I was watching a segment on CNN this past weekend about the dilemmas of doctors who have moral, ethical or religious objections to certain medical procedures (abortion being the most obvious) and how they deal with the consequences of their objections. And there ARE consequences.
One doctor said that as an intern two decades ago, she was denied opportunities that other interns were given, based on the fact that the other interns 'earned' the opportunities because they performed many abortions and she did not. They were therefore rewarded with increased opportunities than the doctors who did not perform abortions.
This doctor (an OB/GYN) to this day has not performed an abortion, nor will she provide referrals for one. A woman would simply need to see a different doctor for the procedure (or the referral).
A new federal law is on the books, looking to protect doctors like this from being excluded from 'rewards' or perks (and to protect them against any kind of discrimination) because of their religious or moral objections. Supporters want to get the law passed under the current Administration, as they believe it will be harder to get passed once the new Obama Administration comes into place on January 20th, 2009.
Critics of the law argue that this new law is too expansive and the long arm of this particular law is far too long. They argue that anyone in a medical setting will be allowed to use this law to the point that it's true meaning will be diluted. An example (my own hypothesis) would be that a custodian would not clean the hospital room of a patient who had an abortion, based on his/her objections to abortion in general and would be protected under the law. Critics of the law fear that areas like fertility treatments and stem cell research will be negatively affected.
Others claim that these doctors are trying to "play God" and have a duty to provide any service, as long as it is legal and the patient is fully aware of his or her situation.
But supporters of the law say that it is needed. That too many doctors are pressured by the business practices of clinics and other partners, to provide services that they are not ethically comfortable with doing. And a doctor should not have to leave his or her beliefs at home and provide services that they have a moral objection to, especially when so many doctors and clinics are ready and willing to provide the services in question.
On it's face value, a somewhat similar issue has occasionally surfaced in pharmacies, where pharmacists have refused to dispense birth control pills or the morning after pill, although from a legal standpoint (and this law in particular), these are entirely different areas.
Tell Us -
What do you think of this law? Should doctors be protected from having to provide services they have a moral or religious objection to? Or should they focus on the needs and wants of the patient, and not their own personal opinion regarding the service requested?
All user-generated information on this site is the opinion of its author only and is not a substitute for medical advice or treatment for any medical conditions. Members and guests are responsible for their own posts and the potential consequences of those posts detailed in our Terms of Service.
Add a Comment11 Comments
If I am bipolar, and my doctor refused to see me on a day I really really needed help, as I was on the brink of suicide, and he didn't think he could help me any longer but neglected to provide me a referral, do I have a possible case against this doctor? I've been looking all over for this information and cannot find it. And is this considered Family Law? I have access to a Family Lawyer who would not charge me for her services. But I have neverr after 2 or 3 years been able to forgive this doctor.
January 30, 2009 - 6:45amThis Comment
Anon said "I have to say that I disagree strongly with any health-care professional making arbitrary decisions regarding my care based upon their personal beliefs."
The decision is yours whether you patronize any given health-care professional or not... as it is to follow their recommended care
What this is about is the force of law to remove the freedom of health care professionals to follow their values.
This hidden agenda comes along with the move to government-provided health care.... medical practitioners are no longer free people but subservient to the state.
So, the question is - are we a country that values freedom for everyone - or for only those who follow the right set of values?
Remember, you are free to choose another provider. Do you really value choice - or only the right choice?
In the UK, the Catholic Church is closing all of its adoption agencies that have served many people over the last two centuries. In the US, Catholic hospitals, 10% of the total in the US, served 80+ million people last year. Many of these people were uninsured and these charitable organizations still served them in fulfilling their mission. This issue has arisen because of the so-called Freedom of Choice Act (FOCA) that Obama has pledged to sign his first day in office. If it is signed, these hospitals would have to perform abortions and the Catholic Church would decide to close down rather than go against their beliefs.
So, are we about freedom for everyone or just for those with the right values? Do we have the right to demand that others serve us by doing something they believe is immoral? Do we own them or are they free citizens of this country?
December 23, 2008 - 4:39pmThis Comment
I have to say that I disagree strongly with any health-care professional making arbitrary decisions regarding my care based upon their personal beliefs.
I would no more want to know my doctor's opinion on lawn fertilizer than I I would want to know about his religious viewpoints. Those personal opinions have no place in our discussions regarding my treatment. Both reflect HIS personal choices, not mine.
December 23, 2008 - 1:17pmThis Comment
Take action! Here's an easy way to email the White House here:
http://www.capwiz.com/now/mail/?id=20004&lvl=F&chamber=P
If you want to take more targeted action, click this link:
December 23, 2008 - 10:57amhttp://www.now.org/issues/reproductive/112408hhsrule.html
This Comment
Anon, to answer your question, I would say that yes, I would definitely prefer that doctors have an ethical and moral code. They are people, first and foremost. I am a journalist by trade, and I have an ethical code that relates to accuracy, integrity and intent. I can tell you for certain that I would not violate those standards at someone else's request, and certainly not because a government told me to. I would rather not practice journalism than make a mockery of it with lies or innuendo.
I think that a doctor who, morally and/or ethically, just cannot perform an abortion is allowed that choice. However, I also think that that doctor does need to provide information to their patient. "First, do no harm" has several arms, and I think a viable argument could be made that sending a patient away without thorough information or a referral would qualify as harm in some instances.
I also believe that doctors must work within the law, as must journalists. If something is legal -- for instance, the morning-after pill for a rape victim -- than a patient has a right to learn about it and, with a doctor, choose that treatment.
If we get the argument away from the more difficult and emotionally charged cases, it seems more logical. A plastic surgeon who turns down surgery on a patient who seems addicted to plastic surgery would be considered ethical. If that plastic surgeon felt that the procedure would harm the patient, must he or she refer the patient to another doctor who will do it?
There is another force at work here, I'm sure, and that's the constant threat of malpractice. I wonder how many ethical decisions are affected by someone's fear of being sued if the outcome isn't what the patient had hoped, or if they later regret doing it. That's cynical, I know, but we hear so much about how malpractice insurance premiums are through the roof that I can't imagine there aren't doctors who, when making decisions about any "elective" procedure, don't take that into account.
December 23, 2008 - 9:24amThis Comment
Kristin-I agree with your post and comments 100%. I think the 10 year old rape victim is a very realistic scenario-which really scares me.
The critics of this new legislation are predicting it will be overturned within the next 60 days-thank goodness. I am not ready to be plunged back into the dark ages as a women. I am so tired of the moral majority pushing their values, and beliefs on me.
Even with turbulent economic times, I for one am so pleased to see President Bush leaving the White House!
December 23, 2008 - 8:48amThis Comment
Kristin, I will challenge you with another question. Many religious believes do not accept medical attention, is the Doctor ethically obligated to provide medical attention despite the rejection by the patient or in a case of a child, the parent of that patient? A 10 year old who is raped has nothing to do with a doctor offering contraception. The forensic exam performed in the ER will be just that, a forensic exam. Why would a doctor even get into the contraception business? A 10 year old would not be assumed to become sexually active after a rape.
I think the main issue here is to respect the Hippocratic Oath doctors take upon graduation from medical school, see excerpts below:
"I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.
But I will preserve the purity of my life and my arts.
I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.
In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.
All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.
If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot."
The Oath above is what most doctors in good conscience will commit to for the rest of their professional lives. Please not that the issue of abortion on this Oath is not a religious statement but one of life preservation versus life termination. A doctor saves lives...at any stage of conception. Why try to impose on their profession an action that goes against their professional Oath?
December 23, 2008 - 1:01amThis Comment
Coach Virginia, in the case of the 10-yr-old rape victim, I was referring to an emergency "morning after pill" to help the young girl avoid pregnancy from the rape. I feel it would be a doctor's duty to provide this option to her, regardless of the doctor's personal stance on contraception or abortion. Regarding your question.... like I wrote previously, I believe it should be the patient's (or patient's parents') choice regarding the care he/she receives. A doctor who keeps treatment options from a patient simply because of the doctor's personal beliefs should not be practicing medicine.
December 23, 2008 - 10:18amThis Comment
As a physician who has a special interest in history, I want to ask an important question. In asking this question, I want us all to put aside our personal beliefs about abortion, whatever they may be. Abortion is an issue about which honest, ethical people disagree. On one extreme, some people believe that it is always murder. On the other extreme, some people believe that personhood starts sometime after birth, and that abortion is acceptable throughout pregnancy. Let’s put that issue aside for a moment, and consider a question in the abstract.
Do you want your own doctor to have a standard of ethics that she will follow, even when the government has a different standard?
Before you answer, consider some historical facts. First, 65 years ago, Hitler’s doctors performed heinous medical experiments on individuals just because they were from different races than his preferred Aryans. Second, between 1932 and 1972, the United States Public Health Service did a study to learn what happened to untreated syphilis by deliberately withholding treatment from unsuspecting Black men in Tuskegee, Alabama. Third, in recent years, allegedly, doctors have been involved in the development of torture protocols used by the intelligence services.
Let’s consider some facts about today. Genocide is commonplace in many parts of the world. Involuntary abortion and sterilization are widely practiced in China. Several countries in Scandinavia now sanction euthanasia, and studies indicate that euthanasia is sometimes done without an explicit request.
Many doctors in this country commit fraud by doing unnecessary tests to make money or to protect themselves from lawsuits, without disclosing it to their patients. Some even do unnecessary surgery for the same reasons. This reflects their lack of an ethical conscience.
So if your doctor has a conscience, and happens to believe that abortion is murder, do you really want to make her violate her conscience? Do you want her to leave medicine altogether? Or do you want to encourage her to hold to standards that are independent of her own self-interest, and independent of whatever the government tells her is legal? If she stays in medicine, perhaps she will be the one to blow the whistle when someone is crossing a different line.
Let’s also separate this issue from one implied in the National Organization of Women website article. This is not just an issue driven by Bush and the religious right. There is a major shortage of doctors in this country right now, particularly in primary care. Many of those who are filling that shortage are from other countries, including Muslim countries. These individuals do not believe that abortion is acceptable. If we drive these individuals out of medicine, there will be a much bigger problem with access.
Existing laws, and existing medical ethical guidelines, already protect the rights of HIV patients and transgender individuals to receive healthcare. In reality, these new regulations simply clarify existing protections of rights of conscience that are already on the books. Read the HHS press release at http://www.hhs.gov/news/press/2008pres/12/20081218a.html. That article also contains a link to the actual rule.
Over the past several years, we have seen greater polarization in our country. I believe that there needs to be more respect for those who have different views from our own. Strident statements by those on both sides of the abortion debate have generated more heat than light. I believe that the NOW article does the same thing. I have no doubt that there will be plenty of abortion providers with or without these new regulations. I also believe that we should not encourage people to violate their consciences, even if their standards are different from our own.
So how do you answer the question: Do you want your own doctor to have a standard of ethics that she will follow, even when the government has a different standard?
December 22, 2008 - 4:34pmThis Comment
Very thought-provoking and interesting comment, but I was caught by your final question. Yes, there is the doctor's standard of ethics, and there are the laws laid down by the government. But what about the rights and the choice of the patient? What about the 10-year-old girl who is in a hospital ER because she's been raped and needs emergency contraception, and yet the ER doctor who is treating her, or the hospital itself, refuses her the contraception?? Personally, as a patient, I'd expect my own doctor to leave personal religious and ethical beliefs at home and treat me with the best care that I need at any given time, and to let me make the choices that impact my body and life.
December 22, 2008 - 10:56pmThis Comment