Friday, February 22, 2008
So this article is in response to two posts I've read recently: MO - we gots teh sigh-ense! and Is There a Catholic Doctor in the House?.
The first article deals with the Missouri bill that will give pharmacies immunity from liability for refusal to perform, assist, recommend, refer to, or participate in any act or service in connection with any drug or device that causes an abortion. Except they define Plan B drugs as a drug that causes an abortion, which is clearly not the case. (If you don't want to follow the link then I'll give you a little spoiler. In brief, Plan B only suppresses the women's ability to produce an egg or not produce an egg. It doesn't interfere with pregnancy. So it's more like super birth control than abortion.)
The second article deals with doctors that refuse to prescribe any kind of birth control under the made the claim that birth control is bad for women and also doesn't fit in with their religious belief. So they're no longer going to offer women contraceptive options under any circumstance.
The question The Exterminator raised is what is the ethical responsibility that a doctor owes to his or her patient. I'm going to expand that to apply to a pharmacist as well, though I'm not sure they're quite the same, they're similar enough to discuss together.
The way I see it, one can view a doctor’s responsibility in five ways:
1. A doctor has a responsibility to do what a consensus of well-informed medical professionals, based on the best scientific data, would think is right for the patient.
2. A doctor has a responsibility to do what he believes is right, regardless of the patient.
3. A doctor has a responsibility to give his patient the best advice he can. But then he should follow his patient’s wishes, whatever they are, as long as they’re not illegal.
4. A doctor has a responsiblity to think of the greater good, even if it means acting against a particular patient’s best interests.
5. A doctor has no more responsibility than any other person who performs a service. He ought to be able to pick and choose the specific jobs he does.
Within that framework, or outside that framework if you care to expound, do you think a doctor or pharmacist should work?
Here's my take on the matter. I want the doctor to be able to refuse a service that he or she feels is harmful to the patient. In the case of circumcision, which is an accepted practice on men in the West, but not on women, should the doctor be able to refuse to perform the operation? What about risky procedures that might put the doctor in great liability?
Regardless of how the doctor or pharmacist comes to the decision, I don't think they should be required to do something they're against. Of course part of the sticky situation comes in with insurance. What if the doctor or pharmacy is the only one available to a patient under insurance? Why should the doctor or pharmacy or insurance company be the ones to decide the care of the patient without another opinion or option?
If I was faced with either situation, I would no longer give my patronage to the doctor or pharmacy. I believe, at least where I live and with the insurance I have, I do have that choice. So wouldn't have that big of an impact on me that either would refuse the service. I personally find it backwards, but it's only going to be a minor convenience as long as I can go to another doctor or pharmacist that will offer to treat me.
Chaplain brought up emergency situations, and I think in that case Philly is right. If someone refuses to treat me based on religious grounds because I'm a woman or an apostate or some other reason, then that person should not be allowed to work in the emergency room. In a life and death matter, there is no room for debate. Someone's personal beliefs do not trump someone's life.
So for me, probably a combination of #1, 3, and 5. As long as the doctor or pharmacist doesn't impinge on my choice or the choice of others, then I don't care. As long as the doctor or pharmacist is clear in what services they will offer and what services they won't then I can make a choice to not give them my patronage. When my choice is taken away, that's where it becomes an issue.