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Title: Bush's new health regulations Post by: Nik on December 19, 2008, 09:17:36 am This sounds ridiculous to me. Bush is going to pass a law saying that health workers can deny providing care for conditions they disagree with morally.
So, if your local pharmacist at WalMart doesn't agree with birth control, that person can refuse to sell you your legal prescription. This is just one scenario on this very vague law that could have sweeping effects. Obama is already trying to figure out how and when to reverse it. http://www.baltimoresun.com/news/nation/politics/bal-te.abortion19dec19,0,1100701.story Title: Bush's new health regulations Post by: Red Arrow on December 19, 2008, 12:37:44 pm I saw something like this in the news at least a year ago. I believe a pharmacist refused to sell birth control pills somewhere in Kansas.
Title: Bush's new health regulations Post by: Ed W on December 19, 2008, 02:37:34 pm As I understand it, the rule is so broadly written that if the cashier opposes contraception, she can refuse the sale. The Bush administration pushed this one through merely to appease the right-wing fundamentalists and cause trouble for the in-coming Obama administration.
Title: Bush's new health regulations Post by: guido911 on December 20, 2008, 09:32:39 am quote: So, a pharmacist or physician that does not want to sell or prescribe RU-486 or any other drug they find morally objectionable should be forced to sell or prescribe it then? Title: Bush's new health regulations Post by: Red Arrow on December 20, 2008, 11:26:33 am It sounds to vague to me. I wonder how long it will be until stores have to post hours when specific medicines are/are not available due to employee schedules.
This week only... No birth control M T W 10:30 to 4:30 No Blood pressure medicine Tuesday only 8:00 to 6:00 No diet pills W T F 12:00 to 6:00 A bit of an exaggeration perhaps but there are some people out there with moral objections to things most of the population doesn't care about. What's next? Home and Garden store employees could refuse to sell rat poison, insecticide, petroleum based fertilizer? Convenience store employees could refuse to sell beer? Independent businesses and persons should be able to choose what they sell. As an employee of that business, if you disagree with the legally available products, maybe you should seek employment elsewhere. As an employer, you should be able to refuse employment to someone who will not sell your products. Title: Bush's new health regulations Post by: Nik on December 20, 2008, 12:30:43 pm quote: Yes. I don't have a problem with a physician refusing to prescribe medicine, as long as his stances are known in advance. But for any person working at a pharmacy (not just an actual pharmacist, but an hourly employee working the counter) to deny a legally prescribed medication is not right. Title: Bush's new health regulations Post by: cannon_fodder on December 22, 2008, 09:44:29 am What if I feel AIDS is a curse from God unto the homosexuals of America?
Can I refuse to hand out ADT? Or cancer drugs? What if I think STDs are righteous? This law is ripe for abuse. IMHO it allows YOUR religious belief's to control my life. If a certain pharmacy wants to set up and operate under such rules that would be fine with me, but to ad hoc allow certain places at random times to deny me whatever medicine they object to seems unworkable. Title: Bush's new health regulations Post by: guido911 on December 22, 2008, 12:23:20 pm quote: Overreact much CF? Go to another provider if you do not like the fact that a physician/pharmacist might have the audacity to have both moral beliefs and a job. God forbid you and others opposed to this regulation might be a little inconvenienced in exchange for granting health care providers the same rights as you and others have to both work and keep moral beliefs. Title: Bush's new health regulations Post by: waterboy on December 22, 2008, 12:41:50 pm Work and keep moral convictions? Not in any corporate setting I've ever been employed by. I find your argument to be stretched way, way out. Nothing will be manufactured, packaged or sold in America should we all start insisting that our moral convictions be met. The honus is on the worker to move on, or the customer to purchase elsewhere, should they disagree with a business strongly enough. Forcing others to abide by personal convictions that are not universally held is just wrong.
Title: Bush's new health regulations Post by: Gaspar on December 22, 2008, 01:13:15 pm Strange how when you read the actual rule it differs from what is being reported in the news.
The rule prohibits recipients of federal money from discriminating against doctors, nurses and health care aides who refuse to take part in procedures because of their convictions, and it bars hospitals, clinics, doctors’ office and pharmacies from forcing their employees to assist in programs and activities financed by the of Department of Health and Human Services. Looks like it says that if your boss is financed by federal money and he wants you to perform an abortion, you have the right to say no, and request that another physician perform the procedure without having your job threatened. Doesn't really pertain to private companies like your Walgreens or CVS. I don't agree with it. I would say that if you sign on to a job and that job requests that you do things that are against your moral convictions, it is your responsibility to discontinue your employment with that organization. . . But I'm one of those weird "personal responsibility" kind of folks. Title: Bush's new health regulations Post by: swake on December 22, 2008, 01:25:26 pm quote: No medical care at all at a doctors office because the Nurse is a Christian Scientist? No pork at one butcher because he's Muslim, no leather shoes at Macy's, the department manager is Vegan? No Zanax, the pharmacist is into Scientology? No adult movies at the local sex shop, the counter girl is a staunch feminist? Honestly, there are some jobs that if you take the position, you need to understand what it entails. Title: Bush's new health regulations Post by: guido911 on December 22, 2008, 01:46:23 pm quote: That I can agree with. However, if it is my medical practice or my pharmacy, it should be my right to say "no", I do not sell/prescribe RU-486 or provide any abortion services. If I lose business because of that decision, it is my fault. Title: Bush's new health regulations Post by: we vs us on December 22, 2008, 01:51:33 pm quote: Unless we're in rural Oklahoma, and you're the only practitioner in town. At that point, do I have to drive to the next town, or county to buy RU-486? Edit: Or condoms? Title: Bush's new health regulations Post by: cannon_fodder on December 22, 2008, 02:02:27 pm Guido,
You have to keep reading... quote: I specifically said if your pharmacy wants to NOT sell a particular drug, so be it. If an attorney doesn't want to do divorces, then don't. If a factory doesn't want to manufacture sexual devices, they won't. My gripe was in the ad hoc nature of the law as reported. I did not look up the text of the law, if allowed for "moral" judgments then an individual would be free to hinder their employer as they saw fit. Furthermore, if on a moral basis I thought all people having sex before marriage should die of STDs then I could withhold drugs from that particular group (no wedding ring? Enjoy your syphilis!) - or other ridiculous "moral" judgments. You can keep whatever moral beliefs you want, until they hinder your job performance. At which point an employer should be free to fire you. Personally, my religion affords me a 3 day weekend and alcohol at 5pm... but I can't find an employer willing to keep with my moral beliefs. Title: Bush's new health regulations Post by: guido911 on December 22, 2008, 02:13:56 pm quote: I guess so or do not abort your baby. Otherwise, as I stated earlier, do you ignore that practioner's rights and force him/her to do something they morally oppose? Title: Bush's new health regulations Post by: guido911 on December 22, 2008, 02:20:12 pm quote: I read the entire post and my impression from the entire post was your hostility to the regulation, in particular the comment "What if I feel AIDS is a curse from God unto the homosexuals of America?" I guess I misundertood. Perhaps your point is if you have advance notice by your provider about their moral objections to certain drugs/treatment then you are okay with their decision. Am I right? If so, we agree. Title: Bush's new health regulations Post by: cannon_fodder on December 22, 2008, 02:44:56 pm Sorry for being unclear, I'm sure you understand how I put these snippets together in a "drive by" fashion. My position is four fold:
1) An employer should not be forced to be encumbered by his employees religious beliefs. An employee is free to believe and practice as they wish, but no one else is forced to recognize nor accommodate those beliefs. Ie. If my boss wants me to work every Sunday for some reason and I object on religious grounds, he can fire me. And if my boss says I need to hand over birth control pills while working at his pharmacy and I morally object, he should have the right to discharge me from his employment. 2) My second notion would be the need for notice as you outlined. If a pharmacy doesn't sell the "abortion pill" then it should be available knowledge. In such a way it could be uniformly applied to avoid potential pitfalls associated with ones moral judgment as cast upon others. My fear of a good Christian pharmacist refusing AIDS drugs to a man they believe is gay was not in jest . I could honestly see that happening (nor would it be restricted to that religion or that circumstance). I see how this conflicts with my Libertarian philosophy but it is a conflict of rights issue: what's more important, the patients ability to get potentially life saving drugs or the pharmacists right to listen to the voice in their head? 3) These medications are restricted because of governmental action. They require the permission of someone licensed by the federal government to be ordered. They are distributed by governmental approved and licensed institutions. To then appear and request your product and have that denied based on "moral" grounds hits a strange note. Hard to really explain it without spending time drafting an actual position, but a pharmacy acts with governmental authority - placing the action of medical distribution under strict scrutiny for discrimination. This law, as reported, would be ripe for violations. This goes hand in hand with the restricted access argument in small towns, in hospitals, late at night, etc. Because of the restricted access it could be nearly impossible to get certain medications when needed. And finally, 4) the much over used slippery slope argument. More a question of interpretation, but along the same vein. Who gets to decide if their "moral" judgment is legitimate? I assume you are OK with refusing abortion pills, but what about the AIDS question? Or diseases that are endemic to a particular race? Who gets to make the final call as to what drugs you can refuse and to whom? Again, if it is an institutional policy it somewhat quells this argument. But nonetheless you see the pitfalls. Title: Bush's new health regulations Post by: we vs us on December 22, 2008, 03:57:52 pm I'm interested in what "rights" a practitioner has, in relation to what type of medicine and/or procedures he is willing to prescribe/perform. Are you talking about the Hippocratic Oath? Or is there another body of law or tradition that I'm unaware of?
I'd only be "for" these sort of regulations if we could guarantee that every American has a ready second option if his/her primary provider opts out of a given procedure/prescription on moral grounds. So in other words, I'm pretty much against it. Title: Bush's new health regulations Post by: nathanm on December 22, 2008, 04:22:41 pm quote: That encompasses almost every doctor and pharmacy in the country, if not every single one. I take it you've never heard of Medicare? Title: Bush's new health regulations Post by: guido911 on December 22, 2008, 05:27:22 pm quote: I am talking about basic, fundamental rights each of us have in deciding how our lives are led. That's all. Title: Bush's new health regulations Post by: pmcalk on December 22, 2008, 07:31:20 pm quote: Your missing the point, Guido. No one has ever been forced to participate in abortions. Pharmacists can refuse birth control, so long as someone else can fill the prescription. I have no problem with the Federal Government ensuring that individuals can keep their job, and still refuse to perform acts that violate their conscious. But this goes so far as to allow doctors to refuse to even consult with their patients regarding legally permissible treatments. Could you imagine if you had a condition that might pose serious health issues, and that there were a medical procedure that could cure you, but your doctor failed to inform you about that? If a doctor doesn't want to provide a service, then fine, but he or she is a specialist who, like lawyers, should at least be legally required to provide you with all of the options, even when they don't agree morally. Title: Bush's new health regulations Post by: guido911 on December 22, 2008, 08:21:12 pm quote: Can you give me an example of the serious health issue situation you discuss? Title: Bush's new health regulations Post by: pmcalk on December 22, 2008, 09:40:54 pm quote: If you were raped, or if your birth control method were to fail, and if a pregnancy posed a serious health risk to you, most doctors would prescribe the morning after pill upon request. Under Bush's new rule, not only does the doctor not have to prescribe it (forgetting that you many not have any other doctor to which to turn), but your doctor does not even have to tell you that the medication exists. You may not know that there exists an non-abortive method to prevent pregnancy. For many women, this would be a much safer method to ensure their health. But for a doctor who morally objects to the morning after pill, she might not have the opportunity to make that choice. Another example--birth control pills are frequently used to help women with fibroids. Shouldn't a doctor be required to tell a patient what the most effective treatment is for a medical condition? I'm not a doctor, so I couldn't tell you all of the circumstances where this might come into play. Ultimately, I simply believe that, when you contract with a doctor to provide medical care, he or she is at least obligated to tell you all of your legal options for treatment. Failure to do so should be considered malpractice. Title: Bush's new health regulations Post by: Gaspar on December 23, 2008, 06:20:37 am quote: No I understand that. You're right, as we become more of a welfare nation most of our health care is provided by the federal government, and therefore this rule would apply to almost all private health providers too. I said I don't agree with this rule, it's silly to need a presidential decree to protect the employment of someone who obviously disagrees with the practices of their employer. If your moral convictions are so strong that you find it necessary to seporate yourself from the responsibilities of your chosen profession as perscribed by your employer, then your moral convictions should steer you to resign. Here is why this rule is illogical and silly: You are responsible for your own actions, and by association you are responsible for the actions of any company or organization that you support as long as you are aware of such actions. So to simply say "I will not prescribe that drug because it's against my religion" does not make you any less responsible for supporting the company or organization that chooses distribute that product. Therefore if your convictions are really that important the only logical step for you to take, is to resign. If you think abortion is murder, but you are willing to work for the abortion clinic as long as they don't make you perform abortions, than how is that make you any less guilty? Wouldn't that be the same as say, working for a hit-man (as his appointment maker [:P]), having knowledge of the fact that he kills people every day, but then telling yourself that you are innocent because you never pulled the trigger. . . It was against your moral convictions. Poppycock! Nothing but poppycock. This rule is poppycock. Sorry for the strong language. Title: Bush's new health regulations Post by: guido911 on December 23, 2008, 04:15:58 pm quote: First, great point on the pregnancy issue. I would hate to think that the precious abortion right would in any way be interfered with. One solution to this problem is the doctor informing his/her patient up front about their moral beliefs. That way, the patient can choose to go elsewhere. Does anyone in this thread believe the government should force a private citizen to perform an act they oppose on moral grounds? If so, why stop with physicians? Title: Bush's new health regulations Post by: nathanm on December 23, 2008, 07:40:41 pm quote: Part of being a professional is being..well..professional. If you don't like what you're asked to do at your job, you have the same recourse the rest of us have. Quit. Title: Bush's new health regulations Post by: guido911 on December 23, 2008, 08:06:01 pm quote: Good solution. Throw the baby out with the bath water. Title: Bush's new health regulations Post by: nathanm on December 23, 2008, 08:33:33 pm quote: I could say that's exactly what you advocate. Title: Bush's new health regulations Post by: pmcalk on December 23, 2008, 09:09:39 pm quote: Do you ever make your own decision, or do you just believe whatever the religious right tells you?? The morning after pill IS NOT a form of abortion. Next, are you going to start singing every sperm is sacred??? I find it amusing when the religious right gets stuck in these conundrums. On the one hand, you want a small government that stays out of business. On the other hand, you want to force businesses to accommodate religious belief, even if that effects their bottom line profit. Personally, I don't have a problem with the government protecting the employment of those who fail to do their jobs based upon religious ground, so long as people are still assured the right to receive legally permissible medical care. On the other hand, failing to even advise a patient of available care is akin to malpractice. What possible notice could negate that? "You will not receive full medical treatment when you see this doctor"? Or "I will not provide you with the information you need to make an informed decision about your health and your body"? Maybe "There may or may not be other options out there for you, but I'm not going to tell"? You trust your doctor with your life. Is it too much to ask that they actually provide you with information for you to make a decision? Title: Bush's new health regulations Post by: cannon_fodder on December 24, 2008, 08:56:53 am quote: I've been committing genocide for decades. [xx(] Guido: Seriously, if a physician verbally and in writing gave a disclaimer that he may not mention life saving medicine or other procedures, pills, or treatments to a patient because he may morally object to some... then I'd be OK with the law. quote: That is what you are arguing in favor of, then fine. If a patient is dumb enough to agree to those terms I'm OK with it. Anything short of that is allowing a physician to steer the decision making of a patient based on whatever their God(s) tell them to do, without having to inform the patient (that pesky informed consent thing, where a Doctor is supposed to KNOW and reveal treatment options). As a licensed position of trust (professionals having the highest duty to the public, by definition) a medical doctor has a higher duty than Joe the Plumber. If he tells a woman there is no choice, she will believe him. If he answers "there is no choice my God(s) will allow" she will rightly question his medical judgment and go elsewhere. This law would allow an Doctor to abstain from recommending vaccinations because they morally object to it. AIDS programs. Birth Control. Cancer trials. Whatever the hell they want to do, they can and I can't fire them and a patient might not know the difference. YOUR moral convictions are YOUR problem. If YOUR convictions prevent YOU from being employed, so be it. I fail to see why something YOUR God(s) tells YOU should interfere with MY health care or my right to tell an employee what to do. You're argument is that anyone should be able to believe anything they want to and act upon that belief in any manner that it may effect their job performance and not suffer any consequences. Unfortunately, that is not how it works. Next up: Pork slaughter houses that can't discriminate against Muslim or Jewish employees. Got bacon? Title: Bush's new health regulations Post by: Gaspar on December 24, 2008, 11:20:06 am I'm looking to buy a Kosher ham for Christmas. Any ideas?
Title: Bush's new health regulations Post by: Red Arrow on December 24, 2008, 11:39:58 am quote: On your grocer's shelf, right next to the Kosher bacon. Title: Bush's new health regulations Post by: guido911 on January 04, 2009, 12:49:16 pm quote: Since apparently no one has actually looked at the regulation, I thought I would post the HHS press release regarding this rule. There is a link in this press release to the actual rule and its history. http://www.hhs.gov/news/press/2008pres/12/20081218a.html I found it interesting that the liberal 1970s Congress passed laws protecting health care providers that were discriminated against because they refused to perform abortions. This regulation was promulgated pursuant to those statutes. The arguments in this thread, not just from you CF, (perform/recommend abortion or get the hell out of the medical profession) appear to have been a reason for the enactment of the statutes. Title: Bush's new health regulations Post by: cannon_fodder on January 05, 2009, 09:14:20 am quote: What a joke. By law, my doctor is free to tell me he has no treatment to recommend and that I should go home and die - because he morally objects to the treatment. He doesn't have to tell me there is a treatment and he morally objects to it. He doesn't even have to tell me that there are some things he won't tell me because of his moral beliefs. He can hold himself out as an expert and give me inferior care if he chooses to. But it would be nice if he had a conversation with me about it first. Doesn't have to. But the Feds would appreciate it if he did. It's a BS law basically designed to allow doctors to refuse abortions if they want to. It pretends to worry about a "doctor shortage" (which the government is a huge contributor to), but this law does NOTHING to help that shortage. Ultimately, it further limits the number of available physicians until you find someone who has the same moral philosophy that you do (lest you receive treatment in line with their moral philosophy instead of your own). quote: 2008 Federal Register, Document E8-30134, at page 78073. Full access... unless their God(s) doesn't think it's a good idea then you don't need full access to it. quote: Id. at 78074. You still have access to them. They might not treat you or they might tell you there is no treatment... but the access to health care is not changed. It goes on to give MORE lip service to the open conversation and full disclosure, but FAILS to make it a requirement. If an MD doesn't want to perform a vasectomy on an unmarried man, won't perform abortions, or won't treat AIDS patients because he thinks it is a punishment from his God(s), then so be it... advise the patient of such and suggest another MD. Disclose to me that you will not offer me a full slate of treatment and professional advice - and I will go else where. As an attorney I am required to give my client the best legal advice I am capable of, if the client wishes to pursue a course that I am not comfortable with I pass that client to another attorney. It's pathetic that my medical treatment is given less consideration to "client' choice. The full rule, proposed and final, along with comments is available as a txt file below: http://edocket.access.gpo.gov/2008/E8-30134.htm Guido, do you think requiring a level of disclosure similar to that of an attorney is too extreme? Do you see what my real concern is here or am I being unclear? Title: Bush's new health regulations Post by: guido911 on January 05, 2009, 12:51:41 pm CF, I completely understand your point. I guess Congress got it wrong by protecting physicians from discrimination because they dare to morally oppose abortion.
I am coming at this issue as an attorney, former military medic, emergency room tech, and someone intimately related to a physician. To me, requiring a physician to act contrary to their moral beliefs is both intrusive and oppresive. To you, it appears you have no problem with that. Seriously, you would want a doctor that is willing to dump on their own integrity taking care of you? Since you oppose this regulation, to be consistent I would assume you would want to do away with that pesky hippocratic oath thing as well. That whole, "first do no harm", and "respect for every human life from fertilization to natural death" and "reject abortion that deliberately takes a unique human life" is BS anyway, right? Here's the oath: The Hippocratic Oath I SWEAR in the presence of the Almighty and before my family, my teachers and my peers that according to my ability and judgment I will keep this Oath and Stipulation. TO RECKON all who have taught me this art equally dear to me as my parents and in the same spirit and dedication to impart a knowledge of the art of medicine to others. I will continue with diligence to keep abreast of advances in medicine. I will treat without exception all who seek my ministrations, so long as the treatment of others is not compromised thereby, and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient. I WILL FOLLOW that method of treatment which according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous. I will neither prescribe nor administer a lethal dose of medicine to any patient even if asked nor counsel any such thing nor perform the utmost respect for every human life from fertilization to natural death and reject abortion that deliberately takes a unique human life. WITH PURITY, HOLINESS AND BENEFICENCE I will pass my life and practice my art. Except for the prudent correction of an imminent danger, I will neither treat any patient nor carry out any research on any human being without the valid informed consent of the subject or the appropriate legal protector thereof, understanding that research must have as its purpose the furtherance of the health of that individual. Into whatever patient setting I enter, I will go for the benefit of the sick and will abstain from every voluntary act of mischief or corruption and further from the seduction of any patient. WHATEVER IN CONNECTION with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad, I will not divulge, reckoning that all such should be kept secret. WHILE I CONTINUE to keep this Oath unviolated may it be granted to me to enjoy life and the practice of the art and science of medicine with the blessing of the Almighty and respected by my peers and society, but should I trespass and violate this Oath, may the reverse by my lot. Title: Bush's new health regulations Post by: swake on January 05, 2009, 01:31:03 pm There's more than one version of the oath,
Here's the original: I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot! http://classics.mit.edu/Hippocrates/hippooath.html And a more modern version in use by many medical schools: I swear to fulfill, to the best of my ability and judgment, this covenant: I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism. I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God. I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. I will prevent disease whenever I can, for prevention is preferable to cure. I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help. http://www.pbs.org/wgbh/nova/doctors/oath_modern.html Title: Bush's new health regulations Post by: cannon_fodder on January 05, 2009, 03:51:30 pm Guido, you are other entirely misconstruing my point or being very obtuse.
1) A doctor is a professional, their highest duty is to the public by definition. Their moral objection to a procedure is not in service of the public and may admittedly cause medical harm to a patient. 2) The oath you cite "rejecting" abortion is one of several version a physician may take. Not all physicians are required to swear they will not perform abortions. If I wanted to take the confrontational " [your position] is BS anyway" approach I'd mock the "DO NO HARM" by adding "unless your God(s) say it is OK." In fact, the version you cited is strongly in the minority to the Classic or Modern versions, or even "alternative oaths" used by most schools (Declaration of Geneva, Oath of Lasagna). Like most ancient codes, if you are attempting to adhere to it pick your version, translation, and message from it and move on. 3) My position on abortion is very well known, I have delineated it as clearly as anyone else. I am not an abortionist, I think the practice is most often ill advised. This issue is not about abortion to me, it is not about stopping a physician from having a moral objection, and it is not about being "oppressive" to a physicians beliefs. If this is a collateral attack on abortion then we can discuss that in a different thread (honestly, if you have strong convictions about abortion I doubt you would take a position at a job that might put you in the position of performing one). If a physician has a moral object to a task inform the patient that you morally can not perform a procedure. And I don't think requiring full disclosure is oppressing a physician. It is about patient care, plain and simple. 4) THE ROOT OF THE PROBLEM, and the point I am interested in seeing addressed: Under the rule a physician does not have to mention that they are failing to recommend a treatment or give advice based on their moral convictions. Given that criteria, how is a patient supposed to make an informed decision? When a patient goes to an MD for advice, they are seeking a professional opinion and in most cases THE professional opinion. But refusing to give advice based on whatever your God(s) have told you - you are subjecting your patient to the constraints of your beliefs. Can a Scientology Gynecologist simply not mention to a woman giving birth that medication or procedures are available that can help ease pain, because his God(s) tell him that pain during child birth is good for the child? Certain sects of Christianity belief blood transfusions are forbidden by the bible, can an ER physician fail to perform a life saving transfusion and not even mention to the victim/family that they should seek another doctor who might save this persons life? A Muslim cardiac surgeon that doesn't suggest heart valve replacement because they are derived from pigs? You wouldn't be pissed if they didn't even mention it because of their moral convictions? Refusing psychiatric drugs because the person is just possessed? Seriously, there are some odd religious beliefs that could come into play here. In most cases this crap won't be an issue. But in some cases, it will be. My primary objection is that a Doctor is not even required to advise a patient of their options nor inform them that the information they are giving is not complete in order to conform with their religious beliefs. I damn sure want to make my health care choices myself. 99% of the time that means going with what the doctor recommended because I trust that the physician knows more than I do. If I have to wonder if he knows more, and chooses not to tell me because of his beliefs, that decision becomes a lot more complicated. SO... without hyperbole about how related you are to a doctor, or how I hate all moral and just people, or that I only want to associate with people who have no integrity... What would be wrong about requiring full disclosure? And if you don't think it should be required, would you then be comfortable being treated by someone who you know to have a different set of religious beliefs than yourself? And when or if a loved one dies because the MD on call to the ER doesn't believe in blood transfusions, you're going to be OK with that? Title: Bush's new health regulations Post by: guido911 on January 05, 2009, 05:19:58 pm We are getting nowhere here CF. I am not being "obtuse" (a word I have heard you use before whenever I do not agree with you). I just think you are missing my point by miring yourself in the slippery slope.
I have no problem with full disclosure by a medical provider to a patient (whom the physician owes the legal duty) of his moral objections. If that is your position, then we agree. In reading your prior posts, in particular that disclaimer quote, I thought you were mocking that approach. I thought you called a patient "dumb" or something for sticking with a physician that disclosed their moral beliefs. I am through with this thread. Plainly you believe a physician should be forced to pocket their moral beliefs because of their duty to the public and I do not. Title: Bush's new health regulations Post by: rwarn17588 on January 05, 2009, 08:54:02 pm quote: Translation: I'm getting my butt beat by cannonfodder's usual well-thought-out, lucid arguments and am going to change the subject. Title: Bush's new health regulations Post by: cannon_fodder on January 06, 2009, 12:11:47 am Then we agree on the main premise. Professionals should be free to restrict their practice to conform with their moral beliefs. But any professional who restricts their advice/treatment of a client on moral grounds should inform that person of their actions in order to enable them to make an informed decision.
quote: Again, for the 5th time: I believe any professional should be able to act on moral conviction. My caveat is that they should tell the person to whom they owe a duty of that conviction. I have been very clear on this point. And personally, yes, I do believe it would be crazy to stick with a physician who may or may not offer you the best course of treatment based on what they think a God or Goddess tells them to do. I want to make that choice myself and allow my God or Goddess to tell me to do it or not. Extrapolating from that main point - if after being informed that you will not receive the best possible care on account of the MDs moral beliefs - you get treated by them anyway, then come what may. Seems silly to me UNLESS you share their moral beliefs. Which adds a new element to finding a good doctor (graduated from... years practicing, number of malpractice suits, surgeries performed, religious conviction?). And for the record, I only use the word obtuse when I believe a poster is being intentionally daft. I believe you knew what I was trying to say long ago, yet insisted on attempting to get in jabs: "I guess Congress got it wrong by protecting physicians from discrimination because they dare to morally oppose abortion" "requiring a physician to act contrary to their moral beliefs is both intrusive and oppresive. To you, it appears you have no problem with that" "you would want a doctor that is willing to dump on their own integrity taking care of you" "I would assume you would want to do away with that pesky hippocratic oath thing as well" "That whole, "first do no harm", and "respect for every human life from fertilization to natural death" and "reject abortion that deliberately takes a unique human life" is BS anyway, right?" Essentially, most of that reply, which I called obtuse, was a snide insult directed at me. Again, it implies (if not directly says) I hate the morals of others, I like abortions, I want to oppress MDs, I would only want an MD with a lack of integrity, and that I don't think an MD should "do no harm." I do not believe you actually distilled that meaning from my posts. While my hypotheticals are hopefully rare events, your reply was purely emotional and directed at me - not the issue. Hence, I suggested that you were being obtuse. It lacked incite and discernment, intentionally so in an attempt to mock my stance. The alternative was that you really did misconstrue my posts - an option which I readily admitted and attempted to correct by clarify my position in detail. At this juncture it appears your position is religiously based. If your position is mostly religiously based on the abortion issue (this law helps stops abortion, God hates abortion, this law is good) then the topic is essentially dead. Logic and rationality have no place in "faith" issues. As Martin Luther said "Reason is the greatest enemy that faith has . . . Reason should be destroyed in all Christian." If my belief and your faith disagree on an issue we end up discussing Russell's teapot and all sorts of ancillary issues. And I bet no one wants that. Thus, if you really disagree with the notion that a physician intending to limit their care based on their beliefs should be required to inform a patient of such - then I would be interested to hear your position. It appears we actually are in agreement in spite of your conflicting statements. I'm sure we can disagree about the ramification of ones convictions in the workplace (workplace does NOT have to accommodate in my world), so if you would like to disagree on something you can run wild with that one. Otherwise, I shall digress to other issues but am interested to see what becomes of this new edict. Title: Bush's new health regulations Post by: guido911 on January 06, 2009, 09:14:35 am quote: [}:)] Arguing with CF on this issue is getting nowhere. I am fervently against any physician being forced to perform medical procedures that are against their moral beliefs and he is not. I am curious as to which well-thought-argument you are impressed with? Was it that a physician owes a "highest" duty to the public? If so, show me where I can find authority for that. A physician owes a duty to his/her patient and that is all. If a physician owes a duty to the public, then under no circumstance could a physician refuse to provide services to someone they do want to. In other words, every person under CF's well-thought-out argument would be every physician's patient. The issue in this thread is what a physician should disclose to their patient and not to the public. Next well-thought-out argument? Is it CF's refusal to accept that Congress in the 1970s found that certain physicians were being discriminated against by other physicians or health care facilities because they did not want to perform/provide abortion-related services and that Congress passed laws to protect those physicians? Remember, this recent regulation was promulgated pursuant to those statutes enacted by a very LIBERAL Congress. Maybe it was CF's astute observation that the version of the hippocratic oath I quoted was "strongly" in the minority to the "classic" hippocratic oath despite the fact that this "classic" version was quoted by Swake in a previous post and plainly contains similar language. I think CF & I agree that physicians should disclose their beliefs to their patient so the patient can decide whether to continue utilizing that physician. When you argue with someone who has their heels dug in on an issue, like CF & I, it comes to a point where you have to stop arguing--your little douchy post notwithstanding. Title: Bush's new health regulations Post by: guido911 on January 06, 2009, 09:49:06 am CF: My position is not religiously based and it is troubling that you would go there given what I have stated in this thread. Indeed, I could just as easily minimize your argument by saying your position is meaningless because you neither have experience in the health care field nor have you made a legitimate life or death decision. My view on the subject is based on my personal/professional experience in the health care field only.
As for a patient being "dumb" for going to a physician that limits the care they provide based on moral belief, call me dumb then because I will more likely go to a physician that is true to their integrity. Title: Bush's new health regulations Post by: cannon_fodder on January 06, 2009, 09:52:28 am Agree with you Guido... except:
[/quote] I am fervently against any physician being forced to perform medical procedures that are against their moral beliefs and [cannon_fodder] is not.[/quote] I have said repeatedly: "I believe any professional should be able to act on moral conviction." I repeated: I think any professional can abstain from providing services if it is against their moral conviction so long as they disclose that to their patient/client. No doctor should be forced to perform an abortion. No lawyer a divorce. No actuary assign a value to human life. A doctor shouldn't have to perform a procedure they morally object to. An MD doesn't have to abort babies. Not sure how else to say it? And no, the MD doesn't have to post a billboard telling everyone their beliefs. Only the people that they wish to treat. If I went to an MD for an opinion I have a right to be fully informed. If your religious convictions are inhibiting my treatment, I have a right to know about it. No billboards, no disclaimer in their ads. But if a patient comes in and asks your advice anything less than full disclosure is imposing your beliefs on them. - - - And the finding of Congress are as arbitrary as they need them to be to propagate whatever laws they want. You know that very well. They could find evidence to support the sky is green if it helps THAT Congress pass whatever agenda they have or that agency promulgate whatever rule they want. And furthermore, I am not even arguing with that contention. I fully believe MDs are discriminated against as everyone else is that is employed. My question would be to what extent is it discrimination against their beliefs and discrimination against the actions that are precipitated by those beliefs. If I choose not to hire a Jehovah's witness for my ER because we only have one attending at a time and they MUST perform blood transfusions - then it is the ACTION precipitated by the belief which I can not employ. Same would apply to an abortion clinic not hiring a fundamentalist Christian. Or a heart clinic that does pig valves not hiring a Muslim. I think you are confusing belief with action. Actions precipitated by beliefs are not protected to the absolute degree the belief itself is. I can not refuse to hire you because you are Jewish, but as a private employer I don't have to accommodate your belief's (Kosher meal plan in the cafeteria, special non-transfusion schedule, 5 times a day prayer breaks... whatever). - - - - I trust you are not offended by my discussion Guido. If I thought you to be an idiot I wouldn't bother responding to you. The fact that you have a different opinion and are capable of supporting it makes the discussion interesting and worthwhile. Title: Bush's new health regulations Post by: Nik on January 16, 2009, 01:00:07 pm Seven states have sued to prevent this from becoming law.
http://www.washingtonpost.com/wp-dyn/content/article/2009/01/15/AR2009011502059.html?hpid=sec-health |