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Category: Medical Care

Making Medical Decisions

Making Medical Decisions

I found this article on MSNBC very interesting in terms of the number of doctors who feel that they can somehow impose their moral choices on their patients. I do have some problems with the methodology involved in the survey and the conclusions drawn–the former don’t clearly support the latter. Nonetheless, these attitudes raise some warning flags for me.

Sometimes, and I don’t know of a scientific study that would tell me precisely how often, the medical profession takes a very arrogant view of the rest of us. They know best, and we ought to listen. But the facts are that there are many, many disagreements on treatment amongst medical professionals. I believe firmly that the individual should be the one to make the choice as to medical care, even if that choice results in his or her death. (When dealing with children, other factors come in, of course.) That decision should potentially be informed to the maximum extent possible, i.e. the medical professionals should provide whatever information the patient desires.

I’m concerned that so many don’t feel obligated to inform patients of procedures to which they may morally object. They may be right about the morality, but that moral decision is not theirs to make for another person.

Faith, Medicine, and Choice

Faith, Medicine, and Choice has an interesting article today on medical practices and faith. The general title belies the content which is almost exclusively about clinics that do not offer birth control, sterilizations, in-vitro fertilization, or abortions.

According to the article there is a growing trend. The article notes:

The number of “NFP-only” practices is unknown, but an Ohio-based Web site promoting them has a registry of nearly 500 doctors who have pledged to practice this way. Most are obstetrician-gynecologists and family practitioners.

Some medical ethicists have a problem with this practice, and the story reports a number of women who have been annoyed when such practices refused to offer certain services. Other ethicists believe that if the advertising is clear, then the practice is acceptable. The story quoted one annoyed patient as follows:

“It caught me completely off guard,” said Elizabeth Dotts, 25, who had a similar experience in Birmingham. “I felt like he was judging me and putting pressure on me. . . . I am the patient. I am the client. It should have been about me — what I needed. Not what he needed or believed.”

And here’s where I have a problem. Provided there is no false advertising, and information on the doctor’s practices are available, I think the patient should be responsible for choosing a doctor that is appropriate. I realize here that people often miss notices, not just in the fine print, but even on large signs in the office. They are focused on something else. But I think people who are focused on something else need to take responsibility for what you get. You don’t see the “we don’t do contraception” notice in the office, go to another one.

Now don’t make any mistake. I personally do not agree with the position that these doctors are taking. I do have a problem with the individual quoted in the story who felt it would be unethical to refer the patient to a physician who would take care of them as they desire. I would also expect ethically that they should inform patients clearly of what their beliefs are, what they will do, and what they won’t, giving the patient an opportunity to choose a different doctor. With all of that, however, I would leave primary responsibility on the patient to make a selection based on their desires and their choices.

This position stems from my broader position that people should be able to make any business relationship they desire, provided fraud or other deception is not involved, and I believe this should be true even in medical care. The final responsibility for your health is yours, and it is not possible to protect you from all negative experiences with medical practitioners. Plan on problems. Investigate your health care provider. Make an informed choice. Even if you do not encounter a doctor whose faith stance causes him to refuse you the kind of treatment you want, let me assure you that you will encounter physicians out there whose care you should avoid.

Doctors should inform, but to make that work, patients should demand the information and refuse to settle for less. If, in the end, that means you change doctors, then it’s time for a change.