Assisting/Observing Abortion.

[Singh.Simran]

Originally Posted by yazoo

Quite right. Unless the patient lacks capacity to make the decision for themselves.

True

I suppose a sizeable minority of GPs won't get involved with abortion, but I have no idea of the figures. I simply know of a few who don't. I know no O&G consultants who refuse to be involved.

There isn't really a get out clause enshrined in law. The GMC guidance is based upon the views of many Drs. While a relatievly small number of Drs draft guidance, all such issues would be open to consensus evaluation prior to being deemed appropriate. So the majority of Drs would agree with the GMC guidance. I certainly have never heard anyone, either privately or publically, disagree with their good practice priciples. Putting them into practice 100% of the time is another matter - to err is human!

So basically, the vast majority of Drs think other Drs should be allowed to refuse to get involved in any case where their persoanl beliefs may influence practice. That makes total sense to me.

I'd agree as to "sizable minority". Enough to make it something worth talking about - and again all those i have met were GPs, which i suppose makes my "go into another specialty" thing fall apart - the only reason their ethics interfere with their specialty is because their specialty is so broad.

Of course people don't disagree as to good practice, but nor does anyone about "Thou shalt not kill". Doesn't make leviticus any less ridiculous

Hmmm.. I think i still have to disagree on the analysis. Though neither of us know definitively, i would hazard that a good doctor has the skills and mental willpower to give good treatment against their ethics if they have to - as part of their job and role as a professional. And since we all agree we don't WANT beliefs to get in the way of care, anything that makes it easier to happen is bad in my view - e.g. this clause.

Fine if it was only used by those who so seriously hate abortion they could fundamentally not provide good care, but i sincerely doubt that there aren't a great many who are somewhere else on the greyscale. it's not black and white.

[Singh.Simran]

Alright, i've found a better analogy -

CookieMonster, this one's for you. Say you were (maybe you are) a devout muslim, seriously orthodox, good doctor but you fundamentally believed your faith did not allow you to touch women when woman doctors were available (i don't mean intimate exams, i mean everything). For the sake of argument, accept that premise.

Currently there would be an opt out for you as regards abortion (which the Dr described above certainly would not be in favour of), but not procedures and treatment involving women.. Is that ridiculous? Should he/you be able to have that second opt-out because of his true and sincere belief? What if his treatment of women becomes compromised because he unwilling to have as much flesh bared as would help, or to palpate without gloves..or?

Etc

[mistyblue]

I don't think that is an equal comparison.......
with abortion you are ending the life(or if you like potential life)
of a person....I think there is nothing professionally wrong with any doctor who does not want to perform this or a medical student who does not want to watch (I know I won't) as long as they remain professional don't inflict the view they don't agree with it to the patient and refer the patient to someone else
I don't ever think it will be a problem that there will not be enough doctors to do it as not everyone feels it is wrong

[yazoo]

Originally Posted by Singh.Simran

Hmmm.. I think i still have to disagree on the analysis. Though neither of us know definitively, i would hazard that a good doctor has the skills and mental willpower to give good treatment against their ethics if they have to - as part of their job and role as a professional. And since we all agree we don't WANT beliefs to get in the way of care, anything that makes it easier to happen is bad in my view - e.g. this clause.

Fine if it was only used by those who so seriously hate abortion they could fundamentally not provide good care, but i sincerely doubt that there aren't a great many who are somewhere else on the greyscale. it's not black and white.

I can see where you are coming from to an extent, but much of medicine is subtle. Say, for example, you have a case in which you feel a young women is may be making an impulsive decision to have an abortion - if you are anti-abortion, the weight you give to this notion may be relatively greater than if you were neutral. Therefore, your opinion may be inherently biased. You may be a great Dr, but Drs are human. You can be influenced by you feelings. Therefore if this is a possibility in relation to serious decisions, someone else should make them.

There is also an issue over whether Drs should be allowed to pick and choose what they do. For example, while I don't necessariliy disagree with the right of a human being to choose assisted suicide if they cannot end life themselves, I have no wish to be personally responsible for someones death. So if the law changed to allow assisted suicide, I would probably opt out, as would many colleagues. I am therefore supportive of a Drs right to choose to treat or refer. Without qualification beyond that my behaviour be acceptable professionally.

[rjm]

Originally Posted by Doc Skin

Maybe some doctors refuse to be involved in abortion because they want to save lives, not end them.

Very simplistic view of what doctors do...

[crog80]

Although as doctors, our role is to help our patients. Why should we go against our own beliefs as human beings, in an attempt fufill these occupational demands.

I personally am not against abortions, who am I to tell a woman what she can and can't do with her body. But, I am strongly against anyone having to go against their own beliefs to fufill their job description.

[Spencer Wells]

Originally Posted by crog80

Why should we go against our own beliefs as human beings, in an attempt fufill these occupational demands.

GMC.
"Duties of a Doctor"
Point number 1.

Originally Posted by crog80

I am strongly against anyone having to go against their own beliefs to fufill their job description.

If they are not happy with the job description, for whatever reason, then they should not be doing the job.

[yazoo]

Originally Posted by crog80
Why should we go against our own beliefs as human beings, in an attempt fufill these occupational demands.

Originally Posted by Spencer Wells

GMC.
"Duties of a Doctor"
Point number 1.

But see same document point 8!>>>

8 If carrying out a particular procedure or giving advice about it conflicts with your religious or moral beliefs, and this conflict
might affect the treatment or advice you provide, you must
explain this to the patient and tell them they have the right to

see another doctor. You must be satisfied that the patient has

sufficient information to enable them to exercise that right. If it is not practical for a patient to arrange to see another doctor,you must ensure that arrangements are made for another suitably qualified colleague to take over your role.

As I said above, Drs are expected to be human. To fail to appreciate that in some circumastances that you (i.e all Drs) may not be the best person to treat a patient is a huge mistake.

Drs bleed, have personal feeling, have faults, health problems, religious and moral beliefs, get frustated.

What do you say to the GP, who acts brilliantly for 99% of his patients, but has one he just cannot develop what he believes to be an effective relationship. He can develop no rapport with the patient, and despite best attempts to suppress the notion that the patient is obnoxious, cannot. Do you say he's a bad Dr if he suggests that a colleague take over as he is now professionally frustrated? Or do you think he's a good Dr?

Overall, it's about acting in patients' best interests. Accepting that you are not perfect (a oddly strange notion to some medical students!!!) and will not always be able to do this is vital, IMO

[Doc Skin]

Originally Posted by rjm

Very simplistic view of what doctors do...

quoting one comment made by me does not demonstrate my view of what doctors do

[BeanOfJelly]

I'm not against abortion but it is wrong to make people do something against their moral conscience, especially as in the case of abortion there are clear and easy ways to avoid it. Its better for the patient to have a doctor who isn't morally opposed to them, and its better for the doctor, who if made to do something they feel is wrong, is ultimately the person who has to live with it.
Obviously, this doesn't apply to all things. A doctor who is morally opposed to touching women (giggles) just isn't going to manage their job, what with women comprising around half of the patient population. There is no easy solution to their indisposition, and they really should have considered it before joining the profession. However, there is no shortage of doctors willing and able to conduct abortions, and they are not a fundamental part of being a doctor (whereas physical exams kind of are).