Interviewer misinformed/full of it?

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Everyone is aware that emergency contraception cannot induce an abortion, right?

That is all...

I dont believe anyone was confused on that. However they do work post-fertilization. That is where the current political conflict arises.
 
Some would argue that people have a "right" to water, but I do think we are getting too much into the semantics of what the word right means. I think we are atleast in agreement that everyone should have healthcare and let's just leave it at that 🙂

Not so sure about that. Everyone should have access to healthcare, but having the ability to seek out healthcare is different from having it automatically provided without cost or obligation to the person seeking it. In fact, it is noteworthy that many studies have shown that people who pay for their care have better outcomes. Further, to state that "everyone should have healthcare" essentially requires a duty of another person and violates their rights. I do not think it is immoral to expect a person to make other sacrifices to maintain his/her health*.



* If you can afford cable TV, a new car every few years, internet service, etc. you can surely find the money to pay for a discount health insurance or health discount plan (even if it requires cutting back on some of those other things). For those who, despite cutting back on these things, cannot afford care, then (and really only then) I can see a need for gov't aid to subsidize the cost of health insurance
 
Not so sure about that. Everyone should have access to healthcare, but having the ability to seek out healthcare is different from having it automatically provided without cost or obligation to the person seeking it. In fact, it is noteworthy that many studies have shown that people who pay for their care have better outcomes. Further, to state that "everyone should have healthcare" essentially requires a duty of another person and violates their rights. I do not think it is immoral to expect a person to make other sacrifices to maintain his/her health*.



* If you can afford cable TV, a new car every few years, internet service, etc. you can surely find the money to pay for a discount health insurance or health discount plan (even if it requires cutting back on some of those other things). For those who, despite cutting back on these things, cannot afford care, then (and really only then) I can see a need for gov't aid to subsidize the cost of health insurance

👍 exactly
 
Not so sure about that. Everyone should have access to healthcare, but having the ability to seek out healthcare is different from having it automatically provided without cost or obligation to the person seeking it. In fact, it is noteworthy that many studies have shown that people who pay for their care have better outcomes. Further, to state that "everyone should have healthcare" essentially requires a duty of another person and violates their rights. I do not think it is immoral to expect a person to make other sacrifices to maintain his/her health*.



* If you can afford cable TV, a new car every few years, internet service, etc. you can surely find the money to pay for a discount health insurance or health discount plan (even if it requires cutting back on some of those other things). For those who, despite cutting back on these things, cannot afford care, then (and really only then) I can see a need for gov't aid to subsidize the cost of health insurance

+2. 👍
 
Moral of the story? Say "blood transfusion" or "euthanasia".

I was just kidding 🙁.

I want to avoid both of those though. I don't know much about blood transfusions, and I'm worried that my interviewer will think PAS == euthanasia.
 
Not so sure about that. Everyone should have access to healthcare, but having the ability to seek out healthcare is different from having it automatically provided without cost or obligation to the person seeking it. In fact, it is noteworthy that many studies have shown that people who pay for their care have better outcomes. Further, to state that "everyone should have healthcare" essentially requires a duty of another person and violates their rights. I do not think it is immoral to expect a person to make other sacrifices to maintain his/her health*.



* If you can afford cable TV, a new car every few years, internet service, etc. you can surely find the money to pay for a discount health insurance or health discount plan (even if it requires cutting back on some of those other things). For those who, despite cutting back on these things, cannot afford care, then (and really only then) I can see a need for gov't aid to subsidize the cost of health insurance

I see your point, but I personally feel everyone should have healthcare. I like the current direction of our healthcare system.
 
Whoa, this thread picked up some steam

What if the patient wants it? (Ignore the ridiculousness of that statement and humor me😀) IMO same logic applies to the abortion in this case

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Well, if the a psych eval proved the patient was competent, I don't think we can perform a mutilating procedure. That would be like removing a patient's eyes because he wanted us to. (I might be way off on this, so please let me know....I don't know if we can or cannot). If it turns out that the law requires me to circumcise a girl if asked, I would be forced to refer her (to a legitimate, non-black-market female circumcisist i guess?) if it is against my moral code to perform the procedure.
 
Whoa, this thread picked up some steam



Well, if the a psych eval proved the patient was competent, I don't think we can perform a mutilating procedure. That would be like removing a patient's eyes because he wanted us to. (I might be way off on this, so please let me know....I don't know if we can or cannot). If it turns out that the law requires me to circumcise a girl if asked, I would be forced to refer her (to a legitimate, non-black-market female circumcisist i guess?) if it is against my moral code to perform the procedure.

1) look up body identity disorder. There are people getting limbs removed as TREATMENT
2) then how do we justify elective plastic surgery? What is the line between mutilation and aesthetic improvement? (look up octomom 😀) Traditional female circumcision has plenty of problems, but it isnt like women arent already having things cleaned up down there with plastics. The difference is semantic
 
I dont believe anyone was confused on that. However they do work post-fertilization. That is where the current political conflict arises.

So it works post-fertilization but not post-implantation-in the sense that it will cause the zygote to detach. Therefore, if a woman is not pregnant due to a lack of implantation then you can't really call it an abortion.

Although, I could understand how some religious zealots would claim that life begins at conception and due to the potential that those cells have it would be murder to terminate them, but I think that's still pretty far fetched and doubt that a majority of the Republican party would hold onto that belief.
 
So it works post-fertilization but not post-implantation-in the sense that it will cause the zygote to detach. Therefore, if a woman is not pregnant due to a lack of implantation then you can't really call it an abortion.

Although, I could understand how some religious zealots would claim that life begins at conception and due to the potential that those cells have it would be murder to terminate them, but I think that's still pretty far fetched and doubt that a majority of the Republican party would hold onto that belief.

😕

Who is calling it abortion? The scope of the conversation was expanded in the process of discussing.

The central focus of the political debate on this subject was on contraception and not abortion. RoeVWade is not going anywhere any time soon. The issue was healthcare coverage of contraception and religious organizations are pissed about it.
 
😕

Who is calling it abortion? The scope of the conversation was expanded in the process of discussing.

The central focus of the political debate on this subject was on contraception and not abortion. RoeVWade is not going anywhere any time soon. The issue was healthcare coverage of contraception and religious organizations are pissed about it.

Yeah, there seems to be some miscommunication; probably from my part. I thought I had read a post that alluded to that EC causes abortions and I stated that they don't. When you addressed my post I thought you were referring to some political debates that dealt with the misconception that some EC can cause abortions, especially if you believe that life begins at conception.

Regardless, sorry for the confusion.
 
My point was that the "standard of care" of often determined with hindsight by a jury of lay people. In the Hopkins case the jury was convinced that the standard of care was breached by the hospital and not the midwife with the suspended license who failed to recognize a complicated pregnancy until it was too late. It would be nice if determination of "standard of care" was as black and white as we like to act it is, but in truth it isnt. Many cases will have more to do with the emotional response of the jury than a critical evaluation of the care given. IMO that needs to change.


I agree with you on this one. The unfortunate thing is that litigation leaves a lot of uncertainty until the ruling comes in. The system allows for bleeding hearts with utter and complete medical ignorance to weigh in in the same fashion as a trained medical expert.

And to the bold: yes 👍

Just read this. I can't believe it. MAN.
 
So it works post-fertilization but not post-implantation-in the sense that it will cause the zygote to detach. Therefore, if a woman is not pregnant due to a lack of implantation then you can't really call it an abortion.

Although, I could understand how some religious zealots would claim that life begins at conception and due to the potential that those cells have it would be murder to terminate them, but I think that's still pretty far fetched and doubt that a majority of the Republican party would hold onto that belief.

I'm not so sure one has to be a "religious zealot" to believe that. In fact, there is no question as to when "life begins" from a biological standpoint. Biologically, life does "begin" at conception (i.e., when we enter a diploid stage of life; the only thing that occurs at birth is an arbitrary change of location for the infant along with the necessary plumbing changes to allow the baby to survive outside of mommy). The question people are really asking is one of a philosophical-spiritual nature, not a scientific one. The question there becomes, "At what point does Society/God/the Pope/the Government consider this life to be 'human'?" If it is at conception, then we must declare abortion murder. If it is at birth, then abortion becomes entirely normal. It is really a question of one's perspective....

Also, I would probably avoid calling people who disagree with you "zealots," as it is not likely to bode well for your professional future. 😉
 
I'm not so sure one has to be a "religious zealot" to believe that. In fact, there is no question as to when "life begins" from a biological standpoint. Biologically, life does "begin" at conception (i.e., when we enter a diploid stage of life; the only thing that occurs at birth is an arbitrary change of location for the infant along with the necessary plumbing changes to allow the baby to survive outside of mommy). The question people are really asking is one of a philosophical-spiritual nature, not a scientific one. The question there becomes, "At what point does Society/God/the Pope/the Government consider this life to be 'human'?" If it is at conception, then we must declare abortion murder. If it is at birth, then abortion becomes entirely normal. It is really a question of one's perspective....

Also, I would probably avoid calling people who disagree with you "zealots," as it is not likely to bode well for your professional future. 😉

Thanks for your opinion and advice. I didn't say that people who disagree with me are religious zealots and I disagree with you that there is no question of when "life begins" from a biological standpoint.

I can understand how you would assume my personal beliefs, but not even I have made up my mind on these ethical matters.

Definitely will not be following up with this comment because I can see how this could go in a completely different direction. If anyone feels offended because I used the word zealot then I apologize, I didn't mean in a derogatory manner (the bible has a few places where it addresses zeal for God and it is not a negative thing). I think that there were a few assumptions made on your part, but I'll try to write more clearly from now on.

Please let's not allow this to continue going any further. Thanks.👍
 
I'm not so sure one has to be a "religious zealot" to believe that. In fact, there is no question as to when "life begins" from a biological standpoint. Biologically, life does "begin" at conception (i.e., when we enter a diploid stage of life; the only thing that occurs at birth is an arbitrary change of location for the infant along with the necessary plumbing changes to allow the baby to survive outside of mommy). The question people are really asking is one of a philosophical-spiritual nature, not a scientific one. The question there becomes, "At what point does Society/God/the Pope/the Government consider this life to be 'human'?" If it is at conception, then we must declare abortion murder. If it is at birth, then abortion becomes entirely normal. It is really a question of one's perspective....

Also, I would probably avoid calling people who disagree with you "zealots," as it is not likely to bode well for your professional future. 😉

Thanks for your opinion and advice. I didn't say that people who disagree with me are religious zealots and I disagree with you that there is no question of when "life begins" from a biological standpoint.

I can understand how you would assume my personal beliefs, but not even I have made up my mind on these ethical matters.

Definitely will not be following up with this comment because I can see how this could go in a completely different direction. If anyone feels offended because I used the word zealot then I apologize, I didn't mean in a derogatory manner (the bible has a few places where it addresses zeal for God and it is not a negative thing). I think that there were a few assumptions made on your part, but I'll try to write more clearly from now on.

Please let's not allow this to continue going any further. Thanks.👍

He is correct. There IS a question where "life begins". You saying conception is where life begins is you simply adhering to a long standing social construct. Others may not feel the same way.

You are calling the sky blue. That is fine. But the issue I take is that you are not even willing to discuss the POSSIBILITY that the sky might not be blue. Using absolute words like in this sentence:

"In fact, there is no question as to when "life begins" from a biological standpoint. Biologically, life does "begin" at conception..."

in a discussion where people are speaking of their different ideologies is kind of arrogant.
 
He is correct. There IS a question where "life begins". You saying conception is where life begins is you simply adhering to a long standing social construct. Others may not feel the same way.

You are calling the sky blue. That is fine. But the issue I take is that you are not even willing to discuss the POSSIBILITY that the sky might not be blue. Using absolute words like in this sentence:

"In fact, there is no question as to when "life begins" from a biological standpoint. Biologically, life does "begin" at conception..."

in a discussion where people are speaking of their different ideologies is kind of arrogant.
I think he was being technical.

A freshly fertilized egg - is it dead? If no then what is it?
He could have worded it better by saying a "new human life" begins at _____.
 
I think he was being technical.

A freshly fertilized egg - is it dead? If no then what is it?
He could have worded it better by saying a "new human life" begins at _____.

Yes, that was what I was saying. I was trying to avoid labeling it a "human life" at that point since the whole philosophical question is whether or not it is "human" at that point. The biological question, more clearly, would be "When does a new biological entity come into existence that genetically resembles a human being but is not the same as its mother?" I simplified that to "a new life" since most people would define individual human beings as genetically (and otherwise) distinct organisms containing enough human DNA to develop into a phenotypically human animal.

There are certainly philosophical questions as to when life "begins" as we know it, but "at birth" is an entirely arbitrary specification. If we were wanting to do it at the point of "when the fetus becomes conscious" we could actually wait until quite a bit later. (I recall some research showing that memories are encoded very differently before about age 3 or 4, so presumably we could consider that a "pre-human consciousness" and start aborting all children until they are able to speak in complete sentences.)
 
I think he was being technical.

A freshly fertilized egg - is it dead? If no then what is it?
He could have worded it better by saying a "new human life" begins at _____.

Technicalities are based of arbitrarily assigned human constructs.
 
Technicalities are based of arbitrarily assigned human constructs.

Some are. But all in all the objections are focused on the definition of a new human life and not life in general. His point was actually quite in line with yours. While HE was being technicAL, those who objected were fretting over technicalITIES

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So I had an interview that went something like this:

Interviewer: Can you think of any controversial topics because of morality/religion?
Me: Abortion
Interviewer: If you were morally against abortion and you had a patient request one, what would you do?
Me: blah blah blah Refer blah blah blah
Interviewer: They trust only you and refuse to see another doctor.
Me: blah blah blah That's their prerogative, but unless they are dying I will stand by my moral code. blah blah blah

This is the point you pull the pregnancy means caring for two patients card and redirect the conversation away from your own moral beliefs to doing what's best for your patient(s), and how harming one to convenience the other goes against nonmaleficience. Not that I believe this to apply, but you want to minimize the impact of your own biases and maximize the opportunity to show you're familiar with medical ethics and your own biases won't change your practice.
 
I thought the first rule of interviewing was to not mention abortion. There are lots of other topics you could have chosen.
 
Is this true for abortion and OB specifically? My impression is that OBs can practice without ever performing an abortion.
Of course. Any OB/gyn who does their residency at a Catholic hospital won't be doing abortions.
 
Of course. Any OB/gyn who does their residency at a Catholic hospital won't be doing abortions.

But are there situations where an emergency abortion is warranted? life and death and such. The thing I was getting at (merely speculative) is that if there was a situation where someone may need an emergency c-section, the ability to do so would fall under at least SOMEONE's definition of minimally competent. I do know that at catholic hospitals they will do emergency c-sections on premies and put them on support even if they are just plain unviable - thereby side stepping the abortion issue (I however have no idea how common this is, just that it happens), but similar to the injured burglar story, a lawyer could make the argument that abortions falls under Dr. X's skillset to be considered minimally competent, since Dr. X did not retain this skill Dr. X is not minimally competent, and it was Dr. X's lack of competence that led to the demise of the patient. :shrug: 😕

I realize that MOST malpractice suits are long shots and that they usually just settle because the business model allows for it rather than fighting it out, but am I missing something major here in which the chances of what I described are just so slim as to not even be entertained?
 
One could easily argue that in such a case, the OB/Gyn, having not performed an abortion since residency (say, 20 years ago, for instance) is not competent to perform the surgery. To do so would place the pt's life in danger in order to make her life more convenient. I would argue that nonmaleficence is the one ethical principle higher than pt autonomy. (This, in essence, is why euthanasia is still considered wrong.)

There is no way one could argue this. The procedure for an abortion (D&C) is the exact same for clearing out fetal remains in the case of a miscarriage so there is no way the OB/GYN would not know how to do it. Also I do not understand why they could not just have another doc in the office write the perscription for the abortion pill 😕
 
There is no way one could argue this. The procedure for an abortion (D&C) is the exact same for clearing out fetal remains in the case of a miscarriage so there is no way the OB/GYN would not know how to do it. Also I do not understand why they could not just have another doc in the office write the perscription for the abortion pill 😕

Being as neither of us have performed an abortion, I would defer this to an actual OB/Gyn and not make the assumption that we know all the specifics of either procedure. There may be some finer (but important) differences of which neither you nor I am aware. In addition, even if the procedures are truly 100% identical (to include any and all medications given), a physician who has not done the procedure in 20 yrs may not be aware of what updates had been made to that procedure even if it were identical to a procedure the OB/Gyn currently performs. The essence of the argument is that the physician is stating s/he is not comfortable performing the procedure due to unnecessary risk of harm to the pt.
 
Being as neither of us have performed an abortion, I would defer this to an actual OB/Gyn and not make the assumption that we know all the specifics of either procedure. There may be some finer (but important) differences of which neither you nor I am aware. In addition, even if the procedures are truly 100% identical (to include any and all medications given), a physician who has not done the procedure in 20 yrs may not be aware of what updates had been made to that procedure even if it were identical to a procedure the OB/Gyn currently performs. The essence of the argument is that the physician is stating s/he is not comfortable performing the procedure due to unnecessary risk of harm to the pt.

A D&C has the same procedure regardless of spontaneous abortion or (regular?) abortion.

http://www.mayoclinic.com/health/dilation-and-curettage/MY00345/DSECTION=why-its-done

I just don't think unncessary risk of harm to patient is a valid reason because not providing abortion care also has a risk of harm to patient... both psychological and physical. Not to discount anyone's work but from everything I have heard abortion is actually a really simple surgery with extremely low risk to the patient.
 
A D&C has the same procedure regardless of spontaneous abortion or (regular?) abortion.

http://www.mayoclinic.com/health/dilation-and-curettage/MY00345/DSECTION=why-its-done

I just don't think unncessary risk of harm to patient is a valid reason because not providing abortion care also has a risk of harm to patient... both psychological and physical. Not to discount anyone's work but from everything I have heard abortion is actually a really simple surgery with extremely low risk to the patient.

I just flat out reject the argument of psychological harm except for rape/incest. Pregnancy is not pathology.

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I just flat out reject the argument of psychological harm except for rape/incest. Pregnancy is not pathology.

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are. you. kidding. me.


A common myth states that hormones released during pregnancy protect women from psychiatric disorders and foster a period of emotional well-being. Recent studies, however, have shown that up to 20% of women suffer from mood or anxiety disorders during the gestation and postpartum periods.
http://womensneuroscience.stanford.edu/wellness_clinic/Pregnancy.html
 
Thoughts? (Btw, I'm not inserting any personal opinion into the conversation. I would just like to see your thoughts on the matter.)

http://en.wikipedia.org/wiki/Tokophobia

Ever worked up a patient and formed a ddx? Epidemiology plays a role. That phobia is so rare as to not be considered in evaluation of the patient. Also, phobias don't necessarily translate into psychological harm if exposed.

For me it falls under the category of patient wants vs patient needs. Patients want lots of things and denial of a want being equated to emotional or psychological harm is more indicative of our societal/social problems than those of public health. Personally, the chance for physical harm trumps the chance of emotional harm here.

This doesn't mean that I am opposed to women getting access to them. I just reject that rationale. I reject it harder when it is linked to talk of liability.

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Ever worked up a patient and formed a ddx? Epidemiology plays a role. That phobia is so rare as to not be considered in evaluation of the patient. Also, phobias don't necessarily translate into psychological harm if exposed.

For me it falls under the category of patient wants vs patient needs. Patients want lots of things and denial of a want being equated to emotional or psychological harm is more indicative of our societal/social problems than those of public health. Personally, the chance for physical harm trumps the chance of emotional harm here.

This doesn't mean that I am opposed to women getting access to them. I just reject that rationale. I reject it harder when it is linked to talk of liability.

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It was interesting to see your response because tokophobia is often brought up in similar conversations (psychological harm related to pregnancy), and I never asked a medical student about it before now.

I agree with your reasoning when considering the scenario people are discussing in this thread though.
 
You guys are all completely wrong. I have it on good authority that women can prevent getting pregnant in cases of legitimate rape. Therefore, if a women's body has a way of shutting down the whole thing then why don't they?

j/k, I'm making fun of certain congressmen in case people didn't realize.
 
You guys are all completely wrong. I have it on good authority that women can prevent getting pregnant in cases of legitimate rape. Therefore, if a women's body has a way of shutting down the whole thing then why don't they?

j/k, I'm making fun of certain congressmen in case people didn't realize.

I feel like crawling into a deep, dark hole whenever I think of the House Committee on Science.
 
You guys are all completely wrong. I have it on good authority that women can prevent getting pregnant in cases of legitimate rape. Therefore, if a women's body has a way of shutting down the whole thing then why don't they?

j/k, I'm making fun of certain congressmen in case people didn't realize.

:laugh:
i mean regardless its a gift from god silly wimmens just need to shut it and go back to making sammichs or something

/snark
 
You guys are all completely wrong. I have it on good authority that women can prevent getting pregnant in cases of legitimate rape. Therefore, if a women's body has a way of shutting down the whole thing then why don't they?

Speaking about context..how do we know the congressman didnt say "gotcha" after he made this statment?
 
It was interesting to see your response because tokophobia is often brought up in similar conversations (psychological harm related to pregnancy), and I never asked a medical student about it before now.

I agree with your reasoning when considering the scenario people are discussing in this thread though.

People love (LOOOOOOOOVEEEEEE!!! and not the romantic kind. The kind that follows a cocaine and whiskey bender with a stripper named after a car manufacturer) to cite obscure exceptions to the rule to bolster their points. The reason is because we have it stuck in our heads that it isn't ok to adopt a policy that may end up hurting even one person. The problem is the hardships of these people get exploited by people with no connection what so ever to them for personal gain. Also.... people with that phobia do not routinely get pregnant anyways. Think about it. If you have arachnophobia how likely are you to go into a room full of spiders without wearing a condom? I... I might have screwed up that analogy but I think you get my meaning :shrug:

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People love (LOOOOOOOOVEEEEEE!!! and not the romantic kind. The kind that follows a cocaine and whiskey bender with a stripper named after a car manufacturer) to cite obscure exceptions to the rule to bolster their points. The reason is because we have it stuck in our heads that it isn't ok to adopt a policy that may end up hurting even one person. The problem is the hardships of these people get exploited by people with no connection what so ever to them for personal gain. Also.... people with that phobia do not routinely get pregnant anyways. Think about it. If you have arachnophobia how likely are you to go into a room full of spiders without wearing a condom? I... I might have screwed up that analogy but I think you get my meaning :shrug:

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I wouldn't want to go into the room of spiders unprotected, lol. Although I don't have a phobia of pregnancy, I certainly don't want to reproduce and deal with all the fun that comes with it. Hey, I already have a nephew that I can spoil.

I sometimes like to ask for people's thoughts without stating my own opinion on the matter, in my experience I tend to get better responses that way. If a woman had tokophobia and didn't want to go through with her pregnancy (especially if she sought counseling), then she should be free to have access to a safe abortion.

However, I get wary when the liability (discussed quite a bit in this thread) enters the equation. Like I said before, I agree with your argument. Thanks for your response!
 
I wouldn't want to go into the room of spiders unprotected, lol. Although I don't have a phobia of pregnancy, I certainly don't want to reproduce and deal with all the fun that comes with it. Hey, I already have a nephew that I can spoil.

I sometimes like to ask for people's thoughts without stating my own opinion on the matter, in my experience I tend to get better responses that way. If a woman had tokophobia and didn't want to go through with her pregnancy (especially if she sought counseling), then she should be free to have access to a safe abortion.

However, I get wary when the liability (discussed quite a bit in this thread) enters the equation. Like I said before, I agree with your argument. Thanks for your response!

Gotcha. Just to clarify one thing, short of rape those women are very unlikely to get pregnant anyways. What do you think the major manifestation is? Anxiety during preggers? Nope. Sexual dysfunction 👍 if you have a legitimate phobia of that you are likely not getting freaky very often and if you do you have many layers of protection and failsafes.

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