Pro-Life Doctors...?

[SeminoleFan3]

I was just wondering how other pro-life future (or current) doctors are going to handle this in their medical practice?
I don't feel that I myself could perform the procedure, nor would I feel comfortable referring them to someone else to have it done (due to moral reasons).

---

Members don't see this ad.

 

[tennisguy896]

Hi there- I think there are some very thorough posts in the "topics in healthcare" forum that have what you are looking.

 

[SeminoleFan3]

Thanks tennis.

 

[91Bravo]

I was just wondering how other pro-life future (or current) doctors are going to handle this in their medical practice?
I don't feel that I myself could perform the procedure, nor would I feel comfortable referring them to someone else to have it done (due to moral reasons).

We don't have to perform any abortions, nor are we required to refer a patient for one. If faced with that situation, I would inform my patient of my core beliefs and suggest that she locate a physician whose beliefs are more congruent with hers.

Good luck with school.

 

[Mah]

We don't have to perform any abortions, nor are we required to refer a patient for one. If faced with that situation, I would inform my patient of my core beliefs and suggest that she locate a physician whose beliefs are more congruent with hers.

Good luck with school.

I second that.. However, I really think it depends on the situation. I would listen to the patient and discuss everything with him/her, then decide if its personally ethical for me to go ahead..

otherwise refer to anyone else, its their life afterall

 

[MarzMD]

Because I know he would post a link if he saw this thread, i will do it for him....

http://pandabearmd.blogspot.com/2005/12/subversive-thought.html

 

[lilnoelle]

There are pro life crisis pregnancy centers that I would strongly recommend. I would possibly go so far as to give prenatal appointments for free or nearly so if it meant the individual would give the child up for adoption instead of abortion.

 

[LifetimeDoc]

We don't have to perform any abortions, nor are we required to refer a patient for one. If faced with that situation, I would inform my patient of my core beliefs and suggest that she locate a physician whose beliefs are more congruent with hers.

Regardless of our own personal beliefs, isn't it our duty as physicians to take care of the patient? I understand not performing the procedure itself, that's our own choice. However, it seems like it would be our duty to help the patient find another physician that can help them, rather than just abandoning them.

 

[Sanctuary]

Hopefully I never end up with a physician who places their own self interests ahead of mine. Thankfully I can't get pregnant anyway; although, Arnold Schwarzenegger did in the movie Junior.. hmm..

 

[trustwomen]

There are pro life crisis pregnancy centers that I would strongly recommend. I would possibly go so far as to give prenatal appointments for free or nearly so if it meant the individual would give the child up for adoption instead of abortion.

If a woman is undecided about what to do, she should not be referred to these centers. They give medically inaccurate information about abortion, and have a long history of harassing clients and pressuring them into placing for adoption (many of them are connected to adoption agencies and get a "cut"). And then there's the one-sided, judgmental counseling - and they have been known to inform parents and partners of the pregnancy against the woman's wishes, call the woman at home daily to "make sure" she hasn't had an abortion, and use guilt/shame/veiled threats. If a woman is certain that she does not want to have an abortion, then they might be good resources for prenatal help - though in my experience they only "help" women who are considering abortion (i.e. their purpose is mainly to prevent an abortion, and they back off once the woman is "safe" from it... too far along, or fully convinced not to do it.) A better referral for prenatal help would be social services or, failing that, individual churches.

I don't think anyone would need to offer free prenatal appointments; all pregnant women qualify for Medicaid, don't they? And I would hope that the free prenatal visits, if offered, would also be offered to women who want to keep? (For nearly all women, that is the only realistic alternative to abortion).

Anti-abortion people won't believe the following, but it's true nonetheless: Planned Parenthood offers pregnancy counseling that is unbiased and non-judgmental. They do not coerce women into choosing one decision or another; they just provide information and support for whatever the woman chooses. Some (not all) non-PP abortion clinics also provide this counseling, called "options counseling". I was a counselor for several years, both at a national pro-choice hotline and at a few clinics. It goes against our values and standards, as pro-choice people, to impose our opinions or beliefs on others. I was trained in options counseling by PP - believe me, it's really good and humane training.

Please note that the counseling done prior to an abortion, after a woman has made an abortion appointment and has presumably made up her mind, is different - "abortion counseling" instead of "options counseling". I was also an abortion counselor, and in that context we do evaluate whether the woman is certain about her decision, if she needs more time or information to think it over, but the goal of abortion counseling is not to reach a decision; it's to ensure that she has all the info and support needed before actually having an abortion, i.e. that she is ready. Women who are unsure should make an options counseling appointment, not an abortion appointment. However, nearly all unsure women who come in for abortions are told to go home and think it over - the unsure ones that get through anyway are the ones who (unfortunately) didn't open up about it in counseling. We hate when this happens (it becomes obvious in the recovery room - I'd guess about 1 in 150 patients), and therefore we try to be as thorough as possible.

To the OP - of course you don't have to do abortions. I think it's unprofessional not to refer, but I doubt you'd actually get into much trouble for it. What you will get in trouble for is lecturing patients, telling them what to do, trying to convince them one way or another, and/or giving false information about abortion (like anything David Reardon or ALL poops out). So, if you must: simply tell them you are personally against abortion and therefore are unable to help them. Just be prepared to lose them as patients. If you want to actually help them, refer them for options counseling at PP. (Most of those who go for options counseling wind up keeping the baby, so don't fret.)

 

[CTSballer11]

If a woman is undecided about what to do, she should not be referred to these centers. They give medically inaccurate information about abortion, and have a long history of harassing clients and pressuring them into placing for adoption (many of them are connected to adoption agencies and get a "cut"). And then there's the one-sided, judgmental counseling - and they have been known to inform parents and partners of the pregnancy against the woman's wishes, call the woman at home daily to "make sure" she hasn't had an abortion, and use guilt/shame/veiled threats. If a woman is certain that she does not want to have an abortion, then they might be good resources for prenatal help - though in my experience they only "help" women who are considering abortion (i.e. their purpose is mainly to prevent an abortion, and they back off once the woman is "safe" from it... too far along, or fully convinced not to do it.) A better referral for prenatal help would be social services or, failing that, individual churches.

I don't think anyone would need to offer free prenatal appointments; all pregnant women qualify for Medicaid, don't they? And I would hope that the free prenatal visits, if offered, would also be offered to women who want to keep? (For nearly all women, that is the only realistic alternative to abortion).

Anti-abortion people won't believe the following, but it's true nonetheless: Planned Parenthood offers pregnancy counseling that is unbiased and non-judgmental. They do not coerce women into choosing one decision or another; they just provide information and support for whatever the woman chooses. Some (not all) non-PP abortion clinics also provide this counseling, called "options counseling". I was a counselor for several years, both at a national pro-choice hotline and at a few clinics. It goes against our values and standards, as pro-choice people, to impose our opinions or beliefs on others. I was trained in options counseling by PP - believe me, it's really good and humane training.

Please note that the counseling done prior to an abortion, after a woman has made an abortion appointment and has presumably made up her mind, is different - "abortion counseling" instead of "options counseling". I was also an abortion counselor, and in that context we do evaluate whether the woman is certain about her decision, if she needs more time or information to think it over, but the goal of abortion counseling is not to reach a decision; it's to ensure that she has all the info and support needed before actually having an abortion, i.e. that she is ready. Women who are unsure should make an options counseling appointment, not an abortion appointment. However, nearly all unsure women who come in for abortions are told to go home and think it over - the unsure ones that get through anyway are the ones who (unfortunately) didn't open up about it in counseling. We hate when this happens (it becomes obvious in the recovery room - I'd guess about 1 in 150 patients), and therefore we try to be as thorough as possible.

To the OP - of course you don't have to do abortions. I think it's unprofessional not to refer, but I doubt you'd actually get into much trouble for it. What you will get in trouble for is lecturing patients, telling them what to do, trying to convince them one way or another, and/or giving false information about abortion (like anything David Reardon or ALL poops out). So, if you must: simply tell them you are personally against abortion and therefore are unable to help them. Just be prepared to lose them as patients. If you want to actually help them, refer them for options counseling at PP. (Most of those who go for options counseling wind up keeping the baby, so don't fret.)

I second that.

 

[hangten]

Regardless of our own personal beliefs, isn't it our duty as physicians to take care of the patient? I understand not performing the procedure itself, that's our own choice. However, it seems like it would be our duty to help the patient find another physician that can help them, rather than just abandoning them.

How about the unborn child? Isn't he our patient too? I think, ultimately, our actions are governed by our morals or lack of. By referring the patient to another physician that would provide the procedure, we are indirectly doing the procedure ourselves. By entering this profession, we commit ourselves to the "Do No Harm" oath. But the fact is, whichever way we take in this particular situation, we are harming someone. The question is now then, which patient's interest (if you consider the baby a patient) do we put first?

Like what other Pro-Lifers would say, "It's not a choice, it's a child." To whose life do we commit ourselves to?

 

[LifetimeDoc]

How about the unborn child? Isn't he our patient too? I think, ultimately, our actions are governed by our morals or lack of. By referring the patient to another physician that would provide the procedure, we are indirectly doing the procedure ourselves. By entering this profession, we commit ourselves to the "Do No Harm" oath. But the fact is, whichever way we take in this particular situation, we are harming someone. The question is now then, which patient's interest (if you consider the baby a patient) do we put first?

Like what other Pro-Lifers would say, "It's not a choice, it's a child." To whose life do we commit ourselves to?

If you choose not to help the mother, you are imposing your own views onto her. I think the right thing to do would be to refer her to another physician that could help her with her decision. By lecturing her, telling her that I can't help her and dismissing her would be, to me, unprofessional as a physician.

As for the child, it's complicated. Is the child your patient? No, it hasn't been born yet. Is the mother your patient? Yes, and it's her decision as far as the law and our profession is concerned. If you don't agree, get the AMA or the law to change.

 

[MeowMix]

as a doctor, you will constantly have to deal with patients making "wrong" decisions.

Hopefully, one of the things you will learn in med school is to respect the patient's ability to make the decision that best serves him/her and the greater good. You provide truthful and complete information; if you are unable to work with the patient and honor her beliefs, you acknowledge that and refer to someone else.

If your spiritual beliefs are this strong, then perhaps you might also trust a higher power than yourself to guide the patient to the right decision.

 

[Anastasis]

Here a link to the thread in Topics: http://forums.studentdoctor.net/showthread.php?t=270845

I'm glad to know others are struggling with this. I'm pro-life and would only perform an abortion in situations where the mother's life was at risk but I was questioning at what point my "standard of care" would end. Does it mean that I just don't do the abortion and have no responsibility past that? Does it mean that I provide the patient with all relevant information but if she chooses to have an abortion tell her I can't perform it and leave it there? Or do I have a responsibilty to do all that AND refer her to a physician who will perform the abortion? It's nice to see other people thinking about this and working through it as well. It's also nice to see this thread hasn't gone down in flames

 

[Anastasis]

as a doctor, you will constantly have to deal with patients making "wrong" decisions.

Hopefully, one of the things you will learn in med school is to respect the patient's ability to make the decision that best serves him/her and the greater good. You provide truthful and complete information; if you are unable to work with the patient and honor her beliefs, you acknowledge that and refer to someone else.

If your spiritual beliefs are this strong, then perhaps you might also trust a higher power than yourself to guide the patient to the right decision.

Wow - great post!

 

[MollyMalone]

Yay! Links to the TIH forum, to Panda's blog... you guys are on the ball!

If people have further comments, it would be most appropriate to post them in the thread in the topics in healthcare forum.

 

[JonnyG]

The only doctor who legally has to provide care is usually an ER doctor because the patient is usually not stable. If you do not want to do something, you don't have to do it. Just don't preach to the patient.

 

[hangten]

If you choose not to help the mother, you are imposing your own views onto her. I think the right thing to do would be to refer her to another physician that could help her with her decision. By lecturing her, telling her that I can't help her and dismissing her would be, to me, unprofessional as a physician.

As for the child, it's complicated. Is the child your patient? No, it hasn't been born yet. Is the mother your patient? Yes, and it's her decision as far as the law and our profession is concerned. If you don't agree, get the AMA or the law to change.

I don't consider it "imposing my views" if I refuse to perform the abortion. (I would simply say "I don't do abortion because of my beliefs" and no lecture involved.) Just as much as we respect our patients' views, our patients should respect ours. I don't consider it personal if they go through with their abortion, so they shouldn't consider it personal if I refuse. I agree that we should not abandon these women in crisis and so did not mention abandoning them. I would definitely refer them to someone (if she chooses), but that would be to a social worker first so that she is well informed about her choices.

As for the child, I do consider him a patient. And I feel that he needs my care more than the mother. The mother can voice out her opinions, he can't.

Now there are definitely case by case situations. And my opinions do not reflect those who are pregnant due to rape/incest or those pregnancies that have complications. My opinions are reflected upon reckless adults who can afford mutiple forms of contraception but doesn't care. (The ones that drink themselves away, have drunken sex or one night stands.) As for the professionalism, I could always make up for that by working extra hours, showing up on time, ironing my scrubs, and great bedside manners. As for the immorality, I can't bring him back to life.

 

[LifetimeDoc]

I don't consider it "imposing my views" if I refuse to perform the abortion. (I would simply say "I don't do abortion because of my beliefs" and no lecture involved.) Just as much as we respect our patients' views, our patients should respect ours. I don't consider it personal if they go through with their abortion, so they shouldn't consider it personal if I refuse. I agree that we should not abandon these women in crisis and so did not mention abandoning them. I would definitely refer them to someone (if she chooses), but that would be to a social worker first so that she is well informed about her choices.

I agree with you 100%

As for the child, I do consider him a patient. And I feel that he needs my care more than the mother. The mother can voice out her opinions, he can't.

Now there are definitely case by case situations. And my opinions do not reflect those who are pregnant due to rape/incest or those pregnancies that have complications. My opinions are reflected upon reckless adults who can afford mutiple forms of contraception but doesn't care. (The ones that drink themselves away, have drunken sex or one night stands.) As for the professionalism, I could always make up for that by working extra hours, showing up on time, ironing my scrubs, and great bedside manners. As for the immorality, I can't bring him back to life.

Well, here we have to delve into law and the rules by which our peers govern our practices. The mother is our patient, and the law gives her the right to make choices about her health care. It's not our place to judge.

Note: I won't say whether I'm pro-life or not as it's not revelant what I believe in. I want to be a physician, not a judge.

 

[mercaptovizadeh]

Legally, no referral is required. Referral is complicity in the act. You have the right to refuse to administer the abortion and to refuse referral. You also have the right to give your advice on the situation.

Let's review: legally, professionally, and most importantly, morally, you are NOT required to participate in ANY way in a woman's abortion.

 

[91Bravo]

it seems like it would be our duty to help the patient find another physician that can help them, rather than just abandoning them.

If the patient can find her way to my office she can find her way to an abortion provider without my help or the need of a referral. It is not "patient abdandonment" to refuse to help her find an abortion provider. If a physician believes abortion is murder, then he/she should not participate as an accomplice to murder.

 

[eastsidaz]

Legally, no referral is required. Referral is complicity in the act. You have the right to refuse to administer the abortion and to refuse referral. You also have the right to give your advice on the situation.

Let's review: legally, professionally, and most importantly, morally, you are NOT required to participate in ANY way in a woman's abortion.

This is true--most states have conscience clauses that recognize that for a pro-life person, referring a woman to an abortion provider would be a form of complicity. People with the other view have to understand that pro-lifers view this as an atrocious crime to which we cannot be party.

 

[MDGuy07]

Legally, no referral is required. Referral is complicity in the act. You have the right to refuse to administer the abortion and to refuse referral. You also have the right to give your advice on the situation.

Let's review: legally, professionally, and most importantly, morally, you are NOT required to participate in ANY way in a woman's abortion.

Well said.

As a physician, I do not have to perform something that is against my religion, nor do I have to refer her to an abortion provider.

 

[lilnoelle]

If a woman is undecided about what to do, she should not be referred to these centers. They give medically inaccurate information about abortion, and have a long history of harassing clients and pressuring them into placing for adoption (many of them are connected to adoption agencies and get a "cut"). And then there's the one-sided, judgmental counseling - and they have been known to inform parents and partners of the pregnancy against the woman's wishes, call the woman at home daily to "make sure" she hasn't had an abortion, and use guilt/shame/veiled threats. If a woman is certain that she does not want to have an abortion, then they might be good resources for prenatal help - though in my experience they only "help" women who are considering abortion (i.e. their purpose is mainly to prevent an abortion, and they back off once the woman is "safe" from it... too far along, or fully convinced not to do it.) A better referral for prenatal help would be social services or, failing that, individual churches.

I don't think anyone would need to offer free prenatal appointments; all pregnant women qualify for Medicaid, don't they? And I would hope that the free prenatal visits, if offered, would also be offered to women who want to keep? (For nearly all women, that is the only realistic alternative to abortion).

Anti-abortion people won't believe the following, but it's true nonetheless: Planned Parenthood offers pregnancy counseling that is unbiased and non-judgmental. They do not coerce women into choosing one decision or another; they just provide information and support for whatever the woman chooses. Some (not all) non-PP abortion clinics also provide this counseling, called "options counseling". I was a counselor for several years, both at a national pro-choice hotline and at a few clinics. It goes against our values and standards, as pro-choice people, to impose our opinions or beliefs on others. I was trained in options counseling by PP - believe me, it's really good and humane training.

Please note that the counseling done prior to an abortion, after a woman has made an abortion appointment and has presumably made up her mind, is different - "abortion counseling" instead of "options counseling". I was also an abortion counselor, and in that context we do evaluate whether the woman is certain about her decision, if she needs more time or information to think it over, but the goal of abortion counseling is not to reach a decision; it's to ensure that she has all the info and support needed before actually having an abortion, i.e. that she is ready. Women who are unsure should make an options counseling appointment, not an abortion appointment. However, nearly all unsure women who come in for abortions are told to go home and think it over - the unsure ones that get through anyway are the ones who (unfortunately) didn't open up about it in counseling. We hate when this happens (it becomes obvious in the recovery room - I'd guess about 1 in 150 patients), and therefore we try to be as thorough as possible.

To the OP - of course you don't have to do abortions. I think it's unprofessional not to refer, but I doubt you'd actually get into much trouble for it. What you will get in trouble for is lecturing patients, telling them what to do, trying to convince them one way or another, and/or giving false information about abortion (like anything David Reardon or ALL poops out). So, if you must: simply tell them you are personally against abortion and therefore are unable to help them. Just be prepared to lose them as patients. If you want to actually help them, refer them for options counseling at PP. (Most of those who go for options counseling wind up keeping the baby, so don't fret.)

As far as the crisis pregnancy centers, I'm speaking of one I know of in particular that is directly supported by my church. Although I have not been there, I'm relatively sure that the advice they give is good advice. I agree that they probably pressure against abortion unless the life of the mother is at stake.
As far as planned parenthood is concerned, you are probably correct. I don't have any first hand information about it and probably have gotten most of my information from those with skewed views.
As far as trying to persuade my patient. I am a very compassionate person and not judgemental. I believe that I can give my viewpoint in a tactful way and if my patient is still set on aborting, then I would just explain that I personally am against it and do not feel comfortable referring the patient.
Just because the government says its ok, doesn't mean I believe its ok and I will act based on my moral beliefs.

 

[trustwomen]

As far as the crisis pregnancy centers, I'm speaking of one I know of in particular that is directly supported by my church. Although I have not been there, I'm relatively sure that the advice they give is good advice. I agree that they probably pressure against abortion unless the life of the mother is at stake.
As far as planned parenthood is concerned, you are probably correct. I don't have any first hand information about it and probably have gotten most of my information from those with skewed views.
As far as trying to persuade my patient. I am a very compassionate person and not judgemental. I believe that I can give my viewpoint in a tactful way and if my patient is still set on aborting, then I would just explain that I personally am against it and do not feel comfortable referring the patient.
Just because the government says its ok, doesn't mean I believe its ok and I will act based on my moral beliefs.

If the patient is set on having an abortion, what will it matter whether you refer her or not? Like some have said, she'll find a provider anyway. The "worst" that could happen if you refer is that she will get her abortion earlier in the pregnancy - which is better than later, no? If you don't believe in pressure tactics, why refer to a crisis pregnancy center? If you believe that the woman should get all the information and make up her mind freely in a supportive environment, why not refer to PP options counseling? However, I guess I'm OK with what you describe above... as long as "giving your viewpoint" doesn't include telling the patient that a fetus feels pain, or abortion causes breast cancer, or any other misinformation that is not based on medical fact (i.e. the stuff that's spread by CPCs).

It does bother me that doctors won't refer based on personal beliefs. There are medical procedures I don't approve of either, but I would definitely refer patients who asked. You probably don't have any legal imperative to refer, so you're covered in that way... but don't be surprised if some of your colleagues disapprove. (Just as I won't be surprised that some of my colleagues will disapprove of me performing abortions.)

 

[lilnoelle]

so your saying the fetus doesn't feel pain?

 

[8744]

Because I know he would post a link if he saw this thread, i will do it for him....

http://pandabearmd.blogspot.com/2005/12/subversive-thought.html

Thanks. I'm through debating this one.

 

[thinknofu3]

so your saying the fetus doesn't feel pain?

There is absolutely not one shred of evidence to support that a fetus can feel pain. The brain's centers for recognizing and feeling pain are present in the developed brain, which isn't present until at least the 7th or 8th month (and most women seeking abortions are in their first trimester). The notion that a fetus can feel pain is an unfortunate myth propagated by the pro-life community. While I support anybody's right to oppose or refuse to perform abortions, we have a responsibility as scientists to be objective and provide people (especially our patients) with correct information. The question of whether the "unborn baby" (a term also invented by the pro-life movement) is a "person" or not is a spiritual one, not a medical one, and should be addressed as such. Medically, a fetus is not a "person" until it is viable, which is about 20 weeks. So we owe to to our patients not to refer to it as "killing" or "murder" of an "unborn baby" - that is biased, loaded language and should be recognized as such. Again, I'm not saying that anybody should be forced to perform the procedure or refer out if they oppose it, only that you have a responsiblity to give your patients correct, scientifically valid and verifiable information.

And also, I think if you're an OB-GYN you are required to learn how to perform the procedure (which is essentially a D & C) in residency. It is your choice whether to perform it or not, but I'm pretty sure you have to at least *know* how to perform it to be board certified.

 

[Trail Boss]

I always made a point of asking one of the doctors I shadowed in undergrad tough questions to see how he handled them (medical marijana, assisted suicide, abortion...) When I asked him what he thought about abortion he responded, "I think it is fine, if you are okay with murdering people". I was a bit taken aback, but impressed. He had a real convition and did not ***** foot around with being PC. I agree with him, but it was refreshing to hear it from a doctor because despite my own beliefs my pre-med advisor always advocated adressing both sides of contentions issues in interviews and trying to show an understanding for the issues while remaining neutral so not to offend. I think that is actually the wrong thing to do. Whatever your convictions, stand up for them. I think adcomms expect us to have an opinon on these things, to have thought them out and be able to expain your reasoning, but stand your ground. I think people who try and please everyone will end up going crazy in the end. When asked about abortion at one of my med school interviews (top ten MD school) I just flat out told them that I understand the argument, but I would never perform one or refer anyone to a doctor that would because I would feel like I had a hand in terminating a innocent life, and where I am from this is called murder. I went into medicine for the exact opposite reason, and if they didn't like it I would be happy to be a biologist for the Forest Service and be able to sleep at night. They let me in, so I would recomend being honest with your self, If adcomms see that then I think they will respect you even if they disagree or think that you are wrong.

 

[tch001]

There is absolutely not one shred of evidence to support that a fetus can feel pain. The brain's centers for recognizing and feeling pain are present in the developed brain, which isn't present until at least the 7th or 8th month (and most women seeking abortions are in their first trimester). The notion that a fetus can feel pain is an unfortunate myth propagated by the pro-life community. While I support anybody's right to oppose or refuse to perform abortions, we have a responsibility as scientists to be objective and provide people (especially our patients) with correct information. The question of whether the "unborn baby" (a term also invented by the pro-life movement) is a "person" or not is a spiritual one, not a medical one, and should be addressed as such. Medically, a fetus is not a "person" until it is viable, which is about 20 weeks. So we owe to to our patients not to refer to it as "killing" or "murder" of an "unborn baby" - that is biased, loaded language and should be recognized as such. Again, I'm not saying that anybody should be forced to perform the procedure or refer out if they oppose it, only that you have a responsiblity to give your patients correct, scientifically valid and verifiable information.

And also, I think if you're an OB-GYN you are required to learn how to perform the procedure (which is essentially a D & C) in residency. It is your choice whether to perform it or not, but I'm pretty sure you have to at least *know* how to perform it to be board certified.

 

[MDGuy07]

There is absolutely not one shred of evidence to support that a fetus can feel pain. The brain's centers for recognizing and feeling pain are present in the developed brain, which isn't present until at least the 7th or 8th month (and most women seeking abortions are in their first trimester). The notion that a fetus can feel pain is an unfortunate myth propagated by the pro-life community. While I support anybody's right to oppose or refuse to perform abortions, we have a responsibility as scientists to be objective and provide people (especially our patients) with correct information. The question of whether the "unborn baby" (a term also invented by the pro-life movement) is a "person" or not is a spiritual one, not a medical one, and should be addressed as such. Medically, a fetus is not a "person" until it is viable, which is about 20 weeks. So we owe to to our patients not to refer to it as "killing" or "murder" of an "unborn baby" - that is biased, loaded language and should be recognized as such. Again, I'm not saying that anybody should be forced to perform the procedure or refer out if they oppose it, only that you have a responsiblity to give your patients correct, scientifically valid and verifiable information.

And also, I think if you're an OB-GYN you are required to learn how to perform the procedure (which is essentially a D & C) in residency. It is your choice whether to perform it or not, but I'm pretty sure you have to at least *know* how to perform it to be board certified.

Your logic is flawed. In high school you learned that the cell was the basic unit of human life. One cell is life. Therefore, by killing even one cell of the unborn fetus you are destroying life.

Your position that the term "killing" is biased, is quite frankly, biased itself, because you have broken the rule that first sentence in any general bio book you open tells you.

Perhaps you should realize how biased you are before blaming the "religious" community for being biased.

 

[C.P. Jones]

what kind/specialty of doctor performs abortions?

 

[eastsidaz]

If the patient is set on having an abortion, what will it matter whether you refer her or not? Like some have said, she'll find a provider anyway. The "worst" that could happen if you refer is that she will get her abortion earlier in the pregnancy - which is better than later, no? If you don't believe in pressure tactics, why refer to a crisis pregnancy center? If you believe that the woman should get all the information and make up her mind freely in a supportive environment, why not refer to PP options counseling? However, I guess I'm OK with what you describe above... as long as "giving your viewpoint" doesn't include telling the patient that a fetus feels pain, or abortion causes breast cancer, or any other misinformation that is not based on medical fact (i.e. the stuff that's spread by CPCs).

It does bother me that doctors won't refer based on personal beliefs. There are medical procedures I don't approve of either, but I would definitely refer patients who asked. You probably don't have any legal imperative to refer, so you're covered in that way... but don't be surprised if some of your colleagues disapprove. (Just as I won't be surprised that some of my colleagues will disapprove of me performing abortions.)

It doesn't "matter" as a practical concern, it "matters" to the individual doing the referral as an issue of conscience. Unless the physician in question is a utilitarian, they won't necessary attach the morality of an action to it's end result. What would matter to them is their relative complicity in the action....ahhhh too complicated to explain. It's actually a pretty complex philosophical argument that isn't really worth getting into. But I think everyone can agree that as a general rule, individuals should be permitted to act according to their own conscience.

 

[potato51]

Your logic is flawed. In high school you learned that the cell was the basic unit of human life. One cell is life.

One cell is not HUMAN life. As you said, the cell is just the basic unit of it. If I were to clap my hands and kill 5000 skin cells, that's tantamount to murder?

You are confusing cellular life with organismal.

 

[Anastasis]

what kind/specialty of doctor performs abortions?

I would think OB/GYN.

 

[mfpullen]

Your logic is flawed. In high school you learned that the cell was the basic unit of human life. One cell is life. Therefore, by killing even one cell of the unborn fetus you are destroying life.

Your position that the term "killing" is biased, is quite frankly, biased itself, because you have broken the rule that first sentence in any general bio book you open tells you.

Perhaps you should realize how biased you are before blaming the "religious" community for being biased.

Is it lonely up on your throne?

Please, stop being so condescending to people just because you disagree, and instead look at it scientifically. Sure, one cell is life. It is NOT, however, ORGANIZED life until a few weeks in. After that, still during the first trimester, the cells are organized, sure. But using the line "killing a cell is still killing", is just kind of, well, silly.

In my embryology text book last year, we had a chart that showed the fate of 20 hypothetical eggs. Of those 20, 18 would be succesfully fertilized. Of those 18, roughly 5 would be able to develop to term. This is disregarding abortion. Nature has a way of reducing the number of viable young. In horses, for example, the stallion will inspect all new young. If he sees one as unfit, he stomps on it and kills it, thus removing an unfit foal. We are beings of nature, and we function within it's bounds. We have been performing herbal and manual abortions ever since we learned which herbs will induce abortion as far back as the Greek Empire, probably before that. Soo...are you saying we are somehow above nature and should not practice some form of limiting the number of unwanted/unfit children?

~MFP

 

[Anastasis]

And also, I think if you're an OB-GYN you are required to learn how to perform the procedure (which is essentially a D & C) in residency. It is your choice whether to perform it or not, but I'm pretty sure you have to at least *know* how to perform it to be board certified.

Yes, it's used for many other things, including if a woman has a spontaneous abortion. It's one of those procedures you just need to know.

Btw, I appreciate your post. It's nice to read someone who disagrees with the pro-life stance but doesn't sound condescending about it. I agree that we have a responsibility to our patients to provide accurrate information. I think that misleading a patient once they have placed their trust and health in your hands is a completely reprehensible act.

 

[Touchdown]

Because I enjoy public mutilitaion Ill add my 2 cents:

As for when life begins:

-2/3rds of all fertilized eggs do not implant, I refuse to believe in a God that lets 2/3rds of all humans die before they live through their first week of life, so it aint conception.

-Birth is such an artificial determinet since there are primis that are born well before 9 months all the time, so there is no way thats a logical pointer.

-Personally I belive life begins at implantation, after that an otherwise healthy blastocyst has a very good chance of surviving pregnancy.

As for the "fetus dont feel pain" I call BS on that one. Im currently taking neuroscience right now and trust me pain receptors are not complicated, further more they are dectected in the same cortical areas as any other touch, which we know fetus have at an early age (since they are capable of kicking, which requires sensory and motor ennervation and understanding.) Pain is a very primal, simple, important pathway (free nerve endings depolarize making AP.) I have a hard time believing that more complex pathways (motor, and fine touch) come online before pain, once you have nerves (first 1-2 months) you must surely have the info structure in place for pain, and I cant belive it wouldnt be turned on.

Also I was shown an ultra sound of an abortion being preformed on a 7 month old, and the baby was litterally fighting for its life to stay away from the suction cup and his mouth made a motion that certainly looked like a scream. Remember, after the first month allmost every organ system is allready made, some havent been activated but the vast majority of work from month 2-onward is simple growth.

 

[lilnoelle]

Up to this point this has been a flame free discussion. Lets try to keep it that way. Touchdown, for the most part I agree with you. I think implantation is a relatively logical point to say life begins. I have not seen the video you've written about, but I've heard it and have known others (siblings, parents) who have seen it, or one like it.
Part of my belief (although I was pro-life before I had children) is based on this. I did not want my first born child. I had big ambitions (med school, etc) and felt having a child would only hinder them. I went ahead and had the baby, but mostly because of the fact that I was married, my husband was thrilled, and because of my beliefs concerning abortion. I have a beautiful 3 year old daughter and an 8 month old son today. My daughter, although not wanted as a fetus, had all the potential to be who she is today. She was the same individual that she is, just not as developed. She is not as developed today as she will be in 17 years. But she was, when I was pregnant, complete. She was not me, nor was she a decision that I could make. The fact that I had no emotional attachment to her till she was three months old did not change the fact that she was (and is) a beautiful human being.
Although she needed me to stay alive while she was in my body, she still needs me just as much. Without me to provide shelter and food, she wouldn't last very long.

 

[MDGuy07]

One cell is not HUMAN life. As you said, the cell is just the basic unit of it. If I were to clap my hands and kill 5000 skin cells, that's tantamount to murder?

You are confusing cellular life with organismal.

Again, you think using flawed logic.

One skin cell does not have the potential to itself become a human being. A fertilized egg does, and thus the choice of whether or not to "abort" should be left up to God only, not man.

 

[MDGuy07]

Is it lonely up on your throne?

Please, stop being so condescending to people just because you disagree, and instead look at it scientifically. Sure, one cell is life. It is NOT, however, ORGANIZED life until a few weeks in. After that, still during the first trimester, the cells are organized, sure. But using the line "killing a cell is still killing", is just kind of, well, silly.

In my embryology text book last year, we had a chart that showed the fate of 20 hypothetical eggs. Of those 20, 18 would be succesfully fertilized. Of those 18, roughly 5 would be able to develop to term. This is disregarding abortion. Nature has a way of reducing the number of viable young. In horses, for example, the stallion will inspect all new young. If he sees one as unfit, he stomps on it and kills it, thus removing an unfit foal. We are beings of nature, and we function within it's bounds. We have been performing herbal and manual abortions ever since we learned which herbs will induce abortion as far back as the Greek Empire, probably before that. Soo...are you saying we are somehow above nature and should not practice some form of limiting the number of unwanted/unfit children?

~MFP

No, it is not lonely up here on my throne. Thank you for asking.

Killing a cell that has the potential to become a man is a whole different situation than killing a skin cell as was previously mentioned.

We are not beings of nature. God has put mankind on Earth to fulfill His wish for us. By recognizing nature and not God, you have once again shown that your argument does not make sense.

 

[Doglover4fever]

Oh my god, the dreaded abortion debate. Well, as a pro-CHOICE applicant, I would not have a problem performing the procedure. However, my advice to you pro-lifers is that you do have an obligation to the patient, and if you don't feel like you can deal with this issue because of moral reasons, you are obligated to refer the woman to another physician who can and will. Whether you believe in it or not, abortion is legal in this country, and all women are entitled to be fully informed about and given access to this option. You don't have to do it yourself, but you can not simply abandon the patient because you disagree with her choice.

 

[Touchdown]

Im not trying to flame, I just wanted to state my views and inform everyone about a misconception about pain.

 

[hangten]

This is disregarding abortion. Nature has a way of reducing the number of viable young. In horses, for example, the stallion will inspect all new young. If he sees one as unfit, he stomps on it and kills it, thus removing an unfit foal. We are beings of nature, and we function within it's bounds. We have been performing herbal and manual abortions ever since we learned which herbs will induce abortion as far back as the Greek Empire, probably before that. Soo...are you saying we are somehow above nature and should not practice some form of limiting the number of unwanted/unfit children?

~MFP

(Again my opinions reflect not the pregnancies due to rape/incest or pregnancies with complications. My opinions are solely those due to recklessness. See my previous post.) My understanding of an abortion (due to recklessness) is that the mother is unable to raise the child maybe because of career ambitions, financial struggle, no support from the father, etc. They don't choose abortion because the child is unfit.

Abortion is not a means of population control. Contraception before the fact and/or abstinence are. Also, I think you misused the word "nature". Nature, in a sense, describes something that we are of no control. So nature in the context of population control would be hurricane, drought, earthquakes, etc. Abortion happens by choice, not by chance.

 

[lilnoelle]

Im not trying to flame, I just wanted to state my views and inform everyone about a misconception about pain.

I wasn't refering to you in particular, I just noticed an escalation of anger in some of the posts.

 

[Touchdown]

Oh my god, the dreaded abortion debate. Well, as a pro-CHOICE applicant, I would not have a problem performing the procedure. However, my advice to you pro-lifers is that you do have an obligation to the patient, and if you don't feel like you can deal with this issue because of moral reasons, you are obligated to refer the woman to another physician who can and will. Whether you believe in it or not, abortion is legal in this country, and all women are entitled to be fully informed about and given access to this option. You don't have to do it yourself, but you can not simply abandon the patient because you disagree with her choice.

Hey I doubt that anyone here is going to object to that, any patient of mine after we have had a discussion of all of the choices, still chooses abortion then I would provide her with a list of my partners that could help her. I may consider abortion a sin, but me being fired because I put my own personal views before my patients and did not follow the laws of this country is certainly not going to change said law.

 

[mfpullen]

No, it is not lonely up here on my throne. Thank you for asking.

Killing a cell that has the potential to become a man is a whole different situation than killing a skin cell as was previously mentioned.

We are not beings of nature. God has put mankind on Earth to fulfill His wish for us. By recognizing nature and not God, you have once again shown that your argument does not make sense.

This is where we part ways. You base your opinions ona faith I do not have. Although the Christian faith is one of the largest religions, as a doctor you need to recognize that it is not the ONLY religion. I respect your opinion, but would rather personally rely on scientific data that can be reproduced rather than an old book someone found in the desert.

I wonder, if a nuclear holocaust were to occur, and thousands of years from now some new society found the only intact book and it was Stephen Seagal's biography...would he be the new god? hehe. Sometimes you need to put religion in perspective.

~MFP

 

[Touchdown]

This is where we part ways. You base your opinions ona faith I do not have. Although the Christian faith is one of the largest religions, as a doctor you need to recognize that it is not the ONLY religion. I respect your opinion, but would rather personally rely on scientific data that can be reproduced rather than an old book someone found in the desert.

I wonder, if a nuclear holocaust were to occur, and thousands of years from now some new society found the only intact book and it was Stephen Seagal's biography...would he be the new god? hehe. Sometimes you need to put religion in perspective.

~MFP

While I accept you have a right to choose your religion there is no need to bash a faith. Christianity is not based off a book "someone found in the desert" it is based on tenents of Judiaism (which has been practiced since the dawn of writen history) and teachings of Jesus Christ, whose works while they were not recorded immediatly were passed down orally and Roman records show Christianity begining right around the time Jesus' death. While the oral history may have changed history, there is still truth in it. The fact is this is a relgion that stems from a continual practice for hundreds of years, its not like someone found a bible written thousands of years ago that has been lost since then and immediatly accpets everything writen in it and instantly converts. Short end, respect my relgion and Ill respect yours (or lack there of.)

 

[lilnoelle]

I have a feeling we're going to get moved to the topics in healthcare forum...