Thursday, December 20, 2007

New Ethics Guidelines for OB-GYNs

The Committee on Ethics of the American College of Obstetricians and Gynecologists has released a new statement to address the problem of doctors who, usually for religious reasons, refuse to perform certain procedures that their patients need. While a lot of this will refer to abortions, there's more to it than that, for instance there have been cases where doctors have refused to prescribe the morning-after pill after a rape, cases where spousal rape was treated as consensual, etc.

The PDF file has some stupid security lock on it that doesn't allow you to cut and paste from it, so I will just type in the abstract for your reading entertainment.
Health care providers occasionally may find that providing indicated, even standard, care would present for them a personal moral problem -- a conflict of conscience -- particularly in the field of reproductive medicine. Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of religious or moral beliefs on patients, negatively affect a patient's health, are based on scientific misinformation, or create or reinforce racial or socioeconomic inequalities. Conscientious refusals that conflict with patient well-being should be accommodated only if the primary duty to the patient can be fulfilled. All health care providers must provide accurate and unbiased information so that patients can make informed decisions. Where conscience implores physicians to deviate from standard practices, they must provide potential patients with accurate and prior notice of their personal moral commitments. Physicians and other health care providers have the duty to refer patients in a timely manner to other providers if they not feel that they can in conscience provide the standard reproductive services that patients request. In resource-poor areas, access to safe and legal reproductive services should be maintained. Providers with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place. In an emergency in which referral is not possible or might negatively have an impact on a patient's physical or mental health, providers have an obligation to provide medically indicated and requested care.

The Limits of Conscientious Refusal in Reproductive Medicine

There's a lot of stuff there -- every sentence is loaded with meaning. You might want to go to the original and read the whole thing.

A couple of things jump out at me. One is the obvious observation that doctors who withhold care already think they're doing the "morally right" thing, they believe they know better than the patient. So talking about decisions that "conflict with patient well-being" are not likely to compute for them -- maybe withholding care is good for the patient's spiritual, if not physical, well-being.

I just can't see a holier-than-thou sadist sharing an office with a doc who cares -- "practice in proximity to individuals who do not share their views..." The way this works is that these people are absolutely sure that they're right and everybody else is not only wrong, but spiritually inferior to them. No, they're not going to ask a sin-monger to share an office with them.

I'm guessing this will not likely change the behaviors of any physicians right away, but it will be interesting to see what happens down the road when a couple of them start losing their accreditation, when they get their names in the paper for ethical violations.

I don't know what the ethical statements for other branches of medicine say. Of course these OB-GYNs are in the crossfire of the culture wars, dealing with fertility and pregnancy issues. What are physicians obligated to do if they have a gay or transgender patient, for instance, say a young person with a lot of questions? Should they be required to tell the patient if they have a religious duty to misinform them, and give them the name of another doctor who is more likely to be truthful? I think that would be fair.

18 Comments:

Anonymous Anonymous said...

"The way this works is that these people are absolutely sure that they're right and everybody else is not only wrong, but spiritually inferior to them."

Isn't this what TTFers think?

December 20, 2007 4:59 PM  
Anonymous Anonymous said...

"Although respect for conscience is important, conscientious refusals should be limited if they constitute an imposition of ... moral beliefs on patients,"

So, doctors can have a conscience as long as the patient does too. Otherwise, in the case of abortion, say, doctors are required to be accomplices in murder.

Sounds like an accreditation that is worthless- an worse.

Time to have a new association start an accreditation process. One which will obviously have more integrity.

December 20, 2007 5:07 PM  
Anonymous Anonymous said...

"What are physicians obligated to do if they have a gay or transgender patient, for instance, say a young person with a lot of questions? Should they be required to tell the patient if they have a religious duty to misinform them, and give them the name of another doctor who is more likely to be truthful? I think that would be fair."

They should obviously tell them the truth.

Gay- This lifestyle is dangerous, harmful and indicative of and associated with mental disorder. Counseling should allow them to enjoy a heterosexual lifestyle.

Transgenders- There is no proof that anyone's gender differs from that which their chromosomal structure indicates. Accumulated scientific studies have shown no measurable and verifiable benefits from sexual reassignment therapy.

December 20, 2007 5:13 PM  
Blogger JimK said...

B-L, this post is a type that I call "red meat for the right-wingers." It's like feeding a bunch of hungry animals, it's there to get a reaction. A thinking person could get something from this discussion of ethics, too, but I know what's going to happen when I post something like this. Have fun with it, man. You're really telling us, yeah, we are totally impressed with your strong reasoning.

JimK

December 20, 2007 5:21 PM  
Blogger BlackTsunami said...

and i know that i am taking the bait but I am bored.

blog logger, there is NO proof that being an lgbt is a dangerous "lifestyle."

All of the stuff that claims this are either discredited studies or studies taken out of context by the anti-gay industry. No legitimate researcher, physician, etc. has ever said that "homosexuality is a dangerous lifestyle."

A perfect example - there is a claim that lesbians have a high rate of alcohol abuse. However, this claim is a distortion of a study that looked at 35 lesbians who ALREADY had problems with alcohol abuse. The original researcher, Joanne Hall, has said that her study should not be taken to mean lesbians in general. However, if you look on the Family Research's Council's web page, you will see this study cited as such.

As far as mental disorder, the studies say that whatever mental disorder (i.e. depression, etc) stems not from the lgbt orientation but having to deal with a homophobic society.

December 20, 2007 7:28 PM  
Anonymous Anonymous said...

"They should obviously tell them the truth.

Gay- This lifestyle is dangerous, harmful and indicative of and associated with mental disorder."


-Distortion technique #6, Dehumanizing Semantics, and Top Anti-Gay Industry Lie #4, Unhealthy behaviors (i.e. substance abuse, promiscuous sexual behavior) is indicative of the gay or lesbian orientation.

"Transgenders- Accumulated scientific studies have shown no measurable and verifiable benefits from sexual reassignment therapy."

-Distortion technique #1, Using nonrepresentative or out of date studies to make generalizations, or
distorting legitimate studies to give misleading conclusions.


From Holy Bullies and Headless Monsters

December 20, 2007 7:28 PM  
Anonymous Anonymous said...

Andrea- not anonSince I always figure these moronic remarks are made by the same pathetic 1 or maybe 2 N. anons, I know it is no use to suggest they go away. Here at TTF- someone pays attention to them.

December 20, 2007 7:30 PM  
Anonymous Anonymous said...

Thought I would pass this along:

December 20, 2007

Sex Ed Leads to Later Sex

Contrary to prior research, teenagers who receive formal sex education in school are far less likely to have sexual intercourse at an earlier age than those in an abstinence-only program, Reuters reports (news.yahoo.com, 12/19).

The study—which followed more than 2,000 teens between the ages of 15 and 19—found that teenage boys who had sex education were 71 percent less likely to have sex before the age of 15, while teenage girls who had sex education were 59 percent less likely to have sex before turning 15.

“Sex education seems to be working,” CDC epidemiologist and study leader Trisha Mueller told Reuters. “It seems to be especially effective for populations that are usually at high risk.”

According to the story, the study also showed that teenage boys who had formal sex education were three times more likely to use contraceptives during the first time they had sex.

December 20, 2007 8:21 PM  
Anonymous Anonymous said...

"B-L, this post is a type that I call "red meat for the right-wingers.""

Could we get it well-done in the future?

"A thinking person could get something from this discussion of ethics, too, but I know what's going to happen when I post something like this."

Yes, you should. Someone will inconveniently point out that the emperor has no clothes.

"You're really telling us, yeah, we are totally impressed with your strong reasoning."

Not a lot of heavy reasoning necessary to counter your assertion that your opinions are facts.

Well, in fairness, you did also throw one outrageous idea into the mix:

That failure to participate in the immoral actions of others is an imposition on them.

You really don't need to be too sharp to see how dangerous this idea is.

December 21, 2007 10:04 AM  
Anonymous Anonymous said...

It's an interesting and challenging question: what do you do when the accepted standards of practice or the requirements of your work differ from your own moral beliefs? Many people (doctors, lawyers and teachers among them) encounter such challenges. Anon's response seems to be "queer people are bad." Kind of repetitive of her.

Robert

December 21, 2007 11:22 AM  
Anonymous Anonymous said...

I am queer and happy God made me that way :). Happy Holidays!

December 21, 2007 12:39 PM  
Blogger Dana Beyer, M.D. said...

Physicians take an oath that trumps their religious convictions, just as elected officials take an oath that trumps their religious convictions.

A physician that violates that oath should be first censured and, on a repetition of the violation, de-licensed. An official who violates her oath should be impeached.

It really is that simple. If you don't like it, don't enter the profession in the first place.

December 21, 2007 1:14 PM  
Anonymous Anonymous said...

Here's some more news from www.nbc4.com.

Student Says School Asked Her To Cover Up Lesbian-Themed Shirt


RICHMOND, Va. -- A Virginia high school student said she was asked by a teacher to cover up a lesbian-themed shirt or face suspension.

Now the ACLU is involved. Bethany Laccone, 17, said earlier this month she wore a shirt that included two interlocked female symbols to a class at I.C. Norcom High School in Portsmouth.

A teacher told her to cover the logo or go to the assistant prinicipal's office. She went to the office and that's where Laccone said she was told she could either zip up her jacket to cover the shirt, turn it inside out or face suspension.

Officials said she is violating the school dress code against "bawdy, salacious or sexually suggestive messages."

But the ACLU said she has a right to express her lesbian identity.

They want the school to revise its dress code. They've given the school until Jan. 11 to respond.

December 21, 2007 1:36 PM  
Anonymous Anonymous said...

"Physicians take an oath that trumps their religious convictions, just as elected officials take an oath that trumps their religious convictions."

I think we were talking about moral convictions. Doctors have to make choices between right and wrong like everyone else. Can't speak for all religions but Judeo-Christianity doesn't have any conflicts with a doctor's oath.

"A physician that violates that oath should be first censured and, on a repetition of the violation, de-licensed. An official who violates her oath should be impeached.

It really is that simple. If you don't like it, don't enter the profession in the first place."

You're half-right. Any doctor that doesn't revere life and assists in convenience killings of unborn children should be barred from practicing medicine immediately. These social leeches do harm first. Of course, most people think professional censure should only be the beginning of the legal consequences but that's another topic.

Ditto for any physician who doesn't warn a patient about the dangers of homosexuality and the uselessness of sexual reassignment surgery when the patient, especially a youth, indicates they are interested in these things. Doctors should give advice that promotes health, happiness and wholesomeness.

December 21, 2007 1:53 PM  
Anonymous Anonymous said...

"Anon's response seems to be "queer people are bad.""

Robert, what you call "queer people" is not a seperate race of human. They are people who have acquired an irrational desire to behave in a manner detrimental to their health. Jim suggests in the original post that it is unethical and harmful to discourage that desire. He couldn't be more wrong.

December 21, 2007 1:58 PM  
Blogger BlackTsunami said...

blog logger,

so you still push the idea that "homosexuality is a dangerous lifestyle," while ignoring what i posted and what emproph posted as to how this claim is a deliberate lie by the anti-gay industry.

I just wanted everyone to note that.

December 21, 2007 3:09 PM  
Anonymous Anonymous said...

Further interesting. Anon asserts that queer people don't really exist. Does she not then agree with with PFOX's contention that "ex-gay" and "ex-trans" people exist? Even the Catholic church acknowledges the existence of people with intrinsic same-gender attractions.

Dearest anon, you need to get the pronouns correct; when discussing queer people with me (or, if you insist, irrational desires to act against ones own best interests), you should use the pronoun "you." We are not uninterested third parties discussing other people. So perhaps you should have said "You are not a separate race of human being, but have acquired an irrational desire to act against your own health." No need to be rude in the abstract, go for the gusto. Just don't be surprised (or snide) when people think you're impolite.

My friend Dan would insist that Christians are people who have acquired a whole set of irrational beliefs. It certainly is difficult when confronted with the myriad of diverging religious beliefs to determine who has it exactly right. My vote is with Einstein; he seemed pretty bright.

December 21, 2007 6:08 PM  
Anonymous Anonymous said...

Blog logger,

You live in a very insular, sad, frightened little world. I sense from your writing that there is little joy, and little love, in your life. Have a very happy holiday anyway, if you can.

December 22, 2007 12:07 AM  

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