Doctors and Morals

[Arch Guillotti]

Well, alright then, your point is taken. I hastily read this thread.

However, I do take exception to your statement that "It's not your job to decide what's best for your patients unless they are incapable of doing that on their own."

I guess my post was mainly in response to that.

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[Planktonmd]

This thread is too long for me to read all the posts so my judgment might be based on partial knowledge but I have to say that Copro is pleasantly surprising me with some very sound logic that I never thought he was capable of.
Good job Copro.

 

[coprolalia]

This thread is too long for me to read all the posts so my judgment might be based on partial knowledge but I have to say that Copro is pleasantly surprising me with some very sound logic that I never thought he was capable of.
Good job Copro.

The back-handed compliment aside, the only other thing I can say is that you should listen to me more often.

-copro

 

[drmwvr]

You're wrong because patient care is not about you and your beliefs.

-copro

What else, beyond training and experience, do I have? I come as a package deal and so do you. You cannot say that your beliefs are why you would assist this person. Why are mine not valid here? Also, autonomy assumes competency, otherwise you are throwing the patient to the wolves (this isn't only with regard to the guy who wants a limb amputated).
The last thing I'll say is that I think you are applying a double standard to me because you have a bias against my beliefs. Yours are valid, mine are not. You have a belief things will turn out well if he acts out his pyschosis, I have a belief they won't, despite the anecdotes you provide. And believe me when I say this, Copro, that particular statement has nothing to do with religion. It honestly doesn't make sense to me.

 

[coprolalia]

What else, beyond training and experience, do I have?

Your personal religious beliefs have nothing to do with the practice of medicine.

And, thank you for, at least, cleanly chipping through the thin veneer of what lies at the heart of your true self-motivation as to why you refuse to provide care to certain people whose beliefs happen to disagree with your own. Contrary to your own misguided self-conceptualization, you don't wield the power given to you by your medical license judiciously; you wield it capriciously.

-copro

 

[emc2a]

will the same persons still refuse when they'll be banking 300$ for a 5min procedure??

I'd rather kill myself first than kill somebody else. $300 is squat.

 

[CambieMD]

Judge patients by their standards, not your own. Otherwise, you're being, at best, a moralizing obstructionist or, at worst, playing God. You are there to advocate for and facilitate your patient's wishes, not decide and mandate your own.

It's not your job to decide what's best for your patients unless they are incapable of doing that on their own.

-copro

As physicians we decide what is best for our patients every day. I do not judge my patients. There are however, procedures that I will not participate in performing. Does that make me, "a moralizing obstructionist?"

Cambie

 

[coprolalia]

As physicians we decide what is best for our patients every day. I do not judge my patients. There are however, procedures that I will not participate in performing. Does that make me, "a moralizing obstructionist?"

Cambie

You'll have to give me examples. I'm not going to speculate about what you refuse to do in providing care to your patients.

-copro

 

[CambieMD]

I do not perform D&Es. I do not judge the people who seek them but I do not perform them. It is the same thing with ETOH.

What one believes must inform his/her actions. We all come to medicine with different experiences. This is a good thing. Our patients also have varied experiences and beliefs.

I don't see this as a bad thing. In a free society everyone is entitled to his/her own beliefs.

There are enough providers who are willing to provide D& Es.

Cambie

 

[dhb]

I'd rather kill myself first than kill somebody else. $300 is squat.

there are exception to the rule... but not many.
300$ 20 times a day is not squat (ask your freind dermatologist )

 

[coprolalia]

I do not perform D&Es. I do not judge the people who seek them but I do not perform them. It is the same thing with ETOH.

What one believes must inform his/her actions. We all come to medicine with different experiences. This is a good thing. Our patients also have varied experiences and beliefs.

I don't see this as a bad thing. In a free society everyone is entitled to his/her own beliefs.

There are enough providers who are willing to provide D& Es.

Cambie

-copro

 

[Arch Guillotti]

It is the same thing with ETOH.

Could you explain a little bit more? Are you saying you don't do cases for people who have been drinking?

 

[coprolalia]

Could you explain a little bit more? Are you saying you don't do cases for people who have been drinking?

I think he's saying that he doesn't drink himself, but doesn't judge those who drink. But, I'd be interested to hear the answer to that... and how he could justify giving anesthesia to an alcoholic.

Also, would he do a D&E for a fetal demise? What about one for a horrible, monstrous congenital anomaly where the fetus has no hope of surviving... and, if the pregnancy progresses to birth, it will be a short, painful, and miserable existence (e.g. holoprosencephaly, anencephaly, Trisomy 13, etc.)?

-copro

 

[drmwvr]

I think he's saying that he doesn't drink himself, but doesn't judge those who drink. But, I'd be interested to hear the answer to that... and how he could justify giving anesthesia to an alcoholic.

Also, would he do a D&E for a fetal demise? What about one for a horrible, monstrous congenital anomaly where the fetus has no hope of surviving... and, if the pregnancy progresses to birth, it will be a short, painful, and miserable existence (e.g. holoprosencephaly, anencephaly, Trisomy 13, etc.)?

-copro

That's quite a leap. Assuming he might deny an alcoholic service because he doesn't drink? Can't anyone object to anything and still be a doctor? As for the horrible, monstrous c.a. where there is no hope....or a short, painful, miserable existence....d&e's are no walk in the park for the soon to be demised, as I'm sure you're aware. Is the kid asleep? Maybe. Surely not with an epidural or spinal. Here is a sincere question for you, Copro. No antagonism intended. What would you say to a bioethicist who said, about the fetuses you describe, that since they are more or less disposeable, let them deliver at or near term an use them in the lab, alive?

 

[CambieMD]

I think he's saying that he doesn't drink himself, but doesn't judge those who drink. But, I'd be interested to hear the answer to that... and how he could justify giving anesthesia to an alcoholic.

Also, would he do a D&E for a fetal demise? What about one for a horrible, monstrous congenital anomaly where the fetus has no hope of surviving... and, if the pregnancy progresses to birth, it will be a short, painful, and miserable existence (e.g. holoprosencephaly, anencephaly, Trisomy 13, etc.)?

-copro

I do not consume as Rush puts it adult beverges. I treat patients who have been injured because of drunk driving or they picked a fight because of liquid courage and were severely beaten or shot. I am @ a level one trauma center. I could not work here if I refused to care for people who hurt themselves through their use of alcohol. I do not use ilicit drugs but I treat patients who have damaged themselves through their use of drugs.

When I see D & E on an OR schedule I do not probe deeper to see if there is a mitigating circumstance involved. I do not want to be a part of those procedures so I pick other rooms.

How could I justify not treating alcoholics. They may be sick and in need of medical attention. I have never preached to trauma patients but they sometimes discussed the events that brought them to the trauma bay. They felt free to speak to me because I wasn't going to use what they told me against them. (Some of the patients hurt people)
They usually said things like," I was high and passed out or I was using again and have no clue what happened to me last night." For some patients their brush with death turned out to be their first step towards recovery. We have great chaplins here and they provide a great service. I have asked some patients if the chaplin may be helpful to them.

Happy new year to everyone.


Cambie