kbordson

Nope. Still wrong. In that analogy, the house is on fire. That is an EMERGENCY. I have already stated that if the patient had a medical condition (and even gave examples) that I would agree that the procedure would NEED to be done and would even do it. but... as an elective termination is NOT an emergency, she can go some where else. I don't impose my beliefs on her. My patients NEVER have to do what I tell them. So why should HER beliefs be imposed on me? And don't say "cuz you're a doctor" because, for the reasons outlined above, I don't HAVE to do what the patient tells me to. There are others out there willing to do abortions. She should go to them.

I fail to see that as having the slightest relevance to the issue at hand. What confuses you about it? (Honestly... am I not communicating well, or are you just being stubborn?) It is an ELECTIVE procedure. Not a medical necessity. I don't HAVE to do those procedures. My patients don't HAVE to stay with me if I don't, but they can't force me to do a surgery or procedure that I feel is not medically indicated. If a woman walked into a plastic surgery office with a 38H and said she wanted enlargement... they didn't HAVE to do that. Yes, they would be leaving money on the table... but sometimes it's not about just making money. Or how about someone with a good knee that goes into the ortho and wants a total knee? He might even have a good reason. But with any surgery comes risks... I have to weigh in my mind if that surgery is worth the risk for me to do. It's not just about the patient... If my patient dies on the table... I have to live with my part in taking her there. Now if it was medically indicated and I refused... that would be a breach of the standard of care.

I have been thinking about this.... and to some point you are correct. If I worked in a Planned Parenthood and my nurse didn't want to assist with terminations, then it would be better for her to find a job more suited to her. Would I "fire" her? I don't know. Are there other tasks that she was needed for? Or is she the only nurse and I rely on the help and support of someone with reservations about her job? If she didn't like it, I would help her find work in a different clinic. But I wouldn't FORCE her to do something she was morally against. My current practice. My nurse would, at times, decline to go into the room and assisst with certain patients when she was pregnant. (examples being recent miscarraiges or infertility patients) She did this out of respect for the ladies cuz she had this big ole tummy and didn't want to put it in their face. She always had someone covering and available if I needed it. There is NO WAY IN HELL that I would fire her for that. In fact, I think it shows very highly of her compassion. But... in either situation, I would not FORCE my nurse to do something that they had objections to.

I do understand what you're saying here. And I do agree. Just to educate you though, stated funded hospitals do not do abortions now... at least KU (University of Kansas - Kansas City) didn't. If we wanted that specific training, we had the option to do a month or two at the local facilities that did provide that service. We were required, however to show competency by doing the same procedure on incomplete miscarraiges (spontaneous abortions that didn't end right) and "missed miscarraiges" / "blighted ovums" (pregnancy never developed) But your point is that by taking away the funds... it might be legal, but there will be no place to have it done. I don't really see that happening though. I do know some OB/Gyn's that have do not have the moral restrictions. They would provide that service. Then you ask "but where?" Honestly... it's better practice now to use medicines to terminate (methotrexate and cytotec) than to do an unnecessary surgery. You don't need a surgical suite to write for those prescriptions. And... then when she comes back to see me 3-4yrs down the road, trying to get pregnant... I feel a little better knowing that it was the medicine that was used and that her cervix wasn't dilated and possibly weakened and that the uterine cavity wasn't scrapped and possibly scarred. . . . So... in my opinion... it will drive terminations to be more medical and less surgical. Which is a good thing.

This is the part of your argument that I disagree with. COCP or "the pill" doesn't work by preventing implantation, it prevents ovulation (and therefore conception.) It can't be considered "abortion" even under the language of this proposal. You'd have to come up with a "zeroth" or "negative first" trimester to make it fit the definition. Or just... you know... become a devout Catholic. You're partially right. It is designed to prevent ovulation. But it can also be used as a abortive agent. (dosing depends on which pill it is) As it would inhibit implantation. And your beliefs on whether "life begins" at fertilization or implation depends on whether you chose to use that or not. (as also mentioned above.... one of the mechanisms of action of one of the IUD's is to prevent implantation... which I counsel patients on in case she might have reservations due to that)

So, are you saying that she didn't claim to refrain from doing the procedure for moral reasons? I did claim that and it is true Or, are you claiming that she didn't claim to inform me that my assumption that many OB/GYN's performed the procedure was incorrect? True again Or, are you claiming that she did not claim to be an OB/GYN? I am an ob/gyn... three for three here If one of those three things is true, then my logic would be faulty. Otherwise it is sound.

If you're gonna post a holier than thou attitude about how you don't perform the procedure because of your beliefs instead of being honest about it not being typically performed by OB/GYN's (or was that where the dishonesty is?), then you shouldn't complain about people accepting your implications at face value. You still don't understand. I am TRAINED to do them. If some woman came in with a bad medical condition (primary pulmonary hypertension - read "REALLY BAD LUNGS") and she was going to DIE because of the pregnancy. I would do that if she requested it. Becuase I believe the life of the mother outweighs the life of the fetus. BUT... she can CHOOSE not to terminate that pregnancy once properly educated on the risks that she is truly taking. However... I dare you to call up your local OB/Gyn clinics (not the abortion clinics) and tell them that you need to schedule an abortion. Tell them the last menstrual period was November. And if you truly have a set... tell them that you have some free time on Friday at 1pm to schedule it. See how many decline. All are TRAINED to do it. My reasons for not doing it are MY reasons alone. But... it should still be her right and her choice on whether she wants it done. A better analogy would be: Someone wants to smoke. I don't agree with it. I shouldn't HAVE to provide them with cigarettes.

Still a wrong analogy. In the military, you surrender some of your rights. You follow the UCMJ. As a soldier, you can CHOOSE to act against that signed contract but then there are consequences for that decision. The needs of the military out weigh the needs of the individual. To be an OB/Gyn, although I am trained to do D&C's (laymans terms - "abortion"), I can CHOOSE not to do any elective cases that I don't agree with. In fact, I don't HAVE to do a hysterectomy just cuz some woman walks in and wants it out... and in fact I typically have to have a medical reason and pathology (meaning "bad stuff") as a reason to do the surgery.

THAT is your wrong assumption RIGHT THERE. Call tomorrow and find out how many local OB/Gyn's would schedule an abortion for you. Note for future reference: Do a little research BEFORE telling someone what their job is. Agreed - the McDonald's Whopper analogy is right on. If a clinic or partnership offered the elective procedure and an individual doctor IN THAT PARTNERSHIP refused to do the procedure, the "fire the doctor" argument MIGHT have merit - it all depends on the agreement when the doctor was hired.. I would be willing to bet that MOST ob/gyn's have discussed this exact issue with their clinic/partnership during the hiring process. Even still, we have some doctors in our practice that don't do obstetrics, some that only do reproductive endocrinology, some that won't do laparoscopy and others that will refer vaginal cases out. AND some random poster on dz.com with (I'm assuming) minimal or no medical training is trying to tell me that I have to do abortions or not be an OB/Gyn!?

THAT is your wrong assumption RIGHT THERE. Call tomorrow and find out how many local OB/Gyn's would schedule an abortion for you. Note in future discussions, you might find it a little helpful to research BEFORE telling someone what their job is.

I don't understand this argument. Where did I state that I would deny my employee their rights?

I mean... why should you have to go to a different fast food place!? You're there! This place should give you what you WANT and make it RIGHT NOW.

Or just walk in and demand a Whopper!!

No... but some people seem to think that they are ENTITLED to whatever the hell they want even if it imposes their beliefs on others. ELECTIVE PROCEDURES ARE ELECTIVE. It's a CHOICE not a need. If someone wants to sue me for NOT doing her abortion, I will refer her to a phone book and she can call any lawyer she wants. Guess what, that lawyer can then decide NOT to take her case.

This topic has strayed FAR from the original post of the link to the RIGHTS of the employees. I'm wondering if it can get back on topic or if certain someones are going to continue to try to browbeat me to believe that I should either schedule a random abortion for tomorrow or give up my practice.

You are entitled to your opinion. But I disagree. I don't think that OB/Gyn's should be required to do ELECTIVE terminations. It's not a required or livesaving procedure. If she comes in with medical or ob complication that requires a termination (Primary pulmonary hypertension, Eisenmenger’s syndrome, Marfans, or ruptured membranes at 18weeks and chorioamnionitis), then that's different. THAT needs to be addressed. But if she is making an elective choice to have that procecure, then she should choose to go to a provider that will do that. I believe that the patient should have the right to make that choice, not influenced by the government... but I should have the right to make my decisions too. I do not impose my beliefs on others, and others should not impose their beliefs on me. There are many other facilities (such as planned parenthood) in this nation that will provide the service that she desires. Not every OB/Gyn has to or is even credentialed for EVERY procedure in the book. I'm preparing to take my oral boards. I KNOW what procedures I'm "required" to do... and TRUST ME... elective terminations isn't on that list. (if you REALLY care to know, pm me and I will bring you up to speed on the current training and credentialling of OB/Gyn's in the US) (To jcd11235 : about serving in the military and exercising your rights to abstain from certain wars. That's a WHOLE different discussion, but yes, you have that right. I would review the UCMJ and maybe have your family look at housing in Leavenworth if you choose to excercise that right though. But being in the military does not give you clearance from morals. "I was ordered to" is not a valid argument for unethical actions.)

Would you respect an employers decision to reject her as an employee if they decided they did want to perform elective abortions at their place of business, and wanted 'similarly minded people' working there? .jim In that situation, he/she probably wouldn't feel comortable working in that enviroment if it was "required." When someone "joins a practice," it's as much his/her choice to join as it is the groups offering the option to join.

Part of being a professional is putting personal feelings aside and doing your job. so your saying that every ob/gyn should be required to perform abortions? That's the opinion that I'm gathering from some of the comments in this thread. Kallend: When I counsel the patients, I try hard NOT to bias my medical opinion or recommendations. My beliefs should not influence her decision, nor should her beliefs be imposed on me. But do tell, which of those procedures SHOULD I do? You didn't answer it. I personally do not agree that I should be required to perform them. But the benefit of the health system here is that I CAN refuse to do procedures that are against my moral standards. I can't abandon the patient... nor should those patients not be counselled appropriately. But I don't have to do the abortion myself. And honestly, if we went to a government system that MANDATED that I preform abortions, then I would stop practicing (as would MANY others)

So... by your post, am I to assume that ANY OB/GYN should be morally ok with doing any abortions? Where does YOUR line stand? Just those pesky first trimester "mistakes" that need to be taken care of? What about a thrid trimester one? How about partial birth abortions? If you're deciding that I should do them, tell me which procedures should be included.

The existence of an Iraqi-led democratic, parliamentary-style federal government based on a civil government (Iraq Constitution) created by Iraqis and approved by referendum (i.e., vote of the Iraqis). VR/Marg Sorry, but your words will fall on deaf ears there. Some people are so focused on their hate of other countries that there is no way they will listen to the opposite argument. You're just a "seppo American" - admit that you are the embodiment of evil and then you will be "right."

As I stated and trophyhusbsnd repeated... if the standard of care is met - the patient is properly counseled on options, she/he is referred to someone that is willing and capable of preforming that service and the patient is in no physical harm..... why does it matter to you WHICH doctor does it and why would you demand that someone do something that they are morally opposed to that procedure. When I went to Peru, we took NO hormonal medications. Hormones and birth control are not normally a necessity or "life saving." They can help with heavy menstrual bleeding, they can decrease some pain with menses, but overall OCP's are more of a "luxury" medication. I don't really understand that first question. And "denial of service" depends on whether it's a required procedures vs. elective procedures, which is an important distinction.

I did seem to hijack it.... I got some info today on some local programs that are already in place... but don't get much publicity. Maybe an option that "protects" me and gets patients seen is to volunteer at those pre-existing locations and increasing public knowledge of them.

Santa? (honestly, I think I know who you mean... and I agree.... judging a book by its cover will sometimes cause you to miss the wonderful person living beneath the skin. . . . but I still don't like to hear my sisters complain about a self induced state)

I don't think this is a womens right issue. Trust me... I'm a woman. I believe in a woman right to choose, in equal opportunity if equally matched. But I don't want discrimination. Whether due to gender, religious beliefs, race or anything. I don't want those nurses to be fired for refusing to help with something they are morally opposed to. I don't want to be forced (as a doctor) to partake in elective terminations. I don't want others to impose their beliefs on me and I won't impose mine on them. That article (as I read it) was just protecting the rights of the employees.