# Physicians refusing to prescribe birth control



## chicagomom

Thought it couldn't get any weirder?

Quote:

Lacey's pharmacist and Kelley's doctors are among hundreds, perhaps thousands, of physicians and pharmacists who now adhere to a controversial belief that birth control pills and other forms of hormonal contraception--including the skin patch, the vaginal ring, and progesterone injections--cause tens of thousands of "silent" abortions every year. Consequently, they are refusing to prescribe or dispense them.
http://www.prevention.com/cda/featur...-7342,00.html?


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## aniT

What the


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## *Erin*

how is that even legal? where's the aclu? that's crap. i hope they all get hives.


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## bobica

no way that can be legal!!! next come chastity belts- argh


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## Nurturing Mama

I don't know about the legalities of it, but it seems to me that it would be within the doctor's rights to avoid doing something that he or she feels is unethical. If the doctor believes abortion is murder and birth control causes abortion, then I would hope that they would stand up for those beliefs. The patients that choose to use birth control can go to another doctor to get their prescription, since these doctors and pharmacists are in the minority.

It's definitely weird though.


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## BelovedBird

What's the big deal if Doctor chooses not to offer a sepecific service? Don't you want doctors to be discerning in what they do ("no, I will not perform an elective c-section on you at 38 weeks so that you can be healed enough from the birth to keep the vacation plans you made with your friends last year" or "no, I will not give you ritalin for your 5 yr. old just because all your friends say he should be on it") I have swiched doctors SO many times because I did not agree with the kind of care they gave. Not all doctors are all things to all patients. You have to find the doctor that is right for you. Don't you? There could really be a problem and i am not understanding it... Is there really a legal standard of what the dr. has to give you a prescription for, when? Why not just have all bc be otc, then?


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## DebraBaker

You have your rights and the doctor has her rights.

Would you want someone to be compelled to do something he felt was killing?

Debra Baker


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## sohj

OK. So, now what are all those people who claim to be pro-life but in favor of birth control going to say?

Perhaps they should define _exactly_ what they regard as birth control.

Considering the large number of people I have know who regard "pulling-out" as a sin because it is "spilling the seed on the ground", or the sin of Onan, I suspect that the larger part of the pro-lifers are _also_ against birth control.


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## DebraBaker

I am prolife but am in favor of *conception* control (I am not personally in favor of things that stop a life after conception.)

People are allowed to follow their consciences as long as they don't impede the rights of others.

Doctors included.

Debra Baker


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## mammastar

That's a fantastic article!! Thank you for sharing it.

I had no idea of the scale. I did go to a walk-in clinic years ago with which I was unfamiliar, for a contraception-related reason - before seeing the doctor you were required to read and sign papers indicating that all of the doctors practiced from a pro-life perspective. I was really taken aback - especially since I had unwittingly been referred there by the office of a doctor who had been instrumental in reproductive rights and setting up the local birth control clinic! I ended up leaving before seeing anyone. At least in that case, they were responsible enough to put their beliefs up front instead of just lying in wait for some unsuspecting female patient.

In theory, I don't have a problem with medical practitioners integrating their personal ethics into their professional decision-making. The problem is, though, what happens when these ideas spread? What would have happened if it was a small town and I couldn't just leave and go to another clinic? That's a scary thought.


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## the sunshine

What bothers me is these "ethics" seem to only affect women, and our right to decide when and when NOT to give birth. I don't hear about them denying viagra to men, or refusing vasectomies.

I see this as a war against women, honestly, not people adhering to their ethics.


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## Nurturing Mama

I see your point, sunshine, but I think the difference is that vasectomies and viagra don't have any chance of harming an embryo, whereas the doctors in the article believe that certain forms of birth control do harm embryos.

This probably won't be a popular opinion, but society has stacked the deck against women once again. We are told that we can have sex with whoever we want, whenever we want, but ultimately, we are the ones that bear the brunt of the consequences if a child is conceived. The only surefire way to decide not to give birth is to not have sex. Regardless of what doctors and pharmacists do, they can't force us to get pregnant and give birth if we don't want to. We will always have that power, except in cases of rape.

I don't mean to advocate abstinence and sexual repression of women, but sexually active women know that the "risk" of conception is always there. Like it or not, biologically, the responsibility rests with us, not doctors, not pharmacists, not even the men we sleep with. It shouldn't be that way, but it is.

Sorry if this is confusing...I'm still sorting out my thoughts on this.


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## 3 little birds

I am more bothered that more drs. don't tell women that their choice of birth control may not allow a fertilized egg to implant. It is an informed consent issue for me.

slightly OT-while many people feel that Onan's sin was spilling his seed, his actual sin was failing to perform the brother in law marriage that was required by the law. If I recall correctly, anyway.









I don't believe should be required to perform services that they find personally unethical.


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## the sunshine

Nurturing mama, yes i see what you're saying.

On that same topic, look around you. Look at the media, look at a lot of men's attitudes about women. Women are and should be sexually available at all times. How many women HERE have said that they think they should be availabe to their husbands whenever he desires?

I don't think you can have it both ways. If women are required to be sexually available then women should have any and all means of contraception available to us.

I'm wondering ..... birth control has always been an issue with the catholic church. Now it seems to be becoming an issue with more and more people. I still think it's more a backlash against women than a religious issue with a lot of people. I'm fortunate to live in a city big enough that I will always be able to find BC. Not all women are so lucky, and I will always fight for their rights to have control of their own fertility.


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## Peppermint

I think it is great when Dr.s refuse to provide services that go against their ethics. If only more did so- in regards to circ., dispensing certain drugs to children, and in regards to BC as well.

FTR there are Dr.s who refuse to do vasectomies as well.


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## Kinipela79

Didn't read the article but just wanted to say - if you don't want birth control that may or may not cause a fertilized egg to implant to be given to women - then you had better be ok with more abortions. I consider myself "prolife" but maybe I'm not. I don't know. I just don't believe that "prolife" people can sit and yap about how "we need to stop abortions" but then not support birth control options that are there for women. Can't talk about women being irresponsible and not keeping their legs closed if dr.s/prolifers/whoever withhold birth control.


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## Missinnyc

Yeah, I've known Dr.s (Catholic) who would not perfrom Vasectomies.

I support a Dr.'s right to not to any procedure he finds personally or morally abhorrent.

" if you don't want birth control that may or may not cause a fertilized egg to implant to be given to women - then you had better be ok with more abortions. "

This may or may not be true, because you don't know that. Women who go to the pharmacy to get birth control would probably either go to another pharmacy or delay sex until they could get the BC elsewhere, like online. And in addition, these Dr.s see hormonal BC AS a form of abortion, so telling them that denying BC will increase abortion doesn't make sense.


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## EFmom

I think that if a person feels they cannot provide the range of medical care associated with a particular medical specialty, they should find another job.


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## Peppermint

Quote:


Originally Posted by *EFmom*
I think that if a person feels they cannot provide the range of medical care associated with a particular medical specialty, they should find another job.

Would the same be true for a pediatrician who doesn't want to vaccinate, or circumcize? How about an OB who doesn't want to perform elective c-sections? Our old pediatrician felt ritalin was an extremely dangerous drug for children and refused to prescribe it, was he wrong?


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## mshollyk

all this does is force one's SUBJECTIVE morality and convictions on others.

oh, the state of humanity


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## cottonwood

I agree that doctors should have the right to practice according to their own personal ethics, just as I should have the right to refuse their services and treat myself. So if physicians aren't legally required to prescribe birth control pills on request, I should be able to go buy them myself. Otherwise there is an imbalance of power.


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## Meiri

Quote:

People are allowed to follow their consciences as long as they don't impede the rights of others.
And impeding the rights of others is Exactly what a pharmacist refusing to fill a legal prescription for bc pills is doing.

As the article I read about this issue points out, those pills are medication for more than just birth control. Never mind that the potential abortifacient effect has NOT been proven, these pharmacists and doctors are imposing their own beliefs onto others who don't share them based on SPECULATION. That's not ethics in my book!


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## momto l&a

Quote:

Lacey's pharmacist and Kelley's doctors are among hundreds, perhaps thousands, of physicians and pharmacists who now adhere to a controversial belief that birth control pills and other forms of hormonal contraception--including the skin patch, the vaginal ring, and progesterone injections--cause tens of thousands of "silent" abortions every year. Consequently, they are refusing to prescribe or dispense them.








About time.


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## the sunshine

momto l&a, what do you propose women do? refuse sex, always and forever, unless the intent is to get pregnant? That doesn't sound doable or fun.

So where is the research to control mens fertility? Let's make this their problem then, let's stop those little sperm BEFORE they can fertilize the egg. that seems to be where the problem lies for so many of you.


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## 3 little birds

I choose not to use birth control that may cause a fertilized egg not to implant for my own personal reasons.

There ARE other forms of birth control.

I am also not just upset that Dr.s don't tell patients about this aspect of hormonal birth control (again the informed consent issue). I also wish they would let patients know about the health risks associated with hromonal birth control (not just the little pamphlet with the tiny print.)

My grandfather was a D.O. that did homebirths and tried to convince mom's not to circ. Some wanted circ anyway, no matter what he said. He performed the circs. I don't think he should have. What if he refused and was forced to because the majority felt that it was the healthiest thing to do?

Why aren't bc pills available OTC? Does anyone know?


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## mama ganoush

Where's my burqa? I keep checking the mail every day certain that it will arrive.


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## 3 little birds

I wanted to add,

Since women in the U.S. are able to obtain abortions, shouldn't Dr.s have the right not to perform them or prescribe drugs that they find unethical?

Is it more important that a woman can obtain hormonal bc from ANY Dr. or that a Dr. has the right to abstain from certain services if they bother his conscience?

The pill is legal in the U.S. Most dr.s aren't going to stop prescribing.

If Dr.'s are forced to do things they find unethical, aren't their freedoms being infringed upon?


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## mama ganoush

what good are rights without access? If my hmo-assigned ob/gyn dr. won't perscribe my birth control of choice, and/or my local pharmacist won't fill said birth control option, what good are my rights? Yes, abortion is legal (still, yet being chipped away every single day), but in fully 80% of counties in America, it is not available.

when oh when oh when will the anti-choicer's unite to help PREVENT unwanted pregnancies in the first place? By some other means than women crossing their legs, please.


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## grisandole

I was under the impression (from reading package inserts and such) that it is the lower dosage birth control where conception can occur, not all hormonal birth control. That the "regular" strength pills prevented ovulation, but the lower dosage ones prevented pregnancy by preventing ovulation and/or implantation. The package inserts for the lower dosage pills clearly states that you can concieve but not implant. That's also how IUD's work, by creating a "hostile" environment where implantation cannot occur.

I'm pro-choice but also for informed consent, I will not use b/c that allows conception.

I believe doctors have the right to prescribe or not prescribe.

Kristi


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## mama ganoush

Do doctors have the right to decide not to treat alcoholics, or drug addicts, or smokers? Or gays and lesbians? Or ap parents? Doctors are not there to excercise their personal religious beliefs. They are there to provide healthcare to a broad group of people. If they are more concerned with exercising their personal beliefs than offerng me healthcare, they can join the clergy.


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## 3 little birds

FTR, I'm not anti-choice. What other people do is their business.

Dr.'s should not be forced to provide services that bother their conscience.


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## mama ganoush

Again, which ethical conerns is it ok for a physician to deny service over? An alcoholic with pancreatitis? An iv drug user with AIDS? Or just women, with their personal family planning issues?


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## 3 little birds

I guess I don't understand what conscience issues are raised with an alcoholic or heroine user. They have a disease that caused their disease.


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## mama ganoush

I agre. However, I'm sure we could find doctors who believe that alcohol and drug use are morally wrong. Probably the same lovely group who would deny a grown woman her birth control of choice.


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## 3 little birds

I see what you're saying.

Not to beat a dead horse, but your example made me think of a friend of mine.

Her OB refused to circ her son. Her dh REALLY wanted the circ because he was intact and was made fun of as a child. They found another OB to circ her son.

Should her first OB have circ'd her baby, because the parents' insisted?


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## Dragonfly

Quote:


Originally Posted by *Meiri*
And impeding the rights of others is Exactly what a pharmacist refusing to fill a legal prescription for bc pills is doing.

I agree about the pharmacist, as their job is to fill orders, not to give them. But I do believe that doctors should be able to practice in line with their personal ethics. A doctor should be a partner in health, so if his/her ethics aren't in line with the patient's, it's probably a good indicator that that doctor isn't the right one for that patient.


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## BelovedBird

Quote:


Originally Posted by *jess7396*
Would the same be true for a pediatrician who doesn't want to vaccinate, or circumcize? How about an OB who doesn't want to perform elective c-sections? Our old pediatrician felt ritalin was an extremely dangerous drug for children and refused to prescribe it, was he wrong?

Could someone answer these questions please? And mine from above. Pretty please?









ITA with Dragonfly. I do see a difference between the pharmicist and the dr. The pharmicist should not be allowed to refuse to fill perscriptions.


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## chicagomom

Pro-life organizations already boycott banks and other businesses that do business with companies like Planned Parenthood. It seems like a next logical step for these pro-life organizations to target pharmacies and physicians who dispense & prescribe hormonal & implantation-prevention type birth control. I wonder if this is already being done.


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## cappuccinosmom

My parents are two of that despised breed of MD. They refuse to perscribe birth control.

Reasons: They are serious Catholics. They do not want to be accountable for any conceptions terminated by the secondary function of the Pill, shots, and IUD, which they would consider abortions. They do not want to be part of objectifying women and girls by stifling thier fertility and making them purely sexual toys for the men around them.
Because of all this, they feel it would be unethical to perscribe bc. Anyone who disagrees with them is free to find a doctor who's ethics do not restrain them so.


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## isleta

I would get a new doctor and most likely inform other friends of their choices.

I feel that is is wrong and that contraceptives should be an option to all sexually active people. However, if a law protects these doctors then either you boycott or try and change the law. I find it a horrible trend that is rising-so I get the word out that this is happening and try my best to get others educated on this trend.

Regarding doctors that don't vax or circ. That's their choice also. However, my son's Dr. has told me to circ. for 3 years and I said no. So, I do have a choice to tell the doctor my opinions and work together to gain a relationship of understanding. She is wonderful in other areas and I usually now see the Nurse Practitioner because ds likes her.


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## Dragonfly

Quote:


Originally Posted by *isleta*
I feel that is is wrong and that contraceptives should be an option to all sexually active people. However, if a law protects these doctors then either you boycott or try and change the law. I find it a horrible trend that is rising-so I get the word out that this is happening and try my best to get others educated on this trend.

Regarding doctors that don't vax or circ. That's their choice also. However, my son's Dr. has told me to circ. for 3 years and I said no. So, I do have a choice to tell the doctor my opinions and work together to gain a relationship of understanding. She is wonderful in other areas and I usually now see the Nurse Practitioner because ds likes her.

Consider it from the other angle, though: Suppose you wanted to circ your son and your doctor said she would not because it went against her beliefs. Do you think she should be forced to circ him anyway?


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## Dragonfly

Quote:


Originally Posted by *the sunshine*
So where is the research to control mens fertility? Let's make this their problem then, let's stop those little sperm BEFORE they can fertilize the egg. that seems to be where the problem lies for so many of you.

I'm all for that!









Unfortunately, as long as most of the people doing the research are men, that probably isn't going to happen.


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## andreac

Quote:


Originally Posted by *Meiri*
As the article I read about this issue points out, those pills are medication for more than just birth control. Never mind that the potential abortifacient effect has NOT been proven, these pharmacists and doctors are imposing their own beliefs onto others who don't share them based on SPECULATION. That's not ethics in my book!

I think this point bears repeating. I know several people who have taken the pill for non-contraceptive (is that even a word?) reasons. How could it possibly be ethical to deny medical treatment to a patient?

I'm all for personal choice, but c'mon you chose to be an ob/gyn!! Pick a different specialty!


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## Meiri

Quote:

Why aren't bc pills available OTC? Does anyone know?
Because the potiential for side effects require a doctor's (or other qualified professional's) supervision.


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## Meiri

Quote:

They do not want to be part of objectifying women and girls by stifling thier fertility and making them purely sexual toys for the men around them.
Yes, much better to objectify us by making us out to be only baby making incubators with no minds of our own capable of making these decisions for OURSELVES.

I despise being patronized, and that's exactly what That attitude is.


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## mshollyk

a resounding THANK YOU!!!

you people who think you know everything need to get over yourselves. life is never simple.

Quote:


Originally Posted by *Meiri*
Yes, much better to objectify us by making us out to be only baby making incubators with no minds of our own capable of making these decisions for OURSELVES.

I despise being patronized, and that's exactly what That attitude is.


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## BoobyJuice

I think everyone should have access to birth control. However, if a Dr. is going to refuse based on a moral objection I can _almost_ understand but I believe they should make that clear from the very beginning. The difference between a Dr. who won't do elective c-sections or circ is that those are medical issues. They are not moral! There is no medical reason to do an elective c-section or circ. Even vaxing, which most Dr.'s feel is a medical necessity, is medical. While I don't necessarily agree with Dr.'s about all things medical, at least that is what they are trained for. If I want someone to make moral judgment that affect my life, I'll turn myself over to a priest, rabbi or a minister. Arguments of when life begins are like argument of
how many angels can dance on the head of a pin. Dr.'s can engage in philosophical arguments on their own time, but I'd prefer if they chose to be DR's, they leave the morals that affect my body up to me.

I completely agree with Dragonfly - how can a pharmacist, who does not sit in on Dr./patient appointments, refuse to fill a legal prescription written
by a Dr.? As it says in the article from the OP

Quote:

"We're seeing a growing trend among pharmacists and medical practitioners who consider it acceptable to impose their morality on women's bodies. I don't think moral aspects should be a concern. Imagine a pharmacist asking a customer whether his Viagra prescription is to enhance sexual performance in his marriage or in an extramarital affair. Never!"
If a pharmacist is going to morally object, should the pharmacy have to have someone else on
at the same time to fill those prescriptions?

This is like arguments about abortion. Yes it is legal. Yes there are still providers. But most women don't have access to them. As mama ganoush said, "but in fully 80% of counties in America, it is not available." I live in a small town. Actually, there is a small town about 20 miles from where I live, which isn't even really a town. There are 3 pharmacies. It is a very religious area - what if all 3 decided not to provide bc? Is it that realistic for all women to drive 100 miles to go to a pharmacy? I know someone mentioned ordering them online, but that just isn't a reality for many women.

OK this post has no flow. It's 1 AM and I need to go to bed. But this kind of stuff drives me crazy. I just feel like the minority religious right is bullying the majority.


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## Ione

Quote:


Originally Posted by *Dragonfly*
I'm all for that!









Unfortunately, as long as most of the people doing the research are men, that probably isn't going to happen.

ITA 100%... Not to mention the fact that, back in my single days, I would have been *very, very* hesitant to trust a date who said, "don't worry, honey, I'm on the pill". After all, *he* wasn't the one who could end up pregnant if he forgot a pill or two, or was just plain lying to get into my pants.


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## Peppermint

So, if these Dr.s wouldn't prescribe BC pills b/c of how horrible they are for a woman's body, that would be ok? Since then it would be a medical issue, not a moral one?

As far as this rising trend goes, I looked in the phone books here- there are over 100 OBGYNs in my area, and NONE of them refuse to prescribe BC, and there are no pharmacists in my area who refuse to fill them, I know this, b/c I would take my business to any Dr. or pharmacist who did, but there are simply none here. As for the areas where there is only one OB within 100 miles, I guarantee you that if that one Dr. refused to fill BC prescriptions, some other OB would LOVE to take on that "market", the same is not true for surgical abortions of course, should all OBs be required to perform surgical abortions?

Oh, and there is no medical reason for elecetive C-sections or circ.s? Umm.. take a look at people like Jennifer Berman telling people why elective c's are the "best" way to have a baby







, and the numerous Dr.s who still feel that circ. is "necessary"







. It wasn't too long ago that the medical commmunity at large (in the US







)agreed that circ. was medically necessary







, so at that time, any Dr. refusing to do them should've been forced?


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## weebitty2

Pharmacists have an ethical obligation (according to the Wisconsin Administrative Code) to refrain from "engaging in any pharmacy practice which constitutes a danger to the health, welfare, or safety of patient or public, including, but not limited to, practicing in a manner which substantially departs from the standard of care." (Wisconsin Administrative Code, Standards of unprofessional conduct, PHR 10.03).

Now there are some states that are looking into passing measures allowing doctors and pharmacists to refuse to treat/prescribe/dispense based on philosophical or moral beliefs.

So basicaly what they're saying is that it's going to be ok to NOT treat a homosexual HIV patient with the reasoning "Oh, I don't think homosexuality is ok. I hate ****." (no offense meant to those of non-hetero orientations =) )

Hippocratic Oath - modern version -
"I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God."

And .. the VERY first item in the Pharmacists' Code of Ethics from the American Pharmaceutical Association.

"*A Pharmacist should hold the health and safety of patients to be of first consideration; he should render to each patient the full measure of his ability as an essential health practitioner."
(entire text : http://www.rphlink.com/therphcode.html )

"*A pharmacist should always strive to perfect and enlarge his professional knowledge. He should utilize and make available this knowledge as may be required in accordance with his best professional judgement."

Now, I may be mistaking here, but that DOES state professional, correct? Not moral, religious, or personal?

I mean, c'mon now. How would this kind of treatment go in other situations?

Hypothetical -

Say I'm a preppy little waitress or a cashier .. and someone goth/punk/lesbian/purple/transvestite/old (take your pick) comes in, and I refuse to serve them because "Oh, I don't think they look/dress/act/are appropriate in this environment."

Would I still have a job? Nope. So is it legal for them just because they went to some college for their occupation?


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## RubyV

This is such bullshit.

The PIll is used for many reasons besides bc. I used it to treat my endo for years. Where does a pharmacist get off making a judgement call on the so called immoral use of bcp?

Quote:

They do not want to be part of objectifying women and girls by stifling thier fertility and making them purely sexual toys for the men around them.
The quote above scares the shit out of me. Handmaid's Tale anyone?

What next? Can they refuse treatment because I'm a Pagan? Bisexual? Latina? What's the difference?


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## Missinnyc

I see a big difference btwn refusing a certain prescription because of it's moral implications, and refusing based on the PERSON or their gender, race, etc. Refusing just because they have a problem with you yourself is obviously not okay. But I feel it's a "slippery slope" (God, I hate that term!) and that we cannot force doctors or pharmacists to do things they feel truly are morally wrong. Forcing someone to (from their perspective) commit an abortion is wrong, if that person truly feels abortion is wrong. And it's condescending and cruel, I think, to say "oh well Hell doesn't exist, don't worry about it" to a person who believes they will be eternally punished for this act.

I would not support doctors being forced to do any procedure they have personal problems with. Doctors are human beings, not automatons. JUst as they should not be forced to circ, or vax, or euthanize, or whatever, if they feel it's wrong, and not in the best interest of the patient.


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## sohj

I want to point out that there is a DIFFERENCE between morals and ethics.

While what these doctors and pharmacists are doing might be "right" in _their_ moral universe, it is not ethical.

Ethics tell me that I have NO right to impose my moral beliefs on others.

And I hold quite a few moral beliefs that probably the majority here would _totally_ disagree with.

The fact that I hold some rather radical moral beliefs that would affect medical patients kept me from going into medicine. For one brief moment as an early teen, I considered forensic pathology as it would be intellecually stimulating AND it would NOT be inconsistent with my MORAL beliefs and would NOT put me in the position of having to act against my morals in order to behave ethically.

However, since my _ETHICS_ prevent me from telling you all what to do, you can all rest assured that I will not infringe on your rights to live your lives as you chose.

Keep your subjective morals off my body.

--NO FORCED PREGNANCY, NO FORCED STERILIZATION--


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## mshollyk

what kind of a god would eternally punish someone for prescribing or filling a prescription for birth control pills?

Quote:


Originally Posted by *MissinNYC*
And it's condescending and cruel, I think, to say "oh well Hell doesn't exist, don't worry about it" to a person who believes they will be eternally punished for this act.


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## cappuccinosmom

Hey, where's the tolerance of differing viewpoints? What about "my truth, your truth"?







MDC is a bastion of tolerance, except for those who aren't liberal.

My parents aren't forcing thier beliefs on anyone. They will refer patients who want bc to another doctor. But, they believe that perscription bc all has damaging effects on health, the treatment of women, and of course, the abortifacient effect. They are not OB/GYN--family practice, rather. They treat all kinds, regardless of religion, moral codes, gender, whatever. They worked for years in a county health office, where most of thier patients were gay men. They wouldn't hesitate to treat someone for std's, regardless of how they got them, or an alcoholic for alcohol induced disease, or whatever. It is the birth control itself that they cannot in good conscience perscribe, and has nothing to do with the individual people who come to see them. Thier business is *healing*, and they simply do not feel that perscription bc has much to do with healing. If a patient came in with verifiable endometriosis, they might perscribe the Pill, but they'd probably either refer her, or look for a better way to treat it.


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## JessicaS

If an OB is going to refuse to prescribe BC then I feel they ought to at least tell people when they are making appts.

Like others stated BC is also used for hormone issues as well as endometriosis.

The sin of Oman IMO had more to do with not doing what God told him to than actually spilling his seed.


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## sntm

As a pro-life, pro-birth control doc who has worked actively in reproductive education (so don't generalize about pro-lifers, okay????), I think that no doctor should be forced to do something that he or she believes causes the loss of life, which is what these doctors believe (and not without reason, though you can argue the validity of the reason.) I think the analogies made above to circs and vaccinations is valid. The discussion about which is medical and which is not is semantic.

Personally, one of the reasons I chose not to go into OB-GYN was because of my views on abortion, not that I felt that I should perform abortions despite my ethical beliefs, but how difficult it would be to survive a residency these days while refusing to participate in abortions. Maybe that is for the best, but maybe a lot of women lost out on an AP, pro-natural birth, no-purely-elective-C-sections OB.

I definitely see the point about women in areas without many options. I'm not sure what the answer is for that one.

FWIW, I stopped taking OCPs partially for this reason, but I still prescribe them -- it's more of a fuzzy area for me and I don't know the right answer. ITA with a PP who said it is an issue of informed consent -- I was a little PO'd when I learned about this and it made me a little sick to think about the times I was lazy with the pill schedule, etc.

Also, FYI, I'm not sure how the FDA makes determinations of OTC or not, but most docs would probably not support making OCPs OTC because of the education required to ensure that they are taken properly (particularly the lower dose pills) and the risk for serious side effects that should be considered, both as an ongoing issue and when first prescribing them (as some are major contraindications and can actually be life-threatening.)


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## Missinnyc

Yes, I agree with you about the Onan thing, but that's not the point. Many non Catholics (and Catholics too) see BCP as not just wrong because they are contraception, but because they are abortifacients. That's the opinion. You can argue with it, but that's not the point. The point is, the Dr. sees it as such. He believes that you may kill a life if you take the pill. He believes that he would have been a part of that.

If someone came to me for a gun and said they might shoot someone, I could not give it to them. I totally understand the pro-choice POV and I am not arguing with it, because the point is not whether abortion is wrong or whether the pill is indeed an abortion. The point is, Dr.s (no one) should be forced to commit an act they feel is morally repugnant.

Suppose a man worked in a prison, as a guard. Imagine capital punishment is illegal in this state. Suddenly, it becomes legal, and part of the man's job will now be to escort men to the death chamber or even to pull the lever or whatever. Should he have to do this if he finds the death penalty incredibly wrong? No.


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## sohj

I cannot think of any other profession that would seriously get to consider taking a "moral" stand on what assignments they get to accept.

Military? Nope. You have a moral qualm about a _legal_ order and you better get yourself out.

Prison guards? Nope. Generally, the guard for executions is volunteer (at least it used to be where I knew people in the prison system), but, although an individual might get to say "no" to a particularly understanding warden, this is not normally acceptable.

Police? Nope. If an officer refuses to uphold a _law_, whether it is a fair one or not, then he or she is in for a rough time.

Engineering? Not in my experience. Not on moral grounds. I've refused to work with someone who gave me a death threat, but that sure wasn't a _moral_ issue. If I had a moral problem with the assignments I got, I sure would get myself another job.

Lawyers? Nope. Everyone has a right to counsel. Ergo, although a lawyer can say "I'm not the right person for you", that cannot be based on moral issues but on skills and knowledge.

Accountants? Nope. Any legally earned money that someone needs help with in a legal manner is _ethically_ just fine.

Sales? Haven't yet met someone who said they refused to sell certain stuff AND kept their job at whatever place sold said morally objectional things.

If any of the above claimed a moral objection to refuse to do their job, they would be in breech of professional ethics.

Why are doctors so special? (And, on a side note, why do doctors give "orders", but all the other civilian professions give "advice"?)


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## Missinnyc

I see no difference in those other professions. I would expect a solider who thought a war was wrong not to fight, in the other professions you spoke of, no death (real or percieved on the part of the actor) is involved.

Do you REALLY think a person should be forced to do what they consider a murder?


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## Aura_Kitten

Quote:

I see no difference in those other professions. I would expect a solider who thought a war was wrong not to fight
if they thought going to war was wrong, why are they a soldier?

i think the main point is that if a person has a moral objection to part of their job which makes them unable to do their job fairly and as well as anyone else, they should find another job. if a pharmacist will not fill a prescription for something because of their own ** unproven ** beliefs about it, they should go out and find another job. they shouldn't keep on being a pharmacist and being allowed to deny patients with valid prescriptions the medication that they need.

when we begin taking access to contraceptives out of women's hands... what then?

we are taking so many steps backward in women's rights it terrifies and appalls me.


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## sohj

Quote:


Originally Posted by *MissinNYC*
...I would expect a solider who thought a war was wrong not to fight...

Then, what is a soldier's job description?

Quote:


Originally Posted by *MissinNYC*
Do you REALLY think a person should be forced to do what they consider a murder?

I think a person should have enough self-awareness and lack of self-delusion to realize when a job description doesn't fit their moral system.

And, I think that a person should be ethical enough to keep their moral system to themselves and their fellow-moral-system-sharers.


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## JessicaS

There are many military position which do not involve carrying a weapon. You can also enlist as a concieous objector and they can still find work for you. Also if you object to a particular war you can file as a concious objector and that's fine. (but you HAVE to do it before you are deployed)

Being a soldier doesn't necessarily involve killing.


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## sohj

If one enlists as a soldier and _plans_ to register as a consciencious objector before being deployed, that is trickery. And unethical. If one changes one's mind once in the military, that is a totally different story. And then it would be unethical to remain. One must leave and not endanger one's fellow soldiers by one's refusal to fight.

If one has CO status _and_ is enlisted (which sounds totally wierd to me), one is STILL supporting the war machine and is, therefore, killing. Except, this time it is by proxy. This is also unethical as a conscienscious objector. Red Cross ambulance driver or refugee work (including sanitation support, building, etc.) were the only things I ever heard a CO doing in a war zone.


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## JessicaS

I was just clarifying that they had to file before being deployed because once you are given orders, filing CO doesn't go over very well.

Besides, not all soldiers have the option to get out of the military. Some still have time left to be served and stop losses can also prevent a soldier from dropping papers.


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## simonee

So if a pharmacist or doctor can refuse to prescribe/fill a prescription for bc, should they also be able to refuse obese people their cholesterol/diabetes meds? Or to give cancer patients with no hope to be cured chemotherapy? Or should a veg/an doctor be able to not prescribe stuff that includes animal products/research?


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## sohj

Or an OB/GYN who is also a member of Zero Population Growth refuse to attend a woman who is having her second or third, etc. child?


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## JessicaS

Goodness....

If Drs are going to be like that they are going to have to clarify in their ads in the Yellow Pages. Can you imagine all the possible qualifyers?

Ugh!


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## Victorian

Whether or not this is legal or ethical (which I believe that it is not), it seems to be happening. I think that we need to start calling insurance companies and complaining that we are paying them. If you go to a DR. and are refused the method of DC that you have the right to choose, that Dr. should not be paid for the visit. Period. If the insurance company continues to support them, the company that issues the issure (you employer) should be complained to. They knew when they got into medicine what it entails. If they don't want to practice according to the standards of practice of their profession then they should not be in it.

Would it be ethical for a skinhead firefighter to refuse to help put out a fire at a jewish community center?

If that doctor is being paid by the government (i.e. medicare) then they should not be allowed to impose a religious believe on you.

I don't know the answer for small towns. This is absolutly TRAGIC in my opinion. These are the same people that picket abortion clinics and then refuse social programs to support mothers.

Victorian

p.s. is anyway sick of the whole Mothering doesn't love me because I'm not a "liberal" crap?


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## phathui5

Quote:

Do doctors have the right to decide not to treat alcoholics, or drug addicts, or smokers? Or gays and lesbians? Or ap parents?
Of course they do. There are moms on here whose doctors have fired them as patients because they weren't going to vax their kids.


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## Peppermint

Can someone please tell me how they would feel about pediatricians who don't want to perform circ.s, b/c they believe it is WRONG to mutilate a child? Say it had nothing to do with the lack of medical benefits, but they just felt it was wrong to mutilate a child?

How about my old pediatrician who I mentioned before who refused to prescribe Ritalin, sure he felt it was not a healthy choice, but also- he simply felt that morally, medicating children's behavior was wrong.

Should pediatrics be a practice of only people who think vaccinations are great, circumcision is the "parents choice" and children should be drugged for behavioral problems?

Again- do those who think these Dr.s should be forced to prescribe BC, think that all OBs should have to perform surgical abortions?


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## sohj

Quote:


Originally Posted by *phathui5*
Of course they do. There are moms on here whose doctors have fired them as patients because they weren't going to vax their kids.

And that is unethical, too.

And those doctors should be castigated and there should be a method to complain about them.


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## sohj

Quote:


Originally Posted by *jess7396*
...Again- do those who think these Dr.s should be forced to prescribe BC, think that all OBs should have to perform surgical abortions?

Yes.

But, they shouldn't _force_ it on their patients. Unlike what they effectively are doing by refusing birth control.

Lots of people get put into situations where they cannot "just say no". Like a submissive wife in a certain kind of marriage. Should she be forced to bear as many children as possible?

My great-grandmother who had seven living children and the mother of my uncle who had 11 both thought birth control, when it came around, was a great idea. It was too late for them, but it was great.


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## kama'aina mama

Quote:


Originally Posted by *abimommy*
You can also enlist as a concieous objector and they can still find work for you. Also if you object to a particular war you can file as a concious objector and that's fine. (but you HAVE to do it before you are deployed)

Being a soldier doesn't necessarily involve killing.

I'm sorry but I am pretty certain you are incorrect. If you try to join the military and tell them you are a concientious objector I believe they will send you away. Nor is it acceptable to choose to become a C/O after joining or in relation to a particular action. the only time C/O status comes into play is when there is a draft.. because they can force you to serve but not to kill.


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## JessicaS

Um no, that isn't how it works. You can still be C/O even if you enlist.

There are *many* C/Os in the military right now and we do not have a draft.


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## kama'aina mama

T
Abimommy, you need to check your facts. There are many non-combatant jobs but that is not the same as being a C/O. People in the medical field and the chaplaincy are in non-combatant roles and do not train with or carry weapons as a general rule but they are not C/O's. I just called three different recruiting offices and was told the same thing. They will not accept you if you claim to be a C/O.


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## sohj

Quote:


Originally Posted by *abimommy*
Um no, that isn't how it works. You can still be C/O even if you enlist.

There are *many* C/Os in the military right now and we do not have a draft.

Then that seems unethical as a c/o ought not to be abetting the killing, either.


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## the sunshine

Doctors refusing to prescribe bc pills are a great example of caring for a **theoretical** fertilized embryo, but not caring at all about the health and safety of an existing fully grown human woman.

I just read elsewhere that a fertilized egg isn't even an embryo until it attaches to the uterine wall. A pregnancy test will not come back positive until this happens, so you aren't pregnant until it attaches.


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## Aura_Kitten

Quote:

do those who think these Dr.s should be forced to prescribe BC, think that all OBs should have to perform surgical abortions?
these are two completely different things. there isn't even any scientific evidence that birth control pills actually have the "post fertilization effect" that these people refer to when refusing to give their patients bc pills.

if a doctor doesn't want to perform surgical abortions than they don't become abortionists.

birth control is not only used as a _contraceptive_ but for many other health reasons, as has already been stated.


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## Missinnyc

Just curious. If it's true that it's not true (follow me here) that BCP can cause a fertilized egg to be... expunged by making the lining hostile, then why do my old BCP say that this can happen on the label?


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## Aura_Kitten

NYC, i'm not sure i followed you...

do you mean, why does your bc label say that the pills may prevent implantation of a fertilized egg if it isn't true?


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## lilyka

NYC- because it is true. The BC manufactuers don't hide this. It is simply how thier product works. This is no mystery. I learned this, and that there were a handful of Dr. and pharmacies that refused to participate in the bc industry 10 years ago when I became sexually active and were examining my choices for my reproductive self (went with NFP).

Ihad a hard time finding a Dr. to treat me for my low thyroid. No big I found anouther. Yes I had ot pay for it out of pocket but my heath is worth it. I couldn't find a Dr. who would take the libility of clipping dd tounge (they thought there was a better way) so I found someone who would. I had to pay out of pocket because medicaid wouldn't cover an elective procedure but her health was worth it. it was those Dr.s right to stick to thier guns and do what they thought was best. I respect them for it but they are no longer my Dr.s because I needed someone who would meet me where they were at.

When I needed my thyroid perscription filled I demanded a certain type of medication. Not what is usually perscribed. I live in a town of 200,000 people we have over 100 pharmacies and no one carried it so I had to have it shipped in. it was thier right not to carry it. I don't know why they would, no one in town perscribes it. (target now orders it in for me







and matchs my last price. Ilove them) Was it a hassle to have it shipped in? you bet. Did I want it bad enough to faithfully have it shipped in every month? You bet!! It was hassle but I wasnted the drug bad enough. Perscriptions are easy to get.

Pharmacies are privately owned businesses and they have a right to carry or not carry whatever they want just like any other retail business. I suppose it would be unethical to say " we have this but we aren't giving it to you" but I don't think it would be unethical to say "we do not carry that, you will have to check another pharmacy." Happens all the time here. My thyroid stuff, my friends dhs chemo pills (only one pharmacy carried them). You can't be all things to all people and if you can live with people being ticked off and taking htier business elsewhere then that is up to the owner of the business. If someone doesn't carry or perscribe what you are looking for then GO SOMEWHERE ELSE! You wouldn't sit at the gap and cry because they didn't carry the jeans you wanted and you cuoldn't insist that they start carrying them. Nor would you probably think twice about it. You would just take your business elsewhere. Same with Dr.s and pharmacies. If they don't provide the services you want take your business elsewhere.







I don't see what the big deal is really. And I consider Dr.s in private practice to be business owners. If you think Dr.s are some kind of angles of mercy doing it for the warm fuzzies they get wake up and smell the coffee.. they are running business and are offering specific services. There is a growing number of Gynos who won't deliver babies. Now that is a problem. You shouldn't have any ttrouble finding one who will prescribe a pill. And it is good business practice to not prescribe this stuff or sell it. I would prefer someone who refused and I know there is are a lot of other people who seek out these Dr.s (see it all balances out). Enough people to constitute a nationwide directory of who does and doesn't. i do think these Dr.s should be up front so that someone doesn't go through an appointment onl;y to find out that the discussion on BC options is a short one.

If your insurance company only lets you see a Dr. who won' prescribe birth control find another insurance company or try going without. it is very freeing







we have been without for most of our 10 years of marraige and are none the worse for it. I am not going to pay anyone that amount of money and have them tell me I can't see a good Dr. and when we were insured I still payed out of pocket for anytyhing they didn't cover. I guess it is thier right as business owners tonot cover whatever so long as it is clearly stated when you buy the product. And health insurance is just that product. don't be surprised when they don't cover things they said they wouldn't cover. Check out the Dr.s before you sign on. Make sure there is one you like.

All this to say I don't see what the big deal is. If you want to pay someone make sure you like them. if you don't then don't buy thier services.







: easy enough. Fertility is not a medical problem. Dr. don't have to treat it.pharmacies don't have to sell anything they don't want to sell. You are free to go somewhere else. Heck you can find a Dr. to prescribe and a pharmacy to fill just about anything on the internet.


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## chicagomom

I think what happens w/bcp and iuds is the mfrs play way, WAY down the fact that we're potentially talking about fertilized eggs here. I think many women really don't know that. Of course, the makers of Norplant aren't going to emphasize that when they do their cheery couples-oriented commercials. Bad for sales!

Re pharmacists and drs, I guess again many women just assume this stuff will be available because it is legal. This is one way the pro-life groups have been very successful - eroding away availability for these things even though they remain legal.


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## Missinnyc

klothos- yeah, that's what I meant. I see a lot of women saying in this thread that it's not proven. I admit I don't know much about it, but I wouldn't think the manufacturers would admit it in the packaging if it weren't true. Right?


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## *Erin*

run by posting, i skimmed everyone's responses, and i wanted to jump in and say,you know, i can *almost*understand if a doctor isnt willing to preform abortions, but for a pharmicist, whose job it is to dispense medications, refuses on moral grounds, which are oh so subjective, to dispense medicine that is legal and safe..that's very frightening to me. and dangerous. i think they should not be in pharmacy if they take that much of an issue with bc pills. i also think that if an obgyn isnt willing to learn how to preform abortions, they're not in the right field of medicine. abortion is a legal, surgical procedure.
what's the quote, if men could get pregnant abortion would be a sacrament?
it really lights my fire when men try and exert control (or even voice their opinions, in their professional life) over women's reproductive choices, and women's bodies.


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## cappuccinosmom

Ahem,
I would just like to point out that it is not only evil men who refuse to perscribe bcp's, IUD's, or do abortions. My mom is most definately female, definately not quite recovered from youthful feminism







, and definately will not perscribe any bc that has a potential abortifacient effect, or do any abortions.

I, also, am female (but not an MD!), and I agree with her. Among the Couple to Couple league doctors that they have met, it's pretty much evenly divided among men and women, all who will not perscribe bc and promote NFP or FAM instead.


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## Aura_Kitten

Quote:

all who will not perscribe bc and promote NFP or FAM instead.
yeah, cuz everyone knows NFP helps control endometriosis...


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## lilyka

I was going to say. I am a woman and I feel 10 times more strongly about this than my dh does. It isn't him evicting the fertilized eggs. It is me. it is my guilt I can't live with. And I can imagine there are just as many female Dr. and pharmasist who are on board as there are men.

and again, pharmacies are private businesses that should be aloowed to sell or not sell what ever they want so long as they aren't discriminating against individuals by saying one person is worthy of this but someone else is not.

And I think there are a lot of people missing the point that there is a need for Dr.s, OBGYNs who will not prefrm abortions. I would not go to someone who did. Then I would be left without medical care. There are plenty of Dr.s for everyone. Let those of us who prefer prolife Dr.s to have them while those of you prefer they weren't can go to the vast magority of Dr.s who aren't.


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## cappuccinosmom

Good point, lilyka! I would not go to a doctor who would perform abortions. One of the (many, many) reasons I do not wish to go back to the local ob/gyn for my next pregnancy has to do with birth control. I (a woman!!!!) *do not want it*, for moral and aesthetic reasons. I do not appreciate being looked on as either a nutcase or a poor oppressed female, and thus I want a doctor caring for me who understands, agrees with, and supports my dh and I in our beliefs on this. Doctors like that are very difficult to find. We are blessed that we know two of them very well.


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## Aura_Kitten

you know, this whole issue touches on another topic that's been the subject of discussion in some other threads around here lately ~ why are women giving up their rights and choices just to follow their doctor's orders? why is ANYONE doing this? don't we as patients have the final say in our health care? _shouldn't we?_

if you don't want an abortion, don't have one. but don't limit others' access to them.

similarly, if you personally object to birth control pills, don't take them.

if you don't believe in vaccinations, you have a right ~ or _should_ have a right ~ not to vaccinate.

if you don't want to circumcise your child, leave them intact.

ultimately, health care providers should provide equal access to all care regardless of their own personal beliefs; if they have a moral objection to an integral part of health care, _they should stop doing what they do and find another job._

and we as patients should have the right to choose our own care, and _have access to it_ regardless of what the health care providers believe in. we have the right to make informed choices. our doctors and pharmacists have an obligation to their patients to provide them with _accurate, scientifically sound_ information, and to allow them the basic freedom of making the final choice about their own health care.

someone here said that if pharmacists and doctors are limiting access to contraceptives, and the contraceptives are not available to the general public, then there is an imbalance of power ~ this is completely true. nobody in a place of power should be allowed to exercise their _personal_ ~ moral, ethical ~ beliefs to restrict others' legal choices.


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## Mamid

One of the reasons why I'm pregnant is because the only hospital near me that has OB/GYN services - hell, it is the only hospital - is a very catholic one and they have such a strong anti-abortion policy that you can't even get your baby sexed on an ultrasound.

I had to travel an hour to get an ultrasound that might have given my Bun's sex, but she didn't moon the camera - although I think the tech saw...

Anyway, if I had wanted an abortion, even if it was medically required, I would have had to travel at least an hour to get one. As it was, when I miscarried, I was given bad looks by the tech when I mentioned it. As if I had committed some sort of sin for daring to miscarry naturally.

And BC for me is a non-issue. It took over 5 almost 6 years that DP and I had been having sex for us to get pregnant naturally. DS doesn't count cause he's a clomid baby. But Bun and that miscarriage that happened on CD5 of the same cycle I got pregnant with Bun on were our only for sure natural conceptions.

that and DP is planning on using "raincoats" as he calls them.














:


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## TiredX2

I believe the following:

No doctor should be forced to perform proceedures/write perscriptions that they are morally opposed to. That said, I believe they should be UP FRONT about this and not take appointments if they do not perform common services in their field.

Pharmacies, IMO, should have the right to carry or not specific prescriptions. Individual pharmacists, though, should dispense the drugs that store carries unless there is another individual available AT ALL TIMES to do so.

If, for moral reasons, a practitioner is going to refuse covered services (specifically for medicaid) I do not think they should be a preferred provider. Since you are sometimes "assigned" a doctor, that would make some people unable to get standard medical treatment, which, IMO, should be illegal.

JMO


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## Mamid

IMO, if the pharmacy refuses to carry BC, then they should also not carry drugs for "Erectile dysfunction." If they do, then it could be considered sexist at the least. And isn't sexism against the US laws?


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## TiredX2

With the matter of birth control & the pharmacy, my major issue is that BCP are often used to treat other problems (in fact, some women cannot GET pg without being on bcp).

With erectile disfunction, that is the body working "wrongly." Trying to prevent pg is actually working against the natural body working. But that arguement goes out the door if the BCP is for other reasons. And I definately don't support individuals having to explain to the pharmacist exactly why they want a specific medication.


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## BoobyJuice

Quote:

*No doctor should be forced to perform proceedures/write perscriptions that they are morally opposed to. That said, I believe they should be UP FRONT about this and not take appointments if they do not perform common services in their field.

Pharmacies, IMO, should have the right to carry or not specific prescriptions. Individual pharmacists, though, should dispense the drugs that store carries unless there is another individual available AT ALL TIMES to do so.*
TiredX2,







that's exactly what I was trying to say . . . only I, umm, ahh, rambled, and ahhh, didn't do it quite so well.


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## cappuccinosmom

So who here has actually found a doctor that "hid" the fact that they don't perscribe bc?? If they don't take out a full-page ad in the paper to warn the community of thier dangerous anti-bc beliefs, is that hiding?

It should be fairly simple to find out. If they don't perscribe it, the first time it comes up they'll let you know, and give you a referral. Most practices have more than one doctor. It would simply be a matter of going to a different office within the same building.

It would be kind of stupid of them to hide it anyway. For what reason would they???


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## Victorian

IMO they should tell women WHEN THEY APPOINTMENT is made. For instance "I have you down for monday at 10:00. For your information, Dr. Smith does not prescripe birth control. If you need these services, I can make you an appointment for Dr. Jones instead".

Why should a women have to see a doctor just to be told "sorry, your request is evil"









Victorian


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## 3 little birds

TiredX2-Very eloquent. I agree.









I also agree that the Dr.s office should let a potential patient know that the Dr. will not prescribe certain types of bc before an appt. is made. It seems a little underhanded to wait until the patient has paid for the visit and is sitting in the office to do so.


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## lilyka

ANy Dr. I ahve ever known who wouldn't prescribe birth control proclaimed it from the Mt. tops. It was why people came to them.


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## JessicaS

And why some women won't. I wouldn't see a Dr that refused certain care for women.

Birth control is used for more than just preventing pregnancy and any Dr that refused to prescribe bc for women who needed it is putting their own opinion over the health needs of their patients and I find that wrong.


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## BoobyJuice

Many posters have mentioned that pharmacies are business and should have the right to refuse to carry any drug (although I wonder how people would feel if it was something like a drug for HIV+ patients that they refused to carry because "it's god's punishment") A business may have a right to carry what it choses, but a lot of this argument stems from individual pharmacists refusing to fill lawfull prescriptions at a pharmacy that carries the medication. Are you supposed to return every 8 hour shift to see if the pharmacist on duty does fill that prescription? The argument has been made repeatedly that you can just find a new Dr. However, with a pharmacist, you get whoever is on duty. Most small pharmacies only have one pharmacist on at a time, some only have one pharmacist total. You do not chose who fills your prescription, although you may chose the pharmacy. Should you have to call around to different pharmacies and say, "I'll be picking that up Tuesday around 3 PM, will I be able to get that filled?"


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## Missinnyc

where does it say that we have a right to medications?


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## the sunshine

missinnyc, we'll remember that next time you're sick.


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## Missinnyc

fine by me.


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## lilyka

I medications were right they would be free. I had to search for A dr who would prescrobe what I needed and a pharmacy that would fill it. It was a pain. I have to frive 150 miles both ways to see my dr and have tomake a long distance phone call (that costs nearnly as much as the medice) to refil it. BUt i don't care. It isn't that big of a deal because my other option was to go without. I would rather drive and call and it is a hassle but the results of me being on said medication is worth it. Dr.s and pharmacies are not owned by the government as a whole and the government has no right to tell them how to run thier business.

I had a job where we had to call and raise money (I know the entire job was dispicable) Since it was a liberally owned telemarketing service (aja research service ) we did a lot of fund raising for liberal organizations that promoted abortion such as PP and NOW. We were allowed to opt out of any assignment (without pay) we wanted and they would usually assign us to the lower paying, survey floor if there was room (and thier usually was). they had the option not to hire us (I say us because the majority of thier employees came over from the local conservative Baptist college ), they warned us in advance and gave s the right to not do anything we were uncomfortable with and they had the right to fire us for not doig this stuff. If we refuse to do our job they can't very well keep us on. Same with pharmasist. Even if it is one dissinter who won't sell BC for moral reasons, it won't be long before some complains to the pharmacy about that. Then iti s up to the privately owned pharmacy to decide if this personis worth keeping on or not and then they are standing up with them if they allow it to continue. What it all comes down to is, is this a pharmacy you like or do you need to take your busines elsewhere. It isn't hard to call around before hand and ask "Do you allow your pharmasist to refuse to fill perscriptions? And doyou carry birth control pills? What brands?". If they say yes we allow our pharmasist to refuse to fill a perscription or no we don't carry that then keep calling. i can assure the majority of pharmacies/pharmasists carry and fill BC pills without a second thought.

Another things about pharmacies - usualy the pharmasist ownes the pharmacy in which you are shopping. Secondly even pharmacies in large chain stores (I know k-mart for sure) the head pharmasisrt is usually a small buisiness owner contracting out space from the store he is in. It is a tricky set up but basiclly he runs the show and the store has little say in what goes on or comes in or out of there.


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## Victorian

I just think that the implications of this are so big. What if you can't get an epidural because pain in birth is Eve's curse? Or help with Cirrosis because you shouldn't drink. I think that the AIDS comparison is a good one. The christian right should not be in charge of what healthcare choices are valid.

MissinNYC - is that the best that you can do? Its OK as long as your on the correct side?


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## Arduinna

Wow, truly shocked by some of these replies.

Sorry but you cannot compare your CHOICE to not see a Dr that refuses rx BC to someone being refused medical care because a Dr refuses to give it.


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## Missinnyc

Victorian- It was a joke. I see drs all the time. I do not refuse to go to drs that give out BCP. This isn't about abortion to me at all (although I admit I am pro-life). I think it's dangerous to start telling people they have to prescribe something they find morally repugnant. I think the same about vaxing, circing, c sections, etc.

I think cases of PCOS or other medical reasons for having the pill are different, but I would guess that more than 90% of women who use the pill use it for BC (total guess, I could be wrong). In cases where women choose to use BCP for BC, there is no medical reason to need it, it's a choice. And if a Dr. thinks that choice is a murder, I think he should have a right not to give a person ammunition with which to commiut murder, just as he should have a right not to euthanize someone. I am surprised that many feel the "right to abortion" or a woman's right to reproductive freedom comes before others' "right to choose" in all situations.

All these comparisons to refusing care to Black people or to gay people or to Jews or whomever are not very good comparisons, as in those cases, the medicine itself has nothing to do with the person's status as a gay person, or a Black person, or whatever. Giving an AIDS patient AZT does not help them continue to be gay, nor does refusing a Jew their heart medicine or their allergy shots help them continue to be Jews ( I think neither of those things are wrong, but I am thinking of what an Anti-semite or homophobe might think). It does not commit sin, whether you like their lifestyle/beliefs or not. But IF (and it's a big if, of course) you believe that abortion=murder and BCP=abortion, then giving the pills helps the abortion happen, and it's reprehensible and immoral, IMO (and dangerous for the medical profession) for a doctor to have to perform any procedure he finds wrong/dangerous/not in the best interest of the patient.


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## Victorian

but in a small town, it is the same as refusing care. not all women have the resources to drive 150 miles to get BC. If your insurance only covers one doctor, what do you do? I guess if you don't have a way to go somewhere else then sex is just out?

I agree that this is not a life or death kind of a thing - I worry more about the precident that it sets and how wowmen's rights are being erroded. IMO, this is a symptom of a larger problem - and it is growing.

For the record, I am against BC because I think that it is hard on our bodies - but that is my choice not one that I will pushing on anyone else. If I was (and will be one day) a midwife and I could prescripe - I would with informed consent.

Victorian


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## Missinnyc

Victorian-
Well, there are lots of other forms of BC, right? I guess that's a choice you have to consider when you choose to live in a small town. I agree that it sucks, but if it's that important, order it online, through a catalog, whatever. I see it much like any other private business- they have a right to refuse to sell anything they want. If you move to a town with a store that won't sell rap music or guns or child whips because they think they're wrong, it's frustrating if you want those things. It would be an inconvenience for some. But I support any establishment's right to sell what they choose, as long as it's not discriminatory. For almost everyone, having sex is a choice, and somethine you do not HAVE to choose to do. I don't think that people shouldn't have sex, and I support women's right to make informed intelligent choices about sex. But if you want to do it so badly, go find someplace to get protection, or use NFP, or FAM.


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## Victorian

I can totally see what your are saying. I just women should have the right to choose. I also think that these doctors are using an opinion that is not based on fact. But regardless of whether or not it is OK, women should have the right to know up front that they need a different doctor. There are so many reasons that women choose this BC. And for sure there are women out their that are taking this without "permission" from a partner and other methods are out (especially since these same doctors are against the other discrete methods).

I stand by my stance that if a doctor is working for women with state health insurance they should have to be willing to prescripe BC to women (separation of church and state)

can you really order BC over the internet without a presciption? weird!

O/T does your name mean "missing NYC" or "Miss in NYC"?


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## Aura_Kitten

Quote:

But I support any establishment's right to sell what they choose, as long as it's not discriminatory.
... but that's what they're doing: discriminating against a particular choice of birth control because they disagree with it.

Quote:

Well, there are lots of other forms of BC, right? I guess that's a choice you have to consider when you choose to live in a small town. I agree that it sucks, but if it's that important, order it online, through a catalog, whatever.
but there aren't lots of other forms of hormonal prescription drugs to assist with the other medical reasons why a woman may need birth control, and there aren't lots of other forms of birth control that empower women. i don't think it's right to force women to go through an alternative source ~ online, catalog, "whatever" ~ to get a prescription which may or may not be filled by a reputable pharmacist because they made the "choice" to live in a small town whose pharmacy refuses to fill certain prescriptions.

health care _is_ a basic human right ~ that's why the government provides low cost and free health care to those who cannot afford it, and that's why those same low cost and free health care programs also cover prescription medication. the prescription drugs covered include birth control.


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## Missinnyc

I don't think I agree that one can discriminate against a form of medication. I meant discriminating as in, "I won't give Miss Brown BCP, because she sleeps around, but I will give Mrs. Black BCP because she is married and has three children already..." etc.

Victorian- I don't agree about state health insurance, but I do think a Dr. with this opinion probably should not work at a free clinic or someplace where women have little choice.
And it's supposed to be "Missin NYC" but I lost the capitalization, and now it looks totally different! Well, I grew up in NYC, so it doesn't matter much!


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## cappuccinosmom

FTR, I do agree about drs notifying patients. OB/GYN's in particular, since a good number of patients probably come in for the sole reason of having a check up and getting bc. But that is very simple. Normally, when you make an appt. they ask you what for. They can either schedule you for a dr who does perscribe bc, or let you know that Dr. X doesn't, and ask what you'd like to do about it.

However, for a family practice doctor, generally birth control is an afterthought for the patient. As in "My 13 yo dd needs a physical" and at the end of the exam "Could you give her a scrip for bc, 'just in case'?". There are actually very few one-doctor practices nowadays, so it wouldn't be that hard for the dr refusing to call another doctor and send the patient down the hall to get thier scrip. And I've never heard of an insurance covering just one, lone, single doctor. In that case, you'd really have a complaint about the insurance company, not the doctor. Even govt. programs will cover practices with several doctors, and give you options to choose which practice you want.


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## sntm

More food for thought.

One other thing not mentioned regarding the issue of the small town is that if these anti-OCP docs were to change jobs, as was suggested, wouldn't these small towns then be even worse off, with no doctor as opposed to a doctor who does not prescribe OCPs?

Again, no one has addressed the question of doctors who are opposed to circumcisions or vaccinations. Should those doctors be obligated to circumcize or vax?

Finally, like it or not, ethics is a part of medicine. It influences things every day. It's absolutely integral, especially in a world where there are limited resources and unlimited demand on those resources. Where doctors have to deal with life and death situations every day. What to do with the patient who is brain dead? What to do with the patient who is not brain dead but on life support with little chance of recovery? What to do with the terminally ill patient? What to do with the minor patient whose parents refuse simple medical intervention? What to do with the preemie? What to do with the mom-to-be of many multiples? What to do with the husband who is HIV and hasn't told his wife? What to do with the TB patient who won't take his meds? What to do with the schizophrenic patient who went off his meds? What to do with the comatose patient whose family disagrees on care? What to do with the cirrhotic patient whose name came up for a liver transplant but who is drinking again and will quickly wreck the new liver? These were just off the top of my head. To say that doctors shouldn't be making moral or ethical decisions is denying the reality that they do and have to everyday.


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## A&A

Refusing to perform an abortion is vastly different than refusing to write a prescription.


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## JessicaS

Quote:


Originally Posted by *A&A*
Refusing to perform an abortion is vastly different than refusing to write a prescription.

*cough* RU-486??

Sorry A&A, just thought I would mention it.


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## Aura_Kitten

abimommy, that's not something that can just be prescribed ~ it's a whole process.

from a fact sheet about it: _In the U.S., the approved FDA regimen involves three steps: 1) a visit to a clinician for counseling and to receive a 600 mg dose of mifepristone, 2) a second visit two days later for an oral dose of misoprostol, and 3) a third visit on day 14 for a follow up visit._


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## Mamid

So she has to go back and get lectured about "unprotected sex" 3 times????

Gez.

No wonder people want to make it OTC.


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## lilyka

Another thought on all those small towns with one non-prescribing Dr. Where are his peers. the ones who will prescribe birth control but don't live in the small town? Why aren't they taking the high road and serviceing these little towns? Why won't they be PP on these crappy health plans who only let you see a handful of Dr.s Are you writing to them? Are you encouraging them to rescue women from thier fertility? Are the coming to the resue?

I suppose those one and only anti-obc Dr. could lieave and take those only pharmacy in town pharmasist with them but then who would take there place? Who else cares enough to live in the stix and get lower pay than thier counter parts. iSay if you live in a town with only one Dr. and ne pharmacy be grateful they are still there. Chances are they won't be for long and then you don't have to worry whether or not they prescribe birth control. If it is really important to you to have a Dr. that prescribes things like this and a pharmacy that fills these prescriptions be sure these champions of womens freedoms are where you live.

And for everyone worried that they may get to the end of an appointment and find out thier Dr. doesn't prescribe thier prefered method of birth control just ask when you make the appointment. heck I check to see what nurse will be working. Howmuch harder to check and make sure that you can get a perscription for BC.


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## Aura_Kitten

Mamid, i think you're thinking of emergency contraception, which is very different from RU-486.

with RU-486: steps 1 and 2 are actually administering the medication in the office after counseling; step 3 is a follow-up exam (and counseling i think) to make sure it "worked." if the abortion wasn't complete, then a surgical abortion must be performed and the uterus scraped to make sure all of the remains of the pregnancy are gone. (







)

with emergency contraception, it's just basically a very high dosage of hormones to prevent implantation of the embryo into the uterine lining, but if implantation has already happened, it won't do anything.

lilyka (and all of the others here who have brought this up) ~ i know it sounds simple enough to check and make sure the doctor will prescribe birth control... but how many women will honestly think this will even be an issue? especially the women who already have existing prescriptions? how many women know that pharmacists and doctors are doing this? i think it's a matter of ignorance ~ you can't prepare for what you don't know...


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## JessicaS

Wow

.......

Well now, at least *I* am learning something from this thread. I didn't know it was two meds on two different days.


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## green betty

It seems to me that talking about the ethics of individual doctors is not the most productive place to stage this debate. What's the role of organizations like the AMA and the federal government? (Both of whom, I believe, have an obligation to the public to ensure that the range of services are reasonably available, ESPECIALLY in small towns and rural areas.) It should be possible to both respect the individual ethics AND work towards changing the cultural milieu so that physicians in general have a deeper understanding of the issues their patients face and their responsibilities in cooperating with colleagues to ensure services, while being able to live within their personal ethical guidelines. Who is in charge of regulating curricula at medical schools?

How can we shift our culture towards the more compassionate?

And just a quick note about the sin of Onan: if you read the text closely you see that what he did was disobey his father's edict to impregnate his older brother's widow (the goal being to produce an heir who would technically be his brother's son). Onan, knowing that HE would inherit instead if she did not conceive, had sex with her but then withdrew and came on the ground. His sin was one of intentional flouting of authority and tradition for personal financial gain, of selfishness above family--but of course our sex-obsessed culture makes it all about the orgasm!


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## chicagomom

Given the discussion the article has sparked, I'm surprised this didn't get a wider audience in the media.

Legal obviously doesn't mean available, and for some drs doesn't mean they'll do it. I think lots of drs out there have preferences about procedures and medications stemming from their own beliefs and biases.

It was a shock to me when I became a mother to discover just how opinionated physicians are - just like me.







I never thought about it until the ped was there giving me unsolicited advice (including subtle threats) on sleep training, supplementing w/formula, weaning, vaxing, and forcibly retracting ds's foreskin. As an adult I like to think my dr will support my decisions, leaving my healthcare in my hands. But it turns out I have to be a much more active advocate for healthcare the way I want it, and sometimes this means arguing w/my dr or finding another one.

I am fortunate to live in an area with choices for physician. I think if I had no choice I'd be much more likely to try to 'educate' my dr if s/he were doing something I felt was crossing a line into imposing their views over mine. But I do understand that drs are people, and people have beliefs and prejudices that of course affect the treatments they will prescribe, and it seems unfair to require them to stop being human.

HOWEVER, in the case of pharmacists, I totally disagree. A pharmacist has no idea why you are getting a particular prescription, and if a drug has been prescribed they should fill it. My pharmacist has no business second-guessing medications prescribed by my dr.


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## lilyka

But they aren't second guessing. They have just chosen not to carry it. Just as if they had chosen not to carry condoms or diet soda or formula or porno magazines. They have an issue with it and choose not to carry it. It nothing personal and the loss of your business is a sacrifice they are willing to make. I htink pharmacies, more so than even Dr.s have every right in the world to not sell anything they don't want to so long as they are not despensing it with prejudice. If they were to say "we have it but aren't giving it to you because we think you're a sinner







" then that would be wrong. But tosimply not carry it at all and sell it to no one is thier choice.


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## kama'aina mama

But Lilyka it is not actually that simple. In some cases the pharmacy _does_ carry it and women are counting on getting their 'scrip filled as usual... but "ooops! Sorry, the pharm on duty right now won't fill YOUR prescription." The pills are there, the scrip is legit... but you have to wait til shift change or til tommorow or whatever. I mean, what next? I can't buy coffee beans or a bottle of wine if the only checker at the market is a Mormon who doesn't want to ring them up?


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## stayinghome

I knew of an ob/gyn practice that was Catholic based, and wouldn't prescribe any b.c. This particular practice was very supportive of natural childbirth, had a terrific midwife there, and had doulas come in and work on Friday's so it was quite popular with both Catholics and non Catholics.

I honestly didn't think a whole lot about the morals of it due to their being natural birth-friendly...


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## 3 little birds

I just thought I'd throw this out there:

My mom had a primary care who refused to prescribe Meridia (before it was known to be dangerous) because she felt that fat pills are not the answer to weight loss. It was her own personal opinion.

More recently, my mom's allergist refused to prescribe a nebulizer to her. She has severe asthma and kept ending up in the ER where they would give her a...nebulizer treatment. The doc just felt that it wasn't necessary. I happen to know that she was almost begging for the nebulizer because she was tired of the ER. On the other hand, my daughter was in the ER one time for a respitory virus and they sent us home with a nebulizer.

I think it's safe to say that Dr.s already make medical decisions based on their personal feelings and motivations. From what has been said here, it seems that there is a demand for both Dr.'s that prescribe BC and perform abortions and those that don't.

Of course, I understand that there is more to the issue, but I think that it would be naive of us to assume that docs' make deicisions for their patients in a vacuum, without thier own beliefs and biases.


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## BoobyJuice

So many people are mentioning Drs and pharmacies (businesses), while ignoring the issue of individual pharmacists chosing not to fill a prescription that is in stock, I wanted to repeat what kama'aina mama said

Quote:

*But Lilyka it is not actually that simple. In some cases the pharmacy does carry it and women are counting on getting their 'scrip filled as usual... but "ooops! Sorry, the pharm on duty right now won't fill YOUR prescription." The pills are there, the scrip is legit... but you have to wait til shift change or til tommorow or whatever.*


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## TiredX2

Quote:

My mom had a primary care who refused to prescribe Meridia (before it was known to be dangerous) because she felt that fat pills are not the answer to weight loss. It was her own personal opinion.

More recently, my mom's allergist refused to prescribe a nebulizer to her. She has severe asthma and kept ending up in the ER where they would give her a...nebulizer treatment.
I feel differently about these two situations and just wondered if anyone else was "there with me" so to speak. W/the first it is a family doctor and treating obesity could fairly, IMO, be considered a specialty. I would not expect to recieve *that* type of service from a family practitioner (nor would I expect chemo, or anything like that). If your mom wanted that perscription it was, IMO, her responsibility to visit a weight loss clinic (or whatever)

With the allergist, though, nebulizers are a STANDARD form of treatment, esp for people w/frequent ER visits. In fact, I think most allergists would consider that *neglegent* of the doctor (along the same lines of refusing an epi-pen!). That doctor owed your mother the curtesy of either a referral to another associated doctor who would treat her differently, giving her the perscription, or being up-front about a refusal to do a standard form of treatment.

This, IMO, is related to OB/GYNs. I have no problem w/pediatricians, opthamologists, cardiologists, etc... refusing to write perscriptions for hormonal birth control without warning. That is not a standard practice for them. OBs/GYNs, meanwhile, do a lot of business in yearly women's care which a primary focus of is, generally, birth control. And if you are not going to support what is probably The MOST common form of BC for those in monogamous relationships, you need to volunteer that information BEFORE an appointment is even scheduled.

Pharmacies as well. If they are no longer going to carry a commonly requested medication, they need to put big signs up about it so people can vote with their $ and take their business elsewhere w/plenty of warning.


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## Peppermint

I think it is completely reasonable for the OBs not prescribing BC pills to let the patients know up front.

In regards to individual pharmacists refusing to fill BC prescriptions, basically- the store (say my friend who works for Walmart) would have every right to fire the pharmacist in that situation. I believe some stores have done that, while others always have 2 pharmacists working. I seriously doubt any chain pharmacy is going to give up the business that they would lose by not making the pill readily available, I just do not see that ever happening.


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## Missinnyc

"I think it is completely reasonable for the OBs not prescribing BC pills to let the patients know up front."

I completely agree. I think it should be posted (if the pharmacy generally sells a decent amount of that pill already) and it should say either "we don't sell XYZ" or "Pharmacist B does not sell the Pill, but we'd be happy to help you with another form of BC or between the hours of X-Z, when another pharmacist will be in."


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## Victorian

this an interesting article on cnn.com.

http://www.cnn.com/2004/HEALTH/09/15....ap/index.html

"Forced referral is stupid," she said. "If we're not going to kill a human being, we're not going to help the customer go do it somewhere else."

hopefully bring this thread back up does not violate the new abortion rules.

V.


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## pageta

My OB does not prescribe the pill. He is also one of the few in town who has a clue about what NFP is. He is very pro-natural birth. He has a very low c-section rate and gives about 1 episiotomy per year (in a very busy OB practice - he had 10 deliveries the week ds was born and that was as of Thursday). Among the doulas in town, he is known as the "midwife with a penis." If you want to have a natural birth in a hospital - no drugs, no interventions - he's your man. Those are many of the reasons why I am a very loyal patient.

I used to take the pill for "medical reason" (aka cramps) but have found other ways to treat that condition without using the pill. I now practice natural family planning (NFP) which is basically very effective birth control without the health risks of options such as the pill. I have sex whenever I want with the understanding in mind that there may be certain consequences if I have sex at a certain time of month (and thus I can choose not to if I wish).

With NFP, not only can you avoid conception, you can also treat infertility and avoid miscarriages without expensive drugs or medical procedures. Again, my OB is one in town who is sought out for his understanding of the female reproductive system when it comes to fertility.

So no, he does not prescribe the pill. However, he does offer a wealth of alternatives and treatments that you rarely find with other doctors. Natural birth is very important to me, and there are very few doctors in our town that I would trust as an OB like I trust my OB.

I find it very interesting that so many people here are so adamant about natural childbirth that they are willing to have their babies at home rather than subjecting themselves to treatment by a doctor but at the same time get upset when a doctor is very "natural" minded and along with that refuses to prescribe the pill. Isn't that a contradiction?


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## Victorian

how can you treat infertility with NFP? If you are not ovulating, it does no good to track your ovulation. How does it prevent miscarriage? Why do you think my homebirth was because I don't like doctors? What do doctors even have to do with natural childbirth? Male Doctors? I think that having a baby with a male doctor in a hospital is a contradiction to love of natural birth.

But I really don't understand what this has to do with the subject on hand: why doesn't your doctor prescribe birth control? Religious reasons? Are you that religion? Would you see him if you were not? Is there other places in your town to get a BC prescription?

Victorian


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## pageta

Infertility can be treated with NFP by teaching women when they are fertile so they can time sex accordingly. As for preventing miscarriage, if you are pregnant and you temperatures start to drop, a miscarriage is imminent but can still be prevented if it is due to hormonal reasons. Many women go through three or four miscarriages before find out they need hormones, and my doctor is quick to treat with hormones because that can be diagnosed somehow using NFP. Those are only examples - I'm no expert.

I don't know why he doesn't prescribe the pill - I haven't asked him. Yes, there are other doctors in town. I've been to some of them and they have no clue about NFP and cannot discuss diagnosis based on the symptoms manifested by things tracked with NFP. They also do routine episiotomies and have high c-setion rates. Even if you go with a midwife, if you end up needing a doctor, the ones that are at the midwife clinics in this town are one you don't want to end up with. They do way more interventions than necessary and have terrible bedside manner when it comes to how they treat their patients. I would much rather have a "midwife with a penis" who can do the whole thing rather than worrying about having to deal with some jerk if my midwife is not what my birth requires.

But really, if doctor's can choose not to delivery babies in whirlpool tubs (which we would like), can't they also choose not to prescribe the pill (which we might not like)? We are the patient - we don't tell them how to practice. We simply find doctors who practice with the mindset we like...and I have found one of those. Personally, I LIKE not being pressured to take the pill. Have you ever read the entire insert? I know the print is tiny, but once you finish the insert, you may find that you're taking more risks by being on the pill than you would be to have an episiotomy or an elective c-section.

As for natural childbirth, I mean no drugs and no interventions. My doctor is the only one who will deliver in a birth tub - the other doctors make the women get out if they have labored in the tub when it comes time for birth. Like I said, his c-section and episiotomy rates are very low. If you want to have a natural birth in a place where more help is available IF you NEED it, it's the way to go. Where I live, midwives are not legally allowed to attend home-births so that is not an option unless you go to a lot of trouble.


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## huggerwocky

Quote:


Originally Posted by *BelovedBird*
What's the big deal if Doctor chooses not to offer a sepecific service? Don't you want doctors to be discerning in what they do ("no, I will not perform an elective c-section on you at 38 weeks so that you can be healed enough from the birth to keep the vacation plans you made with your friends last year" or "no, I will not give you ritalin for your 5 yr. old just because all your friends say he should be on it") I have swiched doctors SO many times because I did not agree with the kind of care they gave. Not all doctors are all things to all patients. You have to find the doctor that is right for you. Don't you? There could really be a problem and i am not understanding it... Is there really a legal standard of what the dr. has to give you a prescription for, when? Why not just have all bc be otc, then?


the pill is not only for contraception but also for acne treatment or irregular cycles.So how can one NOT care?


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## huggerwocky

Quote:


Originally Posted by *DebraBaker*
You have your rights and the doctor has her rights.

Would you want someone to be compelled to do something he felt was killing?

Debra Baker


then what about all the medication that can cause birth defects? Will we stop getting those,too..because we might be pregnant?


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## huggerwocky

Quote:


Originally Posted by *Kinipela79*
Didn't read the article but just wanted to say - if you don't want birth control that may or may not cause a fertilized egg to implant to be given to women - then you had better be ok with more abortions. I consider myself "prolife" but maybe I'm not. I don't know. I just don't believe that "prolife" people can sit and yap about how "we need to stop abortions" but then not support birth control options that are there for women. Can't talk about women being irresponsible and not keeping their legs closed if dr.s/prolifers/whoever withhold birth control.


totally agree.limiting birth control choices leads to more abortions.Youc an't have it both ways!


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## huggerwocky

Quote:


Originally Posted by *MissinNYC*
I see a big difference btwn refusing a certain prescription because of it's moral implications, and refusing based on the PERSON or their gender, race, etc. Refusing just because they have a problem with you yourself is obviously not okay. But I feel it's a "slippery slope" (God, I hate that term!) and that we cannot force doctors or pharmacists to do things they feel truly are morally wrong. Forcing someone to (from their perspective) commit an abortion is wrong, if that person truly feels abortion is wrong. And it's condescending and cruel, I think, to say "oh well Hell doesn't exist, don't worry about it" to a person who believes they will be eternally punished for this act.

I would not support doctors being forced to do any procedure they have personal problems with. Doctors are human beings, not automatons. JUst as they should not be forced to circ, or vax, or euthanize, or whatever, if they feel it's wrong, and not in the best interest of the patient.


i wonder if you'd still say this after one of your family members bled to death because the ER doctor was a jehovas wittness who believes blood transfusions are against god's will.


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## Penalt

Quote:


Originally Posted by *huggerwocky*
i wonder if you'd still say this after one of your family members bled to death because the ER doctor was a jehovas wittness who believes blood transfusions are against god's will.

Whoa!









I just asked my father for clarification on this as he is a practicing Jehovah's Witness. The JW ER doc would not administer a blood transfusion to the patient. The doc would treat the patient otherwise normally but another doc or a nurse would have to administer the transfusion. According to my dad the JW doc would have to have some sort of declaration of that in his file so that the rest of the medical staff would be aware of that and act upon it.

I guess the best analogy would be asking a Orthodox Jewish waiter for ham slices with your omelette in a restaurant.

JW's know that their stance on transfusions has risks and so would never make that decision for an uninformed adult. They might feel poorly for the person afterward and pray for them but that is all. JW's feel that a person must give _informed_ consent to be able to refuse a transfusion.

They will make that choice for their children but as a parent it is their right to choose treatment for their children. Much like it is our right to choose treatment for our children. Like refusal to vaccinate. I know, world of difference, but the principle of choice remains the same.

Sorry to jump on you about that but your statement was in error and had to be corrected. Please don't send me PM's about the right or wrongness of the JW stance on blood. I am not a JW anymore. I am just telling you how it is from their viewpoint.


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## TiredX2

Quote:

limiting birth control choices leads to more abortions.Youc an't have it both ways!
But, devils advocate here: the people taking this stance consider hormonal birth control to effectively BE an abortion.


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## huggerwocky

Quote:


Originally Posted by *TiredX2*
But, devils advocate here: the people taking this stance consider hormonal birth control to effectively BE an abortion.


I'll never understand that! I yet have to see studies showing me that the birth control pill leads to an abortion IF after a remote chance yous till get pregnant.I personally know of many women who,despite the pill got pregnant and had the baby anyway.


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## huggerwocky

Quote:


Originally Posted by *Penalt*
Whoa!









I just asked my father for clarification on this as he is a practicing Jehovah's Witness. The JW ER doc would not administer a blood transfusion to the patient. The doc would treat the patient otherwise normally but another doc or a nurse would have to administer the transfusion. According to my dad the JW doc would have to have some sort of declaration of that in his file so that the rest of the medical staff would be aware of that and act upon it.

I guess the best analogy would be asking a Orthodox Jewish waiter for ham slices with your omelette in a restaurant.

JW's know that their stance on transfusions has risks and so would never make that decision for an uninformed adult. They might feel poorly for the person afterward and pray for them but that is all. JW's feel that a person must give _informed_ consent to be able to refuse a transfusion.

They will make that choice for their children but as a parent it is their right to choose treatment for their children. Much like it is our right to choose treatment for our children. Like refusal to vaccinate. I know, world of difference, but the principle of choice remains the same.

Sorry to jump on you about that but your statement was in error and had to be corrected. Please don't send me PM's about the right or wrongness of the JW stance on blood. I am not a JW anymore. I am just telling you how it is from their viewpoint.


ahm, I didn't intend to send you any PNs about your belief, you entitled to believe what you want to.

and where do I stand corrected? he would not order blood transfusion which is what I said.


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## shine

Well, since I'm graduating next summer as a nurse practitioner, and I will be prescribing drugs for my patients, I guess as an ethical practitioner I shouldn't prescribe Viagra to unmarried men. I mean, while we're being so moralistic about it.

Because, as we all know, since, as a practitioner, I have control over who gets drugs and who doesn't, I get to impose my morals on my patients.

I mean, it's not like we have the LEGAL RIGHT to reproductive choices...

Oh wait a minute... WE DO.

As providers of health care we are not above the law. 1) Informed consent: in order to do a proper informed consent process with our patients we are mandated to provide information on all alternatives even if we don't like them. 2) It is not my job as a practitioner to decide for another person whether or not they can exercise their legal rights. If I don't like a law, then I can write to my congressional representatives, I can get involved in the process, but in the meantime I don't have the right to interfere in someone exercising their rights. 3) While I can opt out of prescribing certain drugs, that information needs to be provided right up front and that does not release me from the obligation of providing information on the alternatives, including the ones which may seem repugnant to me. Informed consent is nothing without the information.

(I am concerned about the previous argument regarding practitioners/doctors refusing to prescribe meds for HIV+ or STDs or whatnot, calling it "god's will" or some such nonsense. That's just scary. I hope we never create that kind of exclusionary behavior as a culture, although I realize it's out there in smaller communities already.)

p.s. I was not saying that Viagra is a reproductive choice, although it looks like that was what I was saying. I was just using it as an example of 'moralistic' medicine.

p.p.s. I wouldn't be prescribing Viagra anyway... I'm a women's health specialist


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## cappuccinosmom

Why is Viagra being compared to bc? I don't get it. Viagra is for sexual function. Birth control is to impair fertility. Perscription birth control has a possible abortifacient secondary action. (PP even says that *both* forms of the pill can do that, and they are certainly not anti-bc).

The MD's who don't perscribe bc have an objection to it's secondary function of making the uterine lining hostile to a conceptus. Those who believe life begins at conception would also feel that by perscribing any bc with that function would make them responsible for phsyical harm and death of another human being. I don't know of any who would refuse to perscribe something to assist a woman's sexual function. I've never heard that idea even in the most wild rantings of the most conservative nutcase websites. In my folk's case, all thier patients know they are very conservative, and if they want counsel (which is what many come in for! Just wanting a listening ear and some advice), they know which doctor in the practice will provide them with what they want to hear. If they want to hear the benefits of abstinence until marriage, traditional family, the stop-smoking/drinking/shooting-up-or-you'll-loose-your-wife-and-kids speech, or some other such thing, they ask for my parents. If they want birth control, or a check-up and no lectures, they schedule with someone else.

Oh, and i think I remember someone asking much earlier in the thread if there was a list of doctors who don't perscribe bc????
There is. "One more soul" publishes a booklet with names and addresses of NFP-only physicians in the USA, some of Canada, and some other places. Just thought that might be of interest.


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## Mamid

because men get viagra covered by their insurance companies, but women have had to fight to get bc covered.

its.. well... stupid. cover the stuff that enables people to have sex but don't cover what would prevent the natural consequences of said sex.

Nor are menstrual supplies. They should be covered, or at least tax free. But they aren't.


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## Penalt

Quote:


Originally Posted by *huggerwocky*
ahm, I didn't intend to send you any PNs about your belief, you entitled to believe what you want to.

and where do I stand corrected? he would not order blood transfusion which is what I said.

No, you said

Quote:

after one of your family members bled to death because the ER doctor was a jehovas wittness who believes blood transfusions are against god's will.
That is a lot different from simply not ordering a blood transfusion. For instance he could order a blood expander or drugs to stimulate the production of new cells from marrow, etc. etc.

As for me, I get hurt. Plug me in doc, make it type O. Okay?

As to the issue at hand. I think I would remind the pharmacist or doctor that Roe v. Wade is still the law of the land and by refusing to fill that scrip the least that may happen to them is the loss of their license to practice.


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## Lucky Charm

Penalt,
OK, so the ER doctor in question wouldn't actually administer the blood. Which is really no big deal, because i have never actually seen a doctor or surgeon actually administer the transfusion him/herself. Would the JW MD write or give the verbal order for blood? What if he or she works in a busy trauma ER and a patient needs blood, but the two other doc's are busy with other patients?

In a truly emergent situation, where every second is a decade, who writes the order?


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## Lucky Charm

Pen, we cross posted.


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## Penalt

Quote:


Originally Posted by *sweetbaby3*
Penalt,
OK, so the ER doctor in question wouldn't actually administer the blood. Which is really no big deal, because i have never actually seen a doctor or surgeon actually administer the transfusion him/herself. Would the JW MD write or give the verbal order for blood? What if he or she works in a busy trauma ER and a patient needs blood, but the two other doc's are busy with other patients?

In a truly emergent situation, where every second is a decade, who writes the order?

I knew you were gonna ask that.









Actually the whole answer I got from my dad was kinda surprising to me. I am half thinking of talking to the elders of the local congregation, some of which remember me from my mom's funeral, about this. So I can get a direct answer from the local folks who liase (liase, is that a word?) with the hospitals on stuff like this.

I don't know who would do what in a split second matter. I would think that the hospital, knowing about the doc's self-imposed restrictions would make sure that their bases were covered in a situation like this. At least I sure hope they would.

I think I will talk to the local elders and get this cleared up. Its been 14+ years since I pounded the pavement with a fistful of Watchtowers. Things have changed with them.

We cross posted?

Does that mean I have to get you flowers, sweetbaby?


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## Lucky Charm

No flowers :LOL

Truthfully, i dont think its up to the hospital to uphold the doctors personal religious views, it would be up to the physician to make sure he or she wasnt in that situation. perhaps picking a specialty other than surgery or emergency medicine? I am not sure a hospital would actually take a known liablilty risk in employing an emergency room physician, or surgeon religiously opposed to giving blood.....at say a level 1 trauma center, you know?

Imagine that one in court?


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## huggerwocky

Quote:


Originally Posted by *Penalt*
No, you said
That is a lot different from simply not ordering a blood transfusion. For instance he could order a blood expander or drugs to stimulate the production of new cells from marrow, etc. etc.

As for me, I get hurt. Plug me in doc, make it type O. Okay?

As to the issue at hand. I think I would remind the pharmacist or doctor that Roe v. Wade is still the law of the land and by refusing to fill that scrip the least that may happen to them is the loss of their license to practice.


Sorry, but you can't always substitute a blood transfusion with something else, can you? Especially in the ER when someone ahs been shot, seriously injured etc.

What I'm trying to say is, if your belief doesn't allow you to do certain things, choose your profession accordingly, that's all.

Like a devoted catholic should be responsible enough to NOT become a GYN/Dermatologist and a JW should not become an ER doctor. It WILL affect the patient sooner or later which is contradictive to the ethics of practising medicine IMO


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## Peppermint

And any person who thinks circumcision is wrong or vaccines are dangerous, should not become pediatricians or OBs either, right?


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## Lucky Charm

Peppermint, i think any doctor who has moral or religious issues, should pick their specialty carefully.

That said, no one ever rushed into my ER, lights and sirens, or via Trauma Hawk with a life or death need for a circumcision or need for a vaccine.


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## Peppermint

Quote:


Originally Posted by *sweetbaby3*
That said, no one ever rushed into my ER, lights and sirens, or via Trauma Hawk with a life or death need for a circumcision or need for a vaccine.

How about for the pill?


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## Victorian

IMO opinion it has to do with standard of care and PATIENT choice. BC is considered a standard treatment, as is blood trans. Circ is no longer recom. and therefore is a choice with informed consent. Vax do not treat a problem, they are intended to avoid a problem. I think that Doctors should administer vax even if they do not agree with it (AFTER GETTING INFORMED CONSENT).

FTR, I am not "for" DC, if fact I think that it is horrible. I am not for doctors being able to deny women standard treatment based on their beliefs. Especially as you can see in the article I quoted above, they don't even want to help them find other sources of help. And to me if a pharm. refuses to fill a prescription, they are practicing medicine without a license.


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## Lucky Charm

Quote:

How about for the pill?
If the question really is does someone come in lights and sirens or via helicopter for the pill, my answer is no.

Does our ER docs prescribe the pill? yes, after consulting with OB, they do, usually for irregular bleeding (not usually for a prescription refill).


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## cappuccinosmom

Umm, not all dr's/pharmacists start out in training with an objective of not perscribing or filling scrips for bc. We know a lot of folks who have objections to hormonal bc, the shots, and iuds, and every one of them arrived at that objection after many years of having no objections. My parents only stopped perscribing bc after 20 years of medical practice--thier beliefs about human life beginning at conception only matured at that time, and then they researched the Pill and came to the conclusion that it was abortifacient. They are Family Practice drs, so it's not like they are sending away half thier practice (as they would in OB/GYN) to find someone else to perscribe bc.

They were also prepared to lose thier jobs if thier beliefs were a problem for thier employer (which so far hasn't happened). I think any medical professional who has similar beliefs should be *ready and willing* to loose thier job over this, and not make a fuss. They have every right to thier beliefs, and to practice them, but they should understand that the profession (and the public) may be hostile to those beliefs, and accept it, rather than retain a lawyer to get thier job back.


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## Merlin

Quote:


Originally Posted by *chicagomom*
Thought it couldn't get any weirder?

Quote:

Lacey's pharmacist and Kelley's doctors are among hundreds, perhaps thousands, of physicians and pharmacists who now adhere to a controversial belief that birth control pills and other forms of hormonal contraception--including the skin patch, the vaginal ring, and progesterone injections--cause tens of thousands of "silent" abortions every year. Consequently, they are refusing to prescribe or dispense them.
http://www.prevention.com/cda/featur...-7342,00.html?

Before I say anything, I want to state three things: I am a man and english is not my first language so pardon my awkward grammar. Third, I sometimes can be very blunt, please pardon my rudeness if I sound like that but I tend to be very honest so apologize if my comments offend you. It is not my intention, believe me.

Anyway I want to say that is considerably ridiculous. First of all, to my understanding that teachers in any schools (America) are not allow to share their or rather, impose their beliefs on students right? Otherwise they will be fired.. Would you like to have some teachers impose their beliefs or their religious on your kids in school against your beliefs/religious? Well? I don't think any of you would stand by and do nothing. That is similar conception.

Second of all, sure these 'chemical' bc are quite dangerous if misuse but it is more conventional for uneducated women (it is not bad term, I will explain in several mins. Please don't take that term wrong. Believe me..) Funny thing is that conventional doctors & hospital has been killed numbers of patients (americans) per year, yet is it ok for them to mistreat and 'kill' you by unnecessary surgeries, medication errors, etc while it is NOT ok for them to prescribe the simple bc to aid women to 'prevent' from pregnancy WHEN they want to outlaw the abortion? They ranted about that it went against their beliefs to prescribe the bc.. on contrary, that is quite bullshit and nonsense. _They simply don't care_.

That's what I don't get it when I read this article. I must say that 'not to prescribe because it is against their beliefs' is a biggest joke of this year, wait no.. this _century_. Yes, sex is mostly for procreation but we as in men & women HAVE our own pleasures to 'satisfy' our needs, why deny the most humanly feeling that God gave to us?

Here's stats on conventional doctors & hospital that needs to consider:

Quote:

ALL THESE ARE DEATHS PER YEAR:

12,000 -- unnecessary surgery 8
7,000 -- medication errors in hospitals 9
20,000 -- other errors in hospitals 10
80,000 -- infections in hospitals 10
106,000 -- non-error, negative effects of drugs 2
These total to 250,000 deaths per year from iatrogenic causes!!
What does the word iatrogenic mean? This term is defined as induced in a patient by a physician's activity, manner, or therapy. Used especially of a complication of treatment.

Dr. Starfield offers several warnings in interpreting these numbers:

First, most of the data are derived from studies in hospitalized patients.
Second, these estimates are for deaths only and do not include negative effects that are associated with disability or discomfort.
Third, the estimates of death due to error are lower than those in the IOM report.1
If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000. In any case, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Even if these figures are overestimated, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebrovascular disease).
And yet it is ok for people to accept these mistreatments from these conventional doctors while some certain groups threw some fusses about bc or abortion? Again, that's what I don't get about these people. 250,000 people died per year, that is something that people needs to rethink on that before they can accept that physicans/pharmacists 'revoke' your rights for their so-called 'beliefs' sake. Also I hope many of you aware that hundreds, perhaps thousands of these 'conventional' medicines cause numbers of deaths & health problems (side effects) annual as well yet these people didn't complain about these.

And one more thing, many texans don't realize that giant pharmacy industry dumped Prozac in their water system for years. They feel that they don't need to disclose the informations to texans until environment team found out and exposed however they are still dumping prozac in texas water system (actually included 30 states) _without_ their knowledges or approvals. The moral question: is that ok for them to do that to you by taking your 'rights' away when they dumped in your water system _without_ your knowledge or approval?

Anyway back to 'unedcated women' term, by that, I mean I am aware that there is natural method to 'prevent' the pregnancy such as 'cycle' method (menstrual cycle) in ancient times. It was like 99.9% chance to not get pregnancy with absolutely no side effects. I am not saying that taking bc is bad for you but it is YOUR choice after all. I refuse to impose my opinions on any women about that since I am not a woman and I respect your choice since your body is yours after all. I realize that many women aren't aware of that 'natural' method to prevent pregnancy, I don't blame them since that kind of 'art of practice' is practically lost on post-industrial revolution civilization after all. Actually, there is a excellent book that explains how to do that without taking these bcs.. Well, you women may want to look into that book to get better understanding of what I said in this post. If I have a girlfriend or wife, I would rather to have my partner to get look at that book and practice that natural method so that she will not suffer these side effects such as water-retention, aches and stuff. But if I or we didn't acquire that natural method knowledge, I would support my wife/girlfriend whatever she wants as long as she think it is best for her. Heck, it is _her_ rights and _her_ body... she is the one who handle it (her health/body), not these idiotic physicans or greedy pharmacists.

If there is any kind of 'prevention' medicine for men or sperm, I am willing to try that out as well but as long as there is no side effects or surgery.

Well, whenever I finally graduate as a doctor, I am going to not allow my so-called beliefs, religious or feelings to impose on any women patients. I am going to treat any women patient based on their _rights_, & _needs_ regardless of my so-called beliefs. _*That's what being a doctor means.*_ Also that's which why I pick osteopathic physician career since based on their practice to a "whole person" approach to medicine, treating the entire person rather that just the symptoms.

I quoted Hippocrates:

Quote:

There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance.
Indeed.

'Dr. Milk'


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## 3 little birds

To those addressing the blood transfusion issue, it is my understanding that JW's in the health profession usually leave the transfusing to someone else. If that were not possible then it would be a conscience decision on their part. The people I know personally would probably go ahead and transfuse if it was an emergency, noone else was available, and that is what the patient desired.

For the record, my desire to avoid blood transfusions was originally for scriptural reasons. However, the more educated I became on the subject, the more it made medical sense. Research shows that patients recover more quickly and with less complications when bloodless medicines, those that expand blood volume, are used.
Check out http://www.bmsi.net/ (not a JW site) for more info if you like.


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## cappuccinosmom

Quote:


Originally Posted by *huggerwocky*
I'll never understand that! I yet have to see studies showing me that the birth control pill leads to an abortion IF after a remote chance yous till get pregnant.I personally know of many women who,despite the pill got pregnant and had the baby anyway.

It depends on how you define pregnancy. The definition has changed so that "pregnancy" is now defined as beginning at implantation.

Those who say bc is abortifacient define pregnancy/human life as beginning at conception. The pill's primary function is to prevent ovulation. However, both forms have a secondary function of making the uterine lining inhospitible to a conceptus (look it up on Planned Parenthood), and with IUD's, that is the primary function. Obviously the primary function fails sometimes, or there wouldn't need to be a secondary one. (and, obviously, the secondary function fails too, or there wouldn't be any Pill or IUD babies) If you believe life begins at conception, then to prescribe any hormonal bc or IUD's would be potentially contributing to the ending of an innocent human life. That is the basis for refusal to perscribe or fill scrips for bc.


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## Lucky Charm

I went to the website, read, and then did a quick search.

I could see how one could plan to reduce blood loss during a "routine" elective surgery. I saw the list of bloodless surgeries and procedures. And i think as medical professionals we should do everything possible to minimize blood loss during a procedure.

Unfortunately i didn't see anything about truly emergent situations, traumas like gunshot wounds and stabbings or cardio-thoracic surgeries where risk for hemorrhaging is great. Denver, Co was doing a study of sorts on synthetic blood.....sort of like a volume expander, but going the extra steps to transport oxygen to tissue and organs. Blood does so much more than keep our vascular walls up.

Giving blood *is* risky. I once gave over 100 units of packed cells, fresh frozen plasma & platelets to a teenager. His poor liver!


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## sleepies

seems to me that they are going to CAUSE more abortions than they are going to prevent!

GRRRRRRRRRRRRRRRRRRRRRRRRRRR


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