Deny applicants who object to performing abortions and physician assisted suicide?

[ciestar]

They should. They have a private employer who can fire them fiiiiire what they want. If they run their own pharmacy they are free to do as they please

Precisely. If you don’t want to dispense misoprostol or the like because it is “against your morals” dont work for places like CVS or Walgreens who are only there to make money. That is their bottom line.

Regardless, i made my point before. It isnt my place to tell anyone else what they should or should not do.

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[LizzyM]

I have a particular moral stance on the issue of forcing physicians to perform procedures they object to (I can agree with some posts above except in extreme or emergent circumstances).

However, I'm more curious about the reverse - would it be acceptable for an institution to reject applicants if they ARE comfortable or do not object to performing certain procedures?

For example, could a religious institution ethically reject an applicant who has expressed a willingness to perform abortions or even an applicant who may have gotten an abortion in the past?

I think that is why some people are somewhat circumspect about their career plans when their school list includes medical schools that might not be entirely open to starting a chapter of Students4Choice on campus. There might be a bias, even an unconscious one, when an applicant's sensibilities goes against the school's. (Don't brag to Loma Linda you've worked as a bartender in a steakhouse.)

 

[premed20172017]

(Don't brag to Loma Linda you've worked as a bartender in a steakhouse.)

This is the best part of the entire thread. Thank you, @LizzyM!!

Edit: Out of curiosity, @Matthew9Thirtyfive are you considering ob/gyn, or are you ruling it out because you won't perform all of the procedures?

 

[Mad Jack]

I have a particular moral stance on the issue of forcing physicians to perform procedures they object to (I can agree with some posts above except in extreme or emergent circumstances).

However, I'm more curious about the reverse - would it be acceptable for an institution to reject applicants if they ARE comfortable or do not object to performing certain procedures?

For example, could a religious institution ethically reject an applicant who has expressed a willingness to perform abortions or even an applicant who may have gotten an abortion in the past?

Liberty refused to consider me (I contacted them prior to applying because I had concerns with their morality clauses and wasn't willing to lie) because I told them I drink wine and live with a girl I'm not married to soooooo

 

[ciestar]

Liberty refused to consider me (I contacted them prior to applying because I had concerns with their morality clauses and wasn't willing to lie) because I told them I drink wine and live with a girl I'm not married to soooooo

Not worth it lol

 

[deleted987519]

Liberty refused to consider me (I contacted them prior to applying because I had concerns with their morality clauses and wasn't willing to lie) because I told them I drink wine and live with a girl I'm not married to soooooo

Surprised you haven’t been incarcerated yet.

 

[Mad Jack]

Surprised you haven’t been incarcerated yet.

I should dig up the email they sent me again for old times' sake, it was pretty hilarious. God forbid they knew about what my life is like these days

 

[deleted804295]

Good points but there are also patients who are looking for physicians who have the same moral sensibilities that they have and that specifically don't perform abortions etc. Find a Pro-Life OBGYN Search Therefore, I think that there is a place in OB-GYN/family medicine for practioners who don't perform these procedures as long as they are clear to patients up-front, before they make an appointment, that they don't do these procedures.

I'm glad you brought this up. I know of many individuals who prefer ob/gyn providers of the same religion so that they can provide alternatives to contraceptive/abortion.

In my experience, providers who are unwilling to provide abortions/contraceptives say so upfront.

 

[deleted804295]

Liberty refused to consider me (I contacted them prior to applying because I had concerns with their morality clauses and wasn't willing to lie) because I told them I drink wine and live with a girl I'm not married to soooooo

Is that even a real US MD school? I keep getting spam email from them.

 

[musician8591]

I find it wholly acceptable for a physician not to perform an abortion, elective or otherwise. However, I have major concerns when a provider refuses even to refer a patient to someone who will perform the procedure they are looking for. I can imagine as a patient, going to a provider who counsels me about abortion. "Ms. so-and-so (I'm really a Mr.), it is my personal conviction that you should not elect to abort. There are several other options, such as..." That's perfectly fine, but if your beliefs do not sway me and you refuse to give a referral, you've created an extreme hardship for me. Due to the insurance market in our healthcare system, many people don't even have a choice in where they receive care. So no, changing PCPs and providers is not always an option. If a patient is so determined to have an abortion, your moral objection is effectively creating a barrier, which may lead to a back alley abortion, which endangers the mother's life.

There is a medication called PrEP (Pre-exposure Prophylaxis) mostly prescribed to men who have sex with men in order to prevent the spread of HIV. Imagine you are morally opposed to promiscuity and decide not to prescribe PrEP so as not to encourage this behavior. (I realize these are not anyone's stated beliefs in this thread). Is it acceptable NOT to refer the patient to someone who will prescribe this medication?

 

[ciestar]

Is that even a real US MD school? I keep getting spam email from them.

Liberty is LUCOM, a DO school

 

[Cornfed101]

There is a medication called PrEP (Pre-exposure Prophylaxis) mostly prescribed to men who have sex with men in order to prevent the spread of HIV. Imagine you are morally opposed to promiscuity and decide not to prescribe PrEP so as not to encourage this behavior. (I realize these are not anyone's stated beliefs in this thread). Is it acceptable NOT to refer the patient to someone who will prescribe this medication?

Little side fact, did you know the inventor of the birth control pill, Dr. John Rock, was a staunch Catholic? He actually tried to convince the Catholic church that the pill was within the teachings of the church because it used the body's natural hormones. The governing body of the church agreed with him, but the Pope shot it down. Interesting to think about how different things would be if the Pope had gone the other way!

To answer your question, I think you should refer people to help them get the healthcare access they need. I think in your example no doctor should be able to use morality to weasel out of providing PrEP to someone. If a known terrorist walked into your ER you would treat him. It doesn't matter what the person has done. It is still your responsibility to treat them. The difference with abortion is that people on the pro-life side believe that life begins at conception (or at least before birth), so they feel that performing an abortion is doing harm to the baby. I think this is the important difference between PrEP and abortion.

 

[Lis207]

Little side fact, did you know the inventor of the birth control pill, Dr. John Rock, was a staunch Catholic? He actually tried to convince the Catholic church that the pill was within the teachings of the church because it used the body's natural hormones. The governing body of the church agreed with him, but the Pope shot it down. Interesting to think about how different things would be if the Pope had gone the other way!

Dr. John Rock used casuistry, a Jesuit form of moral reasoning, to argue that the suffering and poverty of the Irish Catholics of Boston would be alleviated by access to birth control. Simply put, the goal of humans and doctors should be to rid the world of suffering.

Similar to Dr. Rock's question, what is our duty to alleviate the suffering of our patients? what is our moral obligation to the patient's wellbeing? If a provider neglects to recommend a safe provider of abortions, what is our moral responsibility when the patient takes to the internet to find their own solution? What is our moral obligation when they are admitted to the ED due to a suicide attempt (one that compromises two lives) because of the emotional distress caused by an unwanted pregnancy.

 

[ciestar]

Dr. John Rock used casuistry, a Jesuit form of moral reasoning, to argue that the suffering and poverty of the Irish Catholics of Boston would be alleviated by access to birth control. Simply put, the goal of humans and doctors should be to rid the world of suffering.

Similar to Dr. Rock's question, what is our duty to alleviate the suffering of our patients? what is our moral obligation to the patient's wellbeing? If a provider neglects to recommend a safe provider of abortions, what is our moral responsibility when the patient takes to the internet to find their own solution? What is our moral obligation when they are admitted to the ED due to a suicide attempt (one that compromises two lives) because of the emotional distress caused by an unwanted pregnancy.

And in some places in the US, that woman would be charged with murder or attemped murder.

Im thankful I live where I live. Doubtful I would make that choice for myself, but that doesn’t mean other women don’t have that right.

 

[Cornfed101]

Similar to Dr. Rock's question, what is our duty to alleviate the suffering of our patients? what is our moral obligation to the patient's wellbeing? If a provider neglects to recommend a safe provider of abortions, what is our moral responsibility when the patient takes to the internet to find their own solution? What is our moral obligation when they are admitted to the ED due to a suicide attempt (one that compromises two lives) because of the emotional distress caused by an unwanted pregnancy.

Exactly, I think situations like the ones you proposed are precisely why a provider should suggest options for someone seeking an abortion. Whether that be finding another provider to perform the procedure, putting the child up for adoption, or other viable options. Simply saying, "sorry you are SOL" is not acceptable in my opinion.

 

[and 99 others]

The reason why @Matthew9Thirtyfive among others is not willing to do that referral is because they would be playing a hand in that abortion and it would be a sin. While they weren't the direct cause of the abortion, they helped in it.

It also is a sin in your religion [Al-Maida 5:2] however you do have your own personal beliefs that might not coincide with your religion.

I'm not sure if you meant to cite another verse but that one has absolutely nothing to do with abortion. As far as I know, the Quran doesn't mention abortion anywhere and the majority of rulings on abortion in Islam come from the Hadith.

 

[deleted804295]

I'm not sure if you meant to cite another verse but that one has absolutely nothing to do with abortion. As far as I know, the Quran doesn't mention abortion anywhere and the majority of rulings on abortion in Islam come from the Hadith.

Yeah I'm not sure where you thought I was quoting a ruling on abortion. My post was about referrals for abortion.

 

[caterwaiter]

This was a difficult thread to read, particularly as a woman. I hope our collective future medical education provides some clarity on this issue (for everyone attending, not just the posters in this thread), because it clearly needs addressing.

 

[deleted480308]

I find it wholly acceptable for a physician not to perform an abortion, elective or otherwise. However, I have major concerns when a provider refuses even to refer a patient to someone who will perform the procedure they are looking for. I can imagine as a patient, going to a provider who counsels me about abortion. "Ms. so-and-so (I'm really a Mr.), it is my personal conviction that you should not elect to abort. There are several other options, such as..." That's perfectly fine, but if your beliefs do not sway me and you refuse to give a referral, you've created an extreme hardship for me. Due to the insurance market in our healthcare system, many people don't even have a choice in where they receive care. So no, changing PCPs and providers is not always an option. If a patient is so determined to have an abortion, your moral objection is effectively creating a barrier, which may lead to a back alley abortion, which endangers the mother's life.

There is a medication called PrEP (Pre-exposure Prophylaxis) mostly prescribed to men who have sex with men in order to prevent the spread of HIV. Imagine you are morally opposed to promiscuity and decide not to prescribe PrEP so as not to encourage this behavior. (I realize these are not anyone's stated beliefs in this thread). Is it acceptable NOT to refer the patient to someone who will prescribe this medication?

There is absolutely an ability to go to other doctors. To act like it’s not is dishonest.

No doc should be forced to offer or refer to any particular procedure/med

 

[gerbell]

This was a difficult thread to read, particularly as a woman. I hope our collective future medical education provides some clarity on this issue (for everyone attending, not just the posters in this thread), because it clearly needs addressing.

i'm glad i'm not the only one who was thinking what you posted... this thread is very stressful (esp as a woman).

 

[achilles0619]

I've found this entire thread really interesting since I was actually asked this question in an interview a few months back, so I have been thinking about it for a while. The question was "Do you think medical students should have to learn procedures that go against their beliefs?" Like a lot of people have brought up, changing providers is not an option for some people. One of the follow up questions my interviewer asked me when I said that I do not think doctors should be forced to do procedures that go against their beliefs, which everyone here seems to agree on, was what if you were the only doctor in a rural area, and your patient didn't have a car, how would you help them?I I think this situation does occur especially with the lack of physicians in rural areas, as well as higher poverty rates in rural areas so less access to transportation, internet access ect...

While I understand that some people feel that directly referring a patient to another PCP is just as bad as doing the procedure, I am wondering what you think about using other members of the care team to do this referral. Social workers, NPs, and other members of your office/ hospital could be counseled in this care, and you could have some planned parenthood packets in your waiting room. For those opposed to even helping your patient find another doctor, would you be willing to have a social worker or nurse who could help your patients in this way?

Edit: Grammar

 

[ChymeofPassion]

i'm glad i'm not the only one who was thinking what you posted... this thread is very stressful (esp as a woman).

What's stressful? Just make sure your OBGYN/PCP supports abortion and you avoid the whole thing.

 

[ChymeofPassion]

I think it’s stressful because the conversation about abortion is just as male-dominated on this website as it is everywhere else

Are you assuming people are men because they don't support elective abortion? I don't know anyone's gender on this website. Also no one is preventing women from commenting, I fail to understand this criticism.

 

[electropartyogram]

I think it’s stressful because the conversation about abortion is just as male-dominated on this website as it is everywhere else

That shouldn't matter. This conversation is about a physician's right to have moral objections to procedures. That those objections are ethically valid, and that people have a right to not be punished for expressing those objections. A person's sex shouldn't be a factor when determining if they should be able to abstain from providing certain procedures/medications. If it helps, only 17% of OB-GYN residents are male (as per Google).

 

[and 99 others]

Yeah I'm not sure where you thought I was quoting a ruling on abortion. My post was about referrals for abortion.

Aha gotcha. Thanks for clarifying!

 

[Lis207]

I think it’s stressful because the conversation about abortion is just as male-dominated on this website as it is everywhere else

Hi! A woman currently working for an OBGyn here! Though my post was pro-abortion access and referral so that might prove your point.

 

[caterwaiter]

There is absolutely an ability to go to other doctors. To act like it’s not is dishonest.

Is it *possible*? Probably. Is it easy or reasonable to navigate? Usually not. In the Medi-cal/Medicare system, it can take MONTHS to be assigned to and get an appointment with a new PCP. This is an issue when it comes to handling an unwanted pregnancy.

What's stressful? Just make sure your OBGYN/PCP supports abortion and you avoid the whole thing.

I would venture a guess to say this isn't something most people would think to ask when they're first meeting a PCP. No one plans ahead to have an abortion.

Are you assuming people are men because they don't support elective abortion? I don't know anyone's gender on this website. Also no one is preventing women from commenting, I fail to understand this criticism.

I think many of us (knowingly or not) mentally assume the gender of users based on their usernames, avatars, and post history. But you're right. We're assuming. Could be wrong. I think the poster of that comment is likely stressed (as I am) by the larger issue of people-without-uteruses doing the majority of very personal decision making for people-with-uteruses.

Note: I have a feeling this thread is going to degenerate quickly.

 

[Cornfed101]

I would venture a guess to say this isn't something most people would think to ask when they're first meeting a PCP. No one plans ahead to have an abortion.

Probably depends on what you mean by PCP. Meeting with your pediatrician when you are 13? No... I would hope someone wouldn't ask about abortions (unless you are already pregnant). But I would hope if you are discussing birth control with your OBGYN that the topic of "what happens if I do get pregnant?" crosses your mind...

 

[caterwaiter]

But I would hope if you are discussing birth control with your OBGYN that the topic of "what happens if I do get pregnant?" crosses your mind...

Fair point, taken. I suppose my hope, then, is that people feel comfortable talking to their OBGYNs about it.

 

[gerbell]

What's stressful? Just make sure your OBGYN/PCP supports abortion and you avoid the whole thing.

I know you mean well by this suggestion, but... That's a much more difficult thing to do than the way you've stated here. It's also not something many people who can get pregnant consider until they are in a situation where they need to terminate a pregnancy. Access to obstetric and gynecological care varies from state, county and city (if you'd like to learn more, search with key words like rural, barriers, etc). You may not think to ask, or feel safe/supported asking, an OB/GYN or PCP about abortion care when you meet them. Or you may be outside of your home state, say if you're in college, and have extremely limited options offered by your insurance - and maybe on top of that you're in a state where access to abortion care is extremely limited.

Stating the situation as "Just do x" does not take into account the mountain of factors that keep many people from accessing the care they need. That's also why reading many people in this thread state that they would not point a patient in the direction of someone who would be able to assist them with the care they're requesting make me really uncomfortable. I understand feeling uncomfortable or upset with assisting with a service you don't agree with. But as healthcare providers, I think that we have a duty to assist our patient with accessing the skilled care they request with sensitivity, sympathy and support.

The healthcare issue they're having will not disappear if you decline to assist them. It just means they have one less source of support during a critical time of their life.

 

[deleted480308]

Is it *possible*? Probably. Is it easy or reasonable to navigate? Usually not. In the Medi-cal/Medicare system, it can take MONTHS to be assigned to and get an appointment with a new PCP. This is an issue when it comes to handling an unwanted pregnancy.

I would venture a guess to say this isn't something most people would think to ask when they're first meeting a PCP. No one plans ahead to have an abortion.

I think many of us (knowingly or not) mentally assume the gender of users based on their usernames, avatars, and post history. But you're right. We're assuming. Could be wrong. I think the poster of that comment is likely stressed (as I am) by the larger issue of people-without-uteruses doing the majority of very personal decision making for people-with-uteruses.

Note: I have a feeling this thread is going to degenerate quickly.

Not the doctor’s problem. Fix medicare and leave the doctors alone.

 

[deleted480308]

What? This is such a reductive and ignorant comment.

Nope. A doctor is not subject to their patients. Both are autonomous adults and a need on a patient’s behalf does not remove moral autonomy from the doctor

 

[AMEHigh]

Do women really go to their PCP to get a referral for abortion? Don't they just go to the phone book (or these days, Google) or call their local Planned Parenthood?

I can see where it might be tricky for 2nd trimester abortions due to fetal anomolies and in those cases, physicians might have an obligation to point patients who want to terminate the pregancy in the direction of providers who do those highly specialized procedures.

Yes, in my practice happens all the time.
Or they come in for whatever, we do a pregnancy test and it’s positive and we do options counseling, then they decide to have an abortion so we guide them.
Luckily where I work as a pcp we do abortions in our health center up to a certain gestational age so it makes the process pretty seamless. We can refer patients to other places as needed for more complex patients.
I guess it depends on where you work and the demographics you work with but reproductive healthcare including abortion care and counseling is what I do on a weekly basis. This includes everything from straight forward abortion care to more complex cases like a patient with cancer who wants to continue the pregnancy but is about to start chemo for example.

 

[Lawpy]

Doctors shouldn't be forced to refer patients to places to get abortions. I don't know why preallo insists on reducing physician autonomy.

 

[Cornfed101]

It's also not something many people who can get pregnant consider until they are in a situation where they need to terminate a pregnancy.

Don't we then need to dedicate more resources at this stage of this issue? It shouldn't be a surprise to anyone that sex leads to pregnancy. Do you think the biggest issue is the lack of birth control options? I have to admit I am fairly naive about this because my wife and I have never had issues with access to inexpensive birth control (with and without insurance).

 

[ChymeofPassion]

Is it *possible*? Probably. Is it easy or reasonable to navigate? Usually not. In the Medi-cal/Medicare system, it can take MONTHS to be assigned to and get an appointment with a new PCP. This is an issue when it comes to handling an unwanted pregnancy.

I would venture a guess to say this isn't something most people would think to ask when they're first meeting a PCP. No one plans ahead to have an abortion.

I think many of us (knowingly or not) mentally assume the gender of users based on their usernames, avatars, and post history. But you're right. We're assuming. Could be wrong. I think the poster of that comment is likely stressed (as I am) by the larger issue of people-without-uteruses doing the majority of very personal decision making for people-with-uteruses.

Note: I have a feeling this thread is going to degenerate quickly.

Cornfed101 already said what I would about talking with the OB-GYN, I figured it would naturally come up when talking about birth control. But I've also never discussed anything like that because I don't have that machinery. I completely agree with the bolded. We've all seen the image of a room full of men deciding abortion laws/rights for women. That shouldn't happen. But that isn't what's happening on this thread. A doctor not performing an abortion and then not giving a referral is their own personal decision making, they are not making the decision for the woman to have the child. For the record, I'm pro-choice (and a man) and would perform an abortion/give a referral, but I also support physician autonomy.

 

[electropartyogram]

I agree that doctors are morally autonomous agents, but (beyond the abortion debate) you are insinuating that problems with healthcare access are not doctors’ responsibilities.

edit: clarity

Why would it be? That is like saying problems with criminal injustice are part of the responsibilities of every lawyer or judge.

 

[gerbell]

Don't we then need to dedicate more resources at this stage of this issue? It shouldn't be a surprise to anyone that sex leads to pregnancy. Do you think the biggest issue is the lack of birth control options? I have to admit I am fairly naive about this because my wife and I have never had issues with access to inexpensive birth control (with and without insurance).

Abortion access, birth control access, and sexual education all go hand-in-hand and are parts of the same whole issue. I don't think we should be treating them as separate, because they're all parts that contribute to a wider knowledge regarding reproductive health and autonomy in patient decision making. Personally, I think we need to do a lot more work destigmatizing all parts of reproductive healthcare! Making birth control free to everyone and not restricting it by parental consent would be a good first step. And I think reproductive education should not be exclusively taught to children/students considered female. It should be taught to everyone.

I think that what you've said here about being naive about this topic speaks to how a lot of other people think too. I mean, why would you ever think about stuff like that if you've never had to worry about it before? I'd really encourage you to read more about reproductive health/reproductive justice... It's a big topic in healthcare (even if you dont want to go into OB/Gyn) and it's a lot more complicated than you'd think at first, haha! I'm really involved w/ it and there's still stuff I'm learning to this day.

Lastly, I just want to gently add that while I'd guess most people know that sex lead to pregnancy, 1) many people may end up in situations where they can't safely or fully consent to sexual activity, 2) **** happens even when you use birth control. Someone close to me had an unexpected (and unviable) pregnancy despite using birth control correctly. They were just really unlucky and failed without them knowing. Having safe, accessible abortion and a supportive doctor helped them out IMMENSELY in what was already an extremely difficult time in their life.

 

[Lawpy]

Abortion access, birth control access, and sexual education all go hand-in-hand and are parts of the same whole issue. I don't think we should be treating them as separate, because they're all parts that contribute to a wider knowledge regarding reproductive health and autonomy in patient decision making. Personally, I think we need to do a lot more work destigmatizing all parts of reproductive healthcare! Making birth control free to everyone and not restricting it by parental consent would be a good first step. And I think reproductive education should not be exclusively taught to children/students considered female. It should be taught to everyone.

I think that what you've said here about being naive about this topic speaks to how a lot of other people think too. I mean, why would you ever think about stuff like that if you've never had to worry about it before? I'd really encourage you to read more about reproductive health/reproductive justice... It's a big topic in healthcare (even if you dont want to go into OB/Gyn) and it's a lot more complicated than you'd think at first, haha! I'm really involved w/ it and there's still stuff I'm learning to this day.

Lastly, I just want to gently add that while I'd guess most people know that sex lead to pregnancy, 1) many people may end up in situations where they can't safely or fully consent to sexual activity, 2) **** happens even when you use birth control. Someone close to me had an unexpected (and unviable) pregnancy despite using birth control correctly. They were just really unlucky and failed without them knowing. Having safe, accessible abortion and a supportive doctor helped them out IMMENSELY in what was already an extremely difficult time in their life.

The stigma arises because of a combination of social, political and religious factors that get dramatically magnified. In this environment, being risk averse is a safe option and it's what many doctors will do (along with following their own morals and beliefs). But if there are doctors willing to perform such procedures or refer them if they can't, that's great. Just don't force risk averse physicians to do something they don't want to. This is true for any medical procedure and/or decision making, not just abortion.

 

[Cornfed101]

I think that what you've said here about being naive about this topic speaks to how a lot of other people think too. I mean, why would you ever think about stuff like that if you've never had to worry about it before? I'd really encourage you to read more about reproductive health/reproductive justice... It's a big topic in healthcare (even if you dont want to go into OB/Gyn) and it's a lot more complicated than you'd think at first, haha! I'm really involved w/ it and there's still stuff I'm learning to this day.

I will add that my wife has had 2 high-risk pregnancies so I have probably been to more OB appointments than many women have (several dozen over the last 6 years), although it was as an observer and not the participant.

Abortion access, birth control access, and sexual education all go hand-in-hand and are parts of the same whole issue. I don't think we should be treating them as separate, because they're all parts that contribute to a wider knowledge regarding reproductive health and autonomy in patient decision making. Personally, I think we need to do a lot more work destigmatizing all parts of reproductive healthcare! Making birth control free to everyone and not restricting it by parental consent would be a good first step.

These are good points. One thing that I hate about the current reproductive stigma is on the flip side. Infertility is severely under covered by insurance, which I find odd given that it is a medical issue. My wife and I struggle with infertility and there was nobody advocating for greater access to infertility treatment when we wanted to start a family.

 

[deleted480308]

edited, failed to initially articulate what I meant.

Issues the with healthcare system are largely out of doctors’ control, yes, but we can’t just not address problems that are caused by limited access and say “fix Medicare.”

NO problem with the system negates my moral autonomy and that is what you are suggesting

 

[gerbell]

These are good points. One thing that I hate about the current reproductive stigma is on the flip side. Infertility is severely under covered by insurance, which I find odd given that it is a medical issue. My wife and I struggle with infertility and there was nobody advocating for greater access to infertility treatment when we wanted to start a family.

Totally! I actually think that stigma against fertility treatments should be considered right alongside stigma against abortion, birth control, etc because its also a topic directly related to reproductive healthcare and patient autonomy. People like to place fertility/infertility as separate but really its just another aspect of the same conversation. And its also a topic the general public know little about/has inaccurate information on until its something THEY have to do!

 

[deleted480308]

Abortion access, birth control access, and sexual education all go hand-in-hand and are parts of the same whole issue. I don't think we should be treating them as separate, because they're all parts that contribute to a wider knowledge regarding reproductive health and autonomy in patient decision making. Personally, I think we need to do a lot more work destigmatizing all parts of reproductive healthcare! Making birth control free to everyone and not restricting it by parental consent would be a good first step. And I think reproductive education should not be exclusively taught to children/students considered female. It should be taught to everyone.

I think that what you've said here about being naive about this topic speaks to how a lot of other people think too. I mean, why would you ever think about stuff like that if you've never had to worry about it before? I'd really encourage you to read more about reproductive health/reproductive justice... It's a big topic in healthcare (even if you dont want to go into OB/Gyn) and it's a lot more complicated than you'd think at first, haha! I'm really involved w/ it and there's still stuff I'm learning to this day.

Lastly, I just want to gently add that while I'd guess most people know that sex lead to pregnancy, 1) many people may end up in situations where they can't safely or fully consent to sexual activity, 2) **** happens even when you use birth control. Someone close to me had an unexpected (and unviable) pregnancy despite using birth control correctly. They were just really unlucky and failed without them knowing. Having safe, accessible abortion and a supportive doctor helped them out IMMENSELY in what was already an extremely difficult time in their life.

Why should birth control be free to everyone if the other meds shouldn’t be?

 

[Lawpy]

NO problem with the system negates my moral autonomy and that is what you are suggesting

That's really the point here. People are trying to focus on various issues here, and while i agree they are important, that doesn't give them the right to force physicians to do something they don't want to. Physician autonomy is important yet preallo wants to eliminate it.

 

[gerbell]

The stigma arises because of a combination of social, political and religious factors that get dramatically magnified. In this environment, being risk averse is a safe option and it's what many doctors will do (along with following their own morals and beliefs). But if there are doctors willing to perform such procedures or refer them if they can't, that's great. Just don't force risk averse physicians to do something they don't want to. This is true for any medical procedure and/or decision making, not just abortion.

Sorry if this turns up as a double post - I’m on mobile!
I totally get what you’re saying here. I think about this often when considering what specialty I’d like to go into in the future!! My issue with what youre saying (if I’m interpreting correctly!) is that a lot of people on this thread are saying that they flat out would not help a patient find further care if they were in a situation that they didnt agree with morally.
Those sort of comments are what made me voice my discomfort originally. I think as premedical students & medical professionals, we can forget how a huge barrier to care is the difficulty getting it. I cannot tell you how many people I know anecdotally who didnt pursue further healthcare that would have hugely benefitted them simply because their physician didnt support them, offer them any alternatives, or it was just too much of a hassle to go through the process of searching & securing an appointment all over again.
I dont think its wrong for a physician to say “no, i dont personally agree with and will not provide you that care.” But I think at minimum, its our responsibility as a patient’s trusted healthcare provider to help them figure out where to go next. Be that referring to them to someone who can provide the service, or providing them with resources/info on in situations where you think a procedure would bring them harm so they can make an informed decision.

 

[gerbell]

Why should birth control be free to everyone if the other meds shouldn’t be?

Again sorry if this double posts- im on mobile.
Personally I’m a HUGE proponent for free medicine! If someone has a chronic condition, I think the medication should be free or at the very least easily affordable. I also feel that would help reduce the stigma surrounding birth control too!

 

[Lawpy]

Sorry if this turns up as a double post - I’m on mobile!
I totally get what you’re saying here. I think about this often when considering what specialty I’d like to go into in the future!! My issue with what youre saying (if I’m interpreting correctly!) is that a lot of people on this thread are saying that they flat out would not help a patient find further care if they were in a situation that they didnt agree with morally.
Those sort of comments are what made me voice my discomfort originally. I think as premedical students & medical professionals, we can forget how a huge barrier to care is the difficulty getting it. I cannot tell you how many people I know anecdotally who didnt pursue further healthcare that would have hugely benefitted them simply because their physician didnt support them, offer them any alternatives, or it was just too much of a hassle to go through the process of searching & securing an appointment all over again.
I dont think its wrong for a physician to say “no, i dont personally agree with and will not provide you that care.” But I think at minimum, its our responsibility as a patient’s trusted healthcare provider to help them figure out where to go next. Be that referring to them to someone who can provide the service, or providing them with resources/info on in situations where you think a procedure would bring them harm so they can make an informed decision.

But see, that's simply imposing your views on others and forcing them to do what you think it's right. Personally, i have zero issues referring patients to appropriate clinics to get abortion services because their care is important to me. However, others with pro-life and religious views don't feel comfortable referring patients because they feel they'll play a role in aiding with procedures that violate their beliefs. That's the issue here. And physician autonomy is important for these reasons.

More generally, there are physicians who won't perform noncontroversial procedures because they don't feel comfortable or aren't qualified, but for whatever reasons, they won't refer. Patients are free to slam the physicians for hindering their care and discourage others to visit them, but unfortunately, physician autonomy still needs to be maintained.

 

[deleted480308]

This is not what I’m suggesting. You made the blanket statement “not my problem, fix Medicare” in regard to an issue of access to healthcare, which IMO violates the principles of beneficence + justice. I agree that physicians have the moral autonomy to refer/not refer for elective procedures, I was just trying to convey that broad statements like this are slippery slopes in terms of medical ethics.

My reply was to a claim that since some coverages don’t have fast pcp changes that I would be obligated to refer. NOPe, not my problem

 

[deleted480308]

Again sorry if this double posts- im on mobile.
Personally I’m a HUGE proponent for free medicine! If someone has a chronic condition, I think the medication should be free or at the very least easily affordable. I also feel that would help reduce the stigma surrounding birth control too!

Oh dear, of course it shouldn’t be free. Needing something doesn’t mean you have a right make someone else buy it for you.

And there is no large societal stigma to birth control. That’s simply not true. Very small segments of society don’t want some methods, that’s it

 

[gerbell]

Oh dear, of course it shouldn’t be free. Needing something doesn’t mean you have a right make someone else buy it for you.

And there is no large societal stigma to birth control. That’s simply not true. Very small segments of society don’t want some methods, that’s it

I think we may fundamentally disagree on your first comment. (EDIT: im on mobile, re-reading originally this came off more passive aggressive than i intended!) Personally, I think that medication and medical access should not cost much if at all to a patient. Physicians and drugmakers should be compensated for their time and work of course. Ideally, I personally would like this to be done through a program that means a patient would pay little to nothing for accessing medical care and treatment. I understand if you feel differently, as it seems you do!

Your second comment, though, concerns me. I really would recommend learning more about reproductive healthcare access! I’m thinking of the United States in all my comments, but stigma blocking access to birth control is a serious healthcare problem. To name a few common scenarios: safe, informed reproductive healthcare access for teens, young adults dependent on a guardian’s insurance coverage for healthcare access, and adults whose employers refuse to include birth control in their insurance coverage. I truly do not mean this in a negative or mean way. I really do want to encourage you to look into this topic further!