Ok with not prescribing OCPs?

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I agree, it's not a contributing factor in that population. But if you trace the history of HIV and AIDS, you will find that in the early years of the disease there was a predilection among gay men, and even clinically if you talk to physicians who were on the forefront of treating AIDS, they will tell you the initial population was mostly like that. But the meteoric rise of the disease in the next period, when it really became a national problem, was mainly due to heterosexuals.

In some respects - but now that the blood supply is more controlled, it really is still mainly related to MSM and IV drug use. The passage rate from male to female is high, but the passage rate from female to male is not all that high - with the usual unprotected intercourse. They aren't putting that info out there loudly, because they don't want men not to get tested for fear of stigmatizing.

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So, for those people saying that a man should have a say in whether or not a woman is allowed to have an abortion (since both the man and the woman made the baby), do you think the woman should need the man's approval to carry to term? If she wants to have the baby, and he wants her to abort, does his opinion matter then? I'd wager you would say not. That's because your issues isn't about men and women having equal ownership over the fetus, it's about making sure the fetus is carried to term. You are anti-abortion, not pro-men-having-a-say-in-whether-a-woman-gestates. So, don't hide behind the "men and women should equally share ownership of the fetus" crap.

Either men have a say in gestation, or they don't. Since the woman is the one whose body is actually DOING the gestating, it is her decision to make. Ownership of the fetus has nothing to do with it. Also, you have to keep in mind situations in which an abusive significant other would force the woman to carry to term so that the child would tie her to him. I have seen that kind of thing happen before, where the child is used as a tool to control the mother and keep her in contact with her abuser. It's absolutely sickening. No woman should ever feel pressured into carrying to term. It's such a monumentally life-changing event that it should be entered into by choice.
 
Contraceptives contribute insofar as they give a false sense of security.

I've seen reports on this kind of thing. The problem is not with contraceptives, but the false sense of security that people are lulled into. The problem is a lack of proper sex education. When someone misuses a tool, it isn't the tool itself that is the problem.
 
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So, for those people saying that a man should have a say in whether or not a woman is allowed to have an abortion (since both the man and the woman made the baby), do you think the woman should need the man's approval to carry to term? If she wants to have the baby, and he wants her to abort, does his opinion matter then?

I discussed this scenario in my post. Please re-read it.

I'd wager you would say not. That's because your issues isn't about men and women having equal ownership over the fetus, it's about making sure the fetus is carried to term. You are anti-abortion, not pro-men-having-a-say-in-whether-a-woman-gestates. So, don't hide behind the "men and women should equally share ownership of the fetus" crap.

Wow, what hostility. The reason why a woman should have the right to carry to term when the man is for an abortion is because in conflicting situations, you have to err on the side of life. Notice I didn't mention the situation in which both parents want an abortion, or when both parents want the child, because in both those cases there is no conflict.

Also, you have to keep in mind situations in which an abusive significant other would force the woman to carry to term so that the child would tie her to him. I have seen that kind of thing happen before, where the child is used as a tool to control the mother and keep her in contact with her abuser. It's absolutely sickening. No woman should ever feel pressured into carrying to term. It's such a monumentally life-changing event that it should be entered into by choice.

Yea, there can be other issues that have an effect. If there is an abusive significant other, I doubt he would stop being abusive if the woman got an abortion. In that situation it's probably best for the couple to separate if her life is in danger.
 
I'm not hostile, I am blunt. I don't beat about the bush or pull my punches here, because I expect people to be able to own up to what they really think on these issues.

Your view is that the woman is a vessel, first and foremost, and that the fetus's life is more important than her wishes concerning the use of her body. So, you will always take the side that makes her gestate, whether she wants to or not. There is no situation other than pregnancy in which you would think it is alright for another person's opinion to undermine hers when it comes to the use of her body. When a woman is forced to continue gestation against her will, it can have a profoundly traumatizing effect on her psychologically.

That's why, even today, women try to perform abortions on themselves. They would rather risk severe injury or even death than be pregnant. Earlier this summer, for example, I was doing an internship at Planned Parenthood. A woman there came in after she had tried to perform the abortion on her own, because she was so ashamed to admit to others that she did not want to be pregnant. She did not want her husband to know that she felt that way. I've met numerous women in my lifetime who have adamately claimed they would attempt the same thing if abortion were made illegal.

Whether you think it is immoral or not, it needs to be safe, accessible, and (like any other medical decision) private. While I think it is best to consult your significant other (in most situations), I do not think that good communication is something that should be legislated by the government or enforced by the medical community. The man is not the patient, the woman is. He is not the one who will go through the gestation or the abortion. While it is preferable (and should be encouraged) that the woman consult him and take his feelings into consideration when making her decision, there is no disputing the fact that she is the one who should make the final call. Her body, her choice, not his.

I am not suggesting that abortion is a cure-all, or even a cure-anything. But in some instances, it can be empowering. For example, I knew a woman in the UK who was in a horribly abusive relationship. Her boyfriend replaced her oral contraceptive pills with look-alike placebos, and then poked holes in the condoms he used before sex. He purposefully got her pregnant, because he was hoping to pressure her into having the baby. His plan was to then sue for joint custody, forcing himself into the woman's life for 18+ years (if he couldn't talk her into marrying him to "do the right thing").

He was willing to pay the child support and do the parenting just so that he could have an element of control over her life. When she found out she was pregnant, the woman realized what he had been doing. She realized that the child would be used as a tool against her (she couldn't give it up for adoption without his consent, legally, and she didn't have the money for the legal battles). Her choice to have an abortion jolted her into understanding what her life had become and where it would go if she allowed herself to be controlled by him. He found out about her appointment, waited until she got home, beat her nearly to death, and then raped her all night, but he was too late to try and break her. She had finally done something that went against his wishes. That was the moment of her rebellion against her abuser, and she left him in the dust after that.

Horrible situation, absolutely. And like I said, I don't think that abortion is necessarily going to fix a person's problems. But, I have seen rare instances in which it has been a powerful liberating tool. However, those rare instances are not the norm, to be sure. They are simply more dramatic ways to illustrate the issues involved in the average cases. They are shocking, and they have the same ultimate point as more average stories.

The bottom line is that women should be able to make the choice for themselves, the man's opinions be damned. We should make it easier for women to carry to term if that's what they want to do. We should make it easier for children to be placed for adoption, particularly in cases of abusive relationships. And, we should make it easy for women to have safe, legal abortions if they decide that they do not want to continue the pregnancy. If all the options are equally feasible, then the greatest number of people will be able to make the choice that they think is best for them. We should not be making that decision for them.
 
Concerning your first point, ask yourself something. If human beings did not live in society and simply roamed the earth like other animals, eating what they could find, sleeping where they could, protecting themselves however they could, would you consider them to be in poverty? If so, would such poverty be a sin, especially since they are in the condition God placed them? As to your second point, the question of what works and what doesn't work is dependent upon the goal being aimed at. What is our goal?

Pillion,
Excuse me if I'm misinterpreting what you're saying but do you view poverty as being ok, because thats the way God made it?? Its easy to see poverty as pre-ordained when surrounded by the comfort of middle-class life but I couldn't disagree with you more. Choco made the point that contraception can aid to improve the lives of those who would otherwise be forever locked into poverty. After a month long MSIV rotation in EMS where we made calls to SW San Antonio daily, I can attest to Choco's speculation on the quality of life that having two kids by age 18 can buy you. I will be the first to admit that financial wealth does not equal a high quality of life, but it sure helps a lot. Working against poverty (including by supporting birth control) isn't working against God's will, its showing love to those around you and if anything its acting as an agent of His will.
M
 
It's like telling your obese patient who just can't give up his Whoppers and Big Macs that it's ok, he doesn't have to control his eating, you'll just up his meds. http://www.billings-centre.ab.ca/general/bc_evi.htm.

Sadly, this is exactly what ends up happening. Family Medicine was so maddening precisely bc of the pt you just described. Of course you try to lead them to making the right decision, but often medical management is the only active role we play in patient's quest to destroy their health.

You are so incredibly out of touch, in part bc you haven't gotten into the clinical world yet. Ideas like avoiding Big Mac or charting cervical mucus sound good in theory but don't play out so well in reality.
 
Pillion,
Excuse me if I'm misinterpreting what you're saying but do you view poverty as being ok, because thats the way God made it?? Its easy to see poverty as pre-ordained when surrounded by the comfort of middle-class life but I couldn't disagree with you more. Choco made the point that contraception can aid to improve the lives of those who would otherwise be forever locked into poverty. After a month long MSIV rotation in EMS where we made calls to SW San Antonio daily, I can attest to Choco's speculation on the quality of life that having two kids by age 18 can buy you. I will be the first to admit that financial wealth does not equal a high quality of life, but it sure helps a lot. Working against poverty (including by supporting birth control) isn't working against God's will, its showing love to those around you and if anything its acting as an agent of His will.
M

In response to a previous poster, I was arguing that being in a state of financial poverty is not a sin. (If anything, it is closer to what God intended for us.) I don't believe God made poverty; he just made us, and whether we live in palaces or in the woods is left to us supposedly rational creatures. The "sin" is on the part of society's members who have the means to help the poor but do not (Maybe that's me, right?). I'm sure you would agree. But we would probably disagree on what helping them means. Having just come from a clinic in SW SA, I'd also attest that poverty is real and that we need real solutions. But I don't believe we should use medicine to try to solve political/social problems. Of course, perhaps you're right about showing God's love by trying to control the number of people created. IMO, there are plenty of other ways to show love for the poor, regardless of whether or onot they ever get out of the financial situation they are in.
 
Never mind this post. Call it a computer glich.
 
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This is not a monogamous relationship.
I absolutely do not believe that a woman should have the right to have an abortion without the say of the father. I'm not saying that this is the way it is now. But if a wife is having a baby and wants to have an abortion, while the husband disagrees, she should not have the right because whatever way you look at it, the child is equally the mother's and father's. When she engaged in intercourse and became pregnant, she was becoming something more than herself. It's not as if she created the child by herself, or as if she was totally responsible for what happened. If the situation was reversed, and the father wanted her to have an abortion and she did not want to, of course she has the right to carry to term. Of course I'm not trying to say that children are property or anything like that, but I think you know what I mean. Both parents have equal responsibility.



It's established that people are having sex at younger ages than ever before, getting STIs at younger ages, etc, etc, etc, and in many others spheres, such as access to drugs and usage of drugs at a younger age. It's much more of a social problem today than it was 50 years ago. This is practically established, I'm not sure where you got the information that the only difference is that people are getting married later, which is true. I don't know anything about rates of extramarital sex today compared to past generations.

My point there was, there are plenty of people who think that they are in monogomous relationships but their SO's are cheating on them and potentially bringing home STD's. Like you couldn't figure that one out. Who really knows what their man/woman is out there doing 100% of the time?
 
Actually, my point was that these women ARE willing to get pregnant...but I personally would rather that they didn't!
Um, that isn't ourdecision, either way. Is it? Neither you, nor I, nor anyone else here gets to decide who is allowed to procreate and who isn't.

Just because we have the access, the knowlege and, in some cases, the seeming "authority" and, for some, the hubris to do so, doesn't mean we have the right to decide which women have children and which women do not. :scared: Talk about "Playing God."

I've had pts tell me about docs with this attitude, always thought they were exaggerating a little. Maybe not.

For whoever asked (can't remember) I don't know about the Council of Bishops or whatever.(I don't work Admin. Thank God.) But, individual medical decisions are not made by the Church or it's denizens in our hospital. Of course, we have an Ethics Commitee, I believe there may be or was a priest MD (he doesn't practice) on it. But, individual prescriptions for OCPs or other forms of BC don't go through this Commitee. We don't do terminations,(a lot of hospitals don't, even if they aren't religious affiliated) or RU486, but other forms of BC, as well as Tubal Ligs and Vasectomies are done all the time. Bishops, priests or anyone else from the Church do not have access to our pts records, even before HIPPA. I'd fight to my dying breath to keep those out of certain hands. But our drug closet, as well as those of other offices are stocked with samples of OCPs ect. The pharmacy carries forms of BC, we were trained to fit Diaphrams ect, just like "normal" Medical Schools. :laugh:

One more thing, study after study confirms that lack of access to Birth Control does not stop people from having sex. But, it does cause increase in unwanted pregnancy, upsuge in later term terminations, ect.

Am I reading this right? It's our duty, as physicians, to help (force) people become as impoverished as possible, so they will be closer to God? I can't have read that right. :confused: I must have missed that lecture.
 
(answer to a post concerning men, their right to make decisoins, abuse ect)
Yea, there can be other issues that have an effect. If there is an abusive significant other, I doubt he would stop being abusive if the woman got an abortion. In that situation it's probably best for the couple to separate if her life is in danger.

Yes, but a child would insure continued contact with the abusive partner, even in a case of separation. An abortion may not also stop an abusive partner from being abusive, but at least the woman would not only have a better chance of getting away on her own, with an abortion. But also, it would help stop the cycle of abuse, by not creating a life thrown immediately into an already abusive relationship.

Whether she leaves or not, the abuser will still be in both the mother and the child's life. If the woman decides she has a better chance at survival, and even eventually having a child who isn't going to be subjected to an abusive father, then that is her decision.

As Larch said, the woman is the patient, not the man.
 
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(answer to a post concerning men, their right to make decisoins, abuse ect)


Yes, but a child would insure continued contact with the abusive partner, even in a case of separation. An abortion may not also stop an abusive partner from being abusive, but at least the woman would not only have a better chance of getting away on her own, with an abortion. But also, it would help stop the cycle of abuse, by not creating a life thrown immediately into an already abusive relationship.

Whether she leaves or not, the abuser will still be in both the mother and the child's life. If the woman decides she has a better chance at survival, and even eventually having a child who isn't going to be subjected to an abusive father, then that is her decision.

As Larch said, the woman is the patient, not the man.

But see, at the point where a woman would have an abortion, she is already pregnant, meaning, WITH CHILD. The life is already created. So to have an abortion is to take the life of that child, the ultimate form of child abuse. I don't see that as ending a cycle of abuse, but merely perpetuating it. Perhaps even enlarging it.

Yes, the woman is the patient, as well as the new life growing within her.
 
Um, that isn't ourdecision, either way. Is it? Neither you, nor I, nor anyone else here gets to decide who is allowed to procreate and who isn't.

Absolutely. I don't think anyone would disagree with you. But we have enormous influence with our patients. If we refuse to prescribe effective birth control, we are automatically increasing the chances that our patients will procreate, so we are in effect making a decision about who's going to procreate. Our allowing or denying access to birth control has a very powerful effect, and that's exactly why our personal preferences shouldn't play a part.

From the US Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services:
"Catholic health institutions may not promote or condone contraceptive practices but should provide, for married couples and the medical staff who counsel them, instruction both about the Church's teaching on responsible parenthood and in methods of natural family planning."

So I still don't get how any Catholic hospital can contravene these guidelines without getting a nasty feeling of guilt.
 
So I still don't get how any Catholic hospital can contravene these guidelines without getting a nasty feeling of guilt.

I get those feelings of guilt all the time, then I go take a healthy crap and all is right with the world again. :smuggrin:
 
But see, at the point where a woman would have an abortion, she is already pregnant, meaning, WITH CHILD. The life is already created. So to have an abortion is to take the life of that child, the ultimate form of child abuse. I don't see that as ending a cycle of abuse, but merely perpetuating it. Perhaps even enlarging it.

Yes, the woman is the patient, as well as the new life growing within her.

If that's how you really feel, you should think it's a CRIME for a pregnant woman to drink or smoke. Wouldn't that fall in the category of "reckless endangerment" at the very least? There are innumerable things that women do, perfectly legally, that can endanger the fetus. Let's also not forget exactly how controversial "double murder" cases for pregnant women are. They go on forever. If things were as clear-cut as you make them out to be, things like that should be a non-issue.

In any case, it is disgusting for you to compare child abuse to abortion. The two actions have completely different motivations. I understand that you think of the fetus as a person, and I can understand you finding abortion horrific. But, it is not related to child abuse. Women who have abortions are not more likely than others to abuse born children. Before you make such implications, I suggest you think more carefully about what you are saying.

Moving on, the value of the fetus is subjective, otherwise we wouldn't even be having this argument. Not everyone thinks it is equivalent to a born child, particularly not at the point that most abortions are performed. The crux of the issue is this...

You have two entities residing in one body, basically. One of them very clearly has rights, the other is currently more questionable. Does the fetus's questionable right to be gestated override the woman's right to dictate how her body is used? Some say yes, others (myself included) say no.
 
Am I reading this right? It's our duty, as physicians, to help (force) people become as impoverished as possible, so they will be closer to God? I can't have read that right. :confused: I must have missed that lecture.

We treat the poor and we treat the wealthy, but it's not our duty as physicians to solve the problem of poverty.
 
From the US Conference of Catholic Bishops, Ethical and Religious Directives for Catholic Health Care Services:
"Catholic health institutions may not promote or condone contraceptive practices but should provide, for married couples and the medical staff who counsel them, instruction both about the Church's teaching on responsible parenthood and in methods of natural family planning."

So I still don't get how any Catholic hospital can contravene these guidelines without getting a nasty feeling of guilt.

If Catholic hospitals are not following these guidelines, they should feel guilt.
 
...the value of the fetus is subjective, otherwise we wouldn't even be having this argument. Not everyone thinks it is equivalent to a born child, particularly not at the point that most abortions are performed. The crux of the issue is this...

You have two entities residing in one body, basically. One of them very clearly has rights, the other is currently more questionable. Does the fetus's questionable right to be gestated override the woman's right to dictate how her body is used? Some say yes, others (myself included) say no.

So when does the unborn baby become a "real" person in your view? When it exits OUTSIDE the mother's body? What makes that baby any more "alive" than when it was still in her womb? Is it the fact that it is breathing air on its own? We have people on vents- they aren't breathing on their own, so are they not human? Or is it perhaps when the fetus reaches 37 weeks gestation that it becomes human? What about a premie then? Does it not become human until it reaches 37 weeks post-fertilization, even though it is living outside its mother's body? What if my baby comes at 40 weeks instead of at 37? Does that mean it lived "as a human" for 3 weeks inside my uterus?

Do these arguments sound ridiculous? Of course they do! It's rather silly to pick some arbitrary point at which the fetus "becomes" human- the fetus IS a human! From the beginning!
 
So when does the unborn baby become a "real" person in your view? When it exits OUTSIDE the mother's body? ... We have people on vents- they aren't breathing on their own, so are they not human? Blah blah blah, I'm trying to pre-emptively berade Larch by trying to guess what he/she might think, but I really don't know, so I'm talking out of my ass.

Do these arguments sound ridiculous? Of course they do! It's rather silly to pick some arbitrary point at which the fetus "becomes" human- the fetus IS a human! From the beginning!

Of course, a human fetus is a human the whole time (it isn't a litter of kittens or a batch of cupcakes, you know). Heck, if you want, you can even think of it as a "person" the whole time. I don't really care what you call it, that won't change what it is or where it is. For me, the debate isn't about the stature of the fetus, but about which entitity (the mother or the fetus) has more right over the woman's body.

It doesn't matter to me if the fetus is capable of tapdancing and singing opera in utero. In my opinion, no matter the circumstance, no matter how far along in gestation, the woman always has full rights over the use of her body (and so, in theory, should be allowed to choose abortion at any time during gestation). The fetus has no right to her body, and is only there because she allows it to be there.

The debate only exists because you have two humans inhabiting the same body at the same time. People on respirators are not attached to other people, and if they were there would likely be a huge debate about whether or not it was ethical to disconnect them (actually, we have that debate already, without the whole "being attached to another person" thing... zing), even though their humanity and personhood are pretty damn clear. That's because what people really care about is bodily autonomy... freedom over your own body.
 
Of course, a human fetus is a human the whole time (it isn't a litter of kittens or a batch of cupcakes, you know). Heck, if you want, you can even think of it as a "person" the whole time. I don't really care what you call it, that won't change what it is or where it is. For me, the debate isn't about the stature of the fetus, but about which entitity (the mother or the fetus) has more right over the woman's body.

It doesn't matter to me if the fetus is capable of tapdancing and singing opera in utero. In my opinion, no matter the circumstance, no matter how far along in gestation, the woman always has full rights over the use of her body (and so, in theory, should be allowed to choose abortion at any time during gestation). The fetus has no right to her body, and is only there because she allows it to be there.

The debate only exists because you have two humans inhabiting the same body at the same time. People on respirators are not attached to other people, and if they were there would likely be a huge debate about whether or not it was ethical to disconnect them (actually, we have that debate already, without the whole "being attached to another person" thing... zing), even though their humanity and personhood are pretty damn clear. That's because what people really care about is bodily autonomy... freedom over your own body.

I could fathom this argument if it was not in reference to a mother and her child. But mothers have a natural duty to protect their children, and that duty overrides her bodily autonomy.
 
I could fathom this argument if it was not in reference to a mother and her child. But mothers have a natural duty to protect their children, and that duty overrides her bodily autonomy.

Not meant to attack your OPINION, but here's something you might find interesting. Some animals that can choose to spontaneously abort when they are being chased by a predator. Zebras come to mind. I remember watching a National Geographic video as a kid, and a pregnant zebra was being chased by a lion. The narrator explained that she voluntarily miscarried in mid-gallop, dropping the fetuses (she was carrying twins) to distract the lion. Lion ate the fetuses, mama zebra got away.

Getting back to humans, though, I don't think anything ever overrides a person's right to bodily autonomy. Don't state something as a fact, when it's really an opinion.

As for the "natural duty" a mother has to protect her offspring, why do you use the word "natural?" Are you suggesting that it is "unnatural" for a mother to not want to protect her offspring? If that's the case, how do you explain women (and females of other species) who abandon their infants? Hell, please explain dwarf hamsters to me. They constantly eat their offspring.
 
Getting back to humans, though, I don't think anything ever overrides a person's right to bodily autonomy. Don't state something as a fact, when it's really an opinion.

As for the "natural duty" a mother has to protect her offspring, why do you use the word "natural?" Are you suggesting that it is "unnatural" for a mother to not want to protect her offspring? If that's the case, how do you explain women (and females of other species) who abandon their infants? Hell, please explain dwarf hamsters to me. They constantly eat their offspring.

You use an example from the world of beasts to backup why a woman has a natural right to abort and then say nothing trumps bodily autonomy. If we stick with your analogy, then no such right exists because animals kill each other all the time without any obligation to respect "rights." Survival of the fittest, or strongest.

To clarify, my use of the term "natural" does not mean nature as the world we observe via science, or on the discovery channel. I mean natural as in what accords with our nature as human beings. In the former use of "nature", compassion and hospitals make no sense. Let's just kill the weak and get on with prosperity and survival. In the latter use, we sense an obligation toward other human beings because of their inherent value as persons. A mother's obligation toward her child, born or unborn, is the prime example of such obligation. Call it an opinion, but what is implied in your view is a world where might makes right. And in that world, your claim to "rights" doesn't mean jack.
 
Come one, I'm not that narrow-minded. She can also join a convent.

Judaism doesn't have convents, so that makes me SOL.

My only comment is that if you are an OB/Gyn that refuses to prescribe BCPs/provide equal care for married or unmarried women, ethically you should advertise that fact on all referral literature. That way you do not waste my time or money and I do not waste your time. Please feel required to put it in large letters under your name in the White pages/Yellow pages/ads.

(Please note that I do not use BCPs, nor am I permiscuous, nor do I believe in abortion. But I want my money and trust to go to a provider that I BELIEVE has ethics and beliefs consistant with mine, and that will provide all care that I and all good women may need in the future.
 
So when does the unborn baby become a "real" person in your view? When it exits OUTSIDE the mother's body? What makes that baby any more "alive" than when it was still in her womb? Is it the fact that it is breathing air on its own? We have people on vents- they aren't breathing on their own, so are they not human? Or is it perhaps when the fetus reaches 37 weeks gestation that it becomes human? What about a premie then? Does it not become human until it reaches 37 weeks post-fertilization, even though it is living outside its mother's body? What if my baby comes at 40 weeks instead of at 37? Does that mean it lived "as a human" for 3 weeks inside my uterus?

Do these arguments sound ridiculous? Of course they do! It's rather silly to pick some arbitrary point at which the fetus "becomes" human- the fetus IS a human! From the beginning!
I draw the line at 26 weeks, because that is about the practical limit for survival ex utero, outside of the occasional fluke case that survives earlier. Even if they do survive below 26 weeks, chances are better that there will be serious developmental, cognitive or sensory abnormalities than that the child will be functional at a level comparable to their peers.
 
Judaism doesn't have convents, so that makes me SOL.

My only comment is that if you are an OB/Gyn that refuses to prescribe BCPs/provide equal care for married or unmarried women, ethically you should advertise that fact on all referral literature. That way you do not waste my time or money and I do not waste your time. Please feel required to put it in large letters under your name in the White pages/Yellow pages/ads.

(Please note that I do not use BCPs, nor am I permiscuous, nor do I believe in abortion. But I want my money and trust to go to a provider that I BELIEVE has ethics and beliefs consistant with mine, and that will provide all care that I and all good women may need in the future.

I agree with your suggestion. Would my business suffer? Maybe. But from my experience, Catholics who want NFP only docs are abundant and underserved. And the few Catholic Ob/Gyns that run such practices are very up-front with their style, and they have plenty of business.
 
Amazing how a question about OCPs turns into one about abortion. I think that, no matter what your views, as a doctor who is supposedly knowledgeable about physiology and thinks in a scientific and evidence-based manner, one MUST acknowledge that birth control and abortion are two seperate topics. You can be opposed to both if you are so inclined, but do not conflate the two. You may see them as morally the same, but they are physiologically, pharmacolgicically and medically completely different. You may wish to provide neither to your patients, but be sure that you are deciding about the two as distinct entities, informed by your scientific knowledge as well as your faith, morals and conscience.

On a similiar note, some comments about EC/Plan B; I know it has been said, but it is worth repeating. IT IS NOT AN ABORTIFACENT! There is no evidence in humans that it disrupts an implanted pregnancy; there is evidence in animals that it specifically DOES NOT interrupt an implanted pregnancy. Read your literature, docs. Refer to the scientific evidence, not to propaganda. It DOES - prevent ovulation, decrease sperm pentration, and alter the uterine environment. Now, if you are opposed to birth control, and are opposed to prescribing birthcontrol, you have some logical basis for an opposition to EC. If you are all right with OCPs, IUDs and barriers you should accept EC based on the evidence concerning how it works. In addition, all available evidence from other countries where it has been OTC for years suggests that other comon arguments against EC (increases promiscuity, decreases BC usage, teens go wild and have orgiastic sex parties) are completely unfounded. Again, go to the literature, not to your own predjudices and fears when deciding about this stuff.
 
Amazing how a question about OCPs turns into one about abortion. I think that, no matter what your views, as a doctor who is supposedly knowledgeable about physiology and thinks in a scientific and evidence-based manner, one MUST acknowledge that birth control and abortion are two seperate topics. You can be opposed to both if you are so inclined, but do not conflate the two. You may see them as morally the same, but they are physiologically, pharmacolgicically and medically completely different. You may wish to provide neither to your patients, but be sure that you are deciding about the two as distinct entities, informed by your scientific knowledge as well as your faith, morals and conscience.

On a similiar note, some comments about EC/Plan B; I know it has been said, but it is worth repeating. IT IS NOT AN ABORTIFACENT! There is no evidence in humans that it disrupts an implanted pregnancy; there is evidence in animals that it specifically DOES NOT interrupt an implanted pregnancy. Read your literature, docs. Refer to the scientific evidence, not to propaganda. It DOES - prevent ovulation, decrease sperm pentration, and alter the uterine environment. Now, if you are opposed to birth control, and are opposed to prescribing birthcontrol, you have some logical basis for an opposition to EC. If you are all right with OCPs, IUDs and barriers you should accept EC based on the evidence concerning how it works. In addition, all available evidence from other countries where it has been OTC for years suggests that other comon arguments against EC (increases promiscuity, decreases BC usage, teens go wild and have orgiastic sex parties) are completely unfounded. Again, go to the literature, not to your own predjudices and fears when deciding about this stuff.

Contraception and abortion are seperate issues, but they are related, especially if you believe human life (and thus pregnancy) begins at conception, not implantation. From this perspective, if plan B prevents implantation of a fertilized ovum, as even regular contraceptives do if breakthrough ovulation/fertilization occurs, then they are acting as an abortifacent.

Also, from what I understand, the legal justifaction of abortion is based in part on the legalization of contraception. In other words, if we are going to allow people to use contraceptives, then we need to allow abortion in the event that the contraceptives fail (which they often do). Correct me if I'm wrong here.
 
Contraception and abortion are seperate issues, but they are related, especially if you believe human life (and thus pregnancy) begins at conception, not implantation. From this perspective, if plan B prevents implantation of a fertilized ovum, as even regular contraceptives do if breakthrough ovulation/fertilization occurs, then they are acting as an abortifacent.

Also, from what I understand, the legal justifaction of abortion is based in part on the legalization of contraception. In other words, if we are going to allow people to use contraceptives, then we need to allow abortion in the event that the contraceptives fail (which they often do). Correct me if I'm wrong here.


Right on, Pillion. In Planned Parenthood v Casey (1992):

"(this is not quite verbatim but it's close) it says that “in several important respects, the decision to use contraceptives is the same as the decision to abort.” Or the decision to have an abortion is the same as the decision to contracept. And it goes on to explain. It says that, “For two decades, couples have based their intimate relationships on the availability of abortion should contraceptives fail.” Now in this whole Supreme Court decision, which is on abortion, there is not one mention of the humanity of the unborn child, not one mention of whether the fetus was a person or not. It's not even dismissed as a question. It's not even considered. But it does say we must have abortions because we have contraceptives. It's a necessity. For two decades, couples have counted on it should their contraceptives fail. The Supreme Court says so. "
(taken from "Contraception: Why Not?" by Janet Smith, PhD)

Contraception and abortion are intimately linked. There is no denying that.
 
On a similiar note, some comments about EC/Plan B; I know it has been said, but it is worth repeating. IT IS NOT AN ABORTIFACENT! There is no evidence in humans that it disrupts an implanted pregnancy; there is evidence in animals that it specifically DOES NOT interrupt an implanted pregnancy. Read your literature, docs. Refer to the scientific evidence, not to propaganda. It DOES - prevent ovulation, decrease sperm pentration, and alter the uterine environment.

OB2B, you would be surprised to learn that many women do not know about this mechanism of action of the pill and plan B. They simply think that it prevents ovulation (or they simply don't think about how it works at all). In any case, many women do believe that life begins at conception, regardless of how certain medical communities choose to define life, and are distraught to learn that the "harmless" pill they have been taking could be acting as an abortafacient. I have seen many women give up their use of the pill after learning this. I wonder why more docs don't inform their patients of this serious implication?
 
Judd,
let me pose you a question:
If you knew of a way to treat your patient's PMS symptoms (just an example) without increasing her risk of

thromboembolism, retinal thrombosis, thrombophlebitis, MI, cerebral thrombosis, cerebral hemorrhage, HTN, severe hepatic adenoma (rare), cholestatic jaundice, gallbladder dz, depressionan, aphylaxis/anaphylactoid rxn, nausea/vomiting, abdominal cramps, bloating, breakthrough bleeding, altered menstrual flow, amenorrhea, breast tenderness, breast changes, edema, headache/migraine, weight changes, cervical secretion changes, emotional lability, vaginal candidiasis, rash, acne, melasma, contact lenses intolerance, elevated BP, glucose intolerance (list taken from epocrates.com)

...wouldn't you choose that option? I know, as a patient, that I would choose the treatment option with the fewest/no side effects! And, as a doctor, I would want to provide that option to my patient. Point of fact is, there are other ways to treat women other than OCPs. What does an OCP do anyway? It masks symptoms, fools the body into a fake "menstural cycle". Have you fixed anything? Not really. Perhaps the women has lighter periods, fewer cramps, less PMS, etc. But the underlying problem has not been corrected. All you've done is introduce fake hormones into her body that cover it up.

Perhaps the reasons that people are so opposed, sometimes violently opposed (as evidenced by many of the posts in this thread) to alternative treatments to OCPs, is that people don't really understand or know ANYTHING about them! Have you ever looked at any of the research? I challenge you to read some of it- it's quite convincing. And I think it's always a good idea to educate oneself about BOTH sides of an issue before coming to a decision.

No one is going to change anyone's mind regarding when life begins and abortion, so I refuse to be involved in that debate.

But when it comes to the non-contraceptive benefits of the pill? All those things listed as risks of taking the pill were all drastically improved for me once I started on the pill. It was wonderful! Note that I also highlighted the word OPTION. If you 100% refuse to prescribe pills, presumably you are not even going to educate your patients about this method of contolling PMS symptoms so you're not really giving her the OPTION at all between using pills and using other methods (almost all of which I tried and did not relieve my symptoms so don't talk to me about "researching both sides" when evidence clearly suggests the most effective method of relieving PMS symptoms is OCPs). The paternalism is insufferable. Of course there are risks in using the pill. That's why you explain them, along with the benefits of the pill, to your patient and let her decide. You don't, in any field of medicine, get to say, "Oh, I don't like this so I'm not going to give it to you" when it's a very legitimate method of treatment for a patient's problem in the absence of obvious contraindications.

Yeah, the pill "masks the symptoms" and "fools the body into a fake menstrual cycle." PMS is a constellation of SYMPTOMS. If you've masked them, you're well on you're way to curing the patient of her PMS symptoms! HELL YES!! you've fixed something by doing that. We give painkillers to migraine sufferers and patients with metastatic bone pain. In fact, every time we are giving a painkiller (including to a woman with painful menstrual cramps), we are just masking the symptoms rather than curing the underlying problem. But if you don't think that's fixing a problem, clearly you've never experienced significant pain before.
 
Well said. Pass a kidney stone without pain meds and then you can talk about "Well, it just masks the symptoms." I'd have taken being shot in the head at that point to make the pain stop. :laugh:
 
I draw the line at 26 weeks, because that is about the practical limit for survival ex utero, outside of the occasional fluke case that survives earlier. Even if they do survive below 26 weeks, chances are better that there will be serious developmental, cognitive or sensory abnormalities than that the child will be functional at a level comparable to their peers.

So ******ed people aren't people? Don't deserve human rights?
 
FYI, there's a nice little review in JAMA this week about the current state of knowledge about EC/Plan B; makes the point that prevention of ovulation, cervical changes are most likely the major mechanisms; evidence for even prevention of implantation of a fertilized egg is weak; no evidence of disruption of implanted pregnancy. I think everyone should read it.

Also, one point about all those side effects of the pill; the incidence of almost all of them - and many, more - are much, much higher in pregnancy than on any form of hormonal contraception (including the patch, which we all got so up in arms about last year). Of course, this is not a reason to keep a woman from getting pregnant. But, those of you out there who wish to deny women birth control or EC are effectively forcing a women to expose herself to risk of pregnancy,and you are quite likely to be instrumental in forcing that women into a pregnancy she doesn't want. And if one of the reasons you cite for not wanting to give OCPs is that there can be health risks - isn't it hypocritical to force her to take a much higher level of risk because of your own values?

I'm also curious (I'm not being antagonistic here, I really am curious) - those of you who oppose prescribing birth control - do you also counsel your patients specifically to not use condoms? If you are confronted with a patient who you know has multiple partners and is not likely to change that behavior, how do you reconcile your own views with the goal of preserving the health of the patient?
 
So ******ed people aren't people? Don't deserve human rights?
No, I didn't say that.....I was just stating the chances of a good outcome are slim at that gestational age. Personally if I were in a situation where I was a patient and knew I was going to come out gorked (DAI, massive intracranial bleed, cardiac arrest with hypoxic encephalopathy, etc), you can not imagine how stringently I would be hoping and praying that my family would have the decency to value quality of life over quantity when it comes to benefits analysis.

The same applies to a child as does to an adult- what are the chances of a decent outcome versus producing someone with the cognitive function of a head of lettuce or at best, a lower chordate?

In fact, taking the stance to withdraw support in such cases- or to prevent suffering in the case of termination of a pregnancy you know is going to result in a piss poor outcome, is exactly basic human rights......there are two standards of "harm" in medicine that can violate the oath we take: the harm that results from us standing idly by and not acting when we should, and the harm that comes from continuing to beat a dead horse (or man, or woman, or child) when we know we are beaten.

I have a sign that used to hang above my desk at the fire department where I was the EMS supervisor.....it reads "Prevent when possible, treat effectively when challenged and above all else support humanely so as to prevent suffering". Given my interest in medical ethics, I like to teach that bit of advice to every EMT, paramedic or RT student I teach.....my interest notwithstanding it is still a valid point and is the basis behind my stance on the issues discussed in this thread.
 
Anti-choice crowd take note: Your god is not welcome in my uterus unless I invite him in. I did not.



Thankyouverymuch.
 
Anti-choice crowd take note: Your god is not welcome in my uterus unless I invite him in. I did not.



Thankyouverymuch.

"Be it done unto me according to Thy will." Just try it sometime.
 
I draw the line at 26 weeks, because that is about the practical limit for survival ex utero, outside of the occasional fluke case that survives earlier. Even if they do survive below 26 weeks, chances are better that there will be serious developmental, cognitive or sensory abnormalities than that the child will be functional at a level comparable to their peers.

Murphy, you took the idea straight from my own mind. How can Ecuadordoc say that a fetus has rights or should have the ability to mandate what the mother does before 26 weeks?! It wouldn't be able to survive before that point (maybe as early as 24-25, but as you alluded to Murphy, "survive" has its own gray zone), so by definition, it is not a living thing. Yes, after that, I would count it as its own "person" because technically it can be one when it is removed from the uterus. Guess what - that's why 3rd trimester abortions aren't legal.
Speaking as a currently pregnant mother, I'm pretty appalled that some of you out there are going into this field of Ob-Gyn (or medicine at all) with these paternalistic attitudes, and such immovable viewpoints about the types of lifestyles you want to force upon your patients. Don't ever forget that every person who comes to you for treatment and help has their own life story and their own motivations for making the choices they make. I personally would never have an abortion, nor would I perform them, but I am more than willing to refer my patients who want them to reliable physicians who will. I am comfortable with my choices, as I sit in my middle class neighborhood, with my healthy marriage, and my supportive family. Not everyone has the same situation I do, and I can't pretend to have everyone's "best interest" in mind when I don't know them for more than a 30 minute clinic visit (if I'm lucky).
 
I'm pretty appalled that some of you out there are going into this field of Ob-Gyn (or medicine at all) with these paternalistic attitudes, and such immovable viewpoints about the types of lifestyles you want to force upon your patients. Don't ever forget that every person who comes to you for treatment and help has their own life story and their own motivations for making the choices they make. I personally would never have an abortion, nor would I perform them, but I am more than willing to refer my patients who want them to reliable physicians who will. I am comfortable with my choices, as I sit in my middle class neighborhood, with my healthy marriage, and my supportive family. Not everyone has the same situation I do, and I can't pretend to have everyone's "best interest" in mind when I don't know them for more than a 30 minute clinic visit (if I'm lucky).

Let's say Doctor A does not believe Drug X is best for his patient and has a moral objection to prescribing it while Doctor B sees no problem with it. Accordingly, Doc A will neither give it to his patient not refer the patient since both actions would violate his conscience as to what is the best health care for his patient. This is not an imposition of one's beliefs onto a patient. The "imposing" enters the picture when someone else forces Doctor A to violate his conscience and adopt their ideas about what is best for the patient.

Try not to be so appalled when other people think or believe something different from you.
 
How can Ecuadordoc say that a fetus has rights or should have the ability to mandate what the mother does before 26 weeks?! It wouldn't be able to survive before that point (maybe as early as 24-25, but as you alluded to Murphy, "survive" has its own gray zone), so by definition, it is not a living thing. Yes, after that, I would count it as its own "person" because technically it can be one when it is removed from the uterus. Guess what - that's why 3rd trimester abortions aren't legal.

...as if the definition of a living thing is being able to survive on your own. Wouldn't that mean all your ICU patients are no longer alive?
 
Nope, ICU patients isn't a fair comparison -- in the ICU we're treating an illness in an existing life.

I understand your argument about your moral objection to termination and OCPs; however if you plan to practice in this country, you should understand that terminations and OCPs are LEGAL and often standard of care. You seem to think you can provide ob/gyn services without addressing this (v. crucial) aspect of women's healthcare and that's fine: no one cares if you can't do/provide these services yourself but if you deny a patient access (ie by refusing to refer a patient who doesn't know how to find these resources herself) to these services, you're violating your duty as an ob/gyn.
 
Nope, ICU patients isn't a fair comparison -- in the ICU we're treating an illness in an existing life.

Or maybe being in a state of dependence does not define who is and who is not a human person.

I understand your argument about your moral objection to termination and OCPs; however if you plan to practice in this country, you should understand that terminations and OCPs are LEGAL and often standard of care. You seem to think you can provide ob/gyn services without addressing this (v. crucial) aspect of women's healthcare and that's fine: no one cares if you can't do/provide these services yourself but if you deny a patient access (ie by refusing to refer a patient who doesn't know how to find these resources herself) to these services, you're violating your duty as an ob/gyn.

For anyone interested in how Ob/Gyn is practiced from a Catholic perspective, check out this link..

www.tepeyacfamilycenter.com/
 
"It's called moral relativism. Try it sometime"

Trust me, it makes things a LOT easier when you can understand that given the right circumstances almost anything is morally acceptable. Hell, sometimes the only way to sleep well at night is to do something that would under any other setting be morally repugnant (killing a burglar being a great example of this).

I may not agree with actually doing something myself, but I have no problem handing them off to someone who doesn't share my objections. The blood, and in this case products of conception, are therefore not on my hands and I can sleep good at night.

pillion said:
Try not to be so appalled when other people think or believe something different from you.

I'll say something my supervisor used to say to a coworker of mine: "Just when I think you've said the dumbest, most hypocritical thing possible, you just keep right on flapping your gums."
 
...as if the definition of a living thing is being able to survive on your own. Wouldn't that mean all your ICU patients are no longer alive?
Spend a few years working with vent patients and learn the proper definition and applicability of the term 'medical futility' and then come back and we'll talk. While you're at it, I would also suggest recommend you spend a while (6 months plus) around a NICU and see the torment of the parents of the patients who are beyond hope but because of false hope they prolong their agony in hopes of a miracle. Once you've done these things you can speak about when or when something is alive, dead, or somewhere in that huge gray abyss in between.
 
Spend a few years working with vent patients and learn the proper definition and applicability of the term 'medical futility' and then come back and we'll talk. While you're at it, I would also suggest recommend you spend a while (6 months plus) around a NICU and see the torment of the parents of the patients who are beyond hope but because of false hope they prolong their agony in hopes of a miracle. Once you've done these things you can speak about when or when something is alive, dead, or somewhere in that huge gray abyss in between.

You imply that ventilated patients are cases of medical futility. That makes tons of sense, especially for all those patients who recover and leave the ICU. My previous statement has nothing to do with the question of medical futility. I was responding to this comment "It wouldn't be able to survive before that point ( 24-25 weeks), so by definition, it (the fetus) is not a living thing." So Dropkick, does being able to survive on your own enter the definition of the human person?
 
"It's called moral relativism. Try it sometime"

Trust me, it makes things a LOT easier when you can understand that given the right circumstances almost anything is morally acceptable. Hell, sometimes the only way to sleep well at night is to do something that would under any other setting be morally repugnant (killing a burglar being a great example of this).

First, killing an intruder or someone who is attacking you is not an example of moral relativism. Second, if you were really a moral relativist, you would have no objections to someone like me who does not want to prescribe contraception, do abortions, etc. because you would realize that the only foundation for your objection is your own isolated opinion. And since it does not and cannot carry the weight of truth, no one would have any moral obligation to listen to you (and perhaps this is why I don't listen to you).

Moral relativism does not work. It's the door to either anarchy or tyranny.

I'll say something my supervisor used to say to a coworker of mine: "Just when I think you've said the dumbest, most hypocritical thing possible, you just keep right on flapping your gums."

DM, you could tell me that you think it's acceptable to sterilize every living woman and man and I wouldn't be surprised because it follows from your relativist logic.
 
You imply that ventilated patients are cases of medical futility. That makes tons of sense, especially for all those patients who recover and leave the ICU. My previous statement has nothing to do with the question of medical futility. I was responding to this comment "It wouldn't be able to survive before that point ( 24-25 weeks), so by definition, it (the fetus) is not a living thing." So Dropkick, does being able to survive on your own enter the definition of the human person?
No, that's not what I'm implying....hence the reference to "proper application of the term". But I do believe that medical futility runs exactly contrary to what your stated beliefs are because it requires a decision to be made that the price being paid is too high in regards for the return- in the name of someone's misguided hope or the skewed philosophy of a few zealots who believe that live is sacred regardless of the quality of it.
 
First, killing an intruder or someone who is attacking you is not an example of moral relativism. Second, if you were really a moral relativist, you would have no objections to someone like me who does not want to prescribe contraception, do abortions, etc. because you would realize that the only foundation for your objection is your own isolated opinion. And since it does not and cannot carry the weight of truth, no one would have any moral obligation to listen to you (and perhaps this is why I don't listen to you).

Yes it is. The situation precludes the belief that killing someone is wrong- I don't believe in hunting people for sport or for my own amusement, but I have zero qualms with killing anyone and everyone who is a clear and present danger to myself and/or those around me. That is the essence of moral relativism in that the situation dictates what is morally correct.

I don't have a problem with you not wanting to do it. I think you're letting your beliefs cloud your judgment but I figure if you want to serve those others who think like you do, more power to you. What I do have a problem with is your blind allegiance and fervent disregard for the rights of those who dissent from your stated viewpoint.

BTW, since your definition of truth comes from the Bible, should it be capitalized? In the sense of "The Truth, The Way, The Light"? :laugh: You apprarently pay me more heed than you would like to believe in that you take the time to feebly attempt to refute my statements.


Moral relativism does not work. It's the door to either anarchy or tyranny.

As opposed to what happens when you base your laws exclusively off what you think God wants at the expense of those who don't agree or outright believe you have your head crammed pretty far up a certain orifice?


DM, you could tell me that you think it's acceptable to sterilize every living woman and man and I wouldn't be surprised because it follows from your relativist logic.

No, not at all actually. I would prefer to trick them into walking into a shower and gassing them en masse. It's just so much more expedient. :rolleyes:
 
as if the definition of a living thing is being able to survive on your own. Wouldn't that mean all your ICU patients are no longer alive?[/QUOTE]

Umm, yes, in Biology (= the study of life) a living thing is defined as one that can survive independently of other organisms. Hence, viruses are not living things; they need cells to perform their metabolic and reproductive functions for them. Under no circumstance can they do this for themselves. Even parasites (such as flukes) can perform all life functions at least temporarily while they are between hosts.

ICU patients were alive before they became ill, so when they are intubated and admitted to the ICU they are "ill" not suddenly and mysteriously "unalive" until such point (GRAAAAAY zone) at which it is decided by treating team/family that they have crossed that line into "no longer alive."

In any case, I feel that you are welcome to your opinions about OCP's, etc. I just don't think you're going to provide good medical care with good informed consent to your patients if you don't give them the opportunity to seek those other treatments which you personally are not in favor of, and explain them in an unbiased manner as part of the "alternative treatments" part of the informed consent process.
 
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