face other censure in order to avoid participating in something I find wrong. The key is first to know the law, both actual law and what the AMA mandates. I admit I do not know the law as well as I'd like at this point, but I guarantee I will either learn what I need to in school or self study.

Now that we get into the nitty-gritty, it is relevant that I'm not really interested in OB/GYN, so it's unlikely to come up.

Stoic, can you talk vaguely about your friend's experience? Availability seems pretty widespread to me, too, so I don't understand where you're coming from.

 

[stoic]

Stoic, can you talk vaguely about your friend's experience? Availability seems pretty widespread to me, too, so I don't understand where you're coming from.

I think key to understanding the situation is understanding what one of the earlier posters pointed out - I'm in the middle of the Bible belt and things are pretty different here than in more liberal parts of the country. There is one abortion clinic in Kansas, and people have been shot by protesters while going into it. The physician who runs the clinic isn't even an Ob/Gyn, he's a family practictioner. So you can see access to quality abortion care IS a major issue here.

My friend was 16, young, scared, and unable to find a physician willing to refer her to an abortion provider without first talking with her parents. Her parents were (and still are) extremely conservative. Abortion wouldn't have been an option for them (at least that was her interpetation). In the end, she saw no options for herself and comitted suicide.

 

[Noeljan]

Hey Stoic,
I am very sorry for your friend's death. That is very unfortunate and you most likely are correct in observations of your area as opposed to mine (NY). I cannot say for sure on the area, because I have not really experienced it myself.
Getting back to the issue. I would refer my patients, I know I said this before. I have had many personal experiences with abortion through friends and family members (as well as working in an OB clinic). I do find it disturbing that many, many of these women have several abortions. I have seen it first hand. I don't know I think that the whole portraying these women as "innocent victims in horrible situations" has a lot to do with it. I think a lot (not all) of pro abortion activists are irresponsible in this regard. Don't you think if more blame was placed on there womens shoulders they would be a lot more responsible the next time? I think this is one thing that REALLY bothers me about the whole pro choice plight. I think I am a pretty open minded person, I have people very close to me who have had abortions. I ask questions to them trying to understand their situations. What I don't get it how a woman who gets pregnant multiple times without protection is seen as a "strong woman facing such hard times". I mean isint she the one who did this to herself? I have seen pregnant women who are having abortions almost babied and consoled as if they are doing such a great thing and none of this is their fault. you know what has happened with these women, they go and get pregnant all over again!!! I have had someone say to me when I asked why don't you make these guys use protection, don't you care? This person commented it gets easier after the first one (meaning abortion). I don't know about you, but I think this is a HUGE flaw in the pro abortion movement. I mean just bc you think abortion is such a great right and blah blah, etc...don't you think more steps should be taken to prevent it from happening again? Don't you think abortion should be looked at as wrong at all? Maybe if more pro abortion advocates said hey I do believe in this but ultimately it is wrong, and the women need to be more careful then it would help a lot. I mean a drunk driver who kills someone in an accident is he/she looked at as a victim? I mean they did it to themselves right? Ok maybe it was a one time thing and the person recovered. etc.....wouldnt the person be looked at a lot worse if they were to do the same thing twice? Shouldn't they have learned their lesson?

 

[stoic]

I absolutely think that much more time and effort should be spent on preventing unwanted pregnancy before it happens... instead of dealing with it after the fact. I'm one of those crazy liberals who thinks they should be handing out condoms in schools. But it goes far beyond just handing out rubbers; unfortunately many of the young woman who get pregnant are not ready to deal with the consequences of a sexual relationship (the guys aren't either, but their consequences don't include getting pregnant). The problem is that 16 year olds with raging hormones don't (maybe even can't) comprehend the ramifications of their actions. It's a really complicated issue. To me, the answer lies in more education, better access to bc methods, and a shift in how American families deal with sexuality. We need for kids and parents to be open about experiences, desires, questions, and the like. Abstience education is one way, but it will NEVER disuade the majority of kids that want to have sex from having sex.

Women who have multiple abortions piss me off, too. Abortion is a poor form of birth control. You would think that after the first, they'd just go on the pill... But that said, it is there right under our law to have abortions. I think it's unfortunate that women who have multiple abortions don't learn from their experiences, but they obviously don't have he same qualms about it as some people do.

However, I do think that we need to maintain sympathy for women who have abortions. I'm idealistic enough to think that for the vast majority of women who have had abortions, it was an emotionally destructive experience; whatever their reason for the procedure. If they go through with it, then I'm inclined to believe that they must have had very compelling reasons.

 

[stoic]

PS: I don't consider a first trimester fetus to be concious in any fashion. Aborting a fetus that has no awareness of it's own existance, to me, isn't murder.

I only added this because you ask. I DO NOT want to debate why these are my beliefs. There is a thread about that in Everyone.

 

[MoosePilot]

Stoic, thank you for sharing. That's an awful thing to have happened.

Several people keep calling abortion a "right" that obligates me to take actions. Now I would love to be educated, but I believe Roe v. Wade really points out the right is to privacy. The right is for individuals not to have the government regulating their lives. So the guarantee is for governmental non-interference, not for doctor assistance. If you can dispute this, I'd be more than happy to listen.

As far as moral counseling vs. medical counseling, there's a fine line between the two. My stance comes from my religious beliefs. I know that not everyone shares those, though. I am still free to present the very real medical alternative of not having an abortion. If I'm smart, I'll have the consequences of both readily available. In order to help with the most likely concerns, I should also have post-birth assistance options available to mention. To me this can easily fall into medical counseling. I certainly wouldn't get all religious on a patient without some clue that they would welcome the introduction of religion into our relationship.

 

[stoic]

The right is for individuals not to have the government regulating their lives.

Correct - meaning that if a woman wants to have an abortion, the government can't stop her. The question here remains "is a physician obligated to refer a patient who desires an abortion when that physician morally opposes abortion?"

To me the answer is yes, to others the answer is no. It's a moral question, meaning that right and wrong are not so cut and dry. It'd be interesting to here the opinions of some practicing physicians. Next time I shadow, I'll pitch the question. I'd encourage you guys to do the same.

Moose,
I'm curious as to whether or not you'll perscribe oral contraceptives?

S

 

[MoosePilot]

Moose,
I'm curious as to whether or not you'll perscribe oral contraceptives?

S

Right now my opinion would be yes, I would. Oral contraceptives keep a fertilized egg from implanting, which you could consider a very, very early abortion in a way, but I'm not comfortable with the start of life that early. I don't think it's a human life until after implantation, because that process is so naturally precarious. It's a tough question, though.

 

[Noeljan]

hey Stoic
I appreciate you response. My beliefs don't come from religion (as I don't believe in God at this point and time in the conventional way) but rather from my morals, and what I feel is evidence(to me). I personally feel that the human is a contstant progression. At the moment of conception life begins and it is the start of a new member of our species(not matter how small I do also believe our lives are special, but I don't have the answers right now as to why. I do firmly believe in birth control methods, and greater availablility. I do know that many young people will never be comfortable in coming ot their parents with sex (heck I still would never). I think maybe in the schools, or media. I do think refraining from sex is a great thing as well, but I don't think that will ever happen in large numbers. Since this will never happen I would rather provide safe methods to those who will take in sexual behaviors. To me abortion is murder, and I don't think I will ever change my mind about that. I do think young people act without thinking, or are unable to really think about the future in a realistic way. I don't think abortion is the answer though. I personally was born from a mother who was 17 so I know first hand what it is like to grow up that way. I also know what it is like to think about if my existance was never allowed to flourish.
One thing I wanted to add though (not to anyone in specific) but another thing that bothers me about pro abortion avocates. I don't understand why it is ok for them to preach their beliefs to patients, but not for pro lifers. Why is it ok for one nnd not the other? When my close friend went to get her abortions, I asked her if they ever really talked to her about alternatives or her previous abortions, etc. She said not really. Well if nobody is willing to ever talk about other options to these women then who will? Just because people believe an abortion is a right does not give them extra power to discuss their morals with pts (meaning pro abortion) and not pro lifers cannot express theirs. I do think that most women in this situation from what I have seen usually have quite a few friends that have had them and know where to go (in my experience though I am sure not all experiences).

 

[8744]

Part of the obligation of a prolife physician who is approached about abortion is to not only provide aftercare, but also to provide the patient information as to where she could get the procedure performed by a competent practitioner.

OK. I didn't read the whole thread so forgive me if someone has already said this.

You are absolutely wrong. Many states (all of them?), including my native Louisiana have laws which protect a physician who, for reasons of conscience, refuses to either preform or refer a woman for an elective abortion. In other words, if I am staunchly pro-life and a patient requests a referral to an abortion clinic, I would be within my legal and professional rights to refuse to either refer her or to provide information to her for a self-referral.

Additionally, in all public hospitals in the State of Louisiana, physicians and other health care providers are forbidden by law from referring, discussing, or performing elective abortions.

Let us please not get into a pointless debate about the morality of abortion. I think there are about 2500 threads on that topic. Do a search and you will read every flavor of opinion from "abort every child" to "keep pregnant woman in prison so there is no risk they'll have an abortion." I am merely pointing out that the law says otherwise from your opinion. And as the law came from a bill which, in Louisiana, was lobbied for by our state medical society you can't even say that it violates some nebulous concept of professional ethics.

I've posted on this same subject a few times and I'm suprised that most medical students don't know that they are free to have nothing at all to do with elective abortion. And this is not my opinion but a matter of law and public record.

I predict a vast outpouring of indignation.

 

[Noeljan]

Thanks Panda
I thought that would be the case, because I think people are confusing medical treatment with an elective abortion. I also heard from an ADCOM that it is illegal to even ask about abortion during an interview. He told this to the entire group of us touring the school so I am pretty sure he was accurate.
I don't think pro choicers realize how serious some people believe abortion is. To some people it is considered murder, I don't really think you can force a dr into providing care of something that they consider to be murder. I am not saying if it is right or wrong, but just the facts of it.

 

[Gleevec]

States should have laws protecting doctors from PERFORMING abortions.

However, doctors cannot play god and dictate to a patient which treatments they can or cannot partake in. And to have laws to protect that is tantamount to saying physicians should have complete control over the pregnancy, instead of the patient.

And that is a terrible, immoral thing.