Are Abortions taught in Med School? Debate someplace else though.

[chicagoschool]

Not interested in having a debate on the matter (not here at least). But are such things taught in current Can Med curricula and if so are they mandatory?

[Intrepid86]

Not interested in having a debate on the matter (not here at least). But are such things taught in current Can Med curricula and if so are they mandatory?

 

Yes it's taught. Yes you have to know about it.

[Lactic Folly]

But medical students aren't taught to do them, if that was the intent of the question.

[Karma]

Yes it's taught. Also, even tough it's taught to med students and obgyn residents, in my university the obgyn residents don't have to perform abortions if they don't feel ethically comfortable doing it, I find it very considerate of the faculty, even though it wouldn't be a problem for me.

[aaronjw]

Yes it's taught. Also, even tough it's taught to med students and obgyn residents, in my university the obgyn residents don't have to perform abortions if they don't feel ethically comfortable doing it, I find it very considerate of the faculty, even though it wouldn't be a problem for me.

 

I'm always curious about how OBGYN physicians can get around doing what amounts to a standard medical procedure just because may not be something they personally agree with?

 

I'm sure many physicians might not agree with treating a rapist/child molester/murderer but they still have to do it.

 

What's the distinction?

[chicagoschool]

^ Any employee can refuse work they don't want to do. I can envision many pro-life physicians simply suggesting that the patient contact another doctor.

[Karma]

There are alot of grey areas in medicine, and I think it may be one of them? Also, the doctors' ethics code allows physicians to refuse to do something that contradicts their moral values, as long as the patient gets referred to another doctor.

[aaronjw]

From CPSO:

 

Moral or Religious Beliefs

If physicians have moral or religious beliefs which affect or may affect the provision of medical services, the College advises physicians to proceed cautiously with an understanding of the implications related to human rights.

 

Personal beliefs and values and cultural and religious practices are central to the lives of physicians and their patients.

 

Physicians should, however, be aware that the Ontario Human Rights Commission or Tribunal may consider decisions to restrict medical services offered, to accept individuals as patients or to end physician-patient relationships that are based on physicians’ moral or religious beliefs to be contrary to the Code.

 

Ontario Human Rights Code: Current Law

Within the Code, there is no defence for refusing to provide a service on the basis of one of the prohibited grounds. This means that a physician who refuses to provide a service or refuses to accept an individual as a patient on the basis of a prohibited ground such as sex or sexual orientation may be acting contrary to the Code, even if the refusal is based on the physician’s moral or religious belief.5

 

The law in this area is unclear, and as such, the College is unable to advise physicians how the Commission, Tribunal or Courts will decide cases where they must balance the rights of physicians with those of their patients.

 

There are some general principles, however, that Courts have articulated when considering cases where equality rights clash with the freedom of conscience and religion.6 They are as follows:

 

There is no hierarchy of rights in the Charter; freedom of religion and conscience, and equality rights are of equal importance;7

Freedom to exercise genuine religious belief does not include the right to interfere with the rights of others;8

Neither the freedom of religion nor the guarantee against discrimination are absolute. The proper place to draw the line is generally between belief and conduct. The freedom to hold beliefs is broader than the freedom to act on them.9

 

The right to freedom of religion is not unlimited; it is subject to such limitations as are necessary to protect public safety, order, health, morals, or the fundamental rights or freedoms of others;10

The balancing of rights must be done in context. In relation to freedom of religion specifically, Courts will consider how directly the act in question interferes with a core religious belief. Courts will seek to determine whether the act interferes with the religious belief in a ‘manner that is more than trivial or insubstantial.’11 The more indirect the impact on a religious belief, the more likely Courts are to find that the freedom of religion should be limited.12

These principles appear to be generally applicable to circumstances in which a physician’s religious beliefs conflict with a patient’s need or desire for medical procedures or treatments. They are offered here to provide physicians with an indication of what principles may inform the decisions of Courts and Tribunals.

 

College Expectations

The College has its own expectations for physicians who limit their practice, refuse to accept individuals as patients, or end a physician-patient relationship on the basis of moral or religious belief.

 

In these situations, the College expects physicians to do the following:13

 

Communicate clearly and promptly about any treatments or procedures the physician chooses not to provide because of his or her moral or religious beliefs.

 

Provide information about all clinical options that may be available or appropriate based on the patient’s clinical needs or concerns. Physicians must not withhold information about the existence of a procedure or treatment because providing that procedure or giving advice about it conflicts with their religious or moral beliefs.

 

Treat patients or individuals who wish to become patients with respect when they are seeking or requiring the treatment or procedure. This means that physicians should not express personal judgments about the beliefs, lifestyle, identity or characteristics of a patient or an individual who wishes to become a patient. This also means that physicians should not promote their own religious beliefs when interacting with patients, nor should they seek to convert existing patients or individuals who wish to become patients to their own religion.

Advise patients or individuals who wish to become patients that they can see another physician with whom they can discuss their situation and in some circumstances, help the patient or individual make arrangements to do so.

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.

 

 

Seems rather ambiguous?

[leviathan]

I'm always curious about how OBGYN physicians can get around doing what amounts to a standard medical procedure just because may not be something they personally agree with?

 

I'm sure many physicians might not agree with treating a rapist/child molester/murderer but they still have to do it.

 

What's the distinction?

It's definitely a grey area. Patients have the right to refuse treatment, but they don't have the right to demand treatment. The way I see it, refusing to offer a treatment is different from refusing to treat a particular kind of patient.

[NLengr]

As long as you are willing to refer them to someone who performs abortions (and its in a timely manner), you'll be fine from a practical point of view.

[xkittens]

From CPSO:

 

 

 

Seems rather ambiguous?

 

My jaw=at the floor right now.

Unbelievable. Go Ontario

[holiday1001]

i seem to remember that if you're in a rural location etc where a timely referral can't be made, aren't you essentially forced to do it?

[tberry3]

I'm genuinely curious: are there any other procedures that are affected by these rules in practice, or if it just abortions? The guidelines seem general enough but I've only ever heard of this being applied in the case of abortions.

 

For example, as unlikely as it may seem, have there been cases of doctors who are Jehova's Witnesses refusing to perform blood transfusions for religious reasons?

[lalab]

I'm always curious about how OBGYN physicians can get around doing what amounts to a standard medical procedure just because may not be something they personally agree with?

 

I'm sure many physicians might not agree with treating a rapist/child molester/murderer but they still have to do it.

 

What's the distinction?

 

What if you feel like because of your beliefs, you are not able to give the patient the quality of care they deserve?

[ellorie]

That's what always comes to my mind when I think about this issue.

 

If a physician is, for example, so homophobic that they feel uncomfortable discussing my sexual orientation with me - I would actually PREFER that they openly let me know and refer me to another physician rather than continue to treat me.

 

I think where this really comes into play is in rural/regional locations and in areas where there is a severe shortage of certain services.

 

If you are an ob/gyn in the middle of Toronto who doesn't want to do abortions, probably not much harm in that. If you are the only ob/gyn in the middle of nowhere and you don't want to do abortions - that could get ugly.

 

To keep the topic on track - at Western I believe clerks have the option of doing a half-day at the pregnancy options program during their ob/gyn outpatient block. We also have a lecture on abortion and all the different procedures during second year.

 

We did have a lunchtime talk by someone whose wife was a physician who worked in a larger group and apparently not only did not provide abortions but also refused to refer to another physician for them. Which struck me as super sketchy.

[rmorelan]

That's what always comes to my mind when I think about this issue.

 

If a physician is, for example, so homophobic that they feel uncomfortable discussing my sexual orientation with me - I would actually PREFER that they openly let me know and refer me to another physician rather than continue to treat me.

 

I think where this really comes into play is in rural/regional locations and in areas where there is a severe shortage of certain services.

 

If you are an ob/gyn in the middle of Toronto who doesn't want to do abortions, probably not much harm in that. If you are the only ob/gyn in the middle of nowhere and you don't want to do abortions - that could get ugly.

 

To keep the topic on track - at Western I believe clerks have the option of doing a half-day at the pregnancy options program during their ob/gyn outpatient block. We also have a lecture on abortion and all the different procedures during second year.

 

We did have a lunchtime talk by someone whose wife was a physician who worked in a larger group and apparently not only did not provide abortions but also refused to refer to another physician for them. Which struck me as super sketchy.

 

Very sketchy - and seems inappropriate

 

Our beliefs aren't supposed to trump the patient's. That is almost another form of paternalism.

[aaronjw]

Interesting article on the travel patterns women in Canada must undertake to find abortion clinics which touches on the point you raise about rural locations...

 

http://www.sciencedirect.com/science/article/pii/S0277539513000186

 

That's what always comes to my mind when I think about this issue.

 

If a physician is, for example, so homophobic that they feel uncomfortable discussing my sexual orientation with me - I would actually PREFER that they openly let me know and refer me to another physician rather than continue to treat me.

 

I think where this really comes into play is in rural/regional locations and in areas where there is a severe shortage of certain services.

 

If you are an ob/gyn in the middle of Toronto who doesn't want to do abortions, probably not much harm in that. If you are the only ob/gyn in the middle of nowhere and you don't want to do abortions - that could get ugly.

 

To keep the topic on track - at Western I believe clerks have the option of doing a half-day at the pregnancy options program during their ob/gyn outpatient block. We also have a lecture on abortion and all the different procedures during second year.

 

We did have a lunchtime talk by someone whose wife was a physician who worked in a larger group and apparently not only did not provide abortions but also refused to refer to another physician for them. Which struck me as super sketchy.

[CapillaryWave]

Very sketchy - and seems inappropriate

 

Our beliefs aren't supposed to trump the patient's. That is almost another form of paternalism.

 

It's not really sketchy at all. If the condition is non-life threatening, you have no obligation to treat or make a referral..

[Bangbangbang]

Very sketchy - and seems inappropriate

 

Our beliefs aren't supposed to trump the patient's. That is almost another form of paternalism.

 

I don't agree with this. My beliefs will come over my patients (in certain circumstances). For example, I believe abortion is murder, so I will never complete one or refer someone. If doctors are someday forced to do them, I will have to take a long hard look at my choice of profession.

[Fresh fry]

I don't agree with this. My beliefs will come over my patients (in certain circumstances). For example, I believe abortion is murder, so I will never complete one or refer someone. If doctors are someday forced to do them, I will have to take a long hard look at my choice of profession.

 

Start looking now, if you don't refer someone you will lose your licence after you are appropriately sued into the dust.

[ellorie]

CPSO policy: http://www.cpso.on.ca/policies/policies/default.aspx?ID=2102

 

...the College expects physicians to do the following:...

 

Physicians must not withhold information about the existence of a procedure or treatment because providing that procedure or giving advice about it conflicts with their religious or moral beliefs.

 

Treat patients or individuals who wish to become patients with respect when they are seeking or requiring the treatment or procedure. This means that physicians should not express personal judgments about the beliefs, lifestyle, identity or characteristics of a patient or an individual who wishes to become a patient.

 

Advise patients or individuals who wish to become patients that they can see another physician with whom they can discuss their situation and in some circumstances, help the patient or individual make arrangements to do so.

[aaronjw]

I don't agree with this. My beliefs will come over my patients (in certain circumstances). For example, I believe abortion is murder, so I will never complete one or refer someone. If doctors are someday forced to do them, I will have to take a long hard look at my choice of profession.

 

You really should spend some time consulting the various provincial College of Physicians policies on this because they are quite clear. In short, you're in for a rude awakening if you adopt this stance.

[Bangbangbang]

Start looking now, if you don't refer someone you will lose your licence after you are appropriately sued into the dust.

 

The type of medicine I plan on entering (pathology), I should never be in this situation.

[Bangbangbang]

CPSO policy: http://www.cpso.on.ca/policies/policies/default.aspx?ID=2102

 

Physicians must not withhold information about the existence of a procedure or treatment because providing that procedure or giving advice about it conflicts with their religious or moral beliefs.

 

This says nothing about referrals. I have no problem discussing the options with my patients. But I myself will not give a patient a referral. I would advise them to see one of my colleagues.

[tberry3]

Physicians must not withhold information about the existence of a procedure or treatment because providing that procedure or giving advice about it conflicts with their religious or moral beliefs.

 

This says nothing about referrals. I have no problem discussing the options with my patients. But I myself will not give a patient a referral. I would advise them to see one of my colleagues.

 

In essence then, wouldn't you be giving them a referral to get a referral? In the end, what's the difference, really? I'm not arguing, just legitimately curious as to how that extra step makes a difference morally speaking.