Doctor with a conscience


It’s good to see someone standing up against Republican idiocy. What we’ve been seeing lately is right-wing theocrats using doctors as a cudgel to batter women (oh, excuse me: sluts and whores) without stopping to think that maybe doctors could refuse to be their tools.

Come to think of it, doctors get far more training in ethics than politicians do, and it shows.

Comments

  1. beccan says

    C’mon MDs, we all know you love to be in charge. ;) Stand up and get politicians out of your offices!

  2. says

    Oh, oh! It sounds like this doctor is proposing civil disobedience. I don’t think that’s allowed anymore… (Republicans will get very angry!)

    On the other hand, maybe it’s time for a comeback!

  3. Ogvorbis: shameless AND impudent! says

    Come to think of it, doctors get far more training in ethics than politicians do, and it shows.

    Do poly-sci students get any training in ethics?

    Though most of the right wing politicians seem to be either lawyers or businessmen and I think that most business schools do require a business ethics course. Not sure about lawyers.

    And what makes anyone think that the right wing will listen to those with actual expertise and experience in that field?

  4. kevinalexander says

    I’ve already commented on this at Libby Anne’s site but I’ll say it again here.

    The good ole boys in Texas will have no trouble with doctors refusing this treatment. Doctors already refuse to kill people by lethal injection so the state must train amateurs and I mean that literally. A lot of people love to do the Lords work.

    The state will simply set up rape saving babies centers staffed by good Christians who will give the sluts misguided girls what god wants for them.

  5. lexie says

    Yes doctors probably get more training in ethics than politicians but I would have thought that you really didn’t need much training in ethics to know that this is repugnant, hideous, backwards, misogynistic, religious legislation. My six year old nephews could tell you that it’s bad hurt and upset people and its wrong to do something to someone if they don’t want it. Basic application of the golden rule would tell you that this is ethically wrong. THIS IS NOT DIFFICULT – YOU CAN NOT RAPE WOMEN!!!

  6. 'Tis Himself, OM says

    It’s a pity the legislators can’t be charged with practicing medicine without a license.

  7. terrellk70 says

    I don’t understand how the GOP can whine about the government being to big and to involved in our everyday life and then push this crap. We really do need the physicians standing up and fighting alone side of women.

  8. says

    Republican idiocy

    Social conservatives = idiots.

    Economic conservatives = defend market capitalism.

    I’m an economic conservative, and I am disgusted with the theocratic social conservatives who are unable to mind their own business. They disgrace the Republican Party. I would never vote for a social conservative politician.

    human ape

  9. Conor Sans Pantaloons says

    I was curious about the physicians position on this recent spat of political anti-choice/anti-women bullshittery. That’s some well thought out rage coupled with explanation, thanks for the link.

  10. laurentweppe says

    Oh, oh! It sounds like this doctor is proposing civil disobedience. I don’t think that’s allowed anymore… (Republicans will get very angry!)

    He’s using the term, but he’s going even farther than that: civil disobedience implies accepting punishment: this doctor openly advocate lying to the authorities about what he does: his text boils down to this
    “This law sucks: break the law, if someone complains, break it some more if (point four) someone forces you at gunpoint to perform an ultrasound, fake it”.
    That’s more than mere civil disobedience, and this doctor is fucking Right to advocate for more than that.

  11. alexanishenko says

    Does the “conscience clause” apply to performing unnecessary medical procedures?

  12. dianne says

    Heh. I love the idea of ultrasounding the bedsheets. No one said it had to be a GOOD ultrasound. Inevitably, this will lead to cases of entrapment, though. Also, Tennessee is either proposing or has already put into place a law requiring publication of the names of doctors who perform abortions. In a state with lax gun control laws. Yeah, that’s perfectly safe and not in the least bit intimidating.

    I admire the Dr. Tillers who risk-and lose-their lives to protect women, but I’m not going to join them. At least not until my kid is 18 and out of the house. One never knows when “pro-lifers” are going to use bombs. Or how bad their aim is.

  13. baal says

    It’s pretty awful when basic medical ethics is civil disobedience. The anonymous doc is spot on.

    @#3 Ogvorbis – lawyers have ethics training and are subject to a set of ethical obligations that can (and do) get them disbarred for violations. They are scope limited, however, to mostly money issues, how clients are targeted and in not out and out lying. The lawyer ethics also vary depending on the status of the non-lawyer party (are they a judge, client, lawyer, generic 3rd party etc). Lawyers don’t generally have a public custodian ethics duty (like we’d hope law makers would).

  14. says

    (oh, excuse me: sluts and whores)

    uh, you forgot bitches and dykes. Because if a woman has sex with a man, then she’s a slut or a whore. But if she doesn’t put out, then it’s because she a bitch or a dyke.

    I really really want to pass a law stating that if you become a state legislator, in order to vote for laws that forces unnecessary medical procedures on anyone, you have to undergo a unnecessary medical procedure.

    Just have a man or woman standing outside a voting booth with a pair of latex gloves on, saying “Think pleasant warm thoughts, but it’s not really going to help.”

  15. FilthyHuman says

    @holytape
    #14

    Just have a man or woman standing outside a voting booth with a pair of latex gloves on, saying “Think pleasant warm thoughts, but it’s not really going to help.”

    OOH! Idea!
    1. Get either a urethral sound, cystoscopy scope, or colonoscopy scope, plus some latex glove.
    2. Stand outside legislative hall.
    3. Anytime a senator/representative who voted for this crap walked by, snap the glove while holding up said scopes.

  16. unbound says

    @3 – “Do poly-sci students get any training in ethics?”

    If they do, I would imagine it is even worse than the “business ethics” training I got as part of my MBA. “Business ethics” is more about not doing illegal things than anything else. The class does talk about morals and ethics, but there is definitely a wink-wink aspect to the discussion since there is always the caveat of doing whatever is not illegal and makes the most profit for the corporation.

  17. says

    Social conservatives = idiots.

    Economic conservatives = defend market capitalism.

    If you think the “reward the rich punish the lazy poor” isn’t a subset of fucking social conservatism you’re deluded…oh sorry forgot who I was talking to.

    Economic conservatism is social conservatism and social Darwinism disguised as economic stupidity

  18. julietdefarge says

    OK, that’s ONE doctor with some balls. Here in Virginia, the silence from doctors is deafening. VA is full of veterans who’ve put their lives on the line for some fairly dubious causes, but doctors can’t risk brief unpleasantness to fulfill the basic requirement of their job: “First, do no harm.”

  19. dianne says

    Kind of random comment here, but…Transvaginal ultrasounds aren’t 100% safe (no procedure is) and aren’t pleasant, but they can be extremely useful in the right context. Also, I had a TVU as part of an infertility workup. I don’t recommend it for a good time, but it wasn’t horribly painful either. Don’t be afraid to get one if you need it. But screw the politicians for trying to force one on you if you don’t need it.

  20. FilthyHuman says

    @Ing
    #17
    Economic conservatives – Conservative enough that I can screw you over. Liberal enough that you can’t screw me over.

  21. says

    Economic conservatives – Conservative enough that I can screw you over. Liberal enough that you can’t screw me over.

    Economic only conservatives are the political equivalent of MRA. They realized “Hey! Conservatism hurts ME as well as all those other nobodies! We should work to ensure it ONLY hurts those nobodies!”

  22. FilthyHuman says

    @Ing
    #18

    Partner has had me peak at what the class “Business Writing” is. Almost as bad as the class is basically Poor Communicating 101

    I guess the worst part is the deliberate miscommunication.
    Or, you could’ve say Lying w/o Lying 101.

  23. says

    This is helping to restore my faith in humanity.

    Unjust laws must be challenged, and it’s great to see someone traditionally thought of as The Authorities prepared to do what is right rather than what they are told.

  24. dianne says

    doctors can’t risk brief unpleasantness

    Tell Dr. Tiller that it’s only “brief unpleasantness.”

  25. keenacat says

    I’ve got my fingers crossed that MDs in the afflicted states actually rise up and follow this one in what is right and just. Ze is spot on about them being the last line of defense for patients rights.
    This whole trainwreck of legislation is grieving me to no end. I can’t even console myself with the fact I don’t live in ‘murka (that is because I’m not a total fucking assclam who LULZ at “cwazymerkans”).
    While I love anesthesiology, I often feel a tug of conscience, thinking I should rather do obstetrics/gynecology. Because we are not safe, either. A gyn I know is the only one at her hospital doing abortions and she keeps getting hatemail.

  26. dianne says

    No offense but not sure why this even needs to be said.

    None taken and because I’m worried that people will get the idea that any TVU under any circumstances will be horribly painful and embarrassing and refuse one that is medically indicated. Of course, it’s any person’s right to refuse any medical procedure*, but it shouldn’t be done out of unnecessary fear.The use of TVU to harass women who want or need an abortion is evil, but the procedure itself is not.

    *Yeah, someone needs to inform a few state legislators of this.

  27. FilthyHuman says

    @dianne
    #27

    Tell Dr. Tiller that it’s only “brief unpleasantness.”

    Well, for Dr. Tiller it is a “brief unpleasantness”. In fact, I would argue that getting shot in the head would be “just” “briefly unpleasant” for the individual involved (assuming they die immediately).

    … okay, I think I’m failing at this snark thingy.

  28. says

    I’ve got my fingers crossed that MDs in the afflicted states actually rise up and follow this one in what is right and just.

    One of the good things about someone stepping forward is that it removes the sanctuary of neutrality. Now people can’t take comfort in “yes it’s wrong but nothing I can do, I just have to keep my head down”. now it really is either choosing to collaborate or resist.

  29. dianne says

    While I love anesthesiology, I often feel a tug of conscience, thinking I should rather do obstetrics/gynecology.

    Do what you love. You can participate by being the anesthesiologist who works with OBs who perform abortions if you want. But you’ll be a better practitioner if you are interested in what you’re doing.

  30. dianne says

    @30: Well, it’s not the snark you’re failing at, it’s the history. Tiller was shot once and his clinic was firebombed once before the antis finally came up with a competent assassin.

  31. FilthyHuman says

    @dianne
    #33

    Tiller was shot once and his clinic was firebombed once before the antis finally came up with a competent assassin.

    Ooh, forgot about that.

  32. lordshipmayhem says

    Historically, the AMA, its specialist medical associations and their state level organizations have been very reluctant to get involved in politics.

    It’s time, I think, that they come out with a common policy against legislative mandates of medical treatments or procedures of any kind. That decision, whether to proceed with that treatment or that procedure (whatever it may be) should properly be left between the doctor and patient, and should be based on what is in the best interests of the patient. If a law mandates a procedure, the Hippocratic Oath’s part about “first do no harm” prevails.

    If a doctor is put on trial for this, his/her defence is that the legislators are practising medicine without a license and he/she is morally (hopefully legally) obligated to ignore that law.

    I encourage everyone reading this to pressure your family physician, your OB/GYN, whatever specialist you use, to push their medical associations for such a declaration, preferably at the national level.

  33. shinobi42 says

    Another commenter on that post already made some excellent points about why this is a bad idea.http://whatever.scalzi.com/2012/03/20/guest-post-a-doctor-on-transvaginal-ultrasounds/#comment-315040

    It’s possible that this course of action would just lead to further limited access to abortion services for women. There is already a lack of abortion providers in many areas. And no one would mind if these providers got closed down for refusing to follow the law. They would in fact, prefer it.

    Civil disobedience sounds nice, but abortion providers are already in a tough legal situation, just for trying to provide women the services we need. Perhaps if more doctors were willing to do the procedures, or were willing to fight these regulations in a more public way.

    But the risk may be too great, and I don’t blame them for that.

  34. raven says

    Most docs even GOP ones, really hate the latest in Tea Party evil.

    Government sanctioned and imposed lying by health care providers.

    Ordinarily, if an MD lies to a patient, there is a word for it already. Malpractice.

  35. raven says

    Also, Tennessee is either proposing or has already put into place a law requiring publication of the names of doctors who perform abortions. In a state with lax gun control laws. Yeah, that’s perfectly safe and not in the least bit intimidating.

    The only reason for that law is so that xian terrorist assassins can find them and kill them.

    In other states, such laws have been ruled illegal because they aid and abet a crime, murder.

    And oh. BTW, did you know that xianity is the basis of all morality? Yeah, I didn’t either.

  36. Beatrice, anormalement indécente says

    Also, Tennessee is either proposing or has already put into place a law requiring publication of the names of doctors who perform abortions. In a state with lax gun control laws. Yeah, that’s perfectly safe and not in the least bit intimidating.

    Is that the one that requires detailed demographics of women who get an abortion published. Things like race, age, number of kids could give away a woman who wants to hide from the community that she had an abortion.
    ….
    Checked, and yes that’s the one:

    The Life Defense Act contains two parts. The first would require doctors to have admitting privileges at a hospital near where they perform abortions, while the second would require the Department of Health to release more information on abortions, including the name of the doctor who performed the procedure and demographics about the women who receive them.

    But the bill also requires the Department of Health to release patient data broken down by county. Critics say that could reveal the identities of some women who receive abortions, particularly in small, rural communities.

    (source)

  37. otrame says

    I know the argument that doctors refusing to perform unnecessary medical procedures will limit women’s access to abortions. I understand that. But damn it, performing unnecessary medical procedures is malpractice. It is serious malpractice. I understand why doctors are having trouble with this one. I like the idea of obtaining a single ultrasound picture that EVERYONE submits as an act of civil disobedience.

    But at the very least, doctors should be standing up and letting people know what is wrong with this. And as much as I am glad one finally did, unless he/she is in the military, he/she should have been willing to put his/her name on that post.

  38. raven says

    But at the very least, doctors should be standing up and letting people know what is wrong with this.

    They have and are.

    It’s not that complicated. This is part of the Tea Party/GOP War on Women and everyone knows it.

    It couldn’t get any more blatant if the made all nonvirgin women wear a giant Scarlet A.

  39. Pteryxx says

    shinobi42:

    Civil disobedience sounds nice, but abortion providers are already in a tough legal situation, just for trying to provide women the services we need. Perhaps if more doctors were willing to do the procedures, or were willing to fight these regulations in a more public way.

    But the risk may be too great, and I don’t blame them for that.

    That’s why doctors who aren’t abortion providers, and organizations, need to speak up about this. Abortion providers are already an endangered species; it shouldn’t be on them to martyr themselves.

    otrame:

    But at the very least, doctors should be standing up and letting people know what is wrong with this. And as much as I am glad one finally did, unless he/she is in the military, he/she should have been willing to put his/her name on that post.

    You missed the harassment, intimidation, nuisance lawsuits, clinic shutdowns, shootings, bombings and murders, I take it. Why do you think Tennessee is trying to pass a name-the-abortion-doctors law? So folks can send them flowers?

    Most abortion providers are already getting pressured and have been for decades. Some donate their services or travel to clinics in other states at their own expense because the need’s so great. The only reason they’re still at it is because they’re dedicated to helping women and saving their lives.

    Dr. Tiller was one example. Check out the experiences of someone who tried to replace him, Dr. Mila Means:

    http://articles.latimes.com/2012/mar/05/nation/la-na-kansas-abortion-20120305

  40. Pteryxx says

    Oh hey, and it’s not just abortion doctors and patients they’re targeting.

    (Apologies for link to Fox News) (via Jon Marcus on Scalzi’s thread here)

    To answer Scott Sigler (and at the risk of getting malletted for treading on the subject of anonymity), here’s an example of the risks Dr. A may be considering:

    http://www.foxnews.com/us/2012/03/20/molotov-cocktails-thrown-at-democratic-texas-state-senators-office/

    Texas State Senator Davis is pro-choice, making her something of an outlier in Texas. Seems at least possible that’s why her office was targeted.

  41. says

    Very good post. I just wish more physicians would speak up on this issue. However many “abortion docs” are vilified by their fellow physicians and sometimes persecuted to the point of losing their licenses by their state boards.

    Would be nice to press the reset and erase button on this whole religious thing, however the mindset in the “prolifers” wouldn’t be affected, I’m afraid.

  42. laurentweppe says

    julietdefarge wrote:

    OK, that’s ONE doctor with some balls. Here in Virginia, the silence from doctors is deafening.

    earlier dianne wrote:

    I admire the Dr. Tillers who risk-and lose-their lives to protect women, but I’m not going to join them. At least not until my kid is 18 and out of the house.

    One may wonder how many doctors are like Dianne: willing to fight the biggots but not if their family is taken in the crossfire.

  43. dianne says

    @46: I apologize for being such a wimp, but we’re talking about people* who are not just willing but eager to kill for their beliefs. And don’t care how many innocent bystanders they kill, if their use of bombs is anything to go by.

    *Not every last “pro-lifer”, of course, is eager to kill, but quite enough are.

  44. Pteryxx says

    Oh, also, bombing and murders aren’t terrorism if good save-the-babies Christians are the bombers and murderers. They’re all lonely unstable individuals operating in a total void, how tragic. *hurk*

  45. Azkyroth says

    I think that most business schools do require a business ethics course.

    Well, they gotta have something for comic relief, right?

  46. Azkyroth says

    Economic conservatives = defend market capitalism.

    What’s your position on requiring companies to pay to clean up the pollution generated by their activities?

  47. Amphiox says

    Quite frankly, these laws are direct violations of medical profession ethics. Far from just encouraging individual doctors to engage in civil disobedience, the regulating medical professional bodies, if they actually wish to follow their professional oaths and not be hypocrites, actually need to be MANDATING ALL PHYSICIANS to disobey these laws, and revoking the licensure of any doctors who DO obey these laws.

    I think the lack of doctors speaking up regarding these laws probably reflects just how few doctors there actually are in the affected states who are actually providing abortion services at all, and the difficult circumstances that they often find themselves in, with respect to being to visible, even before these laws were passed.

  48. Azkyroth says

    It should. Like for most things that should, it depends on the person you’re asking.

  49. says

    I don’t now how realistic it is, but ideally, we should have medical societies making public statements against it.

    “We were just following orders” is not a valid excuse. Would it be possible to sue a doctor for malpractice over this? This seems to me a case worthy of the most principled stance. How can we accept the government passing laws to dictate medical decisions?

    It’s sick. It’s disgusting. It’s so vile that honestly saying what I think would open me up to criminal prosecution.

  50. coffeehound says

    Posted this over there, but would like to cross post to all those physicians who might be reding here;

    As a fellow physician This is a wonderful response that is long overdue, but I have a question and a challenge to all of the other physicians on the board.
    1. Why are pharmacists allowed to not provide the morning after pill in some legislation, and physicians are allowed to LIE to their patients about their medical information in others if it would lead to an abortion, when there is apparently no provision in any of these to allow a doctor who is a conscientious objector to this stupidity to refuse to do the ultrasound? I’m not an OB/GYN but it appears to me absurd to respect the delicate sensibilities of anyone who would object to an abortion and not to a doctor who doesn’t want to feel like they’re raping their patient.
    2. I challenge all other physicians on the board to write to their local congressman to demand amendents to these bills to allow objections of moral conscience, for a start.I will be writing to my congress tonight(wish me luck, I live in friggen Arizona). I mean, if they are really worried about freedom of religious choice it should cut both ways.

  51. DLC says

    Trans-vaginal ultrasound, the new Jim Crow.
    Sorry, I had some nifty faux-MRA snark ready but I just haven’t the heart for it now.

  52. carlie says

    I don’t now how realistic it is, but ideally, we should have medical societies making public statements against it.

    Like the AMA? Yeah, they’ve been curiously silent about all of this.

  53. says

    coffeehound:

    1. Why are pharmacists allowed to not provide the morning after pill in some legislation, and physicians are allowed to LIE to their patients about their medical information in others if it would lead to an abortion

    They managed that by using religion as a shield, and made enough noise that their religious “rights” were legislated into law.

  54. dianne says

    So, bottom line on these laws: they’re going to kill people. Women will certainly die because of them, physicians may die because of them, but women certainly will.

    Pregnancy is not safe. It’s a dangerous undertaking and some women lose the lottery. And that’s not including the risk inherent in illegal abortion. Because there will be women and teenage girls who will attempt illegal or self-abortion and will die of it.

    The future of the US will look like the past of Romania.

  55. says

    Pregnancy is not safe.

    I’ve spent 36 hours studying for ecology and geology exams, on too little sleep and too much caffeine and sugar. Result:

    my brain decided that children are enslaver parasites: in the larval stage, they eat your tissue and steal your nutrients from the inside out, AND fuck up your brain to make you like them and completely rearrange your life to serve them, only to occasionally kill you upon leaving your body.

  56. bwe4 says

    ron paul is a doctor. lots of doctors have next to no concept of the ethics. I get the point this is making and good on them for it. (like the academics out there who publish scholarly articles for peer-review boycotting elsevier,)

    Maybe my experience is anecdotal but in my experience Dr’s have pretty much learned everything they are gonna learn outside of the mechanics of the body and the names of the pharmaceutical reps that service their office before they ever step foot in medical school. At least, their worldview is pretty set. Medical school is not science or philosophy. It is learning the schematics and mechanics of a single machine.

    And I’m also glad they spend as much time learning what they do but they aren’t a particularly well educated or well read group in my experience. At least, they don’t stand out among professionals as being good critical thinkers.

    I don’t have any evidence supporting that other than anecdotal, but the inclusion of Ron Paul in the group of people on the pedestal makes me cautious about donating to the pedestal maintenance fund. :)

    Still, Let’s hope that sane people the world around refuse to enable the wingnuts in the republican party. Maybe they will fade to obscurity through refusal to cooperate. Otherwise, hopefully, we survive their insane moment in the sun.

  57. bwe4 says

    oi. Apologies to md’s in the audience. Hit submit instead of preview.

    I meant that Dr’s have no inherently more educated perspective on things outside of medicine than any other college graduates. Not that Dr’s are usually ignorant.

    Having problems thinking today.