Thursday, May 21, 2009

Conscience Clause

There exists a contingent of people, I assume mostly evangelical christians and catholics, who think that providers of medical care should be able to not only refuse to perform or provide a particular treatment (which they can already legally do) but to also refuse to educate their patients about the same or even refer them to a provider who will provide that treatment. They are under the mistaken impression that the current laws force health care providers to do anything other than give their patients all of the information and allow them to choose for themselves what the best path is.

What the individuals and groups pushing this law want is for the government to force employers to hire and/or keep employees who refuse to perform all the duties in their job descriptions. I agree that any medical practitioner should be able to choose what procedures they want or don't want to perform, what medication they will and will not prescribe or any other decision they want to make about their practicing of medicine. And as private physicians and nurses they have the ability to do that. However, it is just as important to preserve the rights patients to informed refusal/consent.

The owners of hospitals and clinics also have the right to decide what procedures and treatments will be available within their facilities and have the proper staff available to provide those services. When these employers are looking to hire physician, nurses or other health care providers it is reasonable to expect potential employees to reveal if they are willing to perform all the duties of the job. It is also reasonable for a hospital or clinic to require a potential employee to reveal if there is any part of the job that they refuse to take part in for any reason and to use that information to decide if they want to hire them. Physicians and nurses also have a choice to search out employers who do not offer those treatments or who are okay employing individuals who won't perform them.

The other problem with this issue is a lack of transparency. Medical care is expensive and patients should be able to acquire a full list of the things that a physician will not do or offer referrals for before choosing them as a care provider. No one should have to spend hundreds of dollars and many hours in appointments with doctors to question them about every every possible treatment or procedure they might ever need or end up with a doctor who will not provide the necessary care, regardless of the reason. Patients should have all the information about a providers ability to care for them so they can make informed decisions on which provider to see.

I for one would not want to see an OB/GYN who would refuse to operate on an ectopic pregnancy because of the infinitesimal chance that it could survive to viability rather than rupture and kill me. Or a family medicine doctor who would refuse to prescribe an OCP to a woman with PCOS because of the possibility it might stop the implantation of a fertilized egg. Or a psychiatrist who refuses to write prescriptions for antidepressants. I am all for them making the choice they feel is appropriate for their conscience/soul/morals/ethics/religion or whatever but patients should have a choice as well. Health care providers should be open, honest and upfront with their patients (or potential patients) about their self imposed limitations and allow the consumers of medical care to make their choice as well.

In the end it comes down to balancing the right of one group against the rights of another. Personal beliefs are just that and should never be forced on others, this is doubly wrong when done without giving them a choice. When faith becomes motive and not a private matter we are no longer a country where people receive the best care, but one where care is given only when it suits the personal choices of the medical staff on hand.

Monday, May 11, 2009

Clipping post for RSS feeds

I use Google reader to keep up with the blogs that I read the most often. It has worked pretty well except for a couple of little quirks. I wish I would get a notification when someone updates an older post and I wish I could get them to show up in chronological order rather than reverse chronology. Those thing aside I have been very happy with it.

Lately though, it is a decision that my favorite bloggers are making that is driving me up the wall. I really appreciate those bloggers that allow the entire post to show up on the reader and I ofter click on to the page to read the comments when I have the time. I am even ok with those who put up one or two paragraphs with a 'click here' to read below the fold. What I can't stand is the 10-15 word truncations that rarely even give me a clue as to what the post is actually about. I get that you want people to go to the actual blog page because it brings in revenue (i guess) but mostly it just make me not want to read your blog at all.