What is Digg?128 Comments
- JoeRandom, on 10/12/2007, -4/+79Any doctor who doesn't disclose all information on religious/political/moral grounds should have their license revoked indefinitely.
- wobitnobby, on 10/12/2007, -5/+28I feel the same way, physicians should leave their beliefs at the door. Unfortunately, Bush has chosen yet another religious nut, Eric Keroack, to head his Family Planning program. In the same way that he's trying to force scientists to report what he wants, he's choosing doctors that will push the kinds of services he wants.
- signal15, on 10/12/2007, -4/+26If you're a doc and don't plan on telling patients about all of their options, then you need to get a new job. Christian hospitals don't provide the morning after pill for rape victims, I hope they get sued when someone gets pregnant. This is getting ridiculous.
- sonaboy, on 10/12/2007, -3/+18Just to be a devil's advocate - it's unconstitutional to discriminate against employing anyone on the basis of their beliefs.
Doctors aren't required to unveil their religious convictions during the hiring process. Unfortunately, this could mean undue suffering and stress to patients in some cases.
I was brought to anger in a similar episode when a pharmacist refused to give a woman her prescribed birth control due to her religious beliefs.
Birth control pills, as many of you know, need to be maintained on a pretty strict schedule, and if you go off of them, you have to wait a few weeks to restart, and then start your cycle alllllll over again.
It seems ridiculous that someone can mess with another person's life in such ways just because they believe there's some bearded man in the sky watching every move they make. - drmangrum, on 10/12/2007, -3/+15Got beat to it. Any doctor that doesnt suggest a treatment based on their personal beliefs is violating the Hippocratic Oath.
- MatthewWilkes, on 10/12/2007, -0/+11No, they can't discriminate based on religion, but they damn well can discriminate if their religion prevents them from doing their job.
- smitting, on 10/12/2007, -2/+12I doubt any doctors would admit to being an atheist, considering the anti-atheism campaign in America.
- Arch4ngel, on 10/12/2007, -0/+10Six of the principles commonly included are:
* Beneficence - a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex.)
* Non-maleficence - "first, do no harm" (primum non nocere).
* Autonomy - the patient has the right to refuse or choose their treatment. (Voluntas aegroti suprema lex.)
* Justice - concerns the distribution of scarce health resources, and the decision of who gets what treatment.
* Dignity - the patient (and the person treating the patient) have the right to dignity.
* Truthfulness and honesty - the patient should not be lied to, and deserves to know the whole truth about his/her illness and treatment.
SOURCE: http://en.wikipedia.org/wiki/Medical_ethics - wobitnobby, on 10/12/2007, -0/+9A great line from the discussion section of the article:
"Female physicians are more supportive of full disclosure and referral than are male physicians, perhaps because many controversial issues in medicine (e.g., abortion, contraception, and assisted reproductive technologies) disproportionately involve the sexual and reproductive health of women."
The physicians most likely to withhold information were religious men. - crimson, on 10/12/2007, -3/+12"Hippocratic Oath", anyone? Guys?
http://en.wikipedia.org/wiki/Hippocratic_Oath - MatthewWilkes, on 10/12/2007, -0/+9No, you can't force a pharmacist to do part of his job that his religion prohibits, but you damn well better fire him.
- wobitnobby, on 10/12/2007, -1/+10They are extrapolating from a random sample of 2000 physicians chosen from the lists of the AMA, a database intended to include all physicians in the US, modestly oversampled in fields such as psychiatry where they considered that death and suffering might be more commonly addressed. They excluded physicians over the age of 65. Response rates (63% overall) did not differ by age, board certification, or region. This still makes it a smallish study but generally that happens the first time researchers look into a problem, and this topic is not well-studied.
I would propose (not from the article) that academic physicians would be less judgemental, which leaves me more nervous - the rural population that has no other option might be stuck with the crusading dr.
I have the original NEJM research article open in another tab and can paste as much as you like. I look forward to bringing it to my next ethics class. - drmangrum, on 10/12/2007, -1/+10But crimson, it's the patients beliefs that matter. The doctor can elect NOT to do the procedure based on their beliefs, but to not give the patient a completely viable alternative is derelict in their duties. The doctor should refer the patient to another doctor when such events occur, if they don't it's greed rearing its ugly head.
- aliengoods, on 10/12/2007, -0/+8There are already pharmacists who refuse to fill prescriptions for birth control on religious grounds. I don't care if they extrapolate, if there is even one it is a problem.
- wobitnobby, on 10/12/2007, -0/+814% won't tell you about all your options, 29% won't help you out with a referral should your moral decision differ.
The kicker is, how would you know? Part of your first meeting with your primary care physician (or urgent care physician) perhaps should include you asking them about their stance on this! Are they religious, and will they allow that to affect their practice of medicine? - wobitnobby, on 10/12/2007, -0/+8Such a physician should take himself away from such situations, or find work in one of the many catholic hospitals. We go through enough education that we have a pretty good idea of what questions and concerns patients will likely have when they walk in, and we are trained to get the patient to state their own moral compass so that we can follow it (within the law). It's the standard of care.
- Decimit, on 10/12/2007, -2/+10Teachers should teach all scientific theories and leave the crackpot stuff to the side...same as doctors.
- littlesaint, on 10/12/2007, -1/+9You're kidding right? Proper medical treatment is equal with teaching evolution/creationism? It's statements like this that make creationists look really stupid.
- inactive, on 10/12/2007, -0/+7I don't give a ***** what kind of fairies my doctor believes in, as long as his beliefs don't interfere with my diagnose and treatment.
- asdfasdf, on 10/12/2007, -0/+7@mbthompson:
"Apart from being blatantly insulting, immature, and inflamatory, you completely missed the point. DO NO HARM. As someone else has brought up, if the doctor feels morally that abortion is murder, how can he recommend that treatment when he would be doing harm in his eyes?"
"Do no harm" is not the same as "do no harm, in accordance to your philosophical or religious beliefs." If the doctor things abortion is murder, he should go protest or become a politician and try to outlaw it. Abortion IS an option, and the doctor should disclose it as such. Otherwise, like wobitnobby suggested, such a doctor should work in a church or move somewhere where his beliefs are also the law (sharia law, divine right, etc). In the United States we have a separation of Church and state.
"Conversely, if the doctor prescribes a birth control pill that is abortive to a patient he knows would be opposed to it, and keeps that information from the patient, how can that be ok?"
It's not OK. The doctor should tell the patient what his options are.
"He may not have a problem with abortion, but the patient does, he chooses to keep that information from the patient because he doesn't have a problem with it."
Doctors have absolutely no right to keep any information from you. Such a decision affects and involves not just the patient, and the doctor probably doesn't know everything you're for or against anyway, let alone what your spouse/bf/gf/family's beliefs are.
Now, if you're talking about doctor's that can read minds, then you might be on to something. - Decimit, on 10/12/2007, -1/+8In my opinion (and possibly a law), anyone in a professional position, especially when being paid for their services, should keep their moral and religions beliefs to themselves unless otherwise requested or understood by all parties. Onto doctors specifically, they are not in a place to make decisions for the patient, they are being paid for their advice, expertise, and opinion. Wouldn't withholding information on any grounds basically be a violation of contract at the least?
- aliengoods, on 10/12/2007, -1/+8@gabriels
A persons religious rights are first amendment rights, but so is freedom FROM religion. And employers can fire someone for refusing to do their job because of religious convictions, if the duties fell in line with what the employee was hired to do. A pharmacist, for example, is expected to fill all prescriptions, including birth control. If they have a problem with that, THEY have a responsibility to disclose that to a potential employer before being hired, as filling prescriptions is part of the job description. I'm assuming that nowhere in the job description does it say, "Fill the prescriptions you agree with".
I am a web developer. Many times I have disagreed with a particular implementation decided on by someone above me. I have strong moral convictions that an all-table layout is a bad thing, but if my boss told me to build it that way, and I refused, I would be fired. And then I can try to find a job at a shop that hates tables. See the point?
Now some doctors refuse to perform abortions. This is fine, but if they got a job at an abortion clinic, and then refused, they too would be fired. And you can bitch about YOUR religious rights all you wish, but in the workplace the courts have rarely found in favor of employees who try to get special privileges and exemptions based on their religion, especially when that religion interferes with the normal operation of a business. Can you imagine GM having to shut down their production lines every hour because a different group of people needed to pray for 15 minutes? I can't. - evilTak, on 10/12/2007, -1/+8If a doctor truly believes that abortion = murder, he still knows that abortion is an option. He should inform his patient and LET HER MAKE HER OWN DECISION.
It isn't like writing a prescription, it's like saying, "There is a drug called Abortimax that some people with your condition use. It has some side effects that I personally don't like, but it's your decision if you'd like to try it or not." - drmangrum, on 10/12/2007, -0/+7@toconnor
This isn't about which drugs to use, this is about treatment alternative. Although, most doctors will discuss with you all the medication available and tell you why they made the choice they made.
Let's say you get cancer. There are several treatment options: You could go the surgery route, you could go the chemo route, or you could go the radiation route. What if your doctor told you the only treatment available was the chemotherapy? What if your doctor made you go through months of painful and dangerous chemical bombardments for a cancerous growth you later found out was a simple, routine surgery? What if you found out the reason your doctor didn't tell you was because they didn't believe in surgery for some wacky reason? - asdfasdf, on 10/12/2007, -3/+9"Actually I think the answer would be to find a doctor that holds your same moral beliefs. I wouldn't want my doctor recommending or prescribing a treatment that was against my own moral/religious beliefs and not telling me about it."
The doctor shouldn't ask you what your beliefs are. It shouldn't be something written on your driver's license or passport. The whole point is that the doctor tells you ALL your options, and then it's up to YOU (yes you, you're a big boy now, right? You don't need mommy or daddy or your priest to make your decisions for you) to decide what option to use.
"Those who say the doctors that have done this should lose their license are simpletons. The first rule of medicine is "do no harm". If the doctor feels that a certain treatment does harm, should he lose his license? No. You should find another doctor."
You, my friend, are a simpleton. Keep in mind that most people who visit a doctor will not seek a second opinion, nor will they consult the 'net for further advice, simply because they believe (and rightly so) that the role of a doctor is to diagnose them and give them all available options.
I believe that doctors who don't check their religious, ethical, moral and philosophical beliefs at the door and do their job as a doctor, and not God, or a priest or a preacher, should most definitely have their license suspended. Another possible option would be to make it law to have a big sign up in their office disclosing what type of treatment(s) they are against. - wrongwayrob, on 10/12/2007, -3/+9@JoeRandom and anyone else who is ready to start burning torches and run all the doctors out of town, perhaps we should think about why this happens...
I think that this study is a little misleading. Often, the doctors won't give you all the options specifically because they fear being sued. If they weren't knee-deep in frivolous lawsuits and paying malpractice insurance out the arse because of it, they may be more prone to share options that are either slightly less tested or more risky.
Yes, in all honesty, you alone should be allowed to make the final decision on your treatment, but until patients are willing to take responsibility for their choices, doctors aren't going to give them as many to make. - pyper, on 10/12/2007, -0/+6@sonaboy your right it's not just doctors than need to be watched. It's more prevalent than you think a major medical journal was almost shut down, when trying to bring to light similar practices by pharmacists over the Plan B contraceptives (morning after pill) they were asking all kinds of inappropriate questions, such as questions about their sex lives.
Plan B article http://www.cmaj.ca/cgi/content/full/173/12/1435
Pharmasists response http://www.cmaj.ca/cgi/content/full/174/1/64 - ray901, on 10/12/2007, -1/+6How do Doctors who refuse treatment according to their 'morals' reconcile this with the fact that they work in a striclty scientific field. If a Doctor believe in god to such an extent that they will refuse/withhold treatment due to their beliefs then their treatment should mostly consist of 'I will pray for you'. Either god is on top or he's not, they cannot put him on top just when it suits them.
- ray901, on 10/12/2007, -1/+6"OK, so teachers are only allowed to present ONE option of creation theory."
Who told you that - whoever it was is either wrong or is manipulating you. It is completely untrue. - s0nicfreak, on 10/12/2007, -0/+5@gabriels
The morning after pill prevents a baby from being conceived. If you consider morning after pills as killing, condoms and birth control pills must be too... - wobitnobby, on 10/12/2007, -0/+5This article specifically chose morally controversial topics, not ones with high risks and rates of lawsuit. If they wanted to assess lawsuit, they'd've looked at forceps delivery, or emergency room care. I think they did a good job excluding the malpractice hoopla.
- drmangrum, on 10/12/2007, -0/+5I fully understand where your coming from. The only problem, as I see it, is most people find a doctor, and stick with them for as long as they can. For the most part, your doctor visits consist of yearly physicals, maybe a minor illness here or there. The treatments you receive are usually standard medicine that a proactive patient could look up on their own and then confirm with their doctor.
Doctors, by their very nature, have earned a monumental amount of trust. The doctor that you frequent only has that trust multiplied. When some major illness or injury does happen, you don't typically second guess the expert. Your scared, your vulnerable, and you want to get better. Keep in mind that nobody thinks their doctor is a "bad doctor"...they wouldn't see them if they did. There is an enormous violation in the trust a patient gives a doctor if the doctor doesn't cover all the bases. - drmangrum, on 10/12/2007, -0/+5You do know there is a difference between the separation of church and state and business right?
Schools are typically run by the state, religion shouldn't be injected into the curriculum.
Medicine is a business. If a client ( patient ) decides they want a Muslim/Christian/Atheist doctor, that is their prerogative. The doctors job is to treat the patient. If their personal belief system interferes with their ability to choose the proper treatment, they should have their practitioners license revoked and be fully prepared for the malpractice lawsuits to come rolling in. - tooasianguys, on 10/12/2007, -0/+4I don't agree with the notion that physicians exercise religious beliefs when treating others. Nowhere in the oath you take to be a physician, and swear to uphold, does it say that you will follow your personal beliefs.
- concertina, on 10/12/2007, -0/+4@gabriels
Stop trying to confuse the issue by substituting terms interchangeably. Life (in the sense that bacteria are alive, or single-cell organisms are alive) may begin at conception, but when *human* life begin, ie, when an embryo is considered to be a human and not merely a lump of cells, is entirely up for debate. - ICSU, on 10/12/2007, -0/+4Some??
- insomniac8400, on 10/12/2007, -0/+4They need to revoke medical licenses when doctors won't do their job because of some dumb religious objection.
- wobitnobby, on 10/12/2007, -0/+4We do our best to ask people on the way in (if they are talking) and if we know they are Jehovah's Witnesses we will make sure they are fully practicing, and then cool it on suggesting transfusion or transplantation. I'm still in the pre-clinical years, so hopefully I'm part of the wave of new, more sensitive physicians!
- littlesaint, on 10/12/2007, -0/+4...it kills a human life...
Depends on your definition of "human life". Doctors apply the lethal injection during executions, which is much more in conflict with the oath than abortion, again depending on your definition of "human life". If a doctor feels abortion or execution is wrong, good for him, but as his patient, I should know this upfront so I can make my own informed decision about my quality of care and options. - inactive, on 10/12/2007, -0/+3You know what pisses me off? People will get up in arms if a Muslim won't let you take alcohol in a taxi cab, but if a Christian doctor refuses to inform patients of treatment options based on his or her religious beliefs, suddenly it's okay. The hypocrisy astounds me.
I have nothing against people having the right to follow whatever beliefs they so choose, but imposing those beliefs on others is an entirely different matter. Okay, fine, refuse the treatment, but you better damn well be ready to turn that person to someone who will give the treatment. I would never impose my religious beliefs on anyone else, and I sincerely wish that I could get that same courtesy back. - ray901, on 10/12/2007, -0/+3I did not know about bioethics - thanks for the heads-up
though wiki is not the best source: http://en.wikipedia.org/wiki/Bioethics - Tebixan, on 10/12/2007, -0/+3"Any doctor that doesnt suggest a treatment based on their personal beliefs is violating the Hippocratic Oath."
While I agree in principal, and I don't really know where to stand on abortion, I just wanted to mention that the original Hippocratic Oath forbids abortion and euthanasia. Then again, the original oath is sworn to greek gods. Just an interesting side note. - GabrielS, on 10/12/2007, -0/+3The abstract doesn't appear to agree with the conclusion.
"Results, Most also believe that physicians are obligated to present all options (86%) and to refer the patient to another clinician who does not object to the requested procedure (71%).
Conclusions Many physicians do not consider themselves obligated to disclose information about or refer patients for legal but morally controversial medical procedures."
I think "Many" is the wrong word here. "Some" is a more accurate description considering that only 14% of the respondants thought they didn't have to present all the patient's options. - wobitnobby, on 10/12/2007, -1/+4Whoa. Whoa, nelly.
I go to medical school.
Pregnancy has ten times the mortality rate of abortion, and birth control is even safer than abortion (also preferable for many other reasons). BUT birth control doesn't always work, nor do all people have access to it.
People are going to have sex, and it's our medical responsibility to try to make that as safe and healthy as possible, to help them avoid pregnancy or achieve it as they choose, and prevent disease. And when pregnancy happens accidentally... 50% of women choose to terminate.
If pregnancy weren't necessary to get children (totally worth it, I'm currently trying to conceive!) we would spread the terrors far and wide, because it puts women at increased risk of hypertension, diabetes, stroke, cardiomyopathy, hemorrhage, hypopituitarism, future infertility, weight gain, nutritional deficiency, mood swings including severe depression. - Laytonx, on 10/12/2007, -1/+4This is really only a problem in the US. When talking about western countries at least.
- nolt, on 10/12/2007, -0/+3interesting how most people would collect a number of bids or estimates to repair their roof but will often just go with the first thing they hear from a medical professional.
doctors, pharmacists, nurses, and whoever else are still subject to human error and difference of opinion. treatment options are sometimes considered 'standard of care' and sometimes theyre debatable.
people should understand that getting a second opinion is not unreasonable and doesnt necessarily convey a dispute of trust with the original recommendation. health care professionals need to realize this as well. - wobitnobby, on 10/12/2007, -0/+3gabriel, please do not speak for me (a medical student) and my peers about what we are in agreement about.
Any tumor has a unique chromosomal complement, looks human upon karyotype testing. - Cerebral, on 10/12/2007, -0/+3What will happen when you end up with a company who choses an HMO where all the doctors support such madness. Good luck paying for whatever referral you end up getting anyway.
And somehow I do not see how someone who would be morally objected to even 'tell' you about abortion options would recommend you to someone who does... this is just so wrong. Please strip them of their licenses if they do not either give you ALL of your options regardless of how they feel about those options or do not have you sign a sheet of paper when you enter the office (first time paperwork and/or every time you make an appointment) that states exactly what procedures said doctor does not believe in, will not mention, suggest etc. If they allow this to go on then they need to have a different system that would require doctors to register nationally this information so it can be searched while looking for doctors. - concertina, on 10/12/2007, -0/+2The problem is that, in an emergency, you don't have a choice in doctors. Nor do you have much choice when you've just been raped, the window for taking plan-b is closing fast, and there's no doctor in a 300-mile radius who will write you a prescription because he thinks a clump of a handful of cells is human, and you don't have a car.
Having physicians sensitive to the needs of their patients is good. Doctors selectively informing patients based on non-medical reasons is bad. Which is, ironically, the same problem whether you are a jehovah's witness being treated by an atheist, or an atheist being treated by a devout christian. -
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