Monday, October 17, 2016

Let's see . . . How Many Way Can We Force People to Comply With Our Religion?

The Discovery Institute has been involved with discussions of BioEthics before and for the most part, I ignored them.  But this time I think they have gone a bit off the deep end and decided to use scare tactics to not only allow people to legally discriminate, but allow medical professionals to discriminate based on their own religion -- with a callous disregard to the welfare of the patient.  Check out how they have overblown the whole discussion in "The Ethical Menace of "Bioethics" Grows" There are several things that bother me about this whole post, first of all, is this what is being said?  I don't believe so.

" . . . the [medical] field increasingly targets the right of doctors to refuse to perform an abortion, euthanize patients, or perform other procedures or issue prescriptions that violate their religious beliefs."
I do love how they lump abortion and euthanasia with contraception (remember, many forms of contraception require a prescription), the key here really isn't the procedure, it's the DI's willingness to let Doctors discriminate based on their religious beliefs.  I have several issues, but before getting into them, let's see what has the DI fired up this time.

Take a look at the part of the bio-ethical statement that got the DI so up in arms, the full statement is at: Consensus statement on conscientious objection in Heathcare, here are the first two articles:
1, Healthcare practitioners’ primary obligations are towards their patients, not towards their own personal conscience. When the patient’s wellbeing (or best interest, or health) is at stake, healthcare practitioners’ professional obligations should normally take priority over their personal moral or religious views.  
2.In the event of a conflict between practitioners’ conscience and a patient’s desire for a legal, professionally sanctioned medical service, healthcare practitioners should always ensure that patients receive timely medical care. When they have a conscientious objection, they ought to refer their patients to another practitioner who is willing to perform the treatment. In emergency situations, when referral is not possible, or when it poses too great a burden on patients or on the healthcare system, health practitioners should perform the treatment themselves. 
Do either of these statements look like they are going to force a doctor to perform an abortion, prescribe contraception, or euthanasia?  Really?  Look at the words, when they have an objection, they should refer the patient to a doctor who isn't carrying their religious baggage.  One of my concerns is that doctors with strong religious feelings might opt out of making a referral.  Seriously!  Think it through.  Many theists preach their particular brand of religion to non-believers in an effort to 'save' them.  Do you really think all theist doctors is going to refer a patient to a doctor who is going to do a procedure that violates their belief system?

I don't think some of them will, and they will use their belief system as rationalization.  Can you trust a doctor who places their belief system ahead of a patients welfare to be honest about things that conflict with that belief set?  See what I mean!  Back to the statements, the one exception is in an 'emergency situation', so let's address that.

Can anyone even imagine an emergency situation requiring euthanasia?  Think about that.  Assisted suicide is legal in a number of states and the reasons are normally because of a incurable illness that will not only degrade any sort of a quality of life but place an incredible financial burden on the remaining family or society.  In those states you can request an assisted suicide.  I'm not saying it's a good or bad idea because I am not in such a situation.  But if it is a legal option, it's something that can be considered . . . but is it an emergency to the point where another doctor cannot be consulted? Hardly! It's not an immediate thing, some states require various forms of counseling to make sure the patient is picking this option for, what the state calls, the right reason.

How about contraception, or other potentially religiously-disagreeable prescription, although the only one that comes to mind is contraception.  If a doctor wants to be a doctor, then they have to face the fact that people are going to do things that the doctor himself might disagree with.  That might be smoking, drinking and sex not for procreation.  The doctor cannot and should not be the arbiter for making those decisions.  If that were the case, why not a prescription for condoms?  But no, what we have are theists who are making the decision for someone, and obviously for women.  As far as I know there are no prescriptions for any male contraception (yet!).  The decision belongs, not to the doctor, but to the patient. But, back to the subject, is there an emergency situation requiring contraception?  No, you might need it and not have it, but it's not an emergency unless you are making a bad movie!

How about an abortion?  There is one case where an emergency abortion might be required and that would be to save the life of the mother.  Any other form of abortion is not an emergency!  To be honest, in my opinion that shouldn't even be a question about whether or not it's legal in any location.  You are talking about saving the patient's life.  At that point any decision should be up to the patient and their family, not the doctor.  Once the decision is made, any doctor worth the title should be able to step past their personal objections and perform the procedure.  Yes, it might be personally disagreeable, but then so is the decision to cut off a leg due to gangrene or many other emergency actions!

See where I am going?  The bio-ethics statements on conscientious objections to any medical procedure is not going to force any doctor to do something against their religious beliefs.  Only one of the examples even apply in an emergency, the other examples are not emergencies and can be referred to other physicians . . . providing their are other physicians who can perform the procedure.

That's issue number 2 for me.  The same groups objecting to these procedures are also trying to make them illegal.  How facilities that are licensed for abortions have been shut down due to losing funding, protests, and even bombings?  Regardless of the other services they provide, Christian Conservatives have been too successful is stripping Planned Parenthood of funding in many states and other actions designed to end medical practices that they claim violate their religious beliefs. That's one tactic, in another they have managed to place such restrictions, for example having hallways wide enough for two stretchers to pass side by side.  This is a requirement for hospitals, not clinics.  But by requiring such standards, they are trying to drive such clinics out of business.  My concern is that it might be acceptable to refer a patient to another doctor or facility, but will there be such a facility available?

 Contraception is regarded by many theists as a violation of their beliefs, to the point where even the Pope speaks out against it!  If they are successful, then where is someone supposed to turn when there is no medical professional practiced in these areas?

My final issue is more related to the DI than this specific issue, it's with this quote:
"Would anyone assert that a non-doctor should be able to diagnose cancer or perform an appendectomy?"
Well for one, the Discovery Institute makes such assertions.  Don't you remember this:
"We don't need to rely slavishly on what scientists say because, in an important sense, we are all scientists, capable of judging a big scientific idea like evolution, if not necessarily the technical details, for ourselves." (More Scientists Praise Douglas Axe's Undeniable)
Yes, we are all capable of judging big scientific ideas for ourselves, right?  If that's so, then we don't need 'experts', we can use our intuition, right?  The DI has been peddling this idea that intuition is as reliable as scientific investigation.  But they aren't saying that here, here they are question the idea that someone other than Doctors might be able to function in some roles currently filled by doctors.  However . . .

Isn't that currently happening?  I mean over my lifetime I have seen role changes for many medical roles that used to be strictly in the doctors' purview.  Nursing roles have changes, many       hospitals are using  Physicians Assistants (Certified),  for many treatment and only bring in an MD or other specialist when needed.  Whether or not someone other than a doctor can do any medical procedure is a matter of training more than anything else.  I'm not saying someone other than a Doctor should diagnose cancer, but then the bio-ethics under discussion aren't saying that either.

Take Hospice Care.  Throughout a recent terminal illness, once Hospice was involved, doctors were pretty much hands off.  It wasn't until there was a new medical requirement did any doctors get into things and you had to transfer from Hospice care back to Medical care or there were all sorts of legal and insurance issues.  BTW, that was in Washington State, the home state of the DI.  So it's OK for non-doctors to manage the care for terminal patients, but if your religious views on life are involved, it's got to be a medical doctor?  Why?

This is pretty typical of the DI.  They take a stand not based on logic or even medical necessity, but one based on their religious beliefs.  Then they create a straw man trying to tell you what someone else is says, in this case the Consensus statement on conscientious objection in Heathcare -- only their strawman doesn't give it to you straight, they 'interpret' it for you . . . in other words spin it for their own purposes.  Then they want you to help demolish the strawman!

I don't know where you stand, but where I stand is simple.  A doctor's oath should come before any other considerations up to and including their belief system.  If they are incapable is setting their beliefs aside for the welfare of their patient, then I believe it's time to find another line of work.  That sounds harsh, but how can a profession develop a level of trust that is needed when the patient cannot be sure the doctor has their welfare as their foremost concern.  The rationalization that the doctor is also concerned for a patients spiritual welfare doesn't hold any water for me.  It's not part of a doctor's duties, training, or even job to play that particular card.

When a doctor let's their religious beliefs take precedence over their medical responsibilities, what they are doing is inflicting their belief set on another human being.  If that is allowed, then where is the line drawn?  Parents who allow their children to die because their belief system doesn't accept medical treatment have been, and should continue, to be held accountable.  Shouldn't we be holding doctors to the same standard?

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