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Alberta physician refuses to prescibe birth control


jfdes

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maybe she still specializes in the elderly? You can do that in FP to a large extent and restrict your patients. There are even +1 in related areas for family doctors. If so she may have tried to a large extent to actually avoid issues - and this might just be a really isolated aspect forced somehow on her. In that or a similar case then the attention would be certainly less warranted and suggestions of unprofessionalism would be overly hyped to say the least. Perhaps it is time to step back another side of the story - it would be interesting to actually hear what she has to say about it.

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Hmm, so there seems to be general agreement that what she is doing is wrong professionally (by either refusing to leave her personal beliefs at the door, or going into a specialty of medicine that she should have been aware would clash with her religion), although legally she's in the clear.

 

What, if anything, should be done in this specific scenario then?

 

To a very large extent we are a self governing field - and within grey areas we make our own choices. There isn't much to do if she is following the basic rules, except do what we are doing - discuss them understand the issues.

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Just playing devil's advocate here: the CTV article states "Dr. Chantelle Barry is an internist/geriatrician"- so no, it looks like she didn't choose family med.

 

I wonder if there's more to the story here, maybe all the doctors are required to do clinic duty and so she is too. It's not an active decision on her part to be in situations where she may be required to write these BCP prescriptions.

 

How is she working at a walk in clinic as an internist anyway? Is she only seeing adult patients?

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Pertinent to this discussion, there has been some goings-on in Ontario lately similar to this situation.

 

A similar situation happened in Ottawa: Does a doctor’s religion trump your prescription?

 

Also, the College of Physicians and Surgeons of Ontario (CPSO) was looking for feedback recently on its policy on doctors and the human-rights code, not sure if they still are: Policy allowing doctors to deny treatment on moral or religious grounds under review

 

What was interesting from the CPSO article was this bit:

 

"Right now, the CPSO – like the self-governing professional bodies that oversee doctors in other provinces – generally supports the prerogative of doctors to decline providing non-emergency treatment for moral or religious reasons. The policies vary around the edges, particularly when it comes to whether physicians who refuse treatment have a duty to refer patients to another doctor, a perennial and often impassioned debate in the context of abortion.

 

The CPSO’s existing policy includes a list of “expectations” it asks physicians to meet when refusing treatment, including communicating clearly and promptly about their refusal to provide certain services; explaining all clinical options based on the patient’s clinical needs and concerns; behaving respectfully to patients they decline to treat; and advising potential patients that they can see another doctor.

 

“The College will consider the extent to which a physician has complied with this guidance, when evaluating whether the physician’s behaviour constitutes professional misconduct,” the policy says.

 

The CPSO does not insist explicitly on a duty to refer, something Carolyn McLeod, a philosophy professor at the University of Western Ontario, hopes the college will add to its expectations when a new draft policy is produced at the end of this year or early next."

 

Even if physicians do not agree with following through on certain procedures/interventions/services for personal/religious/moral reasons, I think that there should be either a) an explicit duty to refer or B) a statement to patients about what procedures/interventions/services the physician will not perform (or both). It displays integrity to the mission to serve patients' health care needs effectively and respectfully.

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http://www.ammsa.com/publications/windspeaker/doctor-training-juggles-studies-family

 

 

http://uofa.ualberta.ca/news-and-events/newsarticles/2010/06/graduationafamilyaffairforchantalbarry

 

 

"“If kids happen or someone is planning on children, there are ways of dealing with it and getting through it. It is all worth it.”

 

LOOOOL 10 points for you!

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I'd also imagine that accepting this type of behaviour sets a a bad precedent. As rmorelan mentioned earlier in the thread, how far do we allow this to go? Can an emergency physician not provide his or her service because the patient is gay or transgendered? Can a firefighter refuse to put out a fire for the same reason?

 

The reason why I bring up the idea of setting a bad precedent is because you only have to look as far as the democratically-run United States to see the effects that religion can have on policy decisions. There were several versions of a bill proposed in a few states that would allow any individual of that state to reject providing a service on the basis of their religion. The bill was so vague that you could technically get away with providing emergency services. Those who proposed the bill said that was not the case, but the wording of the legislation stated otherwise.

 

This is obviously an extreme example, but I think it's an important one to give. If this type of behaviour is allowed, what stops anyone else from using the same excuse?

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This Dr has no business practising medicine. Imagine the state of the profession if every patient whose behaviour went against our own personal moral code was denied care. Unacceptable. She needs to check her own beliefs at the door and do her job.

 

I am also extremely disappointed by the response from the College here in Alberta, which reaffirmed her right to refuse to provide service, and then had the gall to say that people shouldn't be going to walk-in clinics for birth control anyway, they should be going to their family doctor. Ha! What idealistic BS. Wilfully ignoring that many are without a family doc, and that for some youth who only see their family doc with their parents, they aren't able to address sex/contraception at those visits.

 

A bigger issue brought up by some medical ethicists is that beyond just refusing to prescribe BCP, she is sending a message that sexual health isn't a safe topic to bring up in her clinic, which is an unacceptable barrier to those seeking care.

 

It's examples like this that make me excited for the day when medicine loses the "privilege" to self-regulate.

 

I think I am going to disagree with you here. The physician did not deny care because she is personally against her patient's behavior. That would be discriminatory. She is clearly against the use of birth control (and there are plenty of reasons to be against it). Since birth control is not a medical necessity, why shouldn't the physician have the right to refuse prescribing it? You can not force a Muslim to sell pork, so why would it be wrong for a physician to refuse prescribing birth control because it conflicts with their moral code?

 

 

This idea might seem a bit odd to you but here it is:

Some doctors refuse to prescribe birth control because they believe it disrupts the natural processes of fertility. If fertility is considered "healthy", then the "pill" sickens the body. This is actually an argument I heard from a feminist. Why are women the ones altering the natural processes of their bodies?

 

For moral reasons, some physicians refuse to prescribe birth control because they think that birth control might cause spontaneous abortion (there is conflicting research on both sides). Similarly, others refuse because of the dangers that the pill causes. "YAZ" Yasmin birth control pills are already suspected in 23 deaths.

And lastly, there are the religious reasons, which I will not dwell into.

 

While medical ethicists are claiming that she is "sending a message that sexual health isn't a safe topic to bring up in her clinic", I think she is doing otherwise. She clearly objects to prescribing birth control because she thinks that it serves more harm than good to her patients. By posting a sign, she is doing a favor for her patients by not wasting their time.

 

In my opinion, since birth control is not usually a medical necessity, I do not see why the doctor shouldn't have the right to refuse this request.

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She clearly objects to prescribing birth control because she thinks that it serves more harm than good to her patients. By posting a sign, she is doing a favor for her patients by not wasting their time.

 

As a patient, I would probably be glad she was up-front in not wasting my time, though discouraged and possibly shamed.

 

However, I would far rather see the sign and go elsewhere to a doctor who can have a healthy and meaningful discussion about my sexual health rather than feel bad vibes off a doctor forced to prescribe BCPs.

 

As an aside, I often wonder if there is any movement to have "safe space" stickers in the same vein as public health clinics and university campuses where LGBTQ people can go to. I wonder how many people get poor advice or are stigmatized by health care providers who are uncomfortable serving them. Would probably lead to poor health outcomes and avoidable outbreaks just as it might with the women who can't go see Dr.Barry because she can't discuss sexual health issues. Having a clear sign in clinics or attached to physician registry entries might make the process of searching out a GP much easier.

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I .....

 

In my opinion, since birth control is not usually a medical necessity, I do not see why the doctor shouldn't have the right to refuse this request.

 

How would you feel if she refused to prescribe it to someone like me?

 

Without some form of control over my PCOS, I suffer from a variety of very unpleasant symptoms, a few of which are annoying but some are potentially dangerous. Besides BCPs, metformin and spirinolactone are pretty much the only other two regular medical management options, but they are not ideal on their own. Spirinolactone isn't safe to take while pregnant (problematic for a male fetus d/t antiandrogen effect) so if I'm not on some sort of contraception, prescribing it would be a poor decision.

 

Should she have the right to refuse my request for BCPs as treatment? It is standard, first line treatment for my condition.

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How would you feel if she refused to prescribe it to someone like me?

 

If it's based on ideology, of course it sucks and I disagree.

 

However, I have met GPs who categorically refuse to ever prescribe certain meds simply because they think that the therapeutic benefit is outweighed by risks. Instead of going case-by-case, they are always prepared to say 'no'.

 

In your case, they would be wrong to not prescribe, but they don't seem to mind being wrong. :rolleyes: I feel that maybe that's how Dr. Barry is justifying this policy?

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I think I am going to disagree with you here. The physician did not deny care because she is personally against her patient's behavior. That would be discriminatory. She is clearly against the use of birth control (and there are plenty of reasons to be against it). Since birth control is not a medical necessity, why shouldn't the physician have the right to refuse prescribing it? You can not force a Muslim to sell pork, so why would it be wrong for a physician to refuse prescribing birth control because it conflicts with their moral code?

 

 

This idea might seem a bit odd to you but here it is:

Some doctors refuse to prescribe birth control because they believe it disrupts the natural processes of fertility. If fertility is considered "healthy", then the "pill" sickens the body. This is actually an argument I heard from a feminist. Why are women the ones altering the natural processes of their bodies?

 

For moral reasons, some physicians refuse to prescribe birth control because they think that birth control might cause spontaneous abortion (there is conflicting research on both sides). Similarly, others refuse because of the dangers that the pill causes. "YAZ" Yasmin birth control pills are already suspected in 23 deaths.

And lastly, there are the religious reasons, which I will not dwell into.

 

While medical ethicists are claiming that she is "sending a message that sexual health isn't a safe topic to bring up in her clinic", I think she is doing otherwise. She clearly objects to prescribing birth control because she thinks that it serves more harm than good to her patients. By posting a sign, she is doing a favor for her patients by not wasting their time.

 

In my opinion, since birth control is not usually a medical necessity, I do not see why the doctor shouldn't have the right to refuse this request.

 

A huge part of all medicine is not medically necessary. There are entire specialties in medicine and people in medicine that spend their entire careers doing nothing but medically unnecessary things. The point of medicine is not just to do the necessary but to enhance and promote health. There is a lot more to health than merely staying alive.

 

She isn't prescribing it because it serves more harm than good to her patients - that is exactly the argument doctors would basically universally accept as a good one (they may argue with your reasoning of what is good or bad but that is another story), she is doing it because she personally feels if violates her individual beliefs. It is her interests that she is serving and not the patients. That is the problem I have with this. I don't want my lawyer serving his interests over mine, I don't what engineers building things where their interests are met above the public good, I don't want government officials putting their beliefs above the public's needs, and I don't want my doctor putting their beliefs ahead of mine either. It is a common tenant of what is means to be a professional. We are supposed to be advocates after and the definition of a advocate is someone that supports or promotes the interests of another - in this case the patient. They are the important one in this relationship.

 

Also even if she did believe all the medical complications were valid etc the usually and accepted approach would be to explain all the risks and benefits of the various treatments to the patient, and then the PATIENT decides what to do. We prescribe medications with up to and including deadly complications all the time to patients - as long as the treatment is generally accepted, and the patients are informed and believe the personal health benefits are worth the risk.

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If it's based on ideology, of course it sucks and I disagree.

 

However, I have met GPs who categorically refuse to ever prescribe certain meds simply because they think that the therapeutic benefit is outweighed by risks. Instead of going case-by-case, they are always prepared to say 'no'.

 

In your case, they would be wrong to not prescribe, but they don't seem to mind being wrong. :rolleyes: I feel that maybe that's how Dr. Barry is justifying this policy?

 

Enh, I was just playing devil's advocate and I'm annoyed about the topic in general because of things unrelated to this physician, heh.

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How would you feel if she refused to prescribe it to someone like me?

 

Without some form of control over my PCOS, I suffer from a variety of very unpleasant symptoms, a few of which are annoying but some are potentially dangerous. Besides BCPs, metformin and spirinolactone are pretty much the only other two regular medical management options, but they are not ideal on their own. Spirinolactone isn't safe to take while pregnant (problematic for a male fetus d/t antiandrogen effect) so if I'm not on some sort of contraception, prescribing it would be a poor decision.

 

Should she have the right to refuse my request for BCPs as treatment? It is standard, first line treatment for my condition.

 

She should not have the right to refuse this request. Here comes the paradox with medicine, right? Some medications can treat certain diseases while causing harm to the same body. In your situation, BCPs are used as a treatment.

 

I do not think this physician is completely ruling out BCPs as a form treatment. They're prob her last resort as a form of treatment. Here is why: most patients coming with PCOS symptoms into a physician's office will not go there with the direct intent of getting BCPs, and so the sign is not entirely denying treatment to people who actually need BCPs.

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A huge part of all medicine is not medically necessary. There are entire specialties in medicine and people in medicine that spend their entire careers doing nothing but medically unnecessary things. The point of medicine is not just to do the necessary but to enhance and promote health. There is a lot more to health than merely staying alive.

 

She isn't prescribing it because it serves more harm than good to her patients - that is exactly the argument doctors would basically universally accept as a good one (they may argue with your reasoning of what is good or bad but that is another story), she is doing it because she personally feels if violates her individual beliefs. It is her interests that she is serving and not the patients. That is the problem I have with this. I don't want my lawyer serving his interests over mine, I don't what engineers building things where their interests are met above the public good, I don't want government officials putting their beliefs above the public's needs, and I don't want my doctor putting their beliefs ahead of mine either. It is a common tenant of what is means to be a professional. We are supposed to be advocates after and the definition of a advocate is someone that supports or promotes the interests of another - in this case the patient. They are the important one in this relationship.

 

Also even if she did believe all the medical complications were valid etc the usually and accepted approach would be to explain all the risks and benefits of the various treatments to the patient, and then the PATIENT decides what to do. We prescribe medications with up to and including deadly complications all the time to patients - as long as the treatment is generally accepted, and the patients are informed and believe the personal health benefits are worth the risk.

 

 

"Also even if she did believe all the medical complications were valid etc the usually and accepted approach would be to explain all the risks and benefits of the various treatments to the patient, and then the PATIENT decides what to do."

 

This would certainly be the ideal response to a situation like this, but this is not an ideal world. With this doctor's situation it's a bit more complicated. Not all patients are willing to wait the long hours for the physician to tell them all the options later to refuse to prescribe BCPs. Imagine the frustration the patient must feel. And more importantly, this physician will likely not want to refer the patient to another doctor. The sign makes everyone's life easier.

 

While I agree with you with the point that physicians should serve their patient's interest, I do not think this should be done in the expense of the physician's fundamental rights. Public health should not be designed to serve the patient's interest on the expense of the physician's. Moral codes are inherent to people, and we should not expect physicians to surrender theirs when serving their patients. While birth control seems ok to you, it might not be for others (for the reasons I mentioned above).

 

I think that public health should be designed in a way that physicians are able to conform to their moral integrity while advocating health.

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She has the complete right to not offer OCP to patients visiting her clinic. Would this patient be as pissed off if the sign said "the doc will not perform bronchoscopies?" Moreover, If her patient wanted her to perform EGD on her, would she be expected to perform it ? ( a licensed MD can provide any medical procedure or medication, however they will have to bear the liability of consequences if they were not trained in it).

 

The soft mushy stuff about patient's interest vs her own interests is naive. This patient was not even her own patient so the q of her referring this patient to someone who does prescribe OCP does not even arise. By doing so, she is not denying them care as there is no patient physician relationship, there are tons of family docs in Alberta who prescribe OCP, the patient could go there. Not getting an OCP would not kill the patient, there is no moral or legal obligation on this doctor to provide treatment actively or to actively refer to another physician. The patient is whining about they can't go to other clinics or not getting time off, ya right, docs are in same position to. They are not messiahs sitting there for the entitled patients.

 

The politically correct reason which could save her ass would be to just say "I am not qualified to prescribe OCP." Would save her some nuisance from bigoted and entitled patients and some physicians and the draconian lawmakers.

 

And this is a rubbish logically incoherent article written by a feminist (surprise!). So if euthanasia becomes legal in Canada and if a physician advertises he/she does not provide euthanasia, would this author still be writing "this event makes it seem that it is not ok to ask for or to practice euthanasia." Ad hominem for attacking the doctor as well as logical fallacy of tautology and circular reasoning by saying "doc A does not prescribe xyz. Hence it is wrong to prescribe to xyz."

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She has the complete right to not offer OCP to patients visiting her clinic. Would this patient be as pissed off if the sign said "the doc will not perform bronchoscopies?" Moreover, If her patient wanted her to perform EGD on her, would she be expected to perform it ? ( a licensed MD can provide any medical procedure or medication, however they will have to bear the liability of consequences if they were not trained in it).

 

The soft mushy stuff about patient's interest vs her own interests is naive. This patient was not even her own patient so the q of her referring this patient to someone who does prescribe OCP does not even arise. By doing so, she is not denying them care as there is no patient physician relationship, there are tons of family docs in Alberta who prescribe OCP, the patient could go there. Not getting an OCP would not kill the patient, there is no moral or legal obligation on this doctor to provide treatment actively or to actively refer to another physician. The patient is whining about they can't go to other clinics or not getting time off, ya right, docs are in same position to. They are not messiahs sitting there for the entitled patients.

 

The politically correct reason which could save her ass would be to just say "I am not qualified to prescribe OCP." Would save her some nuisance from bigoted and entitled patients and some physicians and the draconian lawmakers.

 

And this is a rubbish logically incoherent article written by a feminist (surprise!). So if euthanasia becomes legal in Canada and if a physician advertises he/she does not provide euthanasia, would this author still be writing "this event makes it seem that it is not ok to ask for or to practice euthanasia." Ad hominem for attacking the doctor as well as logical fallacy of tautology and circular reasoning by saying "doc A does not prescribe xyz. Hence it is wrong to prescribe to xyz."

 

You make very good points about the fact that there is no patient/physician relationship in the first place.

It's very troubling to see where public health is heading. Forcing physicians to abandon their moral integrity is not a good way to go.

 

The article is extremely biased and unsound. That is true for sure. They make an argument with non-existent claims.

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She has the complete right to not offer OCP to patients visiting her clinic. Would this patient be as pissed off if the sign said "the doc will not perform bronchoscopies?" Moreover, If her patient wanted her to perform EGD on her, would she be expected to perform it ? ( a licensed MD can provide any medical procedure or medication, however they will have to bear the liability of consequences if they were not trained in it).

 

The soft mushy stuff about patient's interest vs her own interests is naive. This patient was not even her own patient so the q of her referring this patient to someone who does prescribe OCP does not even arise. By doing so, she is not denying them care as there is no patient physician relationship, there are tons of family docs in Alberta who prescribe OCP, the patient could go there. Not getting an OCP would not kill the patient, there is no moral or legal obligation on this doctor to provide treatment actively or to actively refer to another physician. The patient is whining about they can't go to other clinics or not getting time off, ya right, docs are in same position to. They are not messiahs sitting there for the entitled patients.

 

The politically correct reason which could save her ass would be to just say "I am not qualified to prescribe OCP." Would save her some nuisance from bigoted and entitled patients and some physicians and the draconian lawmakers.

 

And this is a rubbish logically incoherent article written by a feminist (surprise!). So if euthanasia becomes legal in Canada and if a physician advertises he/she does not provide euthanasia, would this author still be writing "this event makes it seem that it is not ok to ask for or to practice euthanasia." Ad hominem for attacking the doctor as well as logical fallacy of tautology and circular reasoning by saying "doc A does not prescribe xyz. Hence it is wrong to prescribe to xyz."

 

1) Your first argument comparing prescribing OBC to performing a bronchoscopy is crap because everyone who graduates their fourth/third year of medicine is qualified to prescribe OBC. It is not a specialist procedure or an obscure set of medications, it is basic primary care. Not wanting to prescribe it is not the same things as not being able to.

 

2) This is not about "mushy" or "entitled" patients wants, this is about access to primary care which women's health is a big part of. If you ever slime your way into medical school you will learn that OBC is used for many non-prophylactic conditions. This "physician" is taking over the role of a real doctor who prescribes OBC she has a patient relationship in the same way that everyone who comes to emerge to see an emerge doc does. There is a set of basic services that are essential to primary medicine of which this is one despite what your personal stone aged opinion on the matter may be. The patients have gone to see her with the understanding that she is able to provide this service only to find that she does not when it is too late to make alternate arrangements. If she had sent out a letter to every patient in the practice beforehand stating that she would not provide this service then your argument might hold some water. You can always tell when people has never had a real job or lived in the real world because they are so quick to cast of other peoples real problems like not having the ability to get more time off work.

 

3) Every physician is qualified to prescribe OBC. So you don't look like a total moron next time look up the word draconian.

 

4) Most of the people here have taken logic at some point in their education so trying to use some buzzwords and mashing them in with right wing newspeak like "political correct" and "feminism" just makes you look even that more ridiculous. When euthanasia becomes legal here it will be provided by specialists as well, refer back to point 1.

 

OBC is a necessary and essential tool in basic primary care, that is a fact and not an opinion, and especially one that is fit to be challenged by some ignorant premed. Women's health is a major part of primary practice and if this charlatan had a moral objection to it then perhaps she should have chosen a different career path. With any luck she will be forced to soon anyway.

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How would you feel if she refused to prescribe it to someone like me?

 

Without some form of control over my PCOS, I suffer from a variety of very unpleasant symptoms, a few of which are annoying but some are potentially dangerous. Besides BCPs, metformin and spirinolactone are pretty much the only other two regular medical management options, but they are not ideal on their own. Spirinolactone isn't safe to take while pregnant (problematic for a male fetus d/t antiandrogen effect) so if I'm not on some sort of contraception, prescribing it would be a poor decision.

 

Should she have the right to refuse my request for BCPs as treatment? It is standard, first line treatment for my condition.

 

 

Most people who follow this belief system would prescribe birth control if it wasn't for the intent of controlling reproduction. The intent is the important factor and not the result. Thus, under this logic if you give BCP's to someone who needs them for an unrelated medical reason and it results in the prevention of pregnancy there is no problem... but if you prescribe them for the prevention of pregnancy there is a problem. Even though the result is the same in both examples in that pregnancy was prevented, the intent is different and thus in one case a wrong has been committed.

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I don't what engineers building things where their interests are met above the public good

 

 

I think a more apt comparison would involve an engineer being asked to build something he feels is not morally right. For example: if he is asked to build a bomb used to murder innocent people should he be forced to do so?

 

 

So if euthanasia becomes legal in Canada and if a physician advertises he/she does not provide euthanasia, would this author still be writing "this event makes it seem that it is not ok to ask for or to practice euthanasia." Ad hominem for attacking the doctor as well as logical fallacy of tautology and circular reasoning by saying "doc A does not prescribe xyz. Hence it is wrong to prescribe to xyz."

 

I love this and it gets to the crux of it. The freedom of any adult person to morally refrain from an act is of the utmost importance. Even if you don't agree with a particular scenario, it is crucial to support those who exercise this right lest we reach a stage where that freedom is also taken from us.

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1) Your first argument comparing prescribing OBC to performing a bronchoscopy is crap because everyone who graduates their fourth/third year of medicine is qualified to prescribe OBC. It is not a specialist procedure or an obscure set of medications, it is basic primary care. Not wanting to prescribe it is not the same things as not being able to.

 

2) This is not about "mushy" or "entitled" patients wants, this is about access to primary care which women's health is a big part of. If you ever slime your way into medical school you will learn that OBC is used for many non-prophylactic conditions. This "physician" is taking over the role of a real doctor who prescribes OBC she has a patient relationship in the same way that everyone who comes to emerge to see an emerge doc does. There is a set of basic services that are essential to primary medicine of which this is one despite what your personal stone aged opinion on the matter may be. The patients have gone to see her with the understanding that she is able to provide this service only to find that she does not when it is too late to make alternate arrangements. If she had sent out a letter to every patient in the practice beforehand stating that she would not provide this service then your argument might hold some water. You can always tell when people has never had a real job or lived in the real world because they are so quick to cast of other peoples real problems like not having the ability to get more time off work.

 

3) Every physician is qualified to prescribe OBC. So you don't look like a total moron next time look up the word draconian.

 

4) Most of the people here have taken logic at some point in their education so trying to use some buzzwords and mashing them in with right wing newspeak like "political correct" and "feminism" just makes you look even that more ridiculous. When euthanasia becomes legal here it will be provided by specialists as well, refer back to point 1.

 

OBC is a necessary and essential tool in basic primary care, that is a fact and not an opinion, and especially one that is fit to be challenged by some ignorant premed. Women's health is a major part of primary practice and if this charlatan had a moral objection to it then perhaps she should have chosen a different career path. With any luck she will be forced to soon anyway.

 

Seems I touched a nerve here.

 

What does "primary care" actually involve? Do you know that there was a time when primary care docs were once providing specialist procedures such as appendectomies? Do you know that there are some primary care family docs who do actually perform colonoscopies in towns where there are no gastroenterologists/general surgeons? Do you know that internists (internal medicine considered primary care in US) can perform bronchoscopies?

 

If every med student by 3rd/4th year is qualified to prescribe OCP, next time when your thoracic surgeon says no when you ask him to stop your ovaries from popping an egg by prescribing an OCP, take him to the court. After all he was qualified to prescribe an OCP by the time he finished 4th year of med school.

 

And I am not a pre-med. I am a doctor. And yes, I am an avid and avowed anti-feminist. Deal with it. Debunk my arguments, rather than attacking me.

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Seems I touched a nerve here.

 

What does "primary care" actually involve? Do you know that there was a time when primary care docs were once providing specialist procedures such as appendectomies? Do you know that there are some primary care family docs who do actually perform colonoscopies in towns where there are no gastroenterologists/general surgeons? Do you know that internists (internal medicine considered primary care in US) can perform bronchoscopies?

 

If every med student by 3rd/4th year is qualified to prescribe OCP, next time when your thoracic surgeon says no when you ask him to stop your ovaries from popping an egg by prescribing an OCP, take him to the court. After all he was qualified to prescribe an OCP by the time he finished 4th year of med school.

 

And I am not a pre-med. I am a doctor. And yes, I am an avid and avowed anti-feminist. Deal with it. Debunk my arguments, rather than attacking me.

 

Primary care is the field responsible for the first contact and for long term management of a patient with preventive care + chronic disease management being key. A thoracic surgeon, who only works as a consultant, is not responsible for primary care of a patient or things outside of the reason for the consultation. A primary care physician performing specialist procedures is an exception to the rule, is not considered primary care, and has no logical bearing on your argument.

 

I'm not sure if I'm for or against this family doctor, but the points you made aren't helping to support your position.

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Saw this story on the news today, what do people think about this?

 

http://calgary.ctvnews.ca/calgary-doctor-s-refusal-to-prescribe-birth-control-triggers-outrage-1.1890211

 

http://globalnews.ca/news/1421470/debate-sparked-after-calgary-doctor-refuses-to-prescribe-birth-control/

 

(the comments in the second link are especially interesting)

 

On the one hand, the physician's primary role is to look after the patient's best interest, which isn't happening if they refuse to prescribe medication that the patient needs. On the other, it isn't fair to physicians to force them to perform medical services that go against their religion (this is supported by law, and as long as they refer to another physician they're legally entitled to uphold their beliefs).

 

Most of the news stories I've read seem to be slanted against the physician, and the one I saw on TV even had representatives from the PC Party of Alberta and the Sexual Health Centre speaking out against it and saying they would look into this issue.

 

At the end of the day, a doctor is still a person as much as the patient is and there should be no professional obligation to do something that could harm their self respect or dignity. It would be her professional obligation to prescribe if she was the only accessible doctor in town but thats not the case. The patient can seek prescription elsewhere without a hassle.

 

Stakes change in an ER. There is a professional obligation to act in the best interest of the patient involved in an emergency. Time is of the essence and her professional obligation would take precedence.

 

Just as any healthy relationship, they have rights and responsibility. Her decision is well within the code. However refusing treatment to a particular sexual orientation like someone mentioned, regardless of her moral or religious beliefs, is a human rights violation.

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Seems I touched a nerve here.

 

What does "primary care" actually involve? Do you know that there was a time when primary care docs were once providing specialist procedures such as appendectomies? Do you know that there are some primary care family docs who do actually perform colonoscopies in towns where there are no gastroenterologists/general surgeons? Do you know that internists (internal medicine considered primary care in US) can perform bronchoscopies?

 

The tone used against you is unfortunate, but none of this has anything to do with "primary care" standards. The argument is that prescription of an OCP for contraception on request and where no contraindications exist is "standard" care. There are multitude other such "standards" that are usually defined by consensus or, sometimes, official guidelines. I understand the "conscience" argument - especially as it applies to more important issues - but I'm not sure it's especially relevant for something like an OCP. On the other hand, there are still countries where both OCPs and abortion are actually illegal (or recently were), so there may be a question of a Canadian vs foreign standard here which isn't readily reconciliable.

 

If every med student by 3rd/4th year is qualified to prescribe OCP, next time when your thoracic surgeon says no when you ask him to stop your ovaries from popping an egg by prescribing an OCP, take him to the court. After all he was qualified to prescribe an OCP by the time he finished 4th year of med school.

 

Definitely something to remember next time I'm in seeing "my" thoracic surgeon for that next wedge resection.

 

And I am not a pre-med. I am a doctor. And yes, I am an avid and avowed anti-feminist. Deal with it. Debunk my arguments, rather than attacking me.

 

I'm not sure what an "anti-feminist" is.

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