Performing abortions if you are against it

[Blackhawkdown24]

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So, let's pretend all of us have the MD or DO right now and we're family practice physicians or gynocologists. Let's throw in that you are strongly against abortion. Would you or would you not preform it? Please let's be respectful and have a meaningful discussion.

 

[KeyzerSoze]

So, let's pretend all of us have the MD or DO right now and we're primary care physicians. Let's throw in that you are strongly against abortion. Would you or would you not preform it? Please let's be respectful and have a meaningful discussion.

How often do you think primary care physicians perform abortions?

 

[Blackhawkdown24]

How often do you think primary care physicians perform abortions?

Oops! Edited it.

 

[CuttingCorneas]

You can always refer patients if you're that strongly against it.

 

[Blackhawkdown24]

You can always refer patients if you're that strongly against it.

Exactly. That's what I would do.

 

[Mountaineer12]

Nope. This is something I would never personally do. I would be willing to refer them to someone though, but that's it.

 

[music2doc]

So, let's pretend all of us have the MD or DO right now and we're family practice physicians or gynocologists. Let's throw in that you are strongly against abortion. Would you or would you not preform it? Please let's be respectful and have a meaningful discussion.

Follow standard data-gathering process.

Focus on Hx -- why does pt want abortion? Given that information, inform pt of availability of referral for abortion but also decide whether to advise pt of other options (e.g., would adoption be a better/available option?) given the circumstances. Throughout the case, keep in mind pt's autonomy is always #1; however, if abortion could be dangerous to the pt's physical or emotional health given other information available, it might be important to let pt know of my concerns. Ethically, that is placing consideration on beneficence and non-maleficence as well. If things were sticky for some reason, consult the Hospital Ethics Board, although you haven't really introduced anything particularly difficult at this pt. The issue is really one of my autonomy as a physician and my pt's. In our culture, the pt is always given autonomy. (In other cultures, we should be aware that while autonomy should still be respected, it may NOT be the accepted #1 ethical guideline and we should NOT impose our own ethical approach on those cultures should we practice, for example, international medicine; nevertheless, your autonomy as a physician will basically never be the determining factor in what you do as far as ethics is concerned.)

 

[calvnandhobbs68]

So, let's pretend all of us have the MD or DO right now and we're family practice physicians or gynocologists. Let's throw in that you are strongly against abortion. Would you or would you not preform it? Please let's be respectful and have a meaningful discussion.

Okay I think you dont really have a good understanding of where people go for abortions. Unless someone is having a theraputic abortion, the vast majority of elective abortions are done in abortion clinics or at somewhere like planned parenthood. So this is really a nonissue...if you want to do abortions you put yourself in that position and if you dont then youre just part of everybody else.

 

[phikapdoctor]

I would not perform an abortion.
This question scares me, I heard a rumor that is reformed healthcare goes through then I would be illegal to deny someone an abortion and you could lose your practice. The only way you could avoid this issue is through private practice, and nobody can get into that these days.


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[music2doc]

Okay I think you dont really have a good understanding of where people go for abortions. Unless someone is having a theraputic abortion, the vast majority of elective abortions are done in abortion clinics or at somewhere like planned parenthood. So this is really a nonissue...if you want to do abortions you put yourself in that position and if you dont then youre just part of everybody else.

This is a good point. I could see, however, a referral being made under certain circumstances. I doubt it happens a whole lot to the fam med or OB guys but it probably does on occasion.

I would not perform an abortion.
This question scares me, I heard a rumor that is reformed healthcare goes through then I would be illegal to deny someone an abortion and you could lose your practice. The only way you could avoid this issue is through private practice, and nobody can get into that these days.


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I have heard rumors along these lines but do not know the exact details

 

[Camy99]

Like someone else said, it's not every doctor who does this procedure. A patient can't just ask their pediatrician or family physician or whomever to do so. Heck if my patient asked me to do any surgery [in the mindset I'm in having never looked into it], I would refer him/her elsewhere. Now a patient could ask me ABOUT abortion. I would give her the same talk any other doctor would give because it's my job, I would give my recommendations/concerns because I'm a human. But I wouldn't say, "Don't do it because I'm pro-life." Just like I wouldn't take a cookie away from my diabetic patient's hand as he/she's eating it. Autonomy, bruh.

 

[XCourtSmash]

I would not perform an abortion.
This question scares me, I heard a rumor that is reformed healthcare goes through then I would be illegal to deny someone an abortion and you could lose your practice. The only way you could avoid this issue is through private practice, and nobody can get into that these days.


Sent from my iPhone using SDN Mobile app

Pretty sure that's nothing more than a rumor. I remember reading a section by section summary of the Patient Protection and Affordable Health Care and saw nothing that would mandate a doctor having to perform an operation against his/her will.


Personally, I would perform one if the mother's life was in danger. There is no black and white, grow up and deal with it.

 

[Leonid Rogozov]

I would not perform an abortion.
This question scares me, I heard a rumor that is reformed healthcare goes through then I would be illegal to deny someone an abortion and you could lose your practice. The only way you could avoid this issue is through private practice, and nobody can get into that these days.


Sent from my iPhone using SDN Mobile app

I'm curious to hear your stand on artificial insemination and ectopic pregnancy.

 

[passerine]

Not all abortions are surgical, though. Mifepristone (the "abortion pill") can be prescribed in the US to terminate a pregnancy up to 49 days into the pregnancy.

http://www.plannedparenthood.org/health-topics/abortion/abortion-pill-medication-abortion-4354.asp

Just an interesting point of discussion, no matter if that changes anyone's stance on whether they'd choose to perform an abortion or not.

 

[music2doc]

Pretty sure that's nothing more than a rumor. I remember reading a section by section summary of the Patient Protection and Affordable Health Care and saw nothing that would mandate a doctor having to perform an operation against his/her will.


Personally, I would perform one if the mother's life was in danger. There is no black and white, grow up and deal with it.

I don't think it's "just a rumor" in that it definitely came up as a talking point at a med student event I was at. There are definitely some physician-advocacy groups lobbying against I even remember there being a discussion about loopholes such as simply not learning the procedure (i.e., deeming oneself incompetent to perform an abortion b/c it had been too long since doing the last one); however, with medical abortions that isn't really a possibility.

 

[45408]

I would not perform an abortion.
This question scares me, I heard a rumor that is reformed healthcare goes through then I would be illegal to deny someone an abortion and you could lose your practice. The only way you could avoid this issue is through private practice, and nobody can get into that these days.

It's possible things will progress to the point where you could get in trouble for not making an appropriate referral, but how the HELL would you get in trouble for not doing one?

Asking a surgeon to perform a procedure they are not comfortable doing is just asking for a complete nightmare. I will never do one, ectopic pregnancies notwithstanding.

Personally, I would perform one if the mother's life was in danger. There is no black and white, grow up and deal with it.

Grow up? How is not wanting to perform abortions an issue of maturity?

 

[XCourtSmash]

I don't think it's "just a rumor" in that it definitely came up as a talking point at a med student event I was at. There are definitely some physician-advocacy groups lobbying against I even remember there being a discussion about loopholes such as simply not learning the procedure (i.e., deeming oneself incompetent to perform an abortion b/c it had been too long since doing the last one); however, with medical abortions that isn't really a possibility.

Hmm do you have any links to that? I've been searching around trying to find some discussion on this and all I'm getting are stories of doctors under fire for performing abortions and the PPACA adding 1$ for the federal insurance plan for abortion, but allowing individual states to offer alternates that don't include the abortion premium.

It's possible things will progress to the point where you could get in trouble for not making an appropriate referral, but how the HELL would you get in trouble for not doing one?

Asking a surgeon to perform a procedure they are not comfortable doing is just asking for a complete nightmare. I will never do one, ectopic pregnancies notwithstanding.


Grow up? How is not wanting to perform abortions an issue of maturity?

Not wanting to perform it is your own personal feelings. That's fine, I wouldn't want to do it unless it was necessary either.

Not willing to do it regardless of the circumstances because of your feelings or beliefs or whatever else you're using to justify it is irresponsible as a physician and immature as an adult. Your duty as a physician is to help the patient. If the patient medically needs the abortion, and you are the only doctor nearby that can do it, grow up and do it. That's how I see it.

 

[Refreshed]

You can always refer patients if you're that strongly against it.

Nope.. Can't refuse to perform an abortion in some states. If you are in one of those states, and you refuse (by referring) then the patient can sue you.

Regardless, this issue will never actually occur in real life. If you are morally against abortions, don't choose a specialty that performs abortions.

I would not perform an abortion.
This question scares me, I heard a rumor that is reformed healthcare goes through then I would be illegal to deny someone an abortion and you could lose your practice. The only way you could avoid this issue is through private practice, and nobody can get into that these days.


Sent from my iPhone using SDN Mobile app

Depending on where you live you already can't refuse to perform an abortion.

http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf

 

[XCourtSmash]

Nope.. Can't refuse to perform an abortion in some states. If you are in one of those states, and you refuse (by referring) then the patient can sue you.

Regardless, this issue will never actually occur in real life. If you are morally against abortions, don't choose a specialty that performs abortions.

Really? I always thought doctors had a right to refuse as protected by federal law... So confused...

Federal law prohibits public officials from requiring recipients of public funds to perform abortions or sterilizations in violation of their religious or moral beliefs. Similarly, federal law prohibits entities receiving public funds from discriminating against personnel who refuse to perform those procedures for those reasons. From Title 42, § 300a-7 of the U.S. Code

 

[Refreshed]

Really? I always thought doctors had a right to refuse as protected by federal law... So confused...

http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf

 

[XCourtSmash]

http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf

I read your link to a pdf. I don't see where it says doctors can't refer to someone else if they are uncomfortable with performing it themselves. It says health care providers in 46 states are allowed to refuse to participate, but I thought that was referring to the hospital as an entity, not individual physicians. Or maybe I'm blind... it is past midnight here...

 

[Refreshed]

I read your link to a pdf. I don't see where it says doctors can't refer to someone else if they are uncomfortable with performing it themselves. It says health care providers in 46 states are allowed to refuse to participate, but I thought that was referring to the hospital as an entity, not individual physicians. Or maybe I'm blind... it is past midnight here...

Read the very last chart. First column "Providers may refuse to participate". A handful of stats do not have laws protecting physicians or institutions (hospitals) from this situation.

 

[phikapdoctor]

I'm curious to hear your stand on artificial insemination and ectopic pregnancy.

Ectopic pregnancies are terrible, I have personally seen one LAnd they are very emotional and very scary for the patient and her family members.

I am talking about deliberate abortion, not life threatening, no other option circumstances..


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[XCourtSmash]

Read the very last chart. First column "Providers may refuse to participate". A handful of stats do not have laws protecting physicians or institutions (hospitals) from this situation.

Yea... I read that and the pdf it links to too.
http://www.guttmacher.org/statecenter/spibs/spib_RPHS.pdf

The section you are referring to, "Providers may refuse to participate" refers to states where policies are in place allowing health care providers to refuse health care to the patient (in this case an abortion).
It says 46 states have policies in place allowing providers to refuse to participate in performing the abortion.... hence most state, 92%, allow physicians to refuse and refer...

The states are Alabama, New Hampshire, Vermont, West Virginia, and Washington DC.

I'm guessing those are just states that don't have any policies at all or something... not a policy that says you MUST perform it considering federal law says:

Federal law prohibits public officials from requiring recipients of public funds to perform abortions or sterilizations in violation of their religious or moral beliefs. Similarly, federal law prohibits entities receiving public funds from discriminating against personnel who refuse to perform those procedures for those reasons. From Title 42, § 300a-7 of the U.S. Code

So it would be pretty difficult to force hospitals to force their doctors to do the operation if it's against their beliefs.

Edit: I'm about to fall asleep in my chair. In case it turns out I totally misread everything, I apologize in advance. I'll re-read it in the morning.

 

[lobo.solo]

Nobody can't force anyone to do anything. The professional thing to do is to refer the pt to the appropriate service that they need.

 

[NickNaylor]

Yea... I read that and the pdf it links to too.
http://www.guttmacher.org/statecenter/spibs/spib_RPHS.pdf

The section you are referring to, "Providers may refuse to participate" refers to states where policies are in place allowing health care providers to refuse health care to the patient (in this case an abortion).
It says 46 states have policies in place allowing providers to refuse to participate in performing the abortion.... hence most state, 92%, allow physicians to refuse and refer...

The states are Alabama, New Hampshire, Vermont, West Virginia, and Washington DC.

I'm guessing those are just states that don't have any policies at all or something... not a policy that says you MUST perform it considering federal law says:



So it would be pretty difficult to force hospitals to force their doctors to do the operation if it's against their beliefs.

Edit: I'm about to fall asleep in my chair. In case it turns out I totally misread everything, I apologize in advance. I'll re-read it in the morning.

Sew Lobo's post above. No one is going to force anyone to do anything.

Also, I would avoid telling your interviewer that those who don't want to perform abortions are "immature" and "need to grow up." That's probably not going to go over well.

(sent from my phone)

 

[redpanda]

Nobody can't force anyone to do anything. The professional thing to do is to refer the pt to the appropriate service that they need.

If you ever decide to do some substantive research on this topic, you will find that federal law and state laws since 1973 (i.e. Roe v. Wade) have provided options for conscientious objection with respect to any medical procedure, most often applied to reproductive health services. The classical application of the conscientious objection clause is "I feel that this medical procedure/medication/practice is against my morals. I will not participate in it"; however, physicians (and any other healthcare provider) should remember that they also have an ethical duty to their patient to preserve life and health wherever possible and to present all options which are within the standard of clinical practice. In the obvious example, denying care to a patient in severe distress with an ectopic pregnancy when you are the only qualified provider is always wrong.

For a less-emergency-style example, if a young, childless (let's say 25 y.o.) patient requests tubal ligation, and the physician is morally opposed to this, the physician may refuse to perform the procedure, but cannot say "doctors don't do tubal ligations for young women" and must refer the patient to a provider who does provide this service because tubal ligation is an option in the current standard of care. Some scholars go further to point out that providers who can reasonably expect to exercise conscientious objection in their practice must disclose this to their boss/administration and patients as soon as feasible so that accommodations can be made to have another provider to provides such services is always available. This additional argument is made because the point of conscientious objection clauses is to allow providers a way out of something that would burden their conscience, not to allow them a route by which to exercise a (perhaps political) opinion whose goal is to deny patients a certain form of care.

Bottom line: Conscientious objection is always an option, but it is not free of obligation, because healthcare providers have dual duties to themselves and their patients. One cannot forsake one duty for the other and expect to be free of legal challenge or professional sanctions.

 

[Praefectus]

http://www.guttmacher.org/statecenter/spibs/spib_OAL.pdf

The most surprising state on that list is Bama. You'd think that a state with one of the highest percentage of registered Republicans in the country would have pro-life laws on the books.

 

[primadonna22274]

The physician deserves autonomy and conscientious objection just as much as the patient. I refuse to participate in abortion personally but I have referred women who asked. I have no moral objection to emergency contraception including IUD placement within 5 days of an unprotected event.

 

[music2doc]

The most surprising state on that list is Bama. You'd think that a state with one of the highest percentage of registered Republicans in the country would have pro-life laws on the books.

May have never been in an issue because of the number of pro-lifers in the area. If no one ever opposes it, why have a law? Laws tend to be reactive rather than proactive.....

 

[NickNaylor]

If you ever decide to do some substantive research on this topic, you will find that federal law and state laws since 1973 (i.e. Roe v. Wade) have provided options for conscientious objection with respect to any medical procedure, most often applied to reproductive health services. The classical application of the conscientious objection clause is "I feel that this medical procedure/medication/practice is against my morals. I will not participate in it"; however, physicians (and any other healthcare provider) should remember that they also have an ethical duty to their patient to preserve life and health wherever possible and to present all options which are within the standard of clinical practice. In the obvious example, denying care to a patient in severe distress with an ectopic pregnancy when you are the only qualified provider is always wrong.

For a less-emergency-style example, if a young, childless (let's say 25 y.o.) patient requests tubal ligation, and the physician is morally opposed to this, the physician may refuse to perform the procedure, but cannot say "doctors don't do tubal ligations for young women" and must refer the patient to a provider who does provide this service because tubal ligation is an option in the current standard of care. Some scholars go further to point out that providers who can reasonably expect to exercise conscientious objection in their practice must disclose this to their boss/administration and patients as soon as feasible so that accommodations can be made to have another provider to provides such services is always available. This additional argument is made because the point of conscientious objection clauses is to allow providers a way out of something that would burden their conscience, not to allow them a route by which to exercise a (perhaps political) opinion whose goal is to deny patients a certain form of care.

Bottom line: Conscientious objection is always an option, but it is not free of obligation, because healthcare providers have dual duties to themselves and their patients. One cannot forsake one duty for the other and expect to be free of legal challenge or professional sanctions.

Physicians have very little room when medical intervention is indicated. No one would disagree with you there. However there are many people who believe physicians are obligated to provide elective care when not medically indicated because it presents an inconvenience for patients. That is a bit of a problem.

(sent from my phone)

 

[45408]

Not willing to do it regardless of the circumstances because of your feelings or beliefs or whatever else you're using to justify it is irresponsible as a physician and immature as an adult. Your duty as a physician is to help the patient. If the patient medically needs the abortion, and you are the only doctor nearby that can do it, grow up and do it. That's how I see it.

Now that's black and white thinking. I would think someone was pretty immature if they could just "get over" their moral boundaries and do something that they thought was morally wrong.

Other than an ectopic - which I don't consider to be an abortion, because it's in a location that is incompatible with life for both the fetus and the mother - I can't think of a situation that would require an urgent abortion. You could always have someone transported to a facility that would evaluate them for such a situation.

Physicians have very little room when medical intervention is indicated. No one would disagree with you there. However there are many people who believe physicians are obligated to provide elective care when not medically indicated because it presents an inconvenience for patients. That is a bit of a problem.

You have to add a number of caveats. Not everyone thinks the same thing is indicated (let's say, a morbid lymphadectomy for melanoma when there are trace subcapsular tumor cells in the sentinel node).

It would also be a horrendously bad idea to have a surgeon perform a procedure that they are not comfortable doing. Surgery is hard enough when you are trained and comfortable with a procedure. Forcing someone to do a procedure that they disagree with is just asking for bad outcomes.

Lastly, it has to be a patient that you have an obligation to. Being called into the ED when you are on call = EMTALA = obligation to patient. Having a patient walk into your outpatient clinic for an elective consult/procedure = very different set of obligations.

 

[redpanda]

Physicians have very little room when medical intervention is indicated. No one would disagree with you there. However there are many people who believe physicians are obligated to provide elective care when not medically indicated because it presents an inconvenience for patients. That is a bit of a problem.

(sent from my phone)

I agree with you that when urgent medical intervention is indicated, there is very little room for the exercise of conscientious objection, but I'm sure you know as well as I do that there are people in healthcare who would rather someone die than have a life-saving but conscience-burdening procedure on them. They do this at the risk of legal and professional sanction.

However, I would say that most of the instances in which conscientious objection is used are non-emergency situations, and I think more people should know that conscientious objection is not a get-out-of-jail free card. It comes with obligations, including the obligation that one uses it exclusively to have a burden-free conscience not to exercise one's political or moral views with an eye toward steering patient care in one direction or another or compromising patient autonomy.

 

[45408]

I agree with you that when urgent medical intervention is indicated, there is very little room for the exercise of conscientious objection, but I'm sure you know as well as I do that there are people in healthcare who would rather someone die than have a life-saving but conscience-burdening procedure on them. They do this at the risk of legal and professional sanction.

....such as? In an emergent situation only. I'm not talking about "Oh, the pharmacist at the only pharmacy for 100 miles wouldn't give Plan B," or "The only PCP wouldn't prescribe any birth control." I'm talking about more of an example like a Jehovah's Witness physician/nurse who didn't give blood and a patient died.

 

[DAPI]

What types of doctors are even trained in performing abortions? Are FM doctors trained to do these types of procedures (beyond prescribing the pill)? Are IM doc's trained in this? I mean, not ever doctor is going to be trained in doing this and if you are really against it, wouldn't you just abstain for learning it during residency or fellowship (whenever its taught)?

 

[passerine]

What types of doctors are even trained in performing abortions? Are FM doctors trained to do these types of procedures (beyond prescribing the pill)? Are IM doc's trained in this? I mean, not ever doctor is going to be trained in doing this and if you are really against it, wouldn't you just abstain for learning it during residency or fellowship (whenever its taught)?

I believe that in the cases where the abortion is a medical one, rather than a surgical one, any licensed doctor can prescribe the abortion pill; the question is whether they would, or if they would refer the patient to an OB for legal reasons, and not just moral ones.

With regard to surgical abortions, I don't think IMs generally have OB/GYN training (my dad is an internist, but n=1 and all that.) AFAIK, FM docs often do include gynecology in their practice, but not obstetrics, so I believe that an OB would be the one to perform the procedure.

 

[anon3]

Oops! Edited it.

Not enough. Unless you're working for an abortion clinic, a family practitioner/gynecologist won't do any abortions that aren't medically necessary. Hospitals don't like protesters outside their doors calling their doctors murderers.

What types of doctors are even trained in performing abortions? Are FM doctors trained to do these types of procedures (beyond prescribing the pill)? Are IM doc's trained in this? I mean, not ever doctor is going to be trained in doing this and if you are really against it, wouldn't you just abstain for learning it during residency or fellowship (whenever its taught)?

Family medicine can do first trimester abortion procedures if they're comfortable with it (which usually means their specific residency trained them or they learned on their own.)

 

[XCourtSmash]

Now that's black and white thinking. I would think someone was pretty immature if they could just "get over" their moral boundaries and do something that they thought was morally wrong.

Other than an ectopic - which I don't consider to be an abortion, because it's in a location that is incompatible with life for both the fetus and the mother - I can't think of a situation that would require an urgent abortion. You could always have someone transported to a facility that would evaluate them for such a situation.

Well, I grew up thinking morals were universal and great. Now that I'm older, I see that some morals vary from society and cultures. I don't really think it's fair as a physician to stick to your "morals" and impose them upon a patient. Like I said in earlier posts, I'm not pro giving abortions willy-nilly. However, I will considering performing them in cases where they are necessary. Not sure how it's "black and white thinking" to treat something as a case by case basis instead of an all or nothing approach, but hey, that's your opinion.

Also, what about fatal birth defects. Wouldn't it be more humane to do the abortion when a fatal birth defect is detected instead of waiting for the child to be born, then the child dies, and there are higher risks of the mother's life being in danger as well.


Lastly... I might have been harsh calling some people "immature," it was pretty late when I was typing. Perhaps a better way to phrase it would be "different view of doctoral duties."
You're right though, I am speaking differently when there is anonymity on an internet forum vs in a real life interview, professional situation.

 

[Blackhawkdown24]

Good discussion everyone. Thank you all for being civil.

 

[45408]

Well, I grew up thinking morals were universal and great. Now that I'm older, I see that some morals vary from society and cultures. I don't really think it's fair as a physician to stick to your "morals" and impose them upon a patient.

I'm not imposing my morals on a patient. I'm imposing my morals on myself. I think that I would be immoral to kill a fetus.

Society imposes morals on its members all the time, by collective agreement. Society decides that murder is wrong and then imposes that one everyone.

Like I said in earlier posts, I'm not pro giving abortions willy-nilly. However, I will considering performing them in cases where they are necessary. Not sure how it's "black and white thinking" to treat something as a case by case basis instead of an all or nothing approach, but hey, that's your opinion.

That's not what I said, now is it?

Morals can encompass a case-by-case basis, but if you don't have any absolute threshold for something, then I'm not sure what the point of morals is.

Also, what about fatal birth defects. Wouldn't it be more humane to do the abortion when a fatal birth defect is detected instead of waiting for the child to be born, then the child dies, and there are higher risks of the mother's life being in danger as well.

From an emotional/personal standpoint, I can understand why someone would want an abortion for a defect that is clearly incompatible with life (e.g., anencephaly), but I wouldn't do the abortion, nor would I want my wife to get one.

 

[xoxx]

So, let's pretend all of us have the MD or DO right now and we're family practice physicians or gynocologists. Let's throw in that you are strongly against abortion. Would you or would you not preform it? Please let's be respectful and have a meaningful discussion.

nvm

 

[IlDestriero]

I don't provide anesthesia for elective terminations. I was asked to do one as a resident, and decided that was not a service that I need to provide. There are plenty of others who can do it. Ectopics, etc are a different story. Of course I will do that. I've done anesthesia for terminations of fetuses with anomalies that are not compatible with life, but I don't do them any more either after witnessing a badly botched attempt. I really couldn't care less what others want to do with their bodies, but I don't have to be a part of it.

 

[Eiot]

I don't really think it's fair as a physician to stick to your "morals" and impose them upon a patient.

The physician wouldn't be imposing their morals onto the patient. If anything, the patient would be imposing their morals onto the physician. Take this situation for example:

*Ding Dong*
Man 1 opens door, "Hello?"
Man 2 "Hi their fella. I'm selling Holy Bibles for my church. Please buy one!"
Man 1 "Uhh thanks but no thanks, I'm actually an atheist."
Man 2 "Are you saying you will not buy a Holy Bible because you don't agree with my religion? How dare you impose your morals onto me!"

 

[LizzyM]

The physician wouldn't be imposing their morals onto the patient. If anything, the patient would be imposing their morals onto the physician. Take this situation for example:

*Ding Dong*
Man 1 opens door, "Hello?"
Man 2 "Hi their fella. I'm selling Holy Bibles for my church. Please buy one!"
Man 1 "Uhh thanks but no thanks, I'm actually an atheist."
Man 2 "Are you saying you will not buy a Holy Bible because you don't agree with my religion? How dare you impose your morals onto me!"

Actually it is more like:

*Clang, clang* Bells on the door jingle as a customer walks into a bookstore.

Customer: I'd like to buy a Holy Bible.
Owner: I don't sell Bibles. This is a secular humanist bookstore.
Customer: There's no law against selling bibles. It is completely legal. You should sell them -- otherwise you are abridging freedom of religion and freedom of the press. Can you give me the name of a bookstore that sells bibles.

Owner hands over a copy of the phonebook.

 

[Sephiroth]

Actually it is more like:

*Clang, clang* Bells on the door jingle as a customer walks into a bookstore.

Customer: I'd like to buy a Holy Bible.
Owner: I don't sell Bibles. This is a secular humanist bookstore.
Customer: There's no law against selling bibles. It is completely legal. You should sell them -- otherwise you are abridging freedom of religion and freedom of the press. Can you give me the name of a bookstore that sells bibles.

Owner hands over a copy of the phonebook.

Looks about right, except for one thing: what the hell is a phonebook?

 

[LizzyM]

Looks about right, except for one thing: what the hell is a phonebook?

my age is showing

 

[Long Way to Go]

There was a mention on an earlier thread of a certain number of circumcisions that a pediatrician is required to perform during residency. I imagine there isn't anything analogous for ob-gyns even for residency?

 

[LizzyM]

There was a mention on an earlier thread of a certain number of circumcisions that a pediatrician is required to perform during residency. I imagine there isn't anything analogous for ob-gyns even for residency?

The analogous requirement would be for different types of deliveries, surgical procedures, etc. Abortion training must be offered by OB-GYN residencies (at outside facilities if the residency program doesn't offer abortions in-house) but residents are permitted to opt-out.

 

[Eiot]

Actually it is more like:

*Clang, clang* Bells on the door jingle as a customer walks into a bookstore.

Customer: I'd like to buy a Holy Bible.
Owner: I don't sell Bibles. This is a secular humanist bookstore.
Customer: There's no law against selling bibles. It is completely legal. You should sell them -- otherwise you are abridging freedom of religion and freedom of the press. Can you give me the name of a bookstore that sells bibles.

Owner hands over a copy of the phonebook.

I'm sure you could take it either way depending on which side of the spectrum you're looking through.

 

[45408]

There was a mention on an earlier thread of a certain number of circumcisions that a pediatrician is required to perform during residency. I imagine there isn't anything analogous for ob-gyns even for residency?

I'm pretty sure there's no requirement to do them, and a lot of residencies are still held in Catholic hospitals that would absolutely not be doing them, so it's easy to see how you could do an OB/gyn residency without ever doing one. A D&C can be used to perform an abortion or other therapeutic procedures, so there is some overlap, I guess.