Saturday, 28 June 2014

Birth Control: Deeply Moral or Inconsequential?

You can't have it both ways.

Either birth control is a highly moral issue on which physicians must be allowed to impose their "conscience" or it is a trivial matter with negligible consequences that can be easily dealt with.

"A doctor at a Calgary walk-in clinic is refusing to prescribe birth control due to her personal beliefs."

This caused a ruckus starting on Facebook and a comment was sought from the College of Physicians and Surgeons of Alberta (bold mine).

Under the College of Physicians and Surgeons of Alberta’s policy on Moral or Religious Beliefs Affecting Medical Care, doctors can refuse to provide medical services, but must ensure the patient is offered timely access to those services from another practitioner.

Trevor Theman, registrar with the CPSA, said the policy does not require Westglen to have a doctor on hand who can prescribe the pill.

He did not specify what “timely” meant, but said a delay in receiving a birth control prescription is “not likely going to disadvantage a patient in a serious way.”

“There’s a degree of urgency but it’s not like life or death today kind of urgency,” he said, adding most women should be seeing a family doctor about their sexual health needs.

“In an ideal world, women who need birth control or are seeking birth control will have a regular doctor and won’t just be dropping into a walk-in clinic to get a prescription for birth control pills.”
Yabbut, this is not an ideal world
Pam Krause, president and CEO of the Calgary Sexual Health Centre, said she’s aware of doctors who morally object to making abortion referrals, but refusing to prescribe birth control is virtually unheard of in Alberta.
Personal beliefs should not interfere with a professional responsibilities, she said, adding that the birth control pill is one of the most highly demanded prescriptions.
In fact, one in five Calgarians ­­— 200,000 people — is without a family doctor and rely on walk-in clinics to serve their medical needs.

So, which is it? Big fucking hairy deal? Or minor matter that non-irresponsible women should sort out on their own?

And that reminded me of the messed-up recall of the birth control pill AlySena in April 2013.
“Although this recall is currently a Type 2 recall and does not require pharmacy to contact patients, due to the potential seriousness of the recall, and in an abundance of caution, care and concern for our customers, London Drugs has chosen to be proactive in advising our customers and patients of the recall,” the blog post read, linking off to the urgent notice.

Class 1 situations require “reasonable probability” that the use of the drug will cause serious health consequences or death. Class 2 could lead to “temporary adverse health consequences,” Health Canada explains on its website.
The maker, Apotex, seemed to consider the issue serious. Health Canada not so much.
The lot was identified as LF01899A and distributor Apotex issued a voluntary recall to wholesalers and retailers on April 3. The affected packages were removed from store shelves on April 5, when most pharmacies received the recall.

But patients were not required to be contacted until April 8, when Health Canada upgraded the recall to Type I, the most serious level.

Health Canada says this type of recall is reserved for “a situation in which there is a reasonable probability that the use of, or exposure to, a product will cause serious adverse health consequences or death.”
Again, an unintended pregnancy seems to strike some in the medical community as a mere "temporary adverse health consequence." Much like the fetus fetishists who insist pregnancy is hardly any bother at all. And women who reject it are selfish bitches.

Gawd, we women and our reproductive systems require a lot of policing, don't we?

Here's a radical idea: Why don't we leave such decisions entirely up to the person most affected? And leave the damned panty-sniffing gatekeepers -- whether MDs, pharmacists, or Health Canada -- out of it.

Let us know if a product is safe and effective, then shut the fuck up.

Reminder: In Ontario, a similar kerfuffle over the "morality" of birth control prescriptions drove the College of Physicians and Surgeons of Ontario to seek public input. Go have your say. The process is open until August 5.


Unknown said...
This comment has been removed by a blog administrator.
fern hill said...

Someone named Leticia Wyatt commented: "Great post!" and added a link to a website for USian medical clinic. Thanks but advertising is not welcome here.

Anonymous said...

Aside from pointing to my comments in the last thread on this issue which you link to in the bottom of your post I would add only this. Since when is not controlling menstrual pain issues "not going to disadvantage a patient in a serious way"? I've known more than a few women including my wife who use birth control even more for that than as anti-pregnancy protection. I'll agree that it may not be life or death, but it far from inconsequential or minor either. What does it say that a layman in his late 40s can see that right off the bat yet the registrar for a Province's College of Physicians appear to not get it? Another example of my favourite expression in action, never underestimate the power of human stupidity.

Either provide services legally sanctioned or do not enter professions or fields within professions where you have such issues, is that really such a hard concept?

fern hill:

I am not going to repeat myself in this thread, partly because I am not home this weekend and this keyboard and I aren't getting along too well, and partly because you have already linked to the thread they are in. But this whole thing is just getting more and more idiotic every time it comes up. Thanks yet again for doing the tedious and no doubt frustrating work of bringing such idiocy to our attention.


Anonymous said...

I don't understand what universe someone lives in if they think they can have a family practice and refuse to prescribe birth control or refer for vasectomies, tubal ligations or abortions. I think medical schools need to start driving this point home to medical students and encourage them to pick another speciality - dermatology or better yet, pathology. Dead people wouldn't be harmed or offended by these assholes.

fern hill said...

@Scotian: Yes, it's tedious (I try to have some fun with it), but it needs to be called out. Thanks to commenters like you who make it worthwhile.

fern hill said...

@Anonymous (19:39): Good point. Medical schools bear more than a little responsibility in steering future MDs towards appropriate specialties. Think reproduction is "up to Gawd"? Sorry, kid, you're not cut out for family practice, much less ob-gyn.

Anonymous said...

National Right to Lifer admits pregnancy more dangerous than abortion


fern hill said...

kitler's link.

Wow. A fetus fetishist admits a sciencey fact. That's rare.

But it is just part of the ongoing rift between the more straightforward and the sneakier branches of the anti-choice movement. The more straightforward base their "argument" on the sacredness of human life, i.e. the fetus. The sneakier, realizing they have a tough sell there to the non-religious, go for the "harm to women" angle, which as this speaker acknowledges is bullshit.

Each branch thinks its way is the winningest and they try (occasionally) to undercut the other.

Thanks, kitler, for finding another example of the conflict. They usually succeed in keeping their arguments to themselves.

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