Need help with abortion ethics question

[TakoCA]

Let's say a 14 year old girl comes into your office asking for an abortion. How do you respond to her?

If she were an older woman and I were against abortion, I would refer her to a physician who was capable of the procedure so as not to impose my beliefs upon her. However, I'm not sure how to tackle the age issue. Is it proper to inform her parents and get them involved in the decision process?

---

Members don't see this ad.

 

[Robizzle]

Let's say a 14 year old girl comes into your office asking for an abortion. How do you respond to her?

If she were an older woman and I were against abortion, I would refer her to a physician who was capable of the procedure so as not to impose my beliefs upon her. However, I'm not sure how to tackle the age issue. Is it proper to inform her parents and get them involved in the decision process?

How bout you start by asking her for more information.

Worst possible answer you can give is to jump to conclusions.

 

[Quix]

That will depend on state statutes; for some states, pregnancy makes her an emancipated minor, capable of making her own decisions. State laws also govern parental disclosure requirements. If these end up not being issues (i.e., legally she is capable of making her own decisions), then it comes down to your personal conscience (there are conscience clauses for these kinds of polarizing procedures), but if there are no alternative clinicians capable of performing the procedure, it falls to you.

 

[Wrigleyville]

Independent of any ethical questions, you will have a number of obligations based on the laws of the state in which you are practicing.

 

[DropkickMurphy]

Let's say a 14 year old girl comes into your office asking for an abortion. How do you respond to her?

If she were an older woman and I were against abortion, I would refer her to a physician who was capable of the procedure so as not to impose my beliefs upon her. However, I'm not sure how to tackle the age issue. Is it proper to inform her parents and get them involved in the decision process?

I think it would depend on the laws of the state whether or not you could inform the parents (I don't believe we can here). But I also believe we are obligated to report to the police any case of suspected child abuse, and given that in most places the age of consent is 16 or higher.....

 

[DropkickMurphy]

Wow.....three of us had basically the same thought simultaneously.

 

[Quix]

Wow.....three of us had basically the same thought simultaneously.

Sick minds think alike.




Still digging your avatar after all of these months.

 

[Tyronebiggums]

What I don't understand is that minors, according to the law, don't have the capacity to consent to intercourse but somehow if they do get pregnant they have the capacity to decide whether or not to abort the baby! But to the OP, if state laws do not require parental consent I believe the physicians job is to inform the patient of her options if she is in fact pregnant and if she decides to abort her baby then the doctor, if he or she is not qualified to administer abortions or is against it, must refer her to an appropriate outlet.

 

[Quix]

No one ever said the letter of the law had to make sense.

 

[Tyronebiggums]

No one ever said the letter of the law had to make sense.

Good point, but it is sort of strange don't you think?

 

[Quix]

Not terribly strange; there are quite a few laws that I don't think make sense (e.g., EMTALA and malingerers who game the system, HIPAA producing paperwork to the point of undermining effective patient care, etc., etc.)

EDIT:

even referring.

I beg to differ. My Law and Ethics class covered conscience clauses, and referrals weren't part of that. You have to provide information.

 

[Tyronebiggums]

Not terribly strange; there are quite a few laws that I don't think make sense (e.g., EMTALA and malingerers who game the system, HIPAA producing paperwork to the point of undermining effective patient care, etc., etc.)

I agree 100% that there are laws that don't make sense but that doesn't mean we should fill the books with more of them.

 

[Cirrus83]

Yeah I'm pretty sure depending on where you're practicing you might very well have to do stuff you might not personally believe in. Just leaving people out in the cold without any info isn't particularly ethical anyway, since it could just lead to some kinda horrible self-abortion attempt (and don't tell me people don't do this, because people do lots of very stupid crap in this situation, even people you never thought would do anything nearly that stupid).

And the last thing you need is your friends finding out that their daughter came to talk to you, but then you ignored her, didn't tell them, and wouldn't refer her anywhere, so she tried some kind of *****ic self-aborting attempt that lands her in the hospital.

 

[Quix]

Panda fought this and won, based on his state law. I will try to do the same.

If I can't, I will simply refuse to see the patient at all, and another doc will have to pick her up. I do know for sure that we all have the right to not treat an individual if it's not an emergency- and a healthy pregnancy is not an emergency (I'm not counting ectopic, etc. here)

First, that's incredibly paternalistic to refuse your patient information because you disagree with what they might do with that. You'll be violating informed consent standards, too, which could put your license in jeopardy. Second, physicians have the right to refuse unnecessary treatments (e.g., dialysis for a head cold), but you are skating on very thin ice with the example at hand. You can certainly refuse to see the patient, provided someone else can, but if there is no one else capable of doing it, and it is medically necessary (and psychological trauma is an inclusion criteria), then you'll have to deal with it. Just a fair warning.

EDIT:

Are you sure you're going into medicine for the right reasons? You seem *incredibly* judgmental about your patients (e.g., paternalistic, dismissive of psychiatric reasons for treatment, etc.) and extraordinarily reckless with what you will and will not do. You might find your license suspended very quickly, if you continue along this path.

 

[chad5871]

EDIT:

even referring.

I beg to differ. My Law and Ethics class covered conscience clauses, and referrals weren't part of that. You have to provide information.

Could you possibly get around this by referring the patient to another physician or clinic that doesn't necessarily provide abortions but refers to another place that does?

Here's a little flow chart of my idea:
Patient-->You-->Referring Physician-->Abortion Clinic

I'd feel more comfortable, however, referring to a clinic that heavily counsels the mothers on other alternatives before even bringing up the topic of an abortion.

 

[trustwomen]

What I don't understand is that minors, according to the law, don't have the capacity to consent to intercourse but somehow if they do get pregnant they have the capacity to decide whether or not to abort the baby!

Many states do have parental consent laws for abortion, actually.

However, none have parental consent for childbirth. Nor can the minor's parents, AFAIK, block an adoption (though the male partner can). Parents cannot legally force a girl to have an abortion against her will, why should they be able to force her to give birth against her will?

I was an abortion counselor for many years and I did see cases of parents who were trying to force their daughters to have abortions. (I sent them home, of course, despite the parents yelling at me - we don't perform abortions without full consent of the patient.) One of the mothers pointed out this hypocrisy to me - "if we were in the opposite situation", she said, "she'd need my consent to have an abortion. But she wants to go ahead and ruin her life at 14, and I have no say?" I didn't know what to say (I was kind of angry), so I muttered something about her daughter having the final word about her own body...

 

[Quix]

"Heavy counseling" is a problematic phrase; what do you mean by this? Referrals are fine, provided you are attempting to coerce the patient (which violates informed consent).

 

[DropkickMurphy]

Couly you possibly get around this by referring the patient to another physician or clinic that doesn't necessarily provide abortions but refers to another place that does?

Here's a little flow chart of my idea:
Patient-->You-->Referring Physician-->Abortion Clinic

I'd feel more comfortable, however, referring to a clinic that heavily counsels the mothers on other alternatives before even bringing up the topic of an abortion.

Then it just becomes a matter of degree......

 

[Tyronebiggums]

Yeah, I know people do stuff that's stupid, Cirrus. But a pregnancy isn't a disease. If the pregnancy appears to be healty, there's no medical reason for its termination. Referr to abortionist is being done for social, not medical reasons (and don't give me that mental health crap )

I will happily refer for any medically necessary procedures. Elective abortions? Not a chance.

I think you are right. I think a strong argument could be made that the mental health problems of women caused by having an abortion are as bad if not worse than the "mental health problems" of continuing the pregnancy. In addition, too many people think of abortion in theoretical terms. A good analogy I think is one of getting a new puppy. Lets say a person gets a cute little puppy and is taking care of it, which requires a lot of time, money and attention, but all of a sudden the owner loses their job and doesn't have the money to pay for the puppy's food. Should the owner then kill the puppy or give it away to the humane society? Most people even "pro choice" people I've talked to always say they would give the puppy to the humane society because it would be barbaric and unecessary to kill the puppy because of social problems. I then ask "how is the puppy more worthy of living than an unborn child when adoption and foster care agencies exist?"....Silence usually ensues.

 

[trustwomen]

Yeah, I know people do stuff that's stupid, Cirrus. But a pregnancy isn't a disease. If the pregnancy appears to be healthy, there's no medical reason for its termination. A referal to an abortionist is being done for social, not medical reasons (and don't give me that mental health crap ) As for the chance that someone will do something stupid on her own, if we spent our time preventing our patients from doing every stupid, dangerous and immoral thing they want to do, we'd have to tag along behind some of the 24 hours a day. Of course, if a patient asks, I will certainly recommend against a home coat-hanger job.

I will happily refer for any medically necessary procedures. Elective abortions? Not a chance.

I assume you only plan to practice in the U.S., in which case choose your state and its laws carefully.

That would not fly in other (i.e. civilized) countries - they'd pull your license just as fast as they would that of a Jehovah's witness who refuses to refer for blood products.

 

[DropkickMurphy]

Lets say a person gets a cute little puppy and is taking care of it, which requires a lot of time, money and attention, but all of a sudden the owner loses their job and doesn't have the money to pay for the puppy's food. Should the owner then kill the puppy or give it away to the humane society? Most people even "pro choice" people I've talked to always say they would give the puppy to the humane society because it would be barbaric and unecessary to kill the puppy because of social problems.

Still....a matter of degree......the humane society will likely euthanize the puppy due to an insufficient number of adoptive homes. So you're analogy is sort of moot given that difference. We can't euthanize children.

 

[Quix]

As you've obviously forgotten, Quix, I was almost aborted, myself. Of course I judge women who consider and receive abortions, and I don't pretend otherwise.

I haven't forgotten, and I don't see the relevance in injecting that into this conversation as if it constitutes a valid rationalization of a violation of professional ethics. The conscience clause gives you an out for performing the procedure absent the unlikely event of no other capable clinicians, but it doesn't give you the ability to refuse to provide information or referral for service.

"Serving life" is fine, but you have already demonstrated in other threads that your objection to abortion is visceral, which doesn't give you the right to force your opinions on your patients. That's coercive, plain and simple, and that goes against the AMA standards.

 

[trustwomen]

I think you are right. I think a strong argument could be made that the mental health problems of women caused by having an abortion are as bad if not worse than the "mental health problems" of continuing the pregnancy. In addition, too many people think of abortion in theoretical terms. A good analogy I think is one of getting a new puppy. Lets say a person gets a cute little puppy and is taking care of it, which requires a lot of time, money and attention, but all of a sudden the owner loses their job and doesn't have the money to pay for the puppy's food. Should the owner then kill the puppy or give it away to the humane society? Most people even "pro choice" people I've talked to always say they would give the puppy to the humane society because it would be barbaric and unecessary to kill the puppy because of social problems. I then ask "how is the puppy more worthy of living than an unborn child when adoption and foster care agencies exist?"....Silence usually ensues.

I am relieved to hear that pregnancy and childbirth are not any more difficult than dropping a puppy off at the pound. Somehow I had the mistaken impression that they were "kind of a big deal".

 

[alwaysaangel]

I'm going into medicine to protect and serve life, Quix, against things that destroy it at the microbiological level as well as the sociological level. I am greatful that I got a chance to live and intend to do everythig I can to ensure that other fetuses get the same chance. At the very least, I will not help them to die.

Belly have you already applied and been accepted?

I just don't see this answer going over well with adcomms in an interview...

 

[Tyronebiggums]

Still....a matter of degree......the humane society will likely euthanize the puppy due to an insufficient number of adoptive homes. So you're analogy is sort of moot given that difference. We can't euthanize children.

I actually think that point makes the argument even stronger since the child will live. No adoption or foster care agencies euthanize children. In addition, the point of the analogy is not what happens to the puppy because we could both easily think of different humane societies in different locations with wildly different numbers of adoptive homes. The puppy might be euthanized at one humane society but given away instantly at another humane society with high demand. My analogy does not become moot because you are selectively picking a hypothetical humane society with an insufficient number of adoptive homes.

 

[chad5871]

"Heavy counseling" is a problematic phrase; what do you mean by this? Referrals are fine, provided you are attempting to coerce the patient (which violates informed consent).

I am referring to clinics that make an attempt to offer more "desirable" alternatives to their patients before allowing them to obtain an abortion without thinking twice. I am sure there are some clinics that require the mother to go through counseling or require her to wait a certain amount of time before the abortion can be granted, and these are the clinics I would choose to refer my patients to. I believe that as long as abortion is legal and the patient is free to make her own choices, she should be allowed to have an abortion and nothing should stop that choice. However, I think that the patient must be fully informed before the abortion can occur, especially regarding possible alternatives. Elective abortion is something I find morally reprehensible and I feel I would be unable to offer this service to my patients unless it was deemed medically necessary (because either the patient's physical or mental well-being was at risk). However, if I was required to refer the patient, I would choose to refer her to a clinic that I had specially selected and I deemed would help her make a truly informed and thoughtful decision.

 

[trustwomen]

I haven't forgotten, and I don't see the relevance in injecting that into this conversation as if it constitutes a valid rationalization of a violation of professional ethics. The conscience clause gives you an out for performing the procedure absent the unlikely event of no other capable clinicians, but it doesn't give you the ability to refuse to provide information or referral for service.

"Serving life" is fine, but you have already demonstrated in other threads that your objection to abortion is visceral, which doesn't give you the right to force your opinions on your patients. That's coercive, plain and simple, and that goes against the AMA standards.

Brilliant response.

However, in many states, she would have the right to refuse to refer. (I know, it's ridiculous.) And in many places in the US, doctors coerce, harass, and bully patients seeking abortions and yet emerge unscathed.

Personally, I'm just so glad that my mother didn't use birth control (and therefore conceived me), that I refuse to even discuss contraception with my future patients.

 

[DropkickMurphy]

I'm going into medicine to protect and serve life, Quix, against things that destroy it at the microbiological level as well as the sociological level. I am greatful that I got a chance to live and intend to do everythig I can to ensure that other fetuses get the same chance. At the very least, I will not help them to die.

I have no problem with abortions for medical reasons, and I really could care less if someone wants to get rid of an embryo because of whatever reason. I don't view life as starting until a fetus is capable of living outside of the mother with some reasonable degree of medical certainty- which is about 26-28 weeks depending upon who you ask.

But then again, I don't have a problem with publicly burning people at the stake as a form of capital punishment (and I believe we should execute MORE people- rapists, child molesters, repetitive abusers of woman, children or the elderly, etc- and after only two appeals (none if you have DNA or video evidence)) so my standard of right and wrong is probably a little different than yours.....

 

[Quix]

What are you smoking, trustwomen? In England's National Health Service, the government absolutely allows individual doctors to flat out deny women abortions (though I think the women can then look elsewhere). Not sure about other countries, but I'm not gonna sweat it, much.

Um, are you sure about this? From the NHS website:

Doctors can refuse to certify a woman for an abortion because of their personal beliefs. If this is the case, they should recommend another doctor who can help.

http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=1

EDIT:

Quix, as you are fully well aware I object to abortion because (1) a fetus is alive (2) a fetus is human and (3) abortion requires the killing of that living human. While it's certainly true that I have a visceral reaction to the graphic and extremely unpleasant nature of that killing, my visceral reaction does not undo the applicability of the conscience clause.

Which means that you have to provide information; again, the conscience clause is not the carte blanche you are making it out to be.

 

[Tyronebiggums]

I am relieved to hear that pregnancy and childbirth are not any more difficult than dropping a puppy off at the pound. Somehow I had the mistaken impression that they were "kind of a big deal".

If you consider yourself pro-choice, which I think you do, you shouldn't try to take my analogy to the logical extreme by believing it somehow shows that I or others who like the analogy do not think pregnancy is a big deal. What could marginalize pregnancy more than supporting abortion besides an abortion itself? If you really thought pregnancy was a "big deal" and so significant you would probably not condone terminating it. You would instead be pro-life. Please ignore this post if you are in fact pro-life.

 

[DropkickMurphy]

Brilliant response.

However, in many states, she would have the right to refuse to refer. (I know, it's ridiculous.) And in many places in the US, doctors coerce, harass, and bully patients seeking abortions and yet emerge unscathed.

Personally, I'm just so glad that my mother didn't use birth control (and therefore conceived me), that I refuse to even discuss contraception with my future patients.

Personally I think we should be allowed to require birth control that is reliable and not subject to "cheating" for those who are on social services such as welfare, etc. I see nothing wrong with birth control and will strongly advocate it especially for my poor patients. Hell, I might even pay for it if it keeps them from breeding.

 

[trustwomen]

What are you smoking, trustwomen? In England's National Health Service, the government absolutely allows individual doctors to flat out deny women abortions (though I think the women can then look elsewhere). Not sure about other countries, but I'm not gonna sweat it, much.

England:
http://www.womenshealthlondon.org.uk/leaflets/pregab/pregabget.html
"Doctors with specific religious views may be against abortion, except in certain circumstances, but in this case they are obliged to refer you to another GP."

http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=1
NHS guidelines themselves: "Doctors can refuse to certify a woman for an abortion because of their personal beliefs. If this is the case, they should recommend another doctor who can help."

Also the case in Canada. You must refer. To refuse to do so is a violation of professional guidelines.

Honestly, I could look up all the other European countries, but I don't care enough to do so right now. But I personally know abortion providers in France and the Netherlands and their guidelines are the same as ours.

It's the US that's the outlier here (well, in the developed world, anyway - these sorts of policies have a lot in common with South America and the Middle East).

 

[alwaysaangel]

Oh trustwomen, that's just insulting. I'm not objecting to preventing the creatin of life. I'm objecting to killing life that already exists. Don't be condescending, and definitely don't put words into my mouth that I didn't say.

Yeah but she has a point. You say a fetus is life. I would agree, but a huge portion of the american population would disagree. Which is why they think abortion is ok.

I say contraception is ok, but a Catholic might say that it is immoral because it is ruining the original purpose of sex, and preventing the creation of life is immoral. Do you think that makes it ok for a Catholic doctor to completely REFUSE to explain to their patients their birth control options?

 

[Anastasis]

That's coercive, plain and simple, and that goes against the AMA standards.

Do you have the citation to the AMA's definition of coercion? (did I spell that right?)

(Not putting my head in the lion's mouth - I'm just curious how the AMA defines that. Meaning what are my limits when prescribing treatment? when does discussion become coercion in the mind of the AMA. BTW, I don't mean that just in reference to abortion).

 

[DropkickMurphy]

Quix, as you are fully well aware I object to abortion because (1) a fetus is alive (2) a fetus is human and (3) abortion requires the killing of that living human. While it's certainly true that I have a visceral reaction to the graphic and extremely unpleasant nature of that killing, my visceral reaction does not undo the applicability of the conscience clause.

I have less of a problem with referring someone for an abortion than I would referring someone for cosmetic surgery. At least society benefits from the former (unless the person being referred to the latter is a would be porn star, then we all benefit).

 

[trustwomen]

Dammit, Quix, you beat me to it.

 

[kypdurron5]

Personally, I don't see what the problem is. There is an ethical dilemma here, but it's not yours. If she wants an abortion all she has to do is check the yellow pages for "abortion providers." The preceding column is usually "abortion alternatives." She doesn't need a referral from you to go to one of these places, and you being against it won't stop her either. I think the best answer to this question is simply to advise her of a good, local (free) women's services center that specializes in pre-abortion and alternatives counseling (plus let's not forget post-abortion counseling). If she wants an abortion she already knows where to go...so referring her to a counseling service is the best option, even if you're ok with abortion. It's the ultimate irrevocable decision, so it's only reasonable to consider the other options first.

I suppose one snag to this whole thing is the "referral" issue. Part of the question could be that she needs your referral for her HMO to pay for the specialist/procedure. First of all, if she's going to use her parent's medical insurance then they will find out anyway...so it's best to encourage her to talk to them beforehand (assuming emancipation state). Secondly, the only thing I can say is that when I worked at CIGNA no referral was required for OB/GYN or abortion procedures. Obviously this will not be the case with every insurance company, but I would imagine the two top possibilities will be 1) no coverage or 2) no referral. If abortion is covered, requiring a referral for something like this could be considered hindering a woman's right to an abortion (since her PCP must "approve" her to go have it done), so I think it's reasonable that the above two plan types will be number one and number two.

 

[Anastasis]

Personally I think we should be allowed to require birth control that is reliable and not subject to "cheating" for those who are on social services such as welfare, etc. I see nothing wrong with birth control and will strongly advocate it especially for my poor patients. Hell, I might even pay for it if it keeps them from breeding.

What about staunch Roman Catholics on gov't support?

(I agree with you, I'm just playing devil's advocate)

 

[DropkickMurphy]

well, in the developed world, anyway - these sorts of policies have a lot in common with South America and the Middle East

Just because they have their moral hangups- just like the zealots in our country do- doesn't make them not part of the developed world. I take it you've never been to Bahrain or Kuwait?

 

[alwaysaangel]

Yes, I've been accepted at 4 schools, so far.

As for this topic, ad comms actually avoided it like the plague with me, backing away in fear when I brought it up, myself! It was actually kind of strangely amusing to watch men who seemed so confident otherwise absolutely blanch when we got near the issue.

They knew my personal background from my PS and my Pre-Med letter, so I think they were kind of terrified to go into it with me.

Were they Christian schools? I'm not trying to be rude, I'm just honestly curious. If I were a non-religious affiliated school I would shy away from accepting anyone with such a judgmental and visceral reaction to abortion when that can have a huge affect on the quality of care that the physician will give future patients.

 

[DropkickMurphy]

I agree with you on this 100%, DKM. In no way do I object to birth control, nor have I ever intimated that I do.

I wasn't directing that at you BDD.....I was directing it at TrustWomen for her statement about not discussing contraception with her pts.

 

[DropkickMurphy]

What about staunch Roman Catholics on gov't support?

(I agree with you, I'm just playing devil's advocate)

They get an extra strong dose. They breed like rabbits.

 

[kypdurron5]

Now that we've hit a bit of a tangent..... Does anyone else find it ironic that the richest families who can afford children have the fewest kids, while the poorest medicaid-food stamp-welfare families pop 'em out one after the other? Something is really wrong when society encourages people to have children they can't afford. Don't get me wrong...there's really no viable solution to this problem, it just strikes me as strange that no one seems to address this issue. Oh well, maybe New York-Themed condoms will be the solution we need .

 

[Quix]

Do you have the citation to the AMA's definition of coercion? (did I spell that right?)

(Not putting my head in the lion's mouth - I'm just curious how the AMA defines that. Meaning what are my limits when prescribing treatment? when does discussion become coercion in the mind of the AMA. BTW, I don't mean that just in reference to abortion).

Not off-hand, unfortunately. If you're interested, though, there are a wealth of AMA opinions at

http://www.ama-assn.org/apps/pf_new/pf_online?category=CEJA&assn=AMA&f_n=mSearch&s_t=&st_p=&nth=1&

 

[trustwomen]

If you consider yourself pro-choice, which I think you do, you shouldn't try to take my analogy to the logical extreme by believing it somehow shows that I or others who like the analogy do not think pregnancy is a big deal. What could marginalize pregnancy more than supporting abortion besides an abortion itself? If you really thought pregnancy was a "big deal" and so significant you would probably not condone terminating it. You would instead be pro-life. Please ignore this post if you are in fact pro-life.

I think a pregnancy (and motherhood) is quite a big deal for a woman, and therefore do not feel comfortable forcing her to go through with one if she does not feel able to.

Abortion rights supporters recognize that pregnancy and motherhood are significant, life-changing events. Saying "you could just have the baby and place it for adoption" minimizes the physical and emotional upheaval involved in doing so, not to mention that for most women, that isn't a realistic option as they cannot imagine ever doing such a thing. Terminating a non-sentient, non-viable pregnancy the size of a pea, however (while not easy by any means), is less traumatic for many women... Whether you think it "should be" or not. (They get to decide, that's sort of the point...)

I firmly support the right of women to freely choose the outcome of their pregnancies. I am against forced abortion and I am against forced childbirth. I also support social systems that make it possible for women to have children when they wish, and not feel coerced into an abortion by finances. I am against state coercion (or any coercion) of women's pregnancy choices.

Yup, I'm Canadian.

 

[Anastasis]

Not off-hand, unfortunately. If you're interested, though, there are a wealth of AMA opinions at

http://www.ama-assn.org/apps/pf_new/pf_online?category=CEJA&assn=AMA&f_n=mSearch&s_t=&st_p=&nth=1&

Awesome! Thanks for the link; bookmarked

 

[DropkickMurphy]

there's really no viable solution to this problem, it just strikes me as strange that no one seems to address this issue

Yes there is but we can't shut the "advocacy groups" up for long enough to start sterilizing people.

 

[trustwomen]

My analogy does not become moot because you are selectively picking a hypothetical humane society with an insufficient number of adoptive homes.

Nope, your analogy becomes moot when you admit that there is a significant difference in the effort and investment required to carry, birth, and relinquish a baby vs. drop off a puppy at the pound.

 

[Quix]

Honestly, yes, I do believe that this is OK. I believe that freedom of speech should include both what we can say and what we can not say. I also believe that we should not be asked to forfeit our constitutional rights on the Altar of Doctoring. Being a doctor is a responsibility, yes: but our first responsibility is, in my opinion, to our oath that we will do no harm. Thus, if a Catholic doctor honestly believes that birth control = harm, then he/she should be perfectly entitled to say (or not to say) what he/she pleases.

Of course, this doctors pateitns are also free to seek out another doctor. But I would not support making a doc compromise him/herself or his/her values.

If you're at a Catholic hospital, then you're fine, because they get to play by special rules. If you're not, you're screwed. Again, you have to realize that we start playing by a different rulebook once we put on the white coat.

Patients share with physicians the responsibility for their own health care. The patient-physician relationship is of greatest benefit to patients when they bring medical problems to the attention of their physicians in a timely fashion, provide information about their medical condition to the best of their ability, and work with their physicians in a mutually respectful alliance. Physicians can best contribute to this alliance by serving as their patients’ advocate and by fostering these rights: (1) The patient has the right to receive information from physicians and to discuss the benefits, risks, and costs of appropriate treatment alternatives. Patients should receive guidance from their physicians as to the optimal course of action.

http://www.ama-assn.org/apps/pf_new....132.HTM&nxt_pol=policyfiles/HnE/E-10.01.HTM&

"Optimal" here meaning "best health outcome", not "best moral outcome from the clinician's perspective".

 

[trustwomen]

I agree with you on this 100%, DKM. In no way do I object to birth control, nor have I ever intimated that I do.

You do know that hormonal birth control (the pill, depo, norplant, emergency contraception) carries a small risk of causing a fertilized egg to fail to implant, don't you? When does life begin for you? Does the fact that this blastula now has a unique DNA code and the blueprint for life in its few little cells not move you at all?

Judie Brown would be displeased.