20 August 2008

Screw the patient or why I think the medical profession hates women

I've been reading quite a bit lately about a new movement in the medical profession to acknowledge, affirm, and support medical professionals who refuse to provide legal medical treatment that conflicts with their personal beliefs.

Before I begin my rant about why this causes Daktari's bullshit meter to top out, let's consider the medical professional's side. Let's say the "legal medical treatment" was sterilizing the mentally deficient (who could not give informed consent), irresponsible medical testing conducted on minority groups without their knowledge, or torture? Without a right of conscientious objection, doctors would be expected to participate in such activities just because they were legal. As it is now, the leading professional organization for the medical professions, the AMA, refuses to allow physicians to participate in the execution of prisoners. We would like to think that doctors, soldiers, and the general public would "just say no" when faced with such choices. The legality of the treatment or procedure, they claim, does not supersede the health care worker's individual rights to say no.

That just sounds peachy, but it is also total bullshit.

A blanket right of conscientious objection to deny treatment based on personal beliefs puts life-and-death power in the hands of people only marginally involved in a patient's health care under circumstances in which this is wildly inappropriate. And I think this issue really pisses me because it disproportionately impacts women.

Case in point, the issues that are causing the greatest objection among health care workers fall squarely into two camps: women's reproductive health, and end-of-life issues. Oh there is also some rumbling about elective surgery, including cosmetic surgery, but that seems less of an issue. But the idea is that doctors should not be expected to perform abortions on women if this conflicts with their beliefs. Pharmacists should not be expected to provide birth control or morning after pills to patients that come through their doors. Doctor's won't pull the plug on poor Uncle Harold who has been brain dead and unresponsive after 5 years on a ventilator.

Abortion. Cosmetic surgery. Elective surgery. Right-to-die with dignity. Apparently, doctors think that they know better than you how you how to live your life.

Let's consider abortion first. If a doctor firmly believes all life is sacred, does this individual have the right to refuse to perform abortions on victims of rape and incest or when the life of the mother is at risk? If I'm pregnant and in distress, can a doctor really just let me die in the emergency room rather than perform an abortion to save my life? Does this individual get to assess the situation and decide when and under what circumstances he or she will perform the abortion? Rape. Check. Incest. Check. Mother's health. Check. Elective abortion. Sorry lady.

Such decisions would demand that a physician or other health care worker assess the patient's circumstances, apply their own morality to another's life, and pronounce judgment without any input from the person to whom this matters most. Does my pharmacist need to know that I was brutally raped in order to offer me a morning-after pill? Is that really any of his or her business?

Let's think this out for a minute. A 19-year-old rape victim, scared half out of her mind and muscles aching from the pain of her attack, somehow manages to get through a post-rape pelvic exam. She has to relive the humiliation of her attack for the police and endure being asked unbelievably personal questions about her previous sexual relationships. All the while, the worst thing that has ever happened to her replays over and over in her head. After going home, taking a shower and getting herself together, she takes her script to the pharmacy only to have some guy, drunk with his newfound C.O. power tell her that he will not give her the morning after pill because he wants to protect the life of her unborn baby. Unable to get the medicine, the embryo implants in her uterus. She can't face the trauma of walking around for the next 9 months with the evidence of this attack staring her down every single day, so she goes back to the doctor seeking an abortion, which the doctor refuses to do.

Welcome back to the land of back-alley abortions and do-it-yourself coat-hanger kits. End result. Women die.

Do doctors and pharmacists and nurses really have a right to force women into these kinds of situations when the procedures are both legal and customary?

If cosmetic or elective surgery is taboo for a particular physician, does that mean that they will also refuse to refer burn victims for reconstructive surgery? To perform circumcisions? Would they look at the burn victim and say "sorry dude, but that's the hand you were dealt?" Does he tell the Jewish parents they are just going to have to learn to live with foreskin? Or do they get to pick and choose? Yes to the burn victim. Yes to the circumcision, but no to the boob job and face lift?

But here's the real thing I don't understand. Sometimes you have to do shitty things in your job that you don't agree with. You do it because it's your job and you agreed to do it when you accepted employment. Why are doctors, nurses, and pharmacists any different than the rest of the fucking world? If these conscientious objectors had any balls at all, they'd leave the profession causing them such distress. Why are they being allowed to deny valid medical treatment sought by patients? Why aren't they being told they can do the job or quit....just like in the real world?

Furthermore, how do I protect myself from these people? Do I have a questionnaire that I ask my potential physician to fill out so I know what I'm getting into? And what about emergency care where I have no control over which physician treats me?

I don't want my physician or anyone else taking my health care decisions away from me. I don't want another's morality applied to me. I want a physician to explain the pros and cons of ALL my options and allow me to make my own health care decisions. Once that decision is made, I expect my health care "professional" to support that decision and not to undermine it. That is the physicians role. That is their only role in that process. I don't need their oppressive morality.

< / rant>

Addendum: I just learned that these conscientious objectors also want there to be laws protecting them from job discrimination based on their "beliefs". So now an abortion clinic must consider the qualifications of physicians that will refuse to perform abortions based on personal beliefs? And what if one of these objectors is the most qualified physician? Can they sue if they aren't hired?

I know a lot of people who would love to get paid to do work they can simply object to on the basis of their belief system.

Only in America, folks.


  1. Great post!

    This behavior in the medical community also carries over to the birthing process. A perfect example: all is going well in a pregnancy, woman is a couple weeks from her due date when all of a sudden her OB starts talking C-section because her baby might be "too big". MIGHT BE. No mention of the inaccuracy of ultrasounds for predicting size late in pregnancy. Also no mention of the doctor's family vacation scheduled right around the patient's due date. Woman ends up with major abdominal surgery and a normal sized baby whom she could have birthed vaginally just fine. But A$$hole doc gets his vacation without worry.

    It happens a lot. Waaaay more than people like to recognize. It's ridiculous. When will patients start being treated like real, live human beings again?

  2. Only had a moment to scan your post, but I think you may be interested in a book called "The Mind Has No Sex?" It's a partial history of women in science (from a Euro perspective, at least), showing how institutions provided certain spaces for women to formally and informally contribute to science for years (interesting point: math at one point was thought to be more "natural" for women, since they had the "idle time" and separation from the cares of state etc. that makes for effective contemplation of math). Anyway, I just got to the chapter on midwives, and the contemporary OB/GYN/midwife tiff actually follows almost exactly the tiff they had when OB/GYNs were invented. History: staging tragedy and farce since 3300 BCE.

  3. Bush hates women too. Yesterday (21 Aug) he released a proposed rule change that strengthens legal protections for health care providers who deny legal medical procedures based on moral or religious grounds. It not only justifies and protects docs who limit access to procedures such as abortion and contraception, but also opens up funding for religious-based pregnancy crisis centers like the one in downtown Carbondale (Shawnee Crisis Pregnancy Ctr) that deceptively attracts vulnerable pregnant women, fails to provide complete and accurate information about available resources and actively discourages abortion. Also protected are doctors who refuse to perform artificial insemination to a lesbian couple.

    You can read the Health and Human Services press release here: http://www.hhs.gov/news/press/2008pres/08/20080821a.html
    There is a link at the bottom for the actual wording of the rule change.

    If you don't like the new rules, you can send your objections within the next 30 days to: consciencecomment@hhs.gov
    You can also give money to Planned Parenthood to fight the rule: https://secure.ga0.org/02/frcp08afspl