Medschoolrunner

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I'm applying for a residency in Ob/Gyn, and due to religious reasons, I don't feel comfortable prescribing OCPs. I really love the field of Ob/gyn, but am worried that my refusal to prescribe birth control will be problematic during my residency years. any one have any in put on this?
 

cjw0918

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Considering that many women use their OB/GYN strictly for contraception purposes and that the Pill is the #1 form of contraception for American women in monogamous relationships, I don't know how this will work for you. I suppose you could cater to clients who want info on other forms of contraception such as natural family planning and the like, but I think you are alienating a large proportion of the general population.
Perhaps you could concentrate mostly in OB and GYN surgery if this interests you? That's great that you are willing to stand up for your convictions, but I don't know if you can reasonably expect a positive response from many women who want to see their OB/GYN for birth control.
I don't know how this will affect your residency either- you may be the only resident who will not provide this service and it could get annoying to the other residents. Good luck with everything. I think you are in for a challenge.
 

klmr

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Not to be argumentative, but I disagree with the above poster who said it's great that you stand up for your convictions. An OB/Gyn who will not provide Rx for OCPs is providing less than the standard of care. Period. How are you going to explain this to your patients? "I think that your desire to use the pill is a sin and I therefore will not write you an Rx for such, but I'm sure one of my [heathen] partners would be happy to."
I guess I don't understand the rationale behind being anti-OCP but I can only assume it would also extend to other contraceptives. Not to be too logical here, but contraceptive planning is a LARGE part of any OB/Gyn practice (as I believe it should be).
Anyone who feels as you do is welcome to have such beliefs but I think it is a disservice to your future patients for you to pursue this field. I certainly hope you plan to make your feelings known on the interview trail as I believe to do less would be fraudulent.

PS...half of me believes this post must be an attempt at an inflammatory joke, but the other half won
 

jvarga

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Although I do not agree with those colleagues that do not prescribe OCPs for personal reasons, I completely respect their decision to so. After all, who are we to force our beliefs on them and vice versa?
To answer the original question, there are residencies that allow residents the freedom to not prescribe OCPs, place IUDs, perform BTLs or EABs if these go against their beliefs. Since this does indeed complicate the logistics of scheduling clinics and procedures around these docs, many residencies would opt out on taking in these docs if they get the chance. As a result, I would be honest with the programs that you interview with so that there will be no surprises in the future. I have seen this work out nicely for a resident in the program where I trained and I'm sure there are plenty other programs that are equally flexible.
Although some residencies are flexible when it comes to this, things could get tougher in private practice. Not many practices like to knowingly hire a physician that already starts with such limitations...it's just not good for business.
 

pillowhead

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Medschoolrunner said:
I'm applying for a residency in Ob/Gyn, and due to religious reasons, I don't feel comfortable prescribing OCPs. I really love the field of Ob/gyn, but am worried that my refusal to prescribe birth control will be problematic during my residency years. any one have any in put on this?
OCPs are used for a variety of reasons besides contraception. Fibroids, endometriosis, dysmenorrhea, severe PMS, acne, irregular cycles, etc. Do you have a problem prescribing them for these reasons?

What about the many other forms of birth control? Depo shots? Implanon that was just approved today? The vaginal ring? IUDs? Diaphragms? Cervical caps? Will you refuse to prescribe or fit patients for these?

Will you not counsel patients about contraception that is available over the counter such as male and female condoms and spermicides?

Will you refuse to participate in tubal ligation surgery?

You are certainly entitled to your own opinion but in my opinion, refusing to do any of the above means you are not fulfilling your duties as an ob/gyn. Your statement also strikes me as being a little uninformed because it sounds like you are against the OCPs without realizing how many other forms of contraception are out there. Are you against all contraception or just OCPs (because I don't know why one would only be against OCPs and not contraception in general.)

I do not see how you could possibly be a resident in MOST ob/gyn programs and refuse to prescribe or advise patients about contraception. I'm sure there are a handful of church-based hospitals out there that will support that, but most programs won't. So much of what ob/gyns do in clinic and post-partum is advising patients about birth control.
 

ygreenst

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pillowhead said:
OCPs are used for a variety of reasons besides contraception. Fibroids, endometriosis, dysmenorrhea, severe PMS, acne, irregular cycles, etc. Do you have a problem prescribing them for these reasons?

What about the many other forms of birth control? Depo shots? Implanon that was just approved today? The vaginal ring? IUDs? Diaphragms? Cervical caps? Will you refuse to prescribe or fit patients for these?

Will you not counsel patients about contraception that is available over the counter such as male and female condoms and spermicides?

Will you refuse to participate in tubal ligation surgery?

You are certainly entitled to your own opinion but in my opinion, refusing to do any of the above means you are not fulfilling your duties as an ob/gyn. Your statement also strikes me as being a little uninformed because it sounds like you are against the OCPs without realizing how many other forms of contraception are out there. Are you against all contraception or just OCPs (because I don't know why one would only be against OCPs and not contraception in general.)

I do not see how you could possibly be a resident in MOST ob/gyn programs and refuse to prescribe or advise patients about contraception. I'm sure there are a handful of church-based hospitals out there that will support that, but most programs won't. So much of what ob/gyns do in clinic and post-partum is advising patients about birth control.
No, I don't think that you can become an Obgyn without perscribing OCPs. You will have to do this at least during residency. I cannot imagine any scenarios where not perscribing OCPs would be okay. No patients will want to see you. If you like the surgical aspect of OB, consider just becoming a surgeon.
 

juddson

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No doubt you should also refuse to provide prenatal care to unmarried women as well, let alone deliver their "illegitimate" babies. The diagnosis and/or treatment of sexually transmissible diseases must also be avoided lest you indirectly condone sexual congress outside the confines of holy matrimony.

You're going to make a wonderful OB/GYN.

Judd
 

fuzzyerin

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Apply to hospitals affiliated with the Catholic Church. They do not do any TOPs, BTLs, or prescribe contraceptives. And there are a lot of these programs out there. I specifically chose NOT to interview at these places for these reasons, but it sounds like these would be a perfect fit for you.
 

obbyjobby

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Dude...I'm not going to argue your religious beliefs with you, but I have a hard time believing you'll be able to attract patients and make a living as an ob/gyn if you refuse to engage contraceptives in your practice.
 

PELE#10

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Medschoolrunner said:
I'm applying for a residency in Ob/Gyn, and due to religious reasons, I don't feel comfortable prescribing OCPs. I really love the field of Ob/gyn, but am worried that my refusal to prescribe birth control will be problematic during my residency years. any one have any in put on this?
I respect your conviction to not take OCP's for yourself. But arent you going to be an advocate for your future patients healthcare and religous beliefs? As much as you want people to respect your beliefs you should respect others.

I would agree that you should make it known that this is what you intend to do while interviewing. If you dont, your beliefs arent really worth much.
 

sdn1977

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fuzzyerin said:
Apply to hospitals affiliated with the Catholic Church. They do not do any TOPs, BTLs, or prescribe contraceptives. And there are a lot of these programs out there. I specifically chose NOT to interview at these places for these reasons, but it sounds like these would be a perfect fit for you.
I actually worked at a Catholic affliated hospital & I don't know about the residency training, but as a pharmacist, I dispensed plenty of contraceptives. There are many reasons to use them other than contraception. And for pts admitted for other than gyn issues - particularly psych illnesses which need inpt tx, they were never taken off their contraceptive just because we were a Catholic hospital. It would have complicated their treatment further.
 

MeowMix

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Go to a Catholic facility, where at least in principle they agree with your beliefs. However, I see the Catholic hospitals/clinics cheating on this issue by prescribing OCPs for "menstrual cycle regulation" when both provider and patient know it is for birth control purposes.

Interestingly, although the hospitals in Mexico (a strongly Catholic country) will not do abortions, they will do tubals and will provide OCPs. They at least recognize that their very high birth rate (and their very high teen pregnancy rate) are not in their best interests and only perpetuate poverty and lack of education for women.
 

DebDynamite

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I respect your conviction to not take OCP's for yourself. But arent you going to be an advocate for your future patients healthcare and religous beliefs? As much as you want people to respect your beliefs you should respect others.

I would agree that you should make it known that this is what you intend to do while interviewing. If you dont, your beliefs arent really worth much.
I agree completely. You should make your beliefs known, and probably go to an intensely Catholic program. And you should be prepared for the majority of your colleagues not to refer anyone to you once they know how you intend to practice. I can assure you that no matter how nice an individual you might be, I would never refer out to you.

You should also consider if you will be able to ethically live with yourself if you join a profession that advocates something you do not. I struggle with this when it comes to going IM or FP, simply because of Polypharmacy and end of life management with inpatients. Every night I question if I want to daily be part of these sticky issues, because I think the way we (modern medicine) deal with these two HUGE issues is WRONG. So, I'm probably not going to join either profession. Similarly, OC's are a major drug for OBGyn- if you are not providing them, are you willing to make that your "niche"? You had better find yourself a community of individuals who want an OBGyn like that, and I seriously consider you look in the real world first for this. Maybe the Catholic community will support you. I'm not trying to be harsh, I think you should hear these opinions before you try to do something incredibly hard.
 

MiesVanDerMom

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OP, i'm assuming, believes OCP is essentially equivalent to abortion and that is "killing" potential babies. Therefore, s/he cannot prescribe even to those with differing religious beliefs. As long as OP practices in an area with a large conservative Catholic population I would think they would be fine. I know the conservative Catholic community keeps tabs of which Ob/Gyns are in line with their beliefs. I would hope OP would teach his/jer patients proper Natural Family Planning methods as the Catholic Church is not against family planning.

I personally don't use OCP but don't believe it to be immoral and wouldn't have a problem prescribing it (haha, if ever I get into med school :) ) but I also think that women would gain a lot from being educated in Natural Family Planning methods/Fertility Awareness Method( a la Toni Wechsler). If properly done, they're as effective as the pill. And one can either abstain during fertile times or use barrier methods. Being aware of our bodies helps women's health in every way. There are also a lot of side effects to OCP and I wish more women knew about fertility awareness methods as an alternative. They also work amazingly well for conceiving quickly. My two meatballs stand as proof :laugh:
 

UCLAMAN

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but I also think that women would gain a lot from being educated in Natural Family Planning methods/Fertility Awareness Method( a la Toni Wechsler). If properly done, they're as effective as the pill.
and therein lies the problem. how many patients "properly" do anything?
 

UCLAMAN

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the catholic church's stance sucks for guys too. i mean, pope john paul says i can't get a vasectomy.

as a male...once i am done having children...i will strongly consider seeing my local urologist.

you know...as a third year i never fully appreciated the ethical/religious/moral issues involved with the field. i was too happy delivering kids, sectioning moms, learning what parents were gonna name their kids.

however, now that i am currently in the application process and having done a month with reproductive genetics(ie CVS and amnios and the counseling and subsequent procedures that go on should there be a trisomy 13 result for example), i feel like i am at a crossroads with my own church's stance on the issues i will be facing everyday for the rest of my career. i also feel like i have to make a decision about it soon.
 

tiredmom

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UCLAMAN - it's a difficult situation... I'm in the same boat. It's made me realize that I know REI is not for me - way too many ethical debates for my taste. I'm comfortable with referring to someone else for abortions after talking it through with my patients. I don't have a problem with OCPs or tubal ligations or vasectomies. But that is against my church's official teachings. I don't agree with terminating created life - but I think the church goes a little far in suggesting that each egg that doesn't get fertilized should have had the opportunity to. I don't see where NFP is any different than using a more reliable method to prevent conception. And on hormonal methods, since you aren't ovulating, those eggs aren't getting ovulated - so as to not have that potential anyways. As far as the trisomy 13 situations - I still haven't settled that debate yet.
 

UCLAMAN

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UCLAMAN - it's a difficult situation... I'm in the same boat. It's made me realize that I know REI is not for me - way too many ethical debates for my taste. I'm comfortable with referring to someone else for abortions after talking it through with my patients. I don't have a problem with OCPs or tubal ligations or vasectomies. But that is against my church's official teachings. I don't agree with terminating created life - but I think the church goes a little far in suggesting that each egg that doesn't get fertilized should have had the opportunity to. I don't see where NFP is any different than using a more reliable method to prevent conception. And on hormonal methods, since you aren't ovulating, those eggs aren't getting ovulated - so as to not have that potential anyways. As far as the trisomy 13 situations - I still haven't settled that debate yet.
honestly, i am leaning towards the same way as you on all of these issues. pope john paul(rest his soul) is not God last i checked.

trisomy 13 and 18 is a tough situation IMO. i don't think i could ever become an abortionist or perform selective reductions. by the way...i would argue that selective reductions are much, much more traumatic to EVERYONE invovled(from the docs to the patients to the u/s tech) than a DnE. in any event...despite the way i am leaning on the abortion issue, i still feel it is important to make sure patients are fully aware of all the options they have in front of them. i also think it is important to support them with whatever decision they make(whether they decide to terminate a pregnancy or not) regardless of my own personal beliefs.

so ya...i agree with you on all fronts. any other thoughts on the issue?
 

MiesVanDerMom

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honestly, i am leaning towards the same way as you on all of these issues. pope john paul(rest his soul) is not God last i checked.

trisomy 13 and 18 is a tough situation IMO. i don't think i could ever become an abortionist or perform selective reductions. by the way...i would argue that selective reductions are much, much more traumatic to EVERYONE invovled(from the docs to the patients to the u/s tech) than a DnE. in any event...despite the way i am leaning on the abortion issue, i still feel it is important to make sure patients are fully aware of all the options they have in front of them. i also think it is important to support them with whatever decision they make(whether they decide to terminate a pregnancy or not) regardless of my own personal beliefs.

so ya...i agree with you on all fronts. any other thoughts on the issue?

wanted to say I agree with you both! And I certainly see what you're saying about patients not following through with NFP. I volunteered at Family Planning and could barely convince most of the patients to use ANY form of contraception; it was all too much of a bother.

As for the Trisomy 13 thing: I have a special needs son with 2 genetic disorders. in my special needs parenting online groups we discuss this issue in terms of what we'll do with future children. I respect the decision each family makes. Some of them do choose to get pregnant with a second child and then test and possibly abort. I've gotta say, though, it's a hard one for me since it's so personal. I just wouldn't ever abort, even knowing how insanely hard it can be to raise a special needs child. to me, it's a definite right/wrong situation. I really don't know how I could handle having a patient decide to terminate their baby because it has a genetic disorder. It may count me out of OB...
 

pillion

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The Catholic Church has plenty of hospitals throughout the States and the World that would welcome an OB/Gyn who adheres to it's teaching on contraception, abortion, etc. The Church's perspective on such issues is profound and well worth learning about.

"Trust in the Lord with all your heart and do not rely on your own insight. In all your ways acknowledge him and he will make straight your paths. Be not wise in your own eyes: fear the Lord, and turn away from evil. It will be healing to your flesh and refreshmment to your bones." - Proverbs 3:5-8
 

MeowMix

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The Catholic Church has plenty of hospitals throughout the States and the World that would welcome an OB/Gyn who adheres to it's teaching on contraception, abortion, etc. The Church's perspective on such issues is profound and well worth learning about.
Having learned a fair amount about the Church's perspective, I find it to be less than profound. It's OK to prescribe hormonal intervention in order to increase my procreative abilities (e.g. clomiphene), but it's not OK to prescribe hormones to decrease my procreative potential (e.g. OCP). John Paul II at least was consistent enough to say that IVF and other forms of assisted reproduction were not congruent with Catholic practice; I see Catholic hospitals in the US getting around this and finding multiple ways to help women have more babies, while ignoring the real problems for poor women who are trying to have fewer kids.

By contrast, hospitals in Catholic Mexico, although they will never provide abortions, will at least provide OCP and other forms of birth control because they recognize that teen parents + multiple kids = poverty.
 

pillion

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Having learned a fair amount about the Church's perspective, I find it to be less than profound. It's OK to prescribe hormonal intervention in order to increase my procreative abilities (e.g. clomiphene), but it's not OK to prescribe hormones to decrease my procreative potential (e.g. OCP). John Paul II at least was consistent enough to say that IVF and other forms of assisted reproduction were not congruent with Catholic practice; I see Catholic hospitals in the US getting around this and finding multiple ways to help women have more babies, while ignoring the real problems for poor women who are trying to have fewer kids.

By contrast, hospitals in Catholic Mexico, although they will never provide abortions, will at least provide OCP and other forms of birth control because they recognize that teen parents + multiple kids = poverty.
It's the difference between helping a blind man to see and helping a seeing man to become blind. Contraceptives essentially try to make the body malfunction for economic (or other) reasons, not medical reasons. There are legitimate uses of hormones (aka contraceptives) in regulating cycles, etc., just as other legit medicines help the body function as it should, but in these instances their use is not as a contraceptive.
 

chocomorsel

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It's the difference between helping a blind man to see and helping a seeing man to become blind. Contraceptives essentially try to make the body malfunction for economic (or other) reasons, not medical reasons. There are legitimate uses of hormones (aka contraceptives) in regulating cycles, etc., just as other legit medicines help the body function as it should, but in these instances their use is not as a contraceptive.
you are seriously not comparing the two? Blindness and contraception? Seriously, so I guess from your statement, we are only supposed to have sex in order to procreate alone not because husband and wife love each other and want to make love? Come on, not trying to step on your beliefs here but how many married men, want to be told by their spouses that they can only have sex the week before ovulation, and the week before menses so as their wives not get pregnant? Basically two weeks per month. And that's assuming that these women have regular cycles which many don't. You live in San Antonio and I'm sure you see the poor Hispanic communities on welfare, barely surviving with multiple kids, starting at an early age. These women don't need to be having all these babies, they are having sex with their SO's for the fun part most of the time, and what happens, OOPS, another baby which means more money that they don't have, more need for welfare or a second job to support yet more babies. Think and tell me how many of these young unwed mothers truly have gotten pregnant by actually trying to have a baby? I don't know but you are doing these people a disservice by not giving them OCP's. And what about barrier contraception? Does that mean you don't advocate that either? Because if so, then more power to you in treating all these women who have undiagnosed GC that leads to PID and then infertility when later on they actually want to have babies. And let's not forget HIV. What do you tell these people, don't have sex, until you are married? Seriously? People like you should stay out of OB-GYN. Ok, stay, but please don't preach this, send them to other OB's who are gonna do these people right by giving them control of their bodies.
 

chocomorsel

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Oh, and I don't mean to just pick on the poor Hispanic community. I meant to pick on the poor, uneducated Hispanic, White, black and etc community, because these are the ones who tend to have the major lack of resources. Just that in San Antonio, half the city is Mexican, with a majority of them poor, uneducated and struggling to raise their babies. Which I can bet, most of them are a suprise. :idea:
 

chocomorsel

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They are talking about the JW in the ER forum so I thought to flip the script and make the JW an ER doc as opposed to a patient. So I a pt comes in with a GSW to the abdomen with 2-3 liters of blood vol. lost is this doc gonna pump them full of fluids and hope for the best? In the ideal world he wouldn't let his own beliefs get in the way of the best treatment FOR HIS PATIENT!!! If he doesn't believe in blood transfusions for himself AND for others, then he needs to stay the hell away from the ER, or any acute setting where a pt might need blood products. He would probably make a great doc in another field, say Psych or path, but not a great EP doc. Just food for thought.
 

MiesVanDerMom

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They are talking about the JW in the ER forum so I thought to flip the script and make the JW an ER doc as opposed to a patient. So I a pt comes in with a GSW to the abdomen with 2-3 liters of blood vol. lost is this doc gonna pump them full of fluids and hope for the best? In the ideal world he wouldn't let his own beliefs get in the way of the best treatment FOR HIS PATIENT!!! If he doesn't believe in blood transfusions for himself AND for others, then he needs to stay the hell away from the ER, or any acute setting where a pt might need blood products. He would probably make a great doc in another field, say Psych or path, but not a great EP doc. Just food for thought.
but in this case those opposed to OCP would say they are analagous to the doc who transfuses and those who prescribe OCP are analagous to one who does not. Because: they see OCP as ending a potential life and not prescribing as saving one.

I think, though, the issue of poverty is an important one. Even if one is mornally opposed to artifcial birth control, there are immediate moral issues that need to be dealt with first. Unless the Church can provide for all the children being born as a result of not using OCP, they should put such laws on hold until they've managed to eradicate poverty and improve the education system so that all women are able to make informed decisions about family size and properly follow natural family planning methods. The Church does 1) recognize that marital intimacy is a valid reason for sex (not just procreation) and 2) families should limit the number of children for valid reasons (truly cannot afford anymore, cannot give enough attention to more children, etc.). But they say that natural methods need to be used instead of artificial. This doesn't work out in the current situation. They either need to start a major campaign to make it possible for for women to actually follow NFP (which, as I said would really mean working on poverty on a global scale) or start supporting all these kids financially.
 

pillion

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but in this case those opposed to OCP would say they are analagous to the doc who transfuses and those who prescribe OCP are analagous to one who does not. Because: they see OCP as ending a potential life and not prescribing as saving one.
The Church's view is not based on ending a "potential life", unless you are referring to the "backup" mechanism of an OCP whereby if conception does occur, the body rejects it. However, in this case, the pill is not working as a contraceptive but as an abortifacient (keeping in mind, of course, that the Church believes life begins at conception). The Church's opposition to contraception deals with the meaning of sexuality. As you noted, the purpose of sex is both procreative and unitive, binding the couple closer together in a spiritual union which is manifested in a physical union - a new human being. The Church's teaching about contraception is essentially the same as it's views on homosexuality and masturbation, all of which deny the truth about sex.

I think, though, the issue of poverty is an important one. Even if one is mornally opposed to artifcial birth control, there are immediate moral issues that need to be dealt with first. Unless the Church can provide for all the children being born as a result of not using OCP, they should put such laws on hold until they've managed to eradicate poverty and improve the education system so that all women are able to make informed decisions about family size and properly follow natural family planning methods.
Your view sounds rather marxist, as though human fulfillment is synonomous with economic stability. The Church's mission in the world is not to eradicate poverty, but to manifest God's love for mankind. Granted. one way of doing this is by serving the poor, but not with false solutions. Since the introduction of OCPs into the mainstream (which is a recent historical phenomenon), the incidence of STDs and unwanted pregancies has only increased.
 

chocomorsel

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The Church's view is not based on ending a "potential life", unless you are referring to the "backup" mechanism of an OCP whereby if conception does occur, the body rejects it. However, in this case, the pill is not working as a contraceptive but as an abortifacient (keeping in mind, of course, that the Church believes life begins at conception). The Church's opposition to contraception deals with the meaning of sexuality. As you noted, the purpose of sex is both procreative and unitive, binding the couple closer together in a spiritual union which is manifested in a physical union - a new human being. The Church's teaching about contraception is essentially the same as it's views on homosexuality and masturbation, all of which deny the truth about sex.



Your view sounds rather marxist, as though human fulfillment is synonomous with economic stability. The Church's mission in the world is not to eradicate poverty, but to manifest God's love for mankind. Granted. one way of doing this is by serving the poor, but not with false solutions. Since the introduction of OCPs into the mainstream (which is a recent historical phenomenon), the incidence of STDs and unwanted pregancies has only increased.
I'm a little confused as to how the pill is working as an abortifacient. Most pills OCP's I believe prevent you from ovulating and therefore, if not ovulating, then how are can you conceive? There is no egg for the sperm to hook up with. Some of the OCP's do create an unoptimal enviroment in the uterus where the fertilized egg does not attach. So if this is the case, why not prescrip OCP's that do no cause ovulation instead of the ones that create a hostile environment for the fertilized egg? Problem solved.
 

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My understanding was the problem the church had with OCP or birth control in general was that it interferes with the life that God planned as that egg and that sperm. In that context, it makes unifies the beliefs stated by JPII regarding in vitro fertilization. However, I've never understood how natural family planning was acceptable, because that also interferes with the "that egg, that sperm, that time" argument. I think it comes down to the church wanting people to "leave it to God" instead of making decisions on their own. I've never been able to reason it out, so I don't follow it. I don't see a difference between the non-ovulation that goes with proper use of hormonal birth control and the NFP method of knowing when you are going to ovulate and abstaining from intercourse (except for the "sacrifice" of not having sex).
 

Doc Zuzu

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Apply to hospitals affiliated with the Catholic Church. They do not do any TOPs, BTLs, or prescribe contraceptives.
Oh, yes they do. The hospital I have privs and our office at is Catholic. We don't do terminations (but we refer like crazy, and have pamphlets for clinic who will do the procedure) and we do presribe BC of all types as well as Tubal Ligations. I presribed Plan B, until it went OTC. (Well it will this month.)
 

pillowhead

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Okay, stop right there. Many of your patients will (shock horror!) not be Catholic or any other form of Christianity. Therefore anything that comes after that phrase is just going to make your patients turn right around and find another doctor. Unless we revert to a world where Christian patients only see Christian doctors, Jewish patients only see Jewish doctors, etc, etc, then I suggest you leave the church's views (YOUR church's views) out of your medical discussions.
 

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They are talking about the JW in the ER forum so I thought to flip the script and make the JW an ER doc as opposed to a patient. So I a pt comes in with a GSW to the abdomen with 2-3 liters of blood vol. lost is this doc gonna pump them full of fluids and hope for the best? In the ideal world he wouldn't let his own beliefs get in the way of the best treatment FOR HIS PATIENT!!! If he doesn't believe in blood transfusions for himself AND for others, then he needs to stay the hell away from the ER, or any acute setting where a pt might need blood products. He would probably make a great doc in another field, say Psych or path, but not a great EP doc. Just food for thought.
Since I'm the one who started the JW debate over in the EM forum....I have to agree that while I am all for someone being able to shuffle off their mortal coil a little earlier than would be normally expected because of their own stupidity (refusing blood transfusion, refusing chemo (that Starchild kid), etc), so long as it harms no one else.

That being said, I believe that abortions and contraception are the most valuable services rendered by gynecologists. This is especially true in the cases of deformity or ******ation that are ID'ed prior to delivery. While I may disagree with abortion as a form of birth control especially past the first two or three months of pregnancy, I certainly won't object if someone wants to inhibit their own breeding.
 

pillion

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Oh, yes they do. The hospital I work at is Catholic. We don't do terminations (but we refer like crazy, and have pamphlets for clinic who will do the procedure) and we do presribe BC of all types as well as Tubal Ligations. I presribed Plan B, until it went OTC. (Well it will this month.)
There are Catholic hospitals that are Catholic and there are Catholic hospitals that carry the name. I'll be the first to admit that the majority of Catholics in the US do not adhere to the Church's teaching on contraception. Fortunately, Catholicism is not a democracy where the majority opinion rules. God help us if it was... wait a second, then God couldn't help us because we would have just nixed him from the picture.
 

pillion

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Okay, stop right there. Many of your patients will (shock horror!) not be Catholic or any other form of Christianity. Therefore anything that comes after that phrase is just going to make your patients turn right around and find another doctor. Unless we revert to a world where Christian patients only see Christian doctors, Jewish patients only see Jewish doctors, etc, etc, then I suggest you leave the church's views (YOUR church's views) out of your medical discussions.
God forbid that doctors have consciences and try to live morally consistent lives. The notion that a doctor should check his conscience at the exam room door is itself a moral view which I'm sure you adhere to faithfully. The only contradiction is thinking that you are somehow outside the moral realm when, in fact, you are not. Granted, the fact that doctors and patients can be at odds in their beliefs can pose genuine problems. I'm still mulling that one over...
 

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I don't post here a lot, but I had to come back to this one. In the state where I live and practice, there is now a law that RpHs have to fill any and all Birth Control prescriptions, or they will lose their licenses. Good law, IMO. If what your main job requires you to do, is inconsistant with your "morals" then do something else (that came out sounding more harsh than I meant it to. Sorry.) What I mean is, maybe think about Gen Surg, or Geriatrics, or something where a huge amount of your pts don't]need care for their reproductive organs to prevent pregnancy. And, yes, often helping a ptnot become pregnant is the best way to adhere to "Do no harm."

OBGYN is about Women's Health. If a major part of your interpretation of "Women's Health" is denying them what they need, or, God Forbid, lecturing them about their Choices concerning their own bodies, it most likely isn't the Speciality for you. My guess would be an OBGYN who won't prescribe Birth Control will have a dearth of patients, once word gets around. (And word does get around.) Also, unless you are going to practice solo, your partners will have a difficult time with your "decision." An OBGYN who won't presribe BC is like an Oncologist who "doesn't beleive" in Chemo. It just won't work. :confused:
 

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Go to a Catholic facility, where at least in principle they agree with your beliefs. However, I see the Catholic hospitals/clinics cheating on this issue by prescribing OCPs for "menstrual cycle regulation" when both provider and patient know it is for birth control purposes.
No, we don't lie or fudge. We just prescribe. Our office's drug closet is filled with at least 6 or 8 different brands of OCPs to give as samples. We do Depo injections, and chart and bill accordingly. Nuvarings are becoming more popular, as is "The Patch" and we write for all of these. The only time we "fudge" is when the pt's Insurance doesn't pay for BC, then we can find an other reason. (Hey, everybody has an occasional irregular menstrual cycle, pelvic pain ect.:D ) This is becoming less and less neccesary, since all the stink was raised about insurance cos who would cover ED meds, but not BC.

I also keep a drawer of latex and poly condoms to give to teens, young 20s and anyone else in need, instead of lollypops. Never had a problem with the Admin or anyone else at our facility.
 

pillion

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maybe think about Gen Surg, or Geriatrics, or something where a huge amount of your pts don't]need care for their reproductive organs to prevent pregnancy. And, yes, often helping a ptnot become pregnant is the best way to adhere to "Do no harm."
How do we care for a patient's CV system, their GI system, their lungs, their kidneys, their bones, etc? We help them function as they are supposed to function, not suppress or destroy them. Your view of caring for the reproductive organs seems less than consistent with the way we treat every other organ in the body.

OBGYN is about Women's Health. If a major part of your interpretation of "Women's Health" is denying them what they need, or, God Forbid, lecturing them about their Choices concerning their own bodies, it most likely isn't the Speciality for you. My guess would be an OBGYN who won't prescribe Birth Control will have a dearth of patients, once word gets around. (And word does get around.) Also, unless you are going to practice solo, your partners will have a difficult time with your "decision." An OBGYN who won't presribe BC is like an Oncologist who "doesn't beleive" in Chemo. It just won't work. :confused:
You mean I won't make hundreds of thousands of dollars? Then forget it, ob/gyn is not for me. I'm in it for the money.

An oncologist uses medications/radiation to heal the body. Is the ob/gyn trying to heal the body or cause it to malfunction, or even damage it, or even destroy the life in it?
 

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An OBGYN who won't presribe BC is like an Oncologist who "doesn't beleive" in Chemo. It just won't work. :confused:
This is a very good point. I think Pillion is missing the boat here and is taking things WAY too literally. Certain procedures/meds and such are a part of the job description with certain areas of medicine. Gynecologists prescribe OCPs. Oncologists prescribe chemo (which, I may add, is seen by SOME as prolonging life in instances where it should not be prolonged), plastic surgeons do liposuction, pain specialists load people with narcs... etc etc etc. So if you have an issue with what the specialty does you should make another choice or be prepared to take a good deal of crap from your fellow residents or even your patients down the road.
 

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Is the ob/gyn trying to heal the body or cause it to malfunction, or even damage it, or even destroy the life in it?
I imagine your scalp and anal sphincters are on a first name basis aren't they?
 

chocomorsel

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It's a shame your mother's doctor was not more effective at that last lofty goal....it would have saved everyone the trouble of reading this thread. :smuggrin:
Very abrasive DropKick. While I agree with you on the previous posts, this was completely unnecessary.
Pillion, seriously, find yourself another specialty whose standards of practice mesh alot more with your beliefs. Ob-Gyn is not for you as OCP's are a very large part of what is expected from an OB. As a previous poster said, you are missing the boat here.
 

DropkickMurphy

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Very abrasive DropKick. While I agree with you on the previous posts, this was completely unnecessary.
Pillion, seriously, find yourself another specialty whose standards of practice mesh alot more with your beliefs. Ob-Gyn is not for you as OCP's are a very large part of what is expected from an OB. As a previous poster said, you are missing the boat here.
Duly noted.....editing my previous post.
 

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Your view sounds rather marxist, as though human fulfillment is synonomous with economic stability. The Church's mission in the world is not to eradicate poverty, but to manifest God's love for mankind. Granted. one way of doing this is by serving the poor, but not with false solutions. Since the introduction of OCPs into the mainstream (which is a recent historical phenomenon), the incidence of STDs and unwanted pregancies has only increased.
Actually I'm more a Catholic Worker anarchist, but I have been know to consort with Marxists.

My point was: 1)of course the Church has an obligation to recognize the sin of allowing children to be born into abject poverty 2) the Church advocates Natural Family Planning. They don't advocate people mindlessly procreating til they've had 100 babies. Natural Family Planning can only be used by someone who has a minimal level of education though. This education cannot be attained when large numbers of people are living in poverty. Major social change would be needed to get women throughout society to this point. Until we do that, Natural Family Planning is not a realistic option. You can't just close your eyes and cover your ears and say "la la la, NFP, la la la" It's not working. Women using no family planning isn't in line with the Church's teachings any more than OCPs. So, factor in the poverty etc. these families are facing and it becomes clear OCP are necessary for the time being. I'd love to see a world where women use NFP. That's why I work towards a world where women are educated, safe, and economically stable.
 

MiesVanDerMom

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Since I'm the one who started the JW debate over in the EM forum....I have to agree that while I am all for someone being able to shuffle off their mortal coil a little earlier than would be normally expected because of their own stupidity (refusing blood transfusion, refusing chemo (that Starchild kid), etc), so long as it harms no one else.

That being said, I believe that abortions and contraception are the most valuable services rendered by gynecologists. This is especially true in the cases of deformity or ******ation that are ID'ed prior to delivery. While I may disagree with abortion as a form of birth control especially past the first two or three months of pregnancy, I certainly won't object if someone wants to inhibit their own breeding.
i hope you're referring to deformities that would prevent the baby from living once born and not just cases of parents who don't want to deal with a special needs child.
 

DropkickMurphy

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Well, I'm talking about anything that would result in a child that will effectively never be able to function as an adult- something that is normally due to mental defect or genetic screwup. I've watched people spend years toiling with a ******ed child, only to have to continue to deal with an invalid, non-functional adult who is simply waiting for a random infection, blood clot or other random event to end its life. The strain it puts on these poor parents is unbelievable...I say if someone wants to avoid that then by all means let them.

If my daughter had been prenatally diagnosed with Down's I would have pushed VERY strongly for termination of the pregnancy simply because I believe in preventing suffering in all its forms where possible. If her mother had refused, I would not have put my name on the birth certificate and I would have demanded DNA testing to prove that the child was mine before I ever paid a cent for it.
 

pillion

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So contraception is ok because 1) it's just what everybody's doing 2) it's a matter of poverty.

Both of these may be true, but they don't touch the question of medicine's role, or purpose. I am not attempting to solve nonmedical problems with medical solutions. IMO, the Church's view is actually less overreaching than those proposed so far. Why? Because it remains truer to the nature of medicine.
 

pillion

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Actually I'm more a Catholic Worker anarchist, but I have been know to consort with Marxists.

My point was: 1)of course the Church has an obligation to recognize the sin of allowing children to be born into abject poverty 2) the Church advocates Natural Family Planning. They don't advocate people mindlessly procreating til they've had 100 babies. Natural Family Planning can only be used by someone who has a minimal level of education though. This education cannot be attained when large numbers of people are living in poverty. Major social change would be needed to get women throughout society to this point. Until we do that, Natural Family Planning is not a realistic option. You can't just close your eyes and cover your ears and say "la la la, NFP, la la la" It's not working. Women using no family planning isn't in line with the Church's teachings any more than OCPs. So, factor in the poverty etc. these families are facing and it becomes clear OCP are necessary for the time being. I'd love to see a world where women use NFP. That's why I work towards a world where women are educated, safe, and economically stable.
Concerning your first point, ask yourself something. If human beings did not live in society and simply roamed the earth like other animals, eating what they could find, sleeping where they could, protecting themselves however they could, would you consider them to be in poverty? If so, would such poverty be a sin, especially since they are in the condition God placed them? As to your second point, the question of what works and what doesn't work is dependent upon the goal being aimed at. What is our goal?
 

chocomorsel

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Concerning your first point, ask yourself something. If human beings did not live in society and simply roamed the earth like other animals, eating what they could find, sleeping where they could, protecting themselves however they could, would you consider them to be in poverty? If so, would such poverty be a sin, especially since they are in the condition God placed them? As to your second point, the question of what works and what doesn't work is dependent upon the goal being aimed at. What is our goal?
How about we all just agree to disagree here? Obviously you are a fanatic for your beliefs, but you shouldn't be letting your religious beliefs get in the way of what the patient needs, wants or is best for them just because you have morals to uphold as you state. Again, most of us here think you and the OP need to find a profession that meshes with your beliefs for the most part if you want to do your patients justice and adhere to that "do no harm" principle we all learn as med students/doctors. And as for one of your above questions, we don't live in a society that simply roams the earth the rest of the animals because we have a brain that works at a higher level than the rest of those animals, Just like God intendend. Thanks to him, we found a way to control our bodies ability to function, and who's to say that's not what he intended in the first place. Whatever, I'm done.
 

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So contraception is ok because 1) it's just what everybody's doing 2) it's a matter of poverty.

Both of these may be true, but they don't touch the question of medicine's role, or purpose. I am not attempting to solve nonmedical problems with medical solutions. IMO, the Church's view is actually less overreaching than those proposed so far. Why? Because it remains truer to the nature of medicine.
I have a question.....do you have to flog yourself daily or is that just something Opus Dei only makes their hitmen do? :smuggrin: