Posted on 02/12/2007 4:25:47 AM PST by theothercheek
Some doctors believe their moral or religious beliefs give them the right to withhold information about treatment they find objectionable - and to refuse to refer patients to other practitioners to receive such treatment - according to a University of Chicago survey of doctors nationwide published in the New England of Medicine.
University of Chicago bioethicist Farr A. Curlin and his colleagues mailed 12-page questionnaires to 2,000 physicians asking their opinions of three controversial practices - sedating dying patients to the point of unconsciousness; prescribing birth control to teenagers without parental consent; and performing abortions after failed contraception.
Of the 1,144 respondents, 17 percent objected to "terminal sedation," 42 percent objected to giving teens birth control without parents' consent and 52 percent objected to performing abortions after failed contraception.
In the survey, 8 percent of doctors said they were under no obligation to discuss treatment options to which they objected; 37 percent would not necessarily inform patients about their objections; and 18 percent would not send patients to other doctors to receive care they would not provide. Extrapolating from their findings, the researchers estimate that 40 Americans may not be told about all legally available treatments, and 100 million may not be given referrals to other healthcare providers.
The study is the first to attempt to quantify the number of healthcare providers who assert a "right of conscience" or "right of refusal" to prescribe or to fill prescriptions for birth control and "morning-after" pills, to participate in abortions, or withhold care from patients who are near death.
The Stiletto is not a bioethicist, but she is a patient. She does not expect her healthcare providers to provide care they find morally objectionable – nor would she follow medical advice that she found morally objectionable, such as intentionally hastening death.
But in keeping with their obligations under the Hippocratic Oath – which, by the way, forbids abortion and facilitating the death of a terminally ill patient, but compels referrals – The Stiletto hopes that her doctors would tell her there are treatment options other than the ones they discussed; that that they have religious or moral qualms about providing those treatments; and that they would offer to refer her to another practitioner who did provide those treatments.
As this survey suggests that no patient can be absolutely sure his or her doctor is not withholding information important to their health, it pays to explicitly ask whether all treatment options have been put on the table.
Note: In case I did not put all the links in correctly, this is the second item in a feature called "The Daily Blade," and follows an item about Tim Russert on the witness stand in the Libby trial, "The Shoe Is On The Other Foot."
So 52% of doctors think abortion immoral. Funny I've never heard that from the press.
Hmmmm. I wonder if The Stiletto would favor doctors informing their patients seeking abortions that there are other options.
Read though other material on the site and you'll find The Stiletto is against abortion, against embryonic stem cell research and against terminal sedation. Interesting that the Hippocratic Oath forbids abortion - so therefore doctors should be informing their patients of other options if they are to live up to their sworn duties as doctors (it goes without saying that the should not be performing abortions, either).
I read somewhere a while back that so few doctors are signing up for classes in med school on how to perform abortion that many med schools dropped the courses. Only a handful of them still teach this "skill." Unfortunately, there seem to be enough doctors around to provide this service that something like one million babies get aborted each year. These doctors must be killing 'em as fast as they can.
Agreed. But many older people are not computer literate - and those are the very ones that too many doctors push to "die with dignity" - in other words, let us give you a lethal dose of morphine so you don't linger and take up a hospital bed and resources. There is a link in the article I posted about one woman whose family was relentlessly pressured to let their father die with dignity and they relentlessly refused on religious grounds. PS The man is alive and fully recovered today.
And that's it. At that point it is up to the family.
Without family you are at the mercy of those who do not fully have your best interest at heart - assuming you have a decent family... If your family hates you, your better off with the doctor... ;-)
For example, why focus on the 52 percent who objected to performing abortions? What about the 48% that have no problem with it? Shouldn't those 48% also be referring their patients to, say, an adoption agency as an alternative solution?
Given what The Stiletto is purportedly against, how do you explain the thrust of the article?
The article is reporting on the survey that doctors were sent by researchers at University of Chicago - and what this means to patients. There is no question that the three practices are morally questionable, if not outright immoral. But some people might find abortion wrong but terminal sedation of a near-death patient OK (i.e., death with dignity). Others, the reverse. Since the survey did not ask about other controversial treatments, there is no way of knowing whetehr there are other treatments doctors withhold information on or refuse to provide referrals to obtain - maybe there will be a follow-up study.
The point is, you and your doctor may have different moral compasses and if your health is on the line, you better make sure that you know all the options available to you so that you can make a choice that's best for your own health and your own conscience.
No kidding - on both your observations. Did you know that many "symptoms" elderly people have that land them in nursing homes (or in the morgue after a dignified death brought on by the doctor) are due to overmedication? The confusion, failure to eat, dizziness that leads to hip-breaking falls, incontinance, etc. - otherwise competent and relatvely healthy elderly people get turned into addled, frail burdens on their families and on the medical establishment because doctors - often without checking to see what else the patient is on - continually shove pills on them. When you go to the Mayo Clinic, the FIRST thing they do is review your medication vs. your chronic illnesses vs. your symptoms and wean you off many of your unnecessary meds before they assess your health and decide on a proper course of treatment. That way, they are dealing with symptoms produced by your own medical conditions and not by the meds your on.
I think I read pretty much the opposite-that they were being forced to take the courses by some schools in order to graduate.
This gets back to the old line: Do you know what they call the student that graduates at the bottom of his class in medical school?
The answer is: Doctor!
Of course, these doctors need an income, too. I suspect that performing abortions would place them well above the bottom of the income distribution. I also suspect that abortionists are not always the most able doctors in the area. Some might even quit to become politicians?
It's like, gee, I'm personally against abortion, but all doctors should be telling their patients about this option and referring them to Planned Parenthood for more information. Ditto euthanasia and birth control.
What, does this make the author more "fair minded", more "tolerant", more "understanding"? In my opinion, it makes her a hypocrite.
What's next from The Stiletto? She's personally against homosexual behavior and prostituion and drug use, but thinks it should be taught in schools as acceptable alternative lifestyles? Just to be fair, you see. Wouldn't want to be thought of as close-minded or old fashioned, you know.
I can't imagine how that would go over.
All she is saying is, don't assume you and your doctors are on the same page. For instance, a doctor might push you to give an ailing parent "help" to get to the afterlife and withhold from you information about other alternatives. This knife cuts both ways, so I don't see why you immediately assume that someone is for or agaist something just because they advise you to ask your doctor if all options have been presented.
I, myself, was offered medical treatment by a doctor that I found morally unacceptable, but for which no other alternative existed. I was planning to decline and take my chances, but as it happens his initial concerns about the state of my health were wrong and I did not need the treatment he was offering after all.
A brother of mine believes in abortion (I don't) but not in terminal sedation (I don't believe in that, either). Another brother of mine does not believe in abortion, but thinks of terminal sedation as "death with dignity." All three of us were raised by the same set of parents, yet if we all went to the same doctor we would make different decisions based on all the options being presented to us.
The point is, you get all the information then you choose. You don't let the doctor choose for you based on non-medical criteria. Whatever your own set of moral principles are, as a patient ask your doctor whether all treatment options have been discussed. If you hear something you don't want to pursue, all you need to say is, "That's not what I want to do."
I am sure that if some medical school did that, Catholic, Orthodox Jewish and and other religious students would immediately file a lawsuit on First Amendment grounds. Or, they would switch schools.
I agree. It does cut both ways. But in this study it was cutting the conservative way, a way which the author then chose to criticize as one-sided. I would expect to see this type of thing in Newsweek or Time, not on a conservative blog.
"The point is, you get all the information then you choose."
I understand the point. I get it. I even happen to agree with it.
But this particular survey was an odd one for a conservative to use to make this point. She's saying, "Don't feel that that you have to settle for the moral and ethical opinion -- either ask for or go out and find an opinion more to your liking."
This is a conservative blogger saying this, mind you.
Well, not all conservatives agree with one another on everything anyway. Like embryonic stem cell research, for instance. But again, you are reading the advice to ask your doctor whether every possible treatment has been discussed as criticism. Obviously, it is up to you to refuse a treatment you consider immoral. For instance, would I want my doctor to tell me that there is a treatment derived from embryonic stem cells? Absolutely. Would I consent to be given a treatment that required the harvesting of stem cells from embryos? Absolutely not. But it would be my choice to make because I knew all the options, as opposed to the doctor winnowing the choices down using non-medical criteria therefore making the choice for me. See the dif?
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