New study about physician's actions when they consider care "unethical"

punkindrublic

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http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyID=2007-02-08T133559Z_01_N07396576_RTRUKOC_0_US-TREATMENT-ETHICS.xml&WTmodLoc=NewsHome-C3-healthNews-3

I thought this was really timely, particularly with the hoorahrah in TX because of the mandatory (unless, of course, the parent opts out) Gardisil vaccine. I was talking with someone the other day who felt that it was wrong to force parents to do something that may be against their beliefs, and while I agree to a certain extent, this was exactly why I felt the law was a good thing. You know, that and the fact that parents don't actually have to do it.

My thinking is that as a doctor, you can't take an autocentric view of morality or ethics, if a procedure or medication is proven safe and effective, it should be presented to the patient. I don't feel that providers should have to perform any procedure or prescribe anything that goes against their beliefs, but there should be full disclosure up front; that this is an option; I won't provide it, but it is out there, and if you want more information about it, you should find another doctor. I think making this shot "mandatory" does a good job of opening a dialogue that may otherwise go unaddressed and get the vaccine to more women before they become infected with HPV.
 

mshheaddoc

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Here's the article, Religion, Conscience, and Controversial Clinical Practices if you want to read it for yourself.
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ABSTRACT

Background There is a heated debate about whether health professionals may refuse to provide treatments to which they object on moral grounds. It is important to understand how physicians think about their ethical rights and obligations when such conflicts emerge in clinical practice.


Methods We conducted a cross-sectional survey of a stratified, random sample of 2000 practicing U.S. physicians from all specialties by mail. The primary criterion variables were physicians' judgments about their ethical rights and obligations when patients request a legal medical procedure to which the physician objects for religious or moral reasons. These procedures included administering terminal sedation in dying patients, providing abortion for failed contraception, and prescribing birth control to adolescents without parental approval.



Results A total of 1144 of 1820 physicians (63%) responded to our survey. On the basis of our results, we estimate that most physicians believe that it is ethically permissible for doctors to explain their moral objections to patients (63%). Most also believe that physicians are obligated to present all options (86%) and to refer the patient to another clinician who does not object to the requested procedure (71%). Physicians who were male, those who were religious, and those who had personal objections to morally controversial clinical practices were less likely to report that doctors must disclose information about or refer patients for medical procedures to which the physician objected on moral grounds (multivariate odds ratios, 0.3 to 0.5).



Conclusions Many physicians do not consider themselves obligated to disclose information about or refer patients for legal but morally controversial medical procedures. Patients who want information about and access to such procedures may need to inquire proactively to determine whether their physicians would accommodate such requests.
 
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