meganbmoore: (Default)
[personal profile] meganbmoore
 Most, I assume, have heard of the proposition that will allow doctors to refuse to perform abortions or provide any sort of preventive medicine or procedure on moral grounds with no consequences.  Apparently, it now goes into effect within 30 days.  Doctors will not be required to offer any aid, or to direct patients to another physician.

This post by [personal profile] naamah_darling links to the actual proposition, and lays things out pretty clearly, and I recommend everyone reads it.  If you look in the comments, any objections to having a problem with this proposition are pretty well addressed.

Now, here's the thing:  I support sticking up for your beliefs.  However, the entire point of taking a moral stance-any stance-is that you make that stance with a willingness to accept the consequences, understanding that there will be consequences.  It means choosing your beliefs over  what is accepted or expected, knowing that you may be condemned for them, and may even suffer for them.   A doctor refusing to offer services under this law will not be making a moral stance.  He or she will be will face no consequences for their actions.

Anyone who went into a medical field where they would be expected to perform abortion or provide other preventive measures within the last few decades knew that is something that would be a part of their duties.  They already made their moral decision.  It's a part of their job, and this law allows them to refuse to do their job with no consequences.  (Actually, that's not true.  The patient has to face the consequences of the doctor's decision.  Other, better people have ranted about that.)  There are medical fields a person can enter where this would never be an issue.

Is it different if a person has a moral conversion, for religious reasons or not, after entering the field?  Yes.  And at that point in time, they should make the choice between their job and their morals.  Not say "well, I no longer feel comfortable with this aspect of my job, so I now refuse to do it, but I don't expect to be held accountable for this, be it reprimand, paycut, suspension, or job loss."

And, quite frankly, how long do you think it will be before this is used to justify refusing other treatments?  Refusing treatment because of a moral objection to homosexuality or different religious beliefs?  Because of a drug overdose?  Because of gang related injuries?  Injuries caused by substance abuse?

And after that, how long until treatment is refused for more personal reasons?  The kid who bullied you in school, that person who cheated on your kid or sibling when they dated, the speaker at a political rally you disagreed with, your ex?

Because if you think it won't spread to anything else, even if it does take a while, I think you are very, very sheltered.  At best.

And as this is largely being portrayed as a religious issue in the media(though not by anyone on the f-list I've seen, or any of the OP-ers I've been linked to), I'd just like to mention that not every Christian believes in forcing their beliefs on others, or expecting them to adhere to the rules they live their own lives by.  Nor does every Christian pass moral judgement on people who don't live by their rules, or expect others to make exceptions for them.  Most are too busy living their lives to dictate how others should live theirs. 

And now I'm going to go read something that actually makes me happy.


Note:  This post is not about abortion.  Very bluntly:  if you comment defending or condemning abortion, or anything close to either-or, for that matter, stating that this is about abortion-I will delete your comment, even if I agree.  Abortion itself is not the point here. 

ETA:  No, really, that note in bold?  I meant it.  Any comments condemning or defending abortion, especially those directed at other commenters, are being deleted.  Period. 

ETA 2:  To clarify:  I consider this to be an issue important to female rights because it's refusal of medical treatment that is specific to women.  Honestly, do you really think a law would be passed saying doctors could refuse male-specific treatments because they don't agree?

Date: 2008-08-23 08:11 pm (UTC)
From: [identity profile] paperclipchains.livejournal.com
I can't say that I really feel that this is a slippery slope issue, but at the same time, I can't say that I agree with doctor's refusing to perform abortions. I agree that tehy should face consequences.

Date: 2008-08-23 08:15 pm (UTC)
From: [identity profile] meganbmoore.livejournal.com
It's the kind of thing they like to whip out as "precedence," which is why I see it eventually becoming slippery slope, even if it takes a decade or two.

And yeah, because who will refuse to do it? Would do it if they might get in trouble.

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Date: 2008-08-23 08:16 pm (UTC)
From: [identity profile] danyellalot.livejournal.com
I completely agree with you. One should not be a doctor if they cannot bring themselves to do their job/handle the consequences due to not doing their job.

Date: 2008-08-23 08:18 pm (UTC)
From: [identity profile] meganbmoore.livejournal.com
Yup. If a person made the stance 6 months ago, I would respect them for standing up for their beliefs. If they make the stance 30 days from now, I will have no respect for them.

Date: 2008-08-24 12:14 pm (UTC)
From: [identity profile] lady-ganesh.livejournal.com
Exactly. It's not like there are only two or three careers in medicine to choose from, either.

Date: 2008-08-23 08:28 pm (UTC)
From: [identity profile] laura-holt-pi.livejournal.com
My mother was a midwife. Her whole reason for working in that field was to help keep babies alive. Thankfully, in her day, her right to refuse to kill them was protected by law.

If people want to kill their children, then they should arrange some sort of system like your country has for executing criminals, it is, after all, the same thing. Doctors and nurses are not supposed to be killing people. To force them to by law is an abomination.

Date: 2008-08-23 08:34 pm (UTC)
From: [identity profile] meganbmoore.livejournal.com
As I said, this is not about abortion or opinions on abortion.

No one is forcing doctors and nurses to do anything. They entered a field (conveniently enough, a higher paying field) knowing that it would be expected of them. They made a choice, and are refusing to face the consequences of their actions.

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Date: 2008-08-23 09:09 pm (UTC)
From: [identity profile] mekosuchinae.livejournal.com
Nitpick: no doctor is forced by law to perform an abortion. The only doctors legally mandated to do so are ... doctors who perform abortions.

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Date: 2008-08-24 12:25 pm (UTC)
From: [identity profile] lady-ganesh.livejournal.com
Last I knew, midwives were still not allowed to perform surgical abortions, so refusal to do them is not a problem. If other people feel as your mother did (and you clearly do), they are free to choose midwifery as a career, not OB-GYN.

Date: 2008-08-23 09:00 pm (UTC)
From: [identity profile] madame-manga.livejournal.com
A few decades ago, it was extremely common for medical professionals, pharmacists, etc., to refuse treatment to certain people or for certain conditions, and refuse to prescribe or dispense certain medications. It's only in fairly recent years that there's been any presumption that a patient deserves treatment no matter what the circumstances.

So there are plenty of people currently in the medical field who entered practice at a time when they would not have expected to have to do anything they didn't personally want to do. The atmosphere has changed only in the last 15-20 years, and even then only in some parts of the country. So though I personally would argue for equal treatment as a basic right for patients, I can't actually claim with justice that everyone who refuses it is violating a condition under which they were certified to practice. I think that medical professionals ARE morally obligated to act without prejudice. But that's not actually a majority opinion in this country.

In effect, what's being proposed is a return to the former status quo, not a brand-new strike against the rights of the medically-discriminated-against. Encoding it into law isn't new either, since of course there used to be numerous laws forbidding various forms of medical fertility control, and keeping the races separated. That's right, in the United States of America within living memory there were entire hospitals that didn't admit non-whites as patients. Not to mention medical schools that refused to train non-whites or women as MDs. (Mopping the floors and emptying bedpans was usually a different matter.) This is nothing more than an attempt to regress to the bad old days.

Date: 2008-08-23 09:14 pm (UTC)
From: [identity profile] laura-holt-pi.livejournal.com
Abortion is not medical treatment. It doesn't make anyone better.

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Date: 2008-08-23 09:54 pm (UTC)
From: [identity profile] meganbmoore.livejournal.com
Oh, trust me, I definitely view it as a return to old ways. And not good old ways.

Even limiting it to 10-15 years, though, that's still a lot of practitioners who made the choice, and I do think that when you enter the field, you make the choice to put your patient's needs before your preferences.

ETA: There's also the fact that they had the choice to change jobs when they were expected to do things they weren't before, but they made the decision to keep their jobs over their personal stances.

Date: 2008-08-23 09:01 pm (UTC)
From: [identity profile] siedhr.livejournal.com
Man, you Americans are getting crazier laws by the minute. What is this, Bush's last stand?

I'm a doctor and I believe that refusing to provide medical services for any reason is wrong and a just reason for removing the license to practice. I honestly can't think of any reason that would justify not doing your job (except for illegal acts, of course - there could be a discussion about abortion legal/illegal, but it's not the place for it here). Would I like to provide medical care to a pedophile/rapist/murderer? No, but I'd still do it, cause it's my fuckin' job. And at the same time, I'm staunchly in favor of the death penalty for all of the above.

There are ways to avoid facing these ethical dilemmas that allow for respecting the tenets of the medical profession. For example, choosing another medical field. There are so many and despite what people think, there is not much difference between them as far as the medical act and the relationship with the patient are concerned. Of course, most OBGYNs happen to have a pole up their asses (they think they're all that etc). Most gynecologists choose this field for the prestige and the money.

Any medical field involves taking hard decisions. I mean, you have people's lives and well-being in your hands. If one cannot take the heat, one should go into research or statistics (cause there are medical fields that don't deal with patients and ethical decisions at all).

I found a modern version of the Hippocratic Oath (http://www.pbs.org/wgbh/nova/doctors/oath_modern.html) that I'm very much in agreement with. We as doctors leave at the door the right to act on our moral judgments on others. All we can do is serve the patient and the tenets of our profession.

Date: 2008-08-23 10:01 pm (UTC)
From: [identity profile] meganbmoore.livejournal.com
The last paragraph is pretty much my entire point: it's forcing your moral stance and opinions on another and expecting them to live by your personal rules, and putting it beforethe health and well being of your patient.

Date: 2008-08-24 01:24 am (UTC)
From: [identity profile] grey-fuzzy.livejournal.com
Of course, most OBGYNs happen to have a pole up their asses (they think they're all that etc). Most gynecologists choose this field for the prestige and the money.


Really? I should really let my mom and all her other Ob/Gyn friends know about that. Maybe they've been doing it wrong this whole time. *snerk*

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Date: 2008-08-24 12:27 pm (UTC)
From: [identity profile] lady-ganesh.livejournal.com
It is exactly Bush's last stand. See also the brilliant idea to discard scientific evidence when determining which species are really endangered.

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Date: 2008-08-23 09:13 pm (UTC)
From: [identity profile] lesbiassparrow.livejournal.com
Given the general nuttiness of some people I foresee doctors and nurses applying for all sorts of positions where they would be required to do things they morally disagree with and then suing when the employer either refuses to hire them or tries to fire them afterwards. It would be the perfect way to break Planned Parenthood, for example.

It's amazing how none of these things ever seem to result in patients getting more rights. Such as the right to get money back from an insurer that will allow you to get free treatments for impotence but not pay for contraception.

ETA: I would use the feminist rage icon but I don't see that as even a feminist issue. As you said, it is surely only the precursor to all sorts of other treatment being denied to people that a doctor or nurse might morally disapprove of.

Date: 2008-08-23 10:05 pm (UTC)
From: [identity profile] meganbmoore.livejournal.com
The feminism comes in because it's something that specifically affects females. Hence why I would have used it.

And, let's face it, do we really think that if it were medical treatments specific to males, there would be a law saying doctors and nurses could refuse if they didn't feel like it?

Date: 2008-08-23 09:36 pm (UTC)
From: [identity profile] fairest1.livejournal.com
The thing is . . . I don't see being pro-choice and pro-life as being mutually exclusive. There's nothing wrong with deciding that you never wish to have an abortion. It comes down to the matter of letting everyone make the decision for themselves.

But it needs to be a choice.

And I think that if doctors feel they can withhold treatment without consequence, patients should be able to tazer doctors without consequence. Gah.

Date: 2008-08-23 10:06 pm (UTC)
From: [identity profile] meganbmoore.livejournal.com
Your first paragraph is close to my own stance, but again, not talking about abortion as it's only a part of the issue.

And I feel your compromise is the perfect solution.

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Date: 2008-08-23 10:52 pm (UTC)
From: [identity profile] may-flyer.livejournal.com
Wow.

A couple of decades ago, Canada had its own defining pair of cases on abortion rights, the R. v. Morgentaler trials. One of the provincial governments decided to pass a law saying women would have to get approval from hospital-appointed tribunals of physicians before they could get legal abortions. The law was struck down by the Supreme Court, on the grounds that allowing doctors that kind of discretion was a violation of the constitutional guarantee of "liberty and security of person". There are now no legal restrictions on abortion in Canada, aside from the regulations that govern all surgical procedures.

I wonder if this proposition will stand up to judicial scrutiny? I confess that I haven't studied the US constitution enough to know if you have an analogous "liberty and security of person" provision.

Date: 2008-08-23 10:59 pm (UTC)
From: [identity profile] meganbmoore.livejournal.com
As it isn't limited to abortion and lawyers love precedence, i really hope it gets struck down fast.

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Date: 2008-08-24 12:33 am (UTC)
From: [identity profile] logically.livejournal.com
Linking this discussion post in my journal.

Date: 2008-08-24 12:34 am (UTC)
From: [identity profile] meganbmoore.livejournal.com
That's fine. If you don't mind, though, please emphasize that the subject of the post is not abortion, but the larger ramifications of the act.

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Date: 2008-08-24 01:19 am (UTC)
From: [identity profile] grey-fuzzy.livejournal.com
Huh, you have an interesting perspective on this issue that I hadn't really considered. I look at it more from the doctors side however. Take my mother, for instance. She's an OB/Gyn, and she performed abortions for quite a few years after opening her own practice. However, after seeing many, many cases of what seemed to her to be frivolous abortions (people deciding that they just didn't feel like having a baby, after already letting the pregnancy progress to a late stage, etc) she decided to stop.

We aren't much of a religious family, so that was never really a part of it for my mom. However, the people that go through medical school to become obstetricians I think can be generalized as people who respect life. These are people who devote most of their lives trying to keep fetuses alive and healthy. It's not an easy job either- babies are often born in the middle of the night, and doctors still go to work the next day, sometimes going a few days without sleep. Not only that, but every time a woman miscarries, these are doctors that have to witness (experience, even) the heartbreaking pain of the would-be mothers.

Having these experiences can make a doctor extremely uncomfortable if she feels that the decision to have an abortion has been made lightly. My mother hasn't performed an abortion in many years; it doesn't mean that her patients that need abortions don't get them, it just means that someone else provides them (usually the local Planned Parenthood.)

Remember, this isn't about a doctor refusing a specific patient, this is about a doctor choosing not to do a specific procedure. I think that's an important distinction, because doctors 'refusing' to do procedures isn't exclusive to abortions. My mother doesn't deliver twins though she is qualified to, for instance, because she feels that an obstetrician with that specialty should do it. Basically, doctors have various reasons that they may choose not to perform a specific procedure. Remember that physicians do not operate on their own family members because it may obscure their judgement. Most physicians take their jobs very seriously (with good reason,) so if one decides to not do a certain procedure, I think their judgement should be respected: their decision may well be to the patient's benefit.

Also, I think you're looking at the wrong slippery slope: a bigger problem in the future of medicine (obstetrics in particular) is going to be the lack doctors left to even do procedures! Outrageous malpractice premiums are already are forcing many doctors to leave the business because they simply cannot make enough money to pay the required insurance.

Date: 2008-08-24 01:38 am (UTC)
From: [identity profile] meganbmoore.livejournal.com
Ah, but see, you're looking at it only from the abortion perspective. The act allows a doctor to refuse any sort of preventive measures, including birth control medications that are for helth reasons, and can't be found elsewhere.

If it was just abortion, it wouldn't be nearly as much of an issue, because there would still be abortion clinics. This would allow a doctor to refuse to prescribe any sort of medicine that has preventive qualities, or any sterilization procedures. In addition, a lot of insurance companies will only allow you to go to certain doctors, sometimes only to one or two places. (A major employer here, for example, only covers doctors associated with one hospital.) If no one covered by your insurance will do it, you're out of luck.

I do agree that it sometimes seems that there are "frivolous" abortions, but I think that's another subject altogether. It isn't the one procedure, but an entire field. I also assume (from what you say) that your mother does direct people elsewhere for procedures she doesn't perform. This act doesn't make any mention of that courtesy. You also mention that she has a private practice, so presumably, she lists off what services she provides, and what she doesn't. With this, a doctor can decide at any point in time what they will and will not do, even after charging for consultations.

I do agree that doctors have difficult jobs, and have to make hard choices, but I don't think this is the right answer.

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Date: 2008-08-24 01:27 am (UTC)
From: [identity profile] kimiren.livejournal.com
Thank you. I find myself agreeing to everything you've said. May I have permission to quote you on my journal?

Date: 2008-08-24 01:28 am (UTC)
From: [identity profile] meganbmoore.livejournal.com
Yes. But please emphasize that this post, at least, is not about abortion, or people's opinions on abortion, but about the larger issue.

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Date: 2008-08-24 06:05 pm (UTC)
From: [identity profile] random-angelic.livejournal.com
[livejournal.com profile] paperclipchains linked me here.

You pretty much sum up my own thoughts since my own first thought upon hearing about this was the precedence it sets and the insurance problems. I've linked to here and a couple other places in my journal. I hope you don't mind.

Date: 2008-08-24 06:38 pm (UTC)
From: [identity profile] meganbmoore.livejournal.com
That's fine.

I think "abortion" is such an inflammatory word that it's hard to look past on either side, but it's only one of many problems. A system of checks and balances would do wonders for this act.

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