Butterfly Cauldron

Saturday, June 23, 2007

But what about my moral beliefs?

Doctor's denying women medical care has finally made the mainstream media. (How long ago was the blog world covering this? Two years or something? I forget.) The article is fairly well done, for a MSM article. I'm just struck by how unfeeling some of these doctors come off. I get that you have your moral beliefs. I respect those. But what about mine? What about what my gods 'tell' me to do? What about those of us who don't believe in any gods at all? What about their moral beliefs? Who decided it was your right to make blanket judgements for all of us?

Rape victim goes to hospital. Has exam, asks for EC.

Boyer stared in disbelief. No? She tried vainly to hold back tears as she reasoned with the doctor: She was midcycle, putting her in danger of getting pregnant. Emergency contraception is most effective within a short time frame, ideally 72 hours. If he wasn't willing to write an EC prescription, she'd be glad to see a different doctor. Dr. Gish simply shook his head. "It's against my religion," he said, according to Boyer. (When contacted, the doctor declined to comment for this article.)

How does he have the right to do that? When she says to him, I'm in danger. When she wants to avoid having a baby due to rape. Where's the compassion? These people call themselves Christians? (This was at a Catholic hospital.) This is what they think Jesus would do? Really? Why would anyone want to follow a god that has so little regard for his followers suffering?

But, some say, EC is now available over the counter. Sure, if you can find a pharmacy that carries it and a pharmacist willing to give it to you. For some women, that's very hard to find.

Planned Parenthood M.D.s report patients coming to them because other gynecologists would not dole out birth control prescriptions or abortion referrals. Infertility clinics have turned away lesbians and unmarried women; anesthesiologists and obstetricians are refusing to do sterilizations; Catholic hospitals have delayed ending doomed pregnancies because abortions are only allowed to save the life of the mother. In a survey published this year in The New England Journal of Medicine, 63 percent of doctors said it is acceptable to tell patients they have moral objections to treatments, and 18 percent felt no obligation to refer patients elsewhere. And in a recent SELF.com poll, nearly 1 in 20 respondents said their doctors had refused to treat them for moral, ethical or religious reasons. "It's obscene," says Jamie D. Brooks, a former staff attorney for the National Health Law Program who continues to work on projects with the Los Angeles advocacy group. "Doctors swear an oath to serve their patients. But instead, they are allowing their religious beliefs to compromise patient care. And too often, the victims of this practice are women."

I wonder if it would be possible to file some sort of gender discrimination suit against these doctors? Since their victims are, predominantly, women. I've never heard of a man being denied any medicine or treatment. (If you have, please email me the info. ) Is this one of those issues that will have to go to the Supreme Court? And gods help us, I hope if it does, we've got a few more liberal justices sitting than we do now.

Because, you'll notice that when doctor's are given the right to refuse, they're given the right to refuse treatment that seems to apply exclusively to women.

In 1973, following Roe v. Wade, Congress passed the so-called Church Amendment, allowing federally funded health care providers to refuse to do abortions. In the years since, 46 states have adopted their own abortion refusal clauses — or, as proponents call them, conscience clauses — allowing doctors to opt out. Now many states have gone further. Sixteen legislatures have given doctors the right to refuse to perform sterilizations; eight states say doctors don't have to prescribe contraception. "This is about the rights of the individual, about our constitutional right to freedom of religion," says Frank Manion, an attorney with the American Center for Law and Justice, a legal group in Washington, D.C. Founded by minister Pat Robertson, the organization has represented health care providers and lobbied for laws that protect them.

Here's the thing: I believe strongly in a person's right to do as they please. I believe a doctor who does not want to perform abortions, she/he does not have to. But I also believe that they should be completely upfront about that fact. Their patients should not be surprised to find out that information. If a doctor won't prescribe birth control, they need to say so, up front. Post a sign somewhere in the lobby, at the sign-in desk. So, if you're there to see the doctor for the Pill, you know not to waste your time.

Because when we're talking about the rights of the individual, we can't forget the rights of the individual patient. Because she's got the right to know, before she spends her co-pay or the only gyno visit her insurance will pay for (One per year, ya know), if her doctor is going to cover all her medical needs or not.

If a pharmacy carries a drug, I don't believe a pharmacists should have the right to refuse to dispense it. The pharmacy itself has the right to decide not to carry something, but if it's in stock and someone comes in with a legitmate script for it, give it to them. If you can't do it, pass it on to someone who will. Period. No one should ever be turned away because someone else has decided to impose their morals upon them. Ever. Because while we do have freedom of religion in this country, that freedom is not allowed to impose itself on others. (I mean, I have the right to fervantly believe Kali will rip their balls off or give them festering boils on their dick, but that doesn't give ME the right to rip 'em off, ya know?)

I don't think emergency room docs should be allowed to deny EC either. Yes, it's over the counter, but if I'm a rape victim, I want the damn pill NOW. I don't want to have to find the nearest Walgreens and hope their pharmacist will let me buy it.

I feel more lenient to doctors in private practice, who don't do the hospital thing. Provided they advertise upfront what they will not do. (Anyone ever heard of a man being denied a vasectomy because of religious issues? Or denied Viagra?)

Since 2005, 27 states introduced bills to widen refusal clauses. Four states are considering granting carte blanche refusal rights — much like the law adopted by Mississippi in 2004, which allows any health care provider to refuse practically anything on moral grounds. "It's written so broadly, there's virtually no protection for patients," says Adam Sonfield, senior public policy associate for the Washington, D.C., office of the Guttmacher Institute, a reproductive-health research group. Sonfield notes that many refusal clauses do not require providers to warn women about restrictions on services or to refer them elsewhere. "You have to balance doctors' rights with their responsibilities to patients, employers and communities," he adds. "Doctors shouldn't be forced to provide services, but they can't just abandon patients."

There has to be a way to balance things. I mean, I'm worried I'll be denied care because I'm a woman, fat, bisexual, chronically ill. And some of these laws would allow the doctor to deny me for any of those reasons. How is that remotely far? How is that remotely moral? Whose morals are these? Because they're not mine, at all. I mean, would we stand for a doctor refusing treatment to a black man because he's black? Or Jewish? And yet, because we're women and want to not be pregnant, it's okay? WTF?

In theory, the laws aren't aimed solely at women's health — a bill in New Jersey lists eye doctors and prosthetics technicians as examples of providers who'd be allowed to refuse care based on their beliefs. But Morrison warns women not to be fooled. "I ask you, what belief would keep someone from fitting a patient with a prosthetic limb?" she asks. "What they're really after is limiting access to women's health care. Reproductive health is seen as something other than regular health care" — not a straightforward matter of treating and healing, but something laden with morality — "and if you treat it that way, it becomes something providers can say yes or no to." Men, for the most part, escape such scrutiny: It's pretty hard to imagine someone being made to feel he's going straight to hell for choosing to take Viagra or get a vasectomy. And if women come to fear their doctors' judgments, a new set of problems can develop. "Then you have women who don't communicate with their doctors or avoid getting care," Morrison warns. "Any way you look at it, it's dangerous for women."

Right. That about sums it up, no? Because why would you go back to someone who makes you feel so bad? That lump in your breast? Oh, that's just a cyst. Those headaches you're having? Too much stress and caffiene. The unexplained weight lose? Why complain, just be glad you're losing. None of those things could be serious.

If there's one thing both sides can agree on, it's this: In an emergency, doctors need to put aside personal beliefs to do what's best for the patient. But in a world guided by religious directives, even this can be a slippery proposition.

Ob/gyn Wayne Goldner, M.D., learned this lesson a few years back when a patient named Kathleen Hutchins came to his office in Manchester, New Hampshire. She was only 14 weeks pregnant, but her water had broken. Dr. Goldner delivered the bad news: Because there wasn't enough amniotic fluid left and it was too early for the fetus to survive on its own, the pregnancy was hopeless. Hutchins would likely miscarry in a matter of weeks. But in the meanwhile, she stood at risk for serious infection, which could lead to infertility or death. Dr. Goldner says his devastated patient chose to get an abortion at local Elliot Hospital. But there was a problem. Elliot had recently merged with nearby Catholic Medical Center — and as a result, the hospital forbade abortions.

"I was told I could not admit her unless there was a risk to her life," Dr. Goldner remembers. "They said, 'Why don't you wait until she has an infection or she gets a fever?' They were asking me to do something other than the standard of care. They wanted me to put her health in jeopardy." He tried admitting Hutchins elsewhere, only to discover that the nearest abortion provider was nearly 80 miles away in Lebanon, New Hampshire — and that she had no car. Ultimately, Dr. Goldner paid a taxi to drive her the hour and a half to the procedure. (The hospital merger has since dissolved, and Elliot is secular once again.)

How much more blatantly could it be framed? These laws endanger women's lives. Unless they're lucky enough to find a doctor who is willing to break the rules or go the extra mile to find them good care, they could die. Or they could lose their fertility. But this isn't about women. Oh, no. No no no. It's about the provider's rights!

Does a woman have to die to get these laws changed? Or rather, how many women have to die? Because one death certainly wouldn't be enough. It would take more than that.

Sometimes, I hate people.

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posted by Zan at 11:56 AM


Hmm, I thought the primier rule in med school was "First, do no harm." It seems to me that doctors can say sayonara to that rule if procedures are against their conscience. Well, why the fuck did they go into a service industry like medicine when it's obvious what they really want to do is preach religion? They should have become gd preachers if they are so moved by religion, and stay the hell away from women and women's health care.

1:59 PM  

Come to think of it, I've never heard of men being discriminated against for being fat. Does anyone look askance when a huge guy puts a huge pile on his buffet plate? Would my female doctors (1) "greet" a man, while reading his chart, with "We need you get you on our nutrition program!" (2) say weight loss decreases blood pressure, rather than explain what causes mid-range blood pressure?

Medicaid gave Viagra to convicted rapists and molesters.

A fertility doctor didn't tell his patient he fertilized her egg with some other woman's husband's sperm. He was afraid she would abort. She meant to be a single parent, but now, she has to deal with the dad's visitation rights, if not shared custody, and the wife meant to not be married to a guy who had a kid with someone else, and presumably gave up on the fertility crap shoot.

Long ago, OurWord had a link to some Catholic Hospital organization, which explains on its web site that offering emergency contraception is in line with Catholic teaching as being merciful in not allowing the woman or girl to be further abused by becoming pregnant.

6:23 PM  

First, do no harm: when abortion was illegal, doctors refused treatment to women with complications unless they gave up the names of their providers. Who did this to you?

The Catholic Health Association's Rape Treatment Protocol.

11:37 PM  

Sad to say that this is par for the course. The medical profession in this country has goen mad - in what other job do people get to bring their religious beliefs to work with them? Do customer service reps get to refuse to help customers whose morality they don't approve of? Can bus drivers refuse rides to women they think are slutty? Can pilots refuse to let people fly because of...
Oh wait, we're already doing the profiling there. Nonetheless, the point stands. What's so special about medicine that people are allowed to refuse to perform part of their jobs because they think it's immoral? You take the job, you do the work. Don't like it? Find another job less likely to conflict with your morals.

9:43 PM  

I'm no longer surprised by these stories, but I'm still outraged everytime I hear another.

7:39 PM  

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