Why we can't give up......

[mendomidwife]

This is why women have to stick together and help support one another......


http://www.msnbc.msn.com/id/19190916/

[mamabadger]

I'm undecided about this matter. Not long ago, there was a discussion here in which many doulas and other birth professionals said they would refuse to provide service to any parents who were planning to circumcize. Is that the same kind of thing, or do you see it as a different situation?

[Earthy Birthy]

Wow.

MDs, as well as mws, have to be able to set aside religious beliefs in order to give women objective information. But yet this kind of thing happens all of the time. In fact, the only place in my area to get the morning-after pill is a chain pharmacy. None of the locally-owned pharmacies carry it. And it reminds me of a incident when I was younger at one of those clinics that offer free pregnancy tests. I was waiting for the results of a test myself in another room, when I overheard a conversation between one of the "counselors" and a young girl. The girl had just taken a negative pregnancy test, and was asking about birth control. The woman started trying to explain the Rhythm Method (not even FAM!--just the 28 day cycle version) to this teenage girl. No mention of condoms or any other form of birth control. Had I been my older self, I would've talked to the girl myself, but hey--I was there POAS myself, so...

And mamabadger, I think that you are trying to compare apples and oranges here. I see circumcision as a purely cosmetic procedure, and it is really another discussion entirely.

[SublimeBirthGirl]

I didn't read the whle thing, just the first part. That's a tough one. I'm pro-choice, personally (are we allowed to say that?) but I don't see why doctors shouldn't be allowed to have principles, if there are options. Where I live, OBs are a dime a dozen. I'd just ask for another doctor. But in situations like small towns with maybe only one doctor? That's different. And I don't know how you separate the two in any real way.

[cristeen]

I have to say that this:

Lawmakers in Missouri, Rhode Island, South Carolina and Vermont are considering sweeping bills that would allow medical professionals to refuse to provide any service they object to.

Makes my blood boil.

I don't have a problem with a doctor who is opposed to abortion refusing to perform one. I do have a problem with medical institutions refusing to allow their employees to perform them. I do have a problem with any doctor refusing to discuss contraception with a patient. I do have a problem with a doctor who is opposed to abortion or contraception refusing a rape victim EC. At the very least, ask another doctor to step in to deal with it rather than just saying no. They've already been victimized and you're just going to victimize them some more?!

Sometimes I feel like we're re-entering the Dark Ages.

[Earthy Birthy]

Originally Posted by cristeen

Sometimes I feel like we're re-entering the Dark Ages.

Yeah, I just read The Handmaid's Tale, and it made me think about how far women have come, but how quickly our rights can be taken from us. I just wish that more women would recognize how much of a *feminist* issue birth is...

[subrosa]

I think the difference between a mw refusing to accept a client who plans on circumsizing and an ER doc refusing to prescribe emergency contraception is the immediacy of the need. If parents *have* to circumsize their sons, then they are free to shop around for providers who are cool with that. A rape victim in an ER is not exactly in the position (or frame of mind) to go doctor-shopping to find someone who will work with her needs.

I do worry about the effect these "provider freedom of choice" laws have on women where there aren't many healthcare providers. Such a disproportionate impact.

[Charmie981]

Hmm..this isn't a new thing to me. I grew up in an area where the local Catholic hospital (and the only hospital that had maternity services) wouldn't do tubal ligations. It meant that moms who had c-sections had to have a separate surgery at a different hospital to have their tubes tied. Nice.

I don't really get it. I have very strong beliefs about things that relate to my faith, but they're MY beliefs and MY faith. It doesn't make much sense to tell someone else "you can't do this because it's against MY religion." For example, imagine the outcry if a doctor happened to be Jehoviah's Witness and refused to order a transfusion for a patient. That's an extreme example, but the issues in that article are just about the same thing.

On the other hand, crap like this is what makes me want to give up. I mean, how far have we REALLY come?

[cristeen]

Originally Posted by TXmidwife

Yeah, I just read The Handmaid's Tale, and it made me think about how far women have come, but how quickly our rights can be taken from us. I just wish that more women would recognize how much of a *feminist* issue birth is...

Ya know, I haven't read it in years, but I still fear that is where we are headed. The images in that book have stuck with me, and really scare the crap out of me. Because I can totally see something like that happening. At one point it may have been pure fiction, but now it's approaching "feasible".

[doctorjen]

I can understand that physician's side of this issue. If you are of the religious or philosophical belief that ending early pregnancy is the same as ending another human life, I'm hard pressed to say you should be forced to do so. I do think physicians have an obligation to inform patients of their own beliefs, though. I don't feel comfortable, though, saying that a physician must violate their own beliefs.

[MsBlack]

Maybe docs who have religious objections to any form of medical treatment/prescribing, need to have an Informed Consent for potential clients to read before they ever are examined or treated by that doc. No, I don't object to concientious objection--I do object to a lack of informed consent and being upfront with folks about what you do and do not provide.

As for the doc in that story, HE should NEVER be allowed to go anywhere near a rape survivor. Period. What a jerk!

[Jenlaana]

I think that it should not be legal for a hospital to make sweeping judgements about patient care based on morality because not everyone has a choice of what hospital to go to. I don't think a doctor should be made to do something they are morally objectionable to. BUT, I think that the patient should be given the doctor available that most meets their requirements. i.e. in a rape analysis interview the nurse, or the form should ask if the patient would be interested in the day after pill - or even more specifically, when she talked to the rape crisis counselor, that information should have impacted which doctor she was given (assuming the counselor was at the hospital since she said she went right there). I don't think it has to be a big activism issue. It just takes some consideration on the part of the care providing facility to make sure the patient is taken care of best. If the patient did not want to abort but wanted information to the other end of the spectrum, then a doctor that believed in that would be more appropriate than one that felt she should just be given the pill and be done with it.

[mendomidwife]

Many good points well taken....
I wonder if these hospitals are privately funded ?
I can totally respect a physicians right to refuse to provide services that he/she might feel uncomfortable with. BUT, I think they should make that known up front, screen patients BEFORE they are admitted and be honest about what the options are.
Do hospitals that have these types of policies advertise as such ? One of the very perplexing aspects in the delivery of health care in this country is what services are provided by health care institutions, and what their charges are.
When I order a pizza, or get a new roof, I am well within my right to ask for an estimate, and decide what the best deal is for my budget.
It has been my experience, and I admit that it is not wide and vast - that when you go to the hospital there is a "smoke and mirrors" type of attitude about what they charge.....they don't post their charges....they sometimes give discounts if you pay cash...if you ask. There are all types of programs but they don't necessarily tell you about them.......and when you are ill or in pain, who has the time to argue.
What happened in this article is WRONG - especially because the woman felt so violated. I respect the doctors personal right, but I hold the hospital administration responsible for expecting their "employee" to follow it despite the implications that there might be harm done for having done so.
If we care about this type of behavior one way or another, then it is our job to find out what is available to women in these types of situations and if it is one of our sisters - get them the help they need.

Carla

[bryonyvaughn]

Originally Posted by Jenlaana

... I think that the patient should be given the doctor available that most meets their requirements. i.e. in a rape analysis interview the nurse, or the form should ask if the patient would be interested in the day after pill - or even more specifically, when she talked to the rape crisis counselor, that information should have impacted which doctor she was given (assuming the counselor was at the hospital since she said she went right there). I don't think it has to be a big activism issue. It just takes some consideration on the part of the care providing facility to make sure the patient is taken care of best...

[Bellejar]

public funding

To answer the question about public funding - all medical facilities are usually 501(c)(3) tax exempt organizations. Additionally most get money from medicaid and medicare. In the current political climate, it probably doesn't matter whether or not they restrict care based on religious beliefs. I personally think it is deplorable. The article was really unbelievable especially the part about the woman who was 14 weeks pregnant whose water broke and whose pregnancy wouldn't survive.

I think if you take the oath "first do no harm" you need to be able to put your personal beliefs aside.

[pigpokey]

Originally Posted by doctorjen

I can understand that physician's side of this issue. If you are of the religious or philosophical belief that ending early pregnancy is the same as ending another human life, I'm hard pressed to say you should be forced to do so. I do think physicians have an obligation to inform patients of their own beliefs, though. I don't feel comfortable, though, saying that a physician must violate their own beliefs.

Absolutely. If I go back to practicing law, should I have to advocate for a parent who is having a legal battle wanting to circumcise a minor over the other parent's objection? Heck no. I couldn't sleep. I would quit the practice before I did that. Would you prefer the doctors affected stopped providing care altogether? Do you want to make them involuntary servants? We want doctors to retain their compassionate spirit in a difficult environment. For some people, tending their spirit means maintaining a relationship with God as they know God. So I would say doctors need to be respectful and up-front about what services they are not willing to provide, to the extent possible. Otherwise, we need to suck it up and go elsewhere, respecting that doctors are people too.

Why should they respect us and our choices if we don't respect theirs?

IMO if you want morning after pills available conveniently to all rape victims, that is a matter more ethically handled by supporting your local rape crisis center, volunteering to go be an advocate for a rape victim in the hospital, and personally locating a pro-pill doc who can call in a script for your client if such docs are rare, than by trying to use the government to bully doctors into doing something they find personally spiritually damaging.

MAP are over the counter now, anyway, right?

[bryonyvaughn]

Originally Posted by pigpokey

Absolutely. If I go back to practicing law, should I have to advocate for a parent who is having a legal battle wanting to circumcise a minor over the other parent's objection? Heck no. I couldn't sleep. I would quit the practice before I did that.

I would support your not taking the case. That being said I don't think your analogy is relevant. You are talking about a custody type of battle. A child circumcised at 48 hours in the hospital is just as circumcised as a child circumcised after 3 months of legal wrangling.

With emergency contraception there is a small window of time where it will work. After that many insurances won't cover it and you're often talking surgery that can have life long impacts on a woman's health and fertility. I understand some religious hospitals legally refuse to offer EC in their ERs. The case in the article was of a non-religious hospital that is obliged to offer EC in their ER, known to do so to the extent that informed raped women seek out that specific hospital, then being denied EC by the ER doc who refuses to get another doc to see the woman and write the script. A raped woman given EC at 12, 24, or 48 hours is not the same as a raped woman given EC at some later date.

Beyond this lawyers customarily offer a free consultation. At the free consultation you could inform an infant circumciser that you would not take the case and give him/her the number for your local bar association for a referral. The raped woman would face at least two ER charges. Every time you step foot into an ER you get slapped with a fee to cover the uninsured. It just seems so wrong to me that an uninsured woman would have to pay $300 to $600 extra dollars for the privilege of getting treated once.

Would you prefer the doctors affected stopped providing care altogether? Do you want to make them involuntary servants? We want doctors to retain their compassionate spirit in a difficult environment. For some people, tending their spirit means maintaining a relationship with God as they know God. So I would say doctors need to be respectful and up-front about what services they are not willing to provide, to the extent possible.

IMO any doctor not able to morally serve his/her God while treating people in the ER needs to find a new specialty.

Otherwise, we need to suck it up and go elsewhere, respecting that doctors are people too.

People DO suck it up and go to hospital that are obliged to provide EC. When a particular doctor's beliefs trumps the hospital's legal obligation, IMO, the doctor needs to suck it up and make a (*&(*&^ $#%^&*( referral so another doctor will treat the patient without a second hospital visit or bill.

Why should they respect us and our choices if we don't respect theirs?

I can respect a doctor's individual choices. I can't respect an ER doctor's refusal both treat an ER patient and refusal to call in a doctor on duty who will. THAT is disrespectful, judgmental, and demeaning.

IMO if you want morning after pills available conveniently to all rape victims, that is a matter more ethically handled by supporting your local rape crisis center, volunteering to go be an advocate for a rape victim in the hospital, and personally locating a pro-pill doc who can call in a script for your client if such docs are rare,

I can agree with you here.

than by trying to use the government to bully doctors into doing something they find personally spiritually damaging.

I think if referring a patient to another doctor on call is so spiritually damaging to a doctor, that doctor has no business in emergency medicine.

FTR as an CAM provider I have struggled with this issue myself. I am pro-life and had a client wanting an herbal abortion. I struggled and prayed, and prayed and struggled over what to do. I had to balance my moral beliefs with my obligation to serve a client/patient. I ended up giving her stats on the efficacy of herbal abortion, information that failed herbal abortion meant surgical abortion (which I knew she found morally reprehensible) or a list of possible birth defects from failed herbal abortion. From the point of view of those who think it's a "woman's body, woman's decision" I could understand the morality of a failed herbal abortion for a male child (if the woman need and refused a surgical abortion and chose to raise a boy with birth defects) but was far more disturbed by the idea of an attempted and failed herbal abortion of a girl where her eggs were damaged leading to grandchildren with birth defects from the original failed abortion.

It was a struggle for me to come up with a way to respectfully serve within my moral constraints. As I'm not in emergency medicine, I wasn't prepare for that ahead of time. You may want to trumpet some docs moral stand but I consider his unwillingness to serve his patients personally or even with a referral, while still getting paid by the hour for ER duty, morally deficient. JMO

~BV

[roadfamily6now]

if that doctor could not Rx her the pill then HE should have found one who would! JERK JERK JERK!

[channelofpeace]

Originally Posted by doctorjen

I can understand that physician's side of this issue. If you are of the religious or philosophical belief that ending early pregnancy is the same as ending another human life, I'm hard pressed to say you should be forced to do so. I do think physicians have an obligation to inform patients of their own beliefs, though. I don't feel comfortable, though, saying that a physician must violate their own beliefs.

Yup

[MidwifeErika]

I don't think anyone needs to violate their own beliefs, but they could still provide decent medical care. If I want birth control (for instance), I make an appointment, have my pap and full exam, and then wait for the script. That is not the time, IMO, for the doc to say "I won't prescribe birth control to you". At that time then I would have to find myself a new doctor and go through the whole deal AGAIN and pay double! Either that doc shouldn't have taken my case..... or..... that doctor could say to me at that time "it is against my religion to prescribe birth control, but let me step out and grab dr. x to write that prescription for you."

I really feel that in the case of a rape victim, if the doctor feels wrong giving EC, then he/she has the medical obligation to find someone else to give it to that patient.