Monday, 16 June 2014

Should Ontario MDs Be Allowed to Refuse Basic Healthcare to Women?

There was a spot of bother a few months back when "at least three" Ottawa family doctors refused to prescribe birth control because such an act would violate their Gord-given right to control women.

The Ontario College of Physicians and Surgeons, feeling the heat, has decided to revisit its policy on human rights and is inviting public input.

The site says the questionnaire will take only a few minutes and it does, but first you should read the existing policy.

It's not all bad but does provide some pretty wide wiggle-room for anti-choicers.

After citing some "general principles" from the Ontario Human Rights Codes, all good in my opinion, the policy offers this (bold mine).

College Expectations
The College has its own expectations for physicians who limit their practice, refuse to accept individuals as patients, or end a physician-patient relationship on the basis of moral or religious belief.

In these situations, the College expects physicians to do the following:

Communicate clearly and promptly about any treatments or procedures the physician chooses not to provide because of his or her moral or religious beliefs.

Provide information about all clinical options that may be available or appropriate based on the patient’s clinical needs or concerns. Physicians must not withhold information about the existence of a procedure or treatment because providing that procedure or giving advice about it conflicts with their religious or moral beliefs.

Treat patients or individuals who wish to become patients with respect when they are seeking or requiring the treatment or procedure. This means that physicians should not express personal judgments about the beliefs, lifestyle, identity or characteristics of a patient or an individual who wishes to become a patient. This also means that physicians should not promote their own religious beliefs when interacting with patients, nor should they seek to convert existing patients or individuals who wish to become patients to their own religion.

Advise patients or individuals who wish to become patients that they can see another physician with whom they can discuss their situation and in some circumstances, help the patient or individual make arrangements to do so.
OK, what's with the namby-pambyness? "In some circumstances"? Should be "in ALL CIRCUMSTANCES refer a patient to a practitioner whom the referrer KNOWS will provide the needed service." They can't get away with waving their hands and saying, "See someone else."

The situation is particularly problematic in under-served areas. What if there is only one OB-GYN for a large area and he or she refuses to prescribe contraception (or some forms of it), insert IUDs, or perform abortions?

What if one or more of a small number of GPs for a region refuses to prescribe birth control or refer for abortion?

How far do they expect women to travel to get basic everyday healthcare?

I don't know how it could be implemented, but the special circumstances of under-served areas require some creative thinking on the part of the College.

In any event, referrals must be mandatory. No exceptions.

We'll say it again. Women's rights and women's healthcare are NOT fucking conscience issues.

Public Service Section
Here's the survey. If you have a few minutes and care about this issue, please give them your thoughts.

Also on its invitation page is a quick poll, one question.
Do you think a physician should be allowed to refuse to provide a patient with a treatment or procedure because it conflicts with the physician’s religious or moral beliefs?

Yes or No.

Currently there are 1090 votes, 984 of which say religion trumps patient care. That's 90%. And that's hard to believe.

LifeShite is directing readers to the survey and quick poll. Gee, do you think they're freeping it?

Since we know most casual, i.e. non-frothing, fetus fetishists have the attention span of a gnat, that's probably as much as they're going to do.

So, certainly answer the one quick question, but if you can take the time, please do the survey.

ADDED: There's also a discussion board. Some interesting stuff there, but lots of whinging from the usual suspects.


UU4077 said...

Sometimes women are prescribed birth control pills because it eases problematic periods. Would these doctors ask their patients to just suffer through it?

fern hill said...

Yes, of course. Because once women are on The Pill, who knows what they'll do? Might fuck, for example.

There are other important reasons to have a birth control pill prescription too. But those might also lead to unsanctioned sex.

Can't have that.

Beijing York said...

I wrote extra feedback and didn't once mention birth control or abortion services. I brought up an example from personal experience where I suspected that I needed a psychiatrist and was told to seek a pastor or priest for guidance by the replacement physician at my on campus clinic.

I am still shocked that it was Ottawa doctors refusing to prescribe the pill. I remember telling friends that my uncle in the old country was a staunch conservative Catholic still practicing ob-gyn in his late 70s and still refusing to provide women with birth control. We thought it so freaking backwards and that was some 3 decades ago. It makes me weep for the cool and opened minded Ottawa I grew up in and miss. Who are these Polliviere supporting miscreants who took over?

fern hill said...

Ha. Being told to talk to a priest or pastor? I wouldn't have thought of that, but that is an excellent, non-gendered example of why this shit has got to stop.

I just looked. Backlash was published in 1991. I read it then and thought: well thank gord that's over.

It's only gotten worse. Way worse.

LGBT rights are zooming into wide public acceptance. I wonder if greater acceptance there will spill over into women's rights.

Kind of a reversal of the 60s and 70s, when women's liberation and civil rights were on the bubble and became natural allies for the gay rights movement.

Ah well, live and see.

Scotian said...


Simple answer: NO.

Long winded typical Scotian answer: HELL NO!

If something is legal then you either provide it or do not go into the field/profession where you might have to. This applies to medicine, pharmacy, law, what-have-you. This is NOT a difficult concept!

It is not the place of doctors to act as if they are priests, only priests get to cite moral objections where performance of their professional duties are concerned in my opinion.

You want to be an activist against something in your professional field that you disagree with on moral grounds on your personal time in your personal capacity, THAT I can accept. You however DO NOT have that right in your professional capacity, especially not when you place the health and welfare of another at potential risk when you do so!!!

In case it wasn't already obvious I have rather strong feelings about this sort of thing. I find this sort of thing incredibly weaselly and despicable, the sort of thing that gives used car salesmen a good image by comparison, let alone politicians and the like.

We don't allow cops to choose who they protect based on their religious beliefs now do we? We don't let firemen choose which place of worship they will save and which they will let burn down do we? I really don't see any fundamental difference here with doctors in particular. This is a bogus piece of bullshit and should not be allowed, period end fucking dot!!!

(I would hope the fact I am using profanity in my comments makes clear just how strong my feelings are on this matter as I normally almost never use any at all, let alone strong profanity)

fern hill said...

My, my, Scotian, yes, your use of profanity is noted. But not at all unwelcome here at the Feminist House of Foul-Mouthedness. :-)

It is simple. And, despite the caterwauling, a policy demanding that all legal and appropriate care be offered does NOT exclude *some groups* from the practice of medicine. Just from the practice of family medicine and OB-GYN.

Let them be earn-nose-and-throat docs.

(I like your cops and firefighters example.)

Scotian said...

fern hill:

Hells, let them become neurospecialists for that matter, lots of money there, as you point out the main areas that this impacts are family medicine and OB-GYN. If you plan on going into either field and you have these religious qualms then how do you not consider yourself a total hypocrite going into these fields knowingly with those issues unless you already plan to pervert your field to suit your religious/moral agenda?

Lots and lots of other parts of the human body to specialize in that have nothing to do with reproduction (which funny enough seems to be the only area that evokes religious/moral turmoil about the human body, and only the female one at that...hmmmmm) in medicine after all, as you so correctly noted.

Note I also said what they do in their private lives and positions on such things is fine, that is part of being in an open society, but there are supposed to be bright lines between personal and professional lives, and I find the bringing of religious/moral issues from one into the other like this to be inherently anathema to that principle. As I said before, it is not like you don't know these services come with the territory BEFORE you enter these fields/professions and are seen by our society as legal and acceptable to require from said professions.

What kills me at times is I am a white male in his late 40s, and I never seem to have trouble seeing the misogyny in our culture, the underlying patriarchal patterns still trying to control women despite all since first the suffragettes and then the Women's Lib movement started making inroads into our society. This is not to say I am in favour of a matriarchal approach, nor that I believe Feminism can't and in some cases doesn't go too far in overcompensation, but what I am is first and foremost a humanist. I see humans in all our wondrous diversity first, not skin colour, not ethnicity, not sexual orientation, and not gender.

I have always been like that, I've always had a hard time since childhood not understanding why this is not the default position for most people (I do understand intellectually of course these days, but growing up I was truly baffled by the various prejudices around me and assumed to be shared by me based on my look and the fact I have a dick...sigh...if there is one expression above all others that raises my hackles it is "bros before hos").

The irony? I was raised by parent who were and still are strongly Roman Catholic, and it was their faith which they used to raise me this way, including giving me a gay god-father whom they knew was gay when they did so back in the late 60s. I grew up around women of strong character and ability who broke barriers in the community as well as serving it greatly. I have never been able to understand the mindset of those that must belittle or diminish others, especially women, and it truly irks me. I do not call myself a feminist only because I find the term too limiting, but I certainly recognize the need for such to this day, I look forward to when such is no longer needed and both the feminism and the foe it fought are BOTH looked back as archaic remnants of an ugly past.

P.S. I knew profanilty was not an issue here, I do read your blog regularly after all...*chuckle* My point was I make it a point to not use it because I find it too often used to cheapen arguments, discredit voices by those moralizers, and over used for emotional emphasis. I prefer to keep it for the rare thing that I feel really needs that extra oomph emotionally to underscore just how passionate I am about something. Hell, I usually call bullshit male bovine excrement, how many people still do that these days? LOL

fern hill said...

A neuro-something speciality would be good. What's that line?

Oh yeah. "Physician, heal thyself."

Scotian said...

fern hill:

I don't know, they appear to have gotten the lobotomy procedure down pat already, perhaps that is how they interpreted that expression?

Unknown said...

This shit boggles me. I can assure you that the CPSO is no friend to doctors, and in other guidelines and standards is very black and white in what we do and don't do. There is no grey, or "namby-pamby," language: Don't ever have sex with patients with whom one has done psychotherapy. Do relevant physical examination and carefully document pain scores when prescribing narcotics. Don't unilaterally terminate a patient unless such-and-such very specific conditions are met. Don't administer any treatment or invasive investigation without consent unless it's an emergency. Only prescribe antibiotics for culture-proven bacterial infections, and for no longer than necessary (this is the practice standard that screws Lyme Disease sufferers--doctors won't prescribe chronic antibiotic treatment since we are essentially barred from doing so and disregarding a practice standard is professional misconduct). Do maintain absolute doctor-patient confidentiality at all times except for such-and-such very specific and serious exceptions. And there are other examples.
My point is that there is no dearth of the CPSO telling us what we must and mustn't do. So the wishy-washy language here is incongruous and I am all for tightening it up. Like most doctors I am pretty confident bordering on arrogance in my professional role, and as such I prefer to be left to my own very good judgment whenever possible. This desire is what distinguishes the genuine professions from other vocations. But I don't deny that our profession lives by some very clear do's and don't's, so there I have no problem at all being told, "If a physician declines to provide a medical service within his scope of practice [for family doctors this includes the full range of legal family planning services including prescribing contraception and referring for abortions] the she or he MUST transfer that aspect of the patient's care to a colleague who provides such services." Of course it is easy for me to get behind this, as such a decree would never affect me--I am such an advocate for patient rights and choice it has made my professional life difficult at times.
There are many more people who want to enter the medical profession in Ontario than there are places in it--nowadays it is actually harder to get into the Faculty of Medicine at the University of Toronto than US Ivy League medical schools like Harvard, Yale, or Dartmouth. As such, I think the misogynist religious kooks and other backward social conservatives need to stay away from the practice of modern medicine in a secular, free society. If you are Catholic medical student who won't attend abortions on your ob-gyn clerkship rotation, you should fail the rotation, and thus medical school, as your duty to comply fully with the requirements of your training for the sake of your future patients supersedes any right you have to be accommodated for your individual moral or religious sensibilities. And if you are a family doctor who won't provide a full scope of family planning services and who won't fully respect your patients' constitutional right to full reproductive choice, you are negligent in your duty and should be censured accordingly.

fern hill said...

@Les Wright. Woo. That's clear. Have you filled out the survey at the CPSO site?

You darned well should.

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