Pure Evil

Krista - posted on 05/31/2012 ( 218 moms have responded )

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From rawstory.com:

Doctors across the nation are now free to refuse medical care to women on the basis of their own personal beliefs. What follows is a particularly egregious application of these “religious conscience” laws, and underscores why women nationwide are standing up and fighting back:
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An Oklahoma mother brought her daughter to a local hospital after she was raped only to be turned away and refused help by a doctor, purportedly because the hospital lacked the staff to properly process the victim’s claims and injuries. Welcome to the reality of processing sexual assault crimes in GOP-land.

The woman and her daughter were reportedly turned away because the hospital did not have any nurses who conduct rape exams on staff. Sexual Assault Nurse Examiners (SANE) are specially trained professionals who deal only with the delicate process of conducting rape exams. The SANE program is coordinated through the YWCA and is a collaboration with local law enforcement, the Oklahoma County District Attorney’s Office and public health officials. The collaborative effort is designed to ensure evidence is properly collected and stored without re-traumatizing the victim and ensuring the most effective prosecution of the perpetrator possible.

~snip~

In this case the doctor involved refused to conduct any exam, nor would he dispense any emergency contraception. The hospital issued a statement grounding those decisions in the need to coordinate through the SANE program. It could also be that this doctor had a moral objection to treating rape victims and dispensing emergency contraception, and thanks to abusive expanses of the conscience-clause by the right, simply refused to deal with her. Either way it’s a lose-lose for rape victims who now face the prospect of looking for treatment after an assault only to be turned away because of a lack of resources or because of religious objections.
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The young woman asked the doctor whether or not emergency contraceptives were available and whether the doctor was simply refusing to provide them. The nurse told her “I will not give you emergency contraceptives because it goes against my belief.” The doctor refused to help her, even though she had just been raped, and refused to find another doctor to help her.


What do you think, folks? If the medical staff had been forced to help her, would that have been a violation of their religious freedom? Or do you, like me, think that in a case like this, that they should have taken their beliefs and stuck them where the sun doesn't shine?

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Isobel - posted on 06/02/2012

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yeah, if you can't touch pork, please don't apply at my butcher shop.

if you can't touch alcohol I will NOT hire you to be a bartender.

and if you will not dispense birth control...get the hell out of my pharmacy.

Johnny - posted on 05/31/2012

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Refusing medical care or refusing to help find appropriate medical care is for physicians a violation of their hippocratic oath. If a physician finds themselves to be the only practitioner available in a life or death or highly time sensitive situation (such as taking the morning after pill) and refuses to offer treatment, they are causing harm to their patient and violating the rights of the patient. If you go into emergency medicine in a locale where you may be the only doctor available, you are in the wrong place if you think that you then can have the choice to refuse to treat a patient for a serious, life-threatening or time-sensitive condition.

In terms of choosing not to perform a rape kit or refusing to find someone to do it, I'm stunned. I think that IS the definition of pure evil. If that girl wanted it, she should have damn well received it and I hope they go after that doctor and his license. What a fucking asshole!

In terms of refusing to prescribe the morning after pill, I have no issue with that as long as there is another physician available to do so and the original physician makes the referral. If neither of those conditions are met, then he has violated his obligations.

It doesn't matter where a physician's personal beliefs come from or why they have them. If they allow those beliefs to interfere with practicing medicine properly and not doing harm, then they should not be in the field. I'm pretty sure there are about a zillion other career choices, including in the field of medicine that do not require much in the way of moral choices.

Merry - posted on 06/03/2012

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Jumping in here blindly with just reading the OP

I believe in 'job qualifications'
If you can't be around smoke then you don't qualify to work at the local bar that allows smoking
If you can't work with beef then you don't qualify to work at the butchers
If you can't dispense certain pills then you don't qualify as a pharmacist
If you can't do a rape kit then you don't qualify as an ER doc
If you can't see you don't qualify as a photographer.

I'm sorry. This is dumb. If your job is in an emergency type place with time sensitive things involved you darn well better be able to do the tasks given to you.
If not then you're in the wrong profession.

I could never perform an abortion. So I'd never put myself in a place where I'd need to!

Krista - posted on 06/03/2012

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But, again, she doesn't have to go to another hospital! If she's only looking for EC, it's given, at pharmacies, without prescription. I don't know where you live that hospitals aren't short staffed, but wasn't that part of the reason they couldn't treat her? That the nurse educated to perform rape kits wasn't avsilable?

We don't know what time of day or night this happened -- it could be that the pharmacies were closed.

Besides, she went to the hospital first, which was the right thing to do. She wasn't JUST looking for EC -- she wanted a rape kit performed. But really, the hospital should be able to say, "Okay, we don't have the resources to do those here. Hospital (name) does. We're going to call ahead and let them know that you're coming, and to have everything in readiness so that you don't have to go through explaining everything again, okay? In the meantime, here's a packet of emergency contraception. You can take the first pill now, and then take the second one in 12 hours."

Wouldn't that be a lot more humane, instead of just refusing to help her at ALL?

Krista - posted on 06/02/2012

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There is a difference, though (a moral difference, if you will) between a hospital not being able to do something, and a hospital being ABLE to do something, but refusing to do so because they just don't want to.

The former is acceptable. I won't get a heart transplant at my little village hospital -- I'd have to be airlifted to Halifax. That's understandable.

But EC is pretty straightforward stuff. You don't need specialized equipment or even specialized training in order to administer it. Like I said, they sell it over the counter here. So there is NO reason why each and every emergency room in the country should not have some on hand, and there is NO reason why a rape victim should have to go to another hospital for it.

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♥♪Megan♫♥ - posted on 06/04/2012

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I know two moms here who had to be transported to Vancouver from here in Kelowna for care. One was back in October because the baby was over due and she was having problems with delivery. The other was because the mom has a medical condition and at the time Kelowna wasn't equipped for it

Lady Heather - posted on 06/04/2012

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I know tons of people who have had to be transported for care here. We have a hospital but some things require more specialty than we have. So they just get flown to Vancouver for free. I'm sorry, but this seems like a decent deal to me. When my friends daughter had to have heart surgery they flew baby and dad down south and then a few days later mum and twin baby were flown down because both babies were trying to breastfeed. This is what I call pretty damn good healthcare. And our cancer centre is almost open so soon we can stay here for cancer treatment and those living in remote areas will have their travel time cut in half. Improvements are definitely being made.

♥♪Megan♫♥ - posted on 06/04/2012

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Heather very true. Before I moved to BC from NY my mom was always scaring me with some of the stuff like wait lists and the medical billing (which happens in the US and Canada) I've also heard that they're thinking of giving dr's more incentives to stay in rural areas.

Besides it's not like UHC prevents you from getting care like the US private pay does. They also can't drop you if they suddenly decide your pregnancy is a pre-existing condition. My friend in Slave Lake has to drive to Edmonton for certain treatments on her shoulder and gets everything reimbersed by AB's health care. Try and get private pay in the US to do that.

Lady Heather - posted on 06/04/2012

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I live in one of those areas with a doctor shortage (although still not as bad as the realllly rural spots) and I still wouldn't trade my system for an American one. I've never actually had a problem getting to see a doctor. If there is something really wrong (like my pregnancy complications) you get whatever you need immediately. If you are in the boonies you get transported to a larger centre for care.

The fact is that northern Canada will never have enough doctors. The people are spread too thinly across a very large area. So someone is always going to have to travel long distances for care. That's the downside to living in those areas and the people who live there are aware of it. Our local university has a medical program now with the goal of keeping more physicians in northern and rural Canada. So we are working on a solution, but it is not an entirely solveable problem. An American system wouldn't change that in the slightest. Money makers go where the money is and there isn't much money to be had in a town of 500 or less a days drive or more from any major centre.

Reading a few articles isn't going to give you the full picture. I'm here living it so I think I have a better idea of what goes on.

♥♪Megan♫♥ - posted on 06/04/2012

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Abortion- yes you can refuse, but sterilization- unless you're going to pay for the kids that come out and give birth to them FFS just do what you went to school for. That's all i have to say right now because I am tired and the laundry hamper took over my bedroom

Aleks - posted on 06/04/2012

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Well pointed out Krista E (well same goes for your friend). And this is exactly what I think as well. Its not just that they should stop being a doctor or stop using all of their education they have worked for for so many years. Its just a matter of picking a different speciality or area in which to apply their medical training.

Krista - posted on 06/04/2012

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By the way, when I talk about how I think a health professional should consider a different field, if their moral objections are so strong as to interfere with their work duties, it's not just me being pig-ignorant about the healthcare system.

I have a friend who is a nephrologist. We have had some great discussions about conscience clauses, and HE'S actually the one who said, "Cripes, if they're that riled up about the pill, or abortion, or whatever, why didn't they go into cardiology, or pediatrics, or research, or the umpteen other fields where they would never have to deal with those issues?"

So it ain't just me...

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/04/2012

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In addition, there obviously has to be a line drawn somewhere. If a patient is unruly and overbearing in wanting treatment for say, a health problem they do not have. Or the said patient, continues to ask for narcotics when there is absolutely no reason for them to have them, medical wise. Then yes, a doctor can fire that patient. They can also let a patient go if they make appts and continuously miss them, without calling in to cancel. It only makes sense really. They are not able to schedule another patient during that time frame but yet, you keep being a no show. My doctors office has this very rule. What they can NOT do is discriminate and they most definitely cannot allow for their personal morals to affect how they prescribe their patients.

Also, I have fired a specialty doctor as of late. Last summer actually. It was my daughters ADHD specialist, that we have gone to since she was 5. I had enough of her NOT doing her best to find alternatives to medication for my girl (her not doing her best, is my perception, maybe it was all she knew). Some doctors do prefer meds over alternative methods. I decided, she was just not what we needed, so I wrote her a letter and pretty much told her to "jam it". However, my general practitioner has once again taken the task to find us another specialist to be referred to. Why? Because it is HIS/HER job to do so.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/04/2012

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Mary--- Yes, we do have a shortage of doctors and nurses but this pertains mostly to rural areas. See, we have a vast amount of rural area. It is very difficult to get a doctor or nurse to practice in these distant places, simply because they do not want to travel so far and/or they are not willing to move to the boonies.

Some doctor offices are full and do not accept new patients BUT we have walk-in clinics, where anyone, with a provincial health card can frequent and get the same medical aid as they would at a doctors office. These are beginning to pop up like crazy. So, in essence, Canada is finding ways to alleviate any shortage of individuals receiving day-to-day medical attention.

We do have a decent amount of waiting lists when it comes to specialty services. However, it does go by how severe a patient needs to use the service. For instance, I need to see a gastroenterologist and I finally have an appt for next week but I have been on the waiting list since last October. This is because I am having complications BUT they are not extreme. I can still go about my day, I just have discomfort at times. If I had been my mothers MIL, of whom has crohn's disease but didn't know at the time, I would have been in within days to a week or two.

Krista - posted on 06/04/2012

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Physicians should provide care until their services are no longer required, or until another suitable physician has assumed responsibility, or give a patient "reasonable notice" of the intention to terminate the relationship."

Exactly. So they can't just say, "Nope. I'm not doing this for you." They cannot leave patients in the lurch, emergent care or not.

Krista - posted on 06/04/2012

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Physicians should recognize all the biases they may have and try to suspend them to provide the best potential care for the patient...

And I guess for me, this is the sticking point. Because in the case of some medical professionals, I really don't think they're putting too much effort into suspending those biases, relying on the conscience clauses as their "out".

And Mary, nobody is suggesting that we want our doctors to be unfeeling automatons. Far from it. But as Johnny suggested, you can be opposed to something but still suck it up and do your job. And if you can't suck it up -- if your moral stance is that uncompromising, then you go do something else. It's the whole "having your cake and eating it too" that bothers me.

Mary - posted on 06/04/2012

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MeMe, I really have very little knowledge about the specifics of healthcare in Canada, but I have seen many a Canadian on here refer to both a shortage of doctors as well as nurses. Just a quick google search of "Canadian Doctor shortage" turned up a multitude of articles. Apparently, Canada has had to recruit a number of foreign doctors, and even so, it seems as if the doctor shortage is still a big issue there ( there is even a documentary on this!). One article that I glanced at from the Frasier Institute said that Canada ranks 26th out of a possible 28 in physician to population ratios among developed countries that have universal healthcare.

Again, I am not well-versed in all of the factors involved in this, but I'm not sure that it's quite as rosy as you would lead me to believe. In truth, I doubt that any country's system is without flaws, or doesn't have areas drastically in need of improvement. I also know that we all have a tendency to think that with which we are familiar is "better". I am fully in support of the US moving to a Universal healthcare system. However, I do know for someone like me, it will most likely equate to a somewhat negative impact compared to what I am used to: I have always had decent insurance, and I live within 45 minutes of both Johns Hopkins and the University of Maryland (the birthplace of the modern day trauma system). Easy Access and availability to the highest level of care have simply never been a problem for me. That doesn't mean I deny that it is for many others.

I also came across this article that was of interest that seems to nullify you claim somewhere in here that Canadian doctors are "slaves to medicine", and must unquestioningly serve and meet the demands of every patient they see:

http://www.theglobeandmail.com/life/heal...

I found this snippet to be worthy of note:

"The Canadian Medical Association code of ethics says physicians can't discriminate based on age, gender, medical condition, sexual orientation and political affiliation, to name just a few. Doctors must provide "appropriate assistance" to any patient with an urgent need for medical care. Physicians should provide care until their services are no longer required, or until another suitable physician has assumed responsibility, or give a patient "reasonable notice" of the intention to terminate the relationship."

This was part of the response to a person who questioned whether or not her family doctor could "fire" her as a patient for being "too demanding of a patient". She received a certified letter in the mail from this doctor notifying her that he would only continue to provide emergency services for a period of 30 days, and that she would no longer be his responsibility after that. The answer to her query was that, yes - her doctor did have the right to do this.

I'm not sure that things are quite as different or perfect in Canada as you would like to believe

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/04/2012

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BTW Mary---- We are doing fairly well for Doctors here and they cannot place their moral beliefs onto their patients and/or staff. We could use more in rural area's but that is another story.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/04/2012

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Mary, I can only talk of ER care. We have no such thing as private doctors that work for themselves. here. So, I am sure they can do as they wish. They decide how many clients will be willing to see them, too. Since, if they are arseholes, they aren't going to have a helluva lot of business.

Honestly, to me, since the concept is so foriegn, I consider them "quaks". There is nothing to prove they aren't. You can "buy" medical licenses these days. Man, the more and more I learn how the USA medical practition works, the more and more I am proud to be Canadian. Not that I wasn't before but I am pretty much ready to kiss, roll around and hug, the ground I walk on here.

Mary - posted on 06/03/2012

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But Meme, the thought process of "You were hired because ALL tasks need to be completed, not ones you pick and choose." really only applies in to hospital house staff seeing patients in the urgent care setting. If we are talking about physicians in their private offices...well, they are self-employed. You, as a patient, are their client, and if you either don't like the job they are doing, or they are not meeting all of your needs, you most certainly can "fire" them, and find another doctor.

I think, pages earlier, Krista was a little off when she spoke about conscience clause laws; since Roe v. Wade was passed in 1973, 47 states have adopted some form of conscience clause laws. Most of them pertain to abortion and sterilization. I believe the number she was referring to are those states that have recently expanded upon them to include not just reproductive health issues, but also assisting in suicide, DNR issues, and embryonic stem cell research and treatments derived from them. Birth Control and Abortion are not the only morally and ethically charged issues that healthcare providers face.

The American Medical Association has, for the most part, supported conscience clauses, but with the stipulation that physician has the responsibility to arrange for transfer/referral of care. A statement from the chair of the AMA Council on Ethical and Judicial Affairs in 2005 said this about conscience clauses:

"We recognize the rights of patients and the rights of physicians to have strong personal beliefs, but it's the responsibility of physicians as professionals to respect the rights and choices of patients as primary.Physicians should recognize all the biases they may have and try to suspend them to provide the best potential care for the patient...That clause is important because, as much as we favor patients' choice and their beliefs, we respect the physicians' beliefs.We would never force them into a position where they'd have to do something that goes against their beliefs. A physician who doesn't wish to comply with a patient's choice then has the obligation to appropriately arrange for transfer of care."

I agree with this sentiment. It's not just about reproductive/women's health issues. The entire healthcare field is chock full of morally and ethically divisive issues on a daily basis. As much as you would like all healthcare providers to be unfeeling automatons (while still kind and compassionate) who can divorce themselves from any personal feelings or beliefs, or only hold the morals that you deem appropriate, that's just not realistic. If we limited the profession to only those who did not feel strongly on any of the myriad of ethical dilemmas they may face over the course of their career, there wouldn't be many candidates to choose from.

Johnny - posted on 06/03/2012

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Sarah, I get the impression from your post that a physician can be sued over a referral. I am wondering how or why this can happen? I am not saying that it can not be done, but it honestly boggles my mind as it could not be done here. Unless a physician knowingly referred a patient to a non-licensed practitioner or to a non-medical professional, there is no way they could be sued for what happens following the referral. Physicians are not expected to guarantee the success of the referral. If we don't like who we are referred to, we can simply request an alternate.

I went back to my doctor after I saw an OB/GYN he referred me to. After 3 visits for which the shortest wait at the office was 90 minutes (after waiting a month to see her), I had simply had enough. When I informed him of the situation he was quite disappointed and stated that he would not use her anymore because that was extremely unacceptable. He just used her because she'd taught one of his OB rotations in medical school.

**note: for any of the grammar police reading this from another thread, I used a preposition to end a sentence, I did it on purpose, and if you don't like it, get bent!

♥♪Megan♫♥ - posted on 06/03/2012

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Krista E, honestly it's a foreign concept for me and I'm from New York State... hmm maybe that's why. NY is pretty liberal, we just legalized gay marriage and have had Democrat governors ever since I can remember. I can't imagine having a doctor refuse my treatment on their moral grounds.

I won't deny that it could happen. My paternal grandma (may she rest in peace) was major into pro life and no birth control. I've taken care of birthers and extremely devout Catholics (I even have some in my family). But I honestly couldn't picture it happening in New York. Well... at least the larger areas.

Oh and Sara, what do you mean you're not all riding around on horseback in OK? Here in BC we're all living in igloos, traveling by dog sled and kayak.

Krista - posted on 06/03/2012

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We have a separation of church and state, that means the state cannot make a law that infringes on one's beliefs.

Sarah, that seems like a pretty gross misinterpretation of the 1st Amendment. Despite the pretty words, the state absolutely prohibits the "free exercise" of someone's religion, if it breaks the law of the land. If I moved to the U.S. and belonged to a religion that demanded human sacrifice, I'm guessing that the First Amendment would probably NOT apply to me in this case.

Sarah - posted on 06/03/2012

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The important part of what you put into bold print, and the part most over looked is, "...it could also be..." That part implies conjecture on the author's part. Because WE DON'T KNOW. We do know if he didn't examine her he couldn't prescribe anything and they were understaffed and he couldn't examine her because Nurses are trained for the SANE/SAFE program and they didn't have one available.
And since a Dr. can be sued for a specific referral, he might not have felt safe referring the girl to anyone in particular. He could've said she needed to go to another ER for the exam. That's a nonspecific referral, keeps his butt covered and still gives her another option.
We have a separation of church and state, that means the state cannot make a law that infringes on one's beliefs. So she is able to use EC, but it also means the state can't make a law forcing anyone to give it.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/03/2012

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From the OP---In this case the doctor involved refused to conduct any exam, nor would he dispense any emergency contraception. The hospital issued a statement grounding those decisions in the need to coordinate through the SANE program. It could also be that this doctor had a moral objection to treating rape victims and dispensing emergency contraception, and thanks to abusive expanses of the conscience-clause by the right, simply refused to deal with her.

No one is saying that IF it was due to being understaffed and not having the correct SANE/SAFE nurse on hand is the problem. That IS understandable but they should have been told where there WAS one of these nurses available. Where it DOES become a problem is within the portion I bolded. This is what we are debating. Whether it IS legal or not, doesn't matter. The fact IS, if it IS legal, it simply should not be. If anything, this doctor should have written a prescription for EC. It would at least have allowed the mother and daughter know if the girl was pregnant, that part was under control.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/03/2012

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From the OP---In this case the doctor involved refused to conduct any exam, nor would he dispense any emergency contraception. The hospital issued a statement grounding those decisions in the need to coordinate through the SANE program. It could also be that this doctor had a moral objection to treating rape victims and dispensing emergency contraception, and thanks to abusive expanses of the conscience-clause by the right, simply refused to deal with her.

No one is saying that IF it was due to being understaffed and not having the correct SANE/SAFE nurse on hand is the problem. That IS understandable but they should have been told where there WAS one of these nurses available. Where it DOES become a problem is within the portion I bolded. This is what we are debating. Whether it IS legal or not, doesn't matter. The fact IS, if it IS legal, it simply should not be. If anything, this doctor should have written a prescription for EC. It would at least have allowed the mother and daughter know if the girl was pregnant, that part was under control.

Krista - posted on 06/03/2012

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I think Johnny's right in that this is definitely a cultural thing. Here in Canada, doctors are nowhere near as afraid of being sued. Part of that is that we're just not a very litigious society, and part of it is that in order to successfully win a malpractice suit, you basically have to prove that the doctor royally fucked you over either due to malice or incompetence. You're not going to win a suit due to a misunderstanding, or an honest mistake, or because things just didn't turn out as you hoped.

So I guess for we Canucks, it's a foreign concept to imagine a medical professional injecting his or her own personal morals into how they treat their patients. Isobel's case is shocking, primarily because cases like that are SO rare here. Stuff like that just does not happen.

Yet another reason (besides universal health care, of course!) why I'm glad I live here.

Sarah - posted on 06/03/2012

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The nurse is the only one I see who had a moral objection. Other than that, we don't know why he refused to treat her. I think he should've referred her, but I also know he could've been sued just because of the referral if the other Dr. mistreated her. In Ok, and most states in the US, Docs have a right to refuse on the basis of contentious objection. He was within his rights, as she was in asking for it. Neither the patient or the hospital staff have the right to stomp on the other's. And either one has the 'right' to tell the other to 'stick them where the son doesn't shine.'
And, again, she was treated. At Baptist hospital, I believe.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/03/2012

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LOL, Johnny, we were thinking the exact same thing.... ;)

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/03/2012

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If you had filed a complaint with the College of Physicians and Surgeons of Ontario (each Province has one, they are a client of ours (at my place of work) here in NS), that doctor would more than likely have been in big doodoo. It is just not allowed to use personal moral beliefs to dictate how you will or won't help a patient, in Canada. I know it was probably easiest to just get the referral another way (it isn't hard when you live in a city) but I can guarentee, the doctor would have been talked to, in the very least, for refusing the referral.

Johnny - posted on 06/03/2012

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Isobel, I know it is a moot point now, but you could have referred him to the College of Physicians and Surgeons. That is a sanctionable offense.

Isobel - posted on 06/03/2012

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ummmm...here in Canada I was denied a referral to a doctor that my friend recommended while I was pregnant with Eve because my family doctor was pro-life and he knew that the OBGYN also performed abortions. Not only would he not give me information about an abortion (if I wanted one which I didn't) but he wouldn't even refer me to him at all.

That's part of the reason that I feel so strongly about this topic. I live in a big city and not to toot my own horn but I ain't stupid either. I went through other channels and got the OB that I wanted but I am not naive enough to believe that all women are in big cities where they have as many options as I do, nor are all women as strong as necessary to stand up to an authority figure and go against his/her decision.

Doctors have a responsibility to make decisions based on YOUR health, not THEIR opinions. period.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/03/2012

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Oh and yes. Jodi and LMCBW - hit the nail on the head.



IF you are so morally opposed to completing certain tasks within your job, then move on. Otherwise, you are going to have to suck it up and look past them. If you choose to continue in a position, where you just may (and probably will) come across certain tasks that go against your moral beliefs, you then have a decision to make. You either learn to bite your tongue and complete each task as they come (whether you agree or not) OR you pick up your purse and coat and go find a different job. It is NOT your right to sit there and refuse to complete tasks due to beliefs, when it IS a part of your job criteria. You were hired because ALL tasks need to be completed, not ones you pick and choose.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/03/2012

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LMCBW---And just think, when discussing getting fired for smoking at a job, you are completely opposed to it. Kinda ironic.



I am completely against it because it IS due to anothers' belief. No one can take their beliefs and place them onto me. I still complete everything in my day, that I am expected to do and more. There is no job that I can think of, where a person smoking would affect their ability to perform. To not be hired for smoking, when it does not pertain to my position would be discrimination. Fortunately, here in Canada this is illegal. So, yes, this is a very different situation, than refusing to do a part of your job due to your own, personal beliefs.

Aleks - posted on 06/03/2012

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Jodi:
"but if you hold yourself strongly to those moral convictions, then you will find a job/hospital that will work with you"

Exactly Jodi, this is kind of what we (myself, MeMe and KristaE, along with a few others) have been saying all along.

As for the OP, its like an earlier post by KristaE, sure go ahead and refer this woman to the hospital that has the necessary staff and tools to perfom the rape kit, together with an explantion why they cannot do it in this hospital. They may also say that when the patient is in that other hospital getting the rape kit done, they will also provide her with EC (and explain that this medication can be taken within 48-72 hours after the event - or whatever time frame it is) or if it has been over a day and time IS of the essence advise the patient that such medication can be acquired OTC at the nearest pharmacy and explain why this cannot be dispensed by the doctor (as per Mary N's explanation regarding dispensing medication to patients who are not examined by the medical staff).
I am sure if the hospital was nice , helpful and empathetic to this woman's and her daughter's plight then somehow, I think, this would have been a non issue and we wouldn't be here arguing about it. But something tells me they were obtuse and rude and made to feel like unwanted intruders and that added salt to their wounds already and now things turned into news.

Johnny - posted on 06/03/2012

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I absolutely agree. If I was THAT morally opposed, I would find another job and not continue in the one I am in now. As I said, the previous woman to hold my position did exactly that. That is exactly the point, that the job requires selling to that industry, so as an employee, I do not get to dictate with whom my company does business. If my company was selling electrical wire to human rights abusing dictatorial regimes like North Korea, I would very definitely be taking my skills elsewhere. My company would not and should not be obligated to cater to the whims of every employee's personal beliefs. Now they could not do business with those regimes because it would violate the law, but if they could and did, I would have to leave. There are quite a lot of tasks that I would not perform. I actually have left a job, with a social services non-profit, because I felt that continuing to follow their methods of practice violated my moral beliefs. If I had refused to do what I was opposed to, advocating for leaving some abused children in the home because of "cultural practices", they would have terminated my contract.

If you are an employee, especially of a vital service, you have the obligation to fulfill the duties of your job. The idea that should be negotiable because you might have a moral objection is a bit frightening for me. If that moral objection is a significant one carried by a large percentage of the population, it is either most likely illegal or that organization will have an impossible time finding employees to do the job (like the employer whom I left did). But allowing the moral opinion of our doctors to make decisions about our medical well-being seems to set a dangerous precedent.

This really does appear to be a cultural issue though. Opinions seem very divided here by nationality.

Jodi - posted on 06/03/2012

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I personally believe, it is entirely up to the hospital. Not just on staffing extra people for reasons exactly like this (the OP that is), but also, whether or not to hire or fire someone over things like this. Like Little Miss said, if you are actually that strongly opposed to something, you won't do it, you can dislike something, you can think it morally objectionable, but if you're still willing to do it for the sake of a paycheck, then you can't be *that* morally against it. If I had a job that asked me to kill people, I would gladly get sacked for refusal to perform my job. Hospitals, like every other business, have the discretion to hire and fire people based on their job duties (or so I believe anyways). That can be the price for having certain moral convictions, but if you hold yourself strongly to those moral convictions, then you will find a job/hospital that will work with you.

Sarah - posted on 06/03/2012

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We do have multiple pharmacies open 24 hours. I understand most people are surprised at all we have going on in Oklahoma, as most believe we still ride horses. But, in OKC, it's like any other metropolitan area, we just have farmland around it.
As for giving her EC, he couldn't for reasons posted below. We don't know if he called ahead to the other hospital, or not. We do know, from what I understand, is only one side of the story from a woman feeling a deep emotional trauma. I'm not saying she was wrong in her depiction, just that she may not have known everything going on behind the scenes. I feel so much for this woman and her child and I pray for them. My prayer is that she's able to get it out and get over it as quickly as I was, I had great family and friends that helped me grieve and, most importantly, helped me move on.
Even if the Dr. mentioned he had a contentious objection to EC, which I don't think was in the original post but I may have missed it, he had that right. I know everyone is concerned about this girls rights, but the Dr. has his, too. He didn't deny her the right to take the pill, just that he wouldn'/couldn't prescribe it.
In giving some rights we take away from others.

Isobel - posted on 06/03/2012

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I haven't read any further since my last post but it just occurred to me. If you don't believe that a woman should be naked in a man's presence you can stay the hell out of my ER as well.

~♥Little Miss - posted on 06/03/2012

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Johnny, sorry to say it but if you are THAT opposed to it, you would not longer be there for your own reasons. Apparently somehow you have looked past your own issues with it. My husband currently works for a company that bleeds mice for testing products on. Guess what? He refused to do it, and did not lose his job. There are plenty of other things for him to do.

~♥Little Miss - posted on 06/03/2012

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Well, I would think after you going through years of training to have a medical degree, you would see things a bit differently. I have also worked for a few practices, so this is not just one practice that holds people morals up highly.

And just think, when discussing getting fired for smoking at a job, you are completely opposed to it. Kinda ironic.

Johnny - posted on 06/03/2012

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I am opposed to the development of Canada's oil sands. However, the company I work for sells a great deal of electrical cabling to oil sands projects. I would have lost my job instantly if I refused to work on transactions to do with oil sands development. My company would have every right to terminate me for non-performance. It is a moral belief, however, I do not have the right to let it interfere with my job and still keep my job. The girl who held my position previously found a new job due to that exact issue. She couldn't do it, so she left and found a new job. She didn't expect them to keep her and yet not fulfill her duties.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/03/2012

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Ah, well you have been lucky, I must say. If someone worked for me and refused to do their job as outlined in their duties, they would be fired.

~♥Little Miss - posted on 06/03/2012

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I have also seen vet techs refuse to help in "puppy torture" which includes tail docking, dewclaw removal at 3-5 days of birth. I have also seen technicians refuse to help abort a litter of puppies. We were spaying the pet, and it was pregnant. Had to call the owner for their decision on what to do, and they did not want the puppies, and gave permission to abort. Infact, I have seen 1 doctor outright refuse to do this when the owner knew about the pregnant cat (I think it was) and they had to find a vet that would do it.



No one got fired, no one got reprimanded. It is a very difficult job working in any medical feild. The more compassion you have, the better you are IMO, and yes that includes holding your own morals to high standards.



As far as blood transfusions go, they are not as common in hospitals and clinics, but are more frequent in specialty hospitals, or veterinary colleges. I have done I think about 8 in my 10 year career, and I was the only technician trained to do them in the one clinic that I was in for over 5 years.



Some assistants stay in kennels for caring of boarding animals, or patients in recovery from surgery. Some are strictly lab technicians, dealing with drawing up vaccinations, reading fecals, heartworm test, running various blood samples, and many other things. Some technicians are strictly assistants in surgery and are trained to administer anesthesia and assist during surgeries that call for a second pair of hands. If you are working in a big enough hospital, you can find a tech or assistant position that fulfills you the most. I am trained in all areas of the hospital, including receptionist. I cover it all, and you bet your sweet ass there are things I refuse to do.

~♥Little Miss - posted on 06/03/2012

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Keep in mind the turn over rate for technicians is very high due to the extreme nature of the job, and the lack of pay.



Edited to add for clarity

~♥Little Miss - posted on 06/03/2012

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Actually funny you mention that MeMe. There were a couple of very specific things I refused to do. For one, when a pet comes in with the potential of being infected with rabies and they decide to put it down (for that reason or other reasons) we have to cut off the heads and have them sent in for testing on the brain to see if they indeed contracted the disease. I refused to do so. I will not, and would not cut off the heads of animals, even though not only is this protocol, but a legal obligation of the hospital. I never got fired, nor was it even a question of losing my job over it.



I would not perform euthanasia(after 1 time doing it) (I assisted, just opted out of actually performing them) Depending on where you live, certain practices will allow vet techs to legally euthanize pets. I have been asked many times to do so, due to difficulty for the doctor to hit the vein or other reasons. I have 2 times placed the euthanasia filled syringe intravenously for the doctor to inject, but those were dire situations, and I REFUSED flat out to inject. Only 1 time I have ever actually euthanized a pet, and I would NEVER do it again. Many patients owners asked me to perform the euthanasia but I still refused. I never lost a client for this, my job, or had any threat of losing my job.



There have been doctors that were questionable with their techniques, and I refused to help them due to me not liking how they handled the animals, or wanted me to handle them unnecessarily roughly. Either I would tell them that I would restrain them how I saw fit, or I could not help them. I did not lose my job, patients, nor was there a threat of me losing my job.

Mary - posted on 06/03/2012

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But really, the hospital should be able to say, "Okay, we don't have the resources to do those here. Hospital (name) does. We're going to call ahead and let them know that you're coming, and to have everything in readiness so that you don't have to go through explaining everything again, okay? In the meantime, here's a packet of emergency contraception. You can take the first pill now, and then take the second one in 12 hours."

I tried to explain earlier why, in reality, this actually cannot happen in the hospital setting, but perhaps it got lost in all of the other issues at hand.

It does need to remembered that the US is an extremely litigious society, and doctors (and all healthcare providers) very much need to practice CYA medicine. In other words, every time they stray from the established standards of care or the explicitly written policies of their institution, they go out on an (indefensible) limb.

The implementation of the SANE program in this area did mean, without exception, that untrained and unlicensed personnel cannot and should not conduct a physical exam. Even if a patient says she wants to waive that right, no smart doc is going to ignore that protocol. To do so would mean censure not only from his hospital administration, but law enforcement as well. It could also come at a later time from the patient, who, after a bit of time, decides that she does want to press charges against her attacker, only to find out that it cannot be done because the exam was not conducted by a certified examiner. That "Oh, I wasn't thinking clearly - I was traumatized and distraught. But as a professional, you should have known better than to comply with my requests, and now it's your fault that there is no admissible physical evidence." This type of thing - doctors following a patient's requests that go against procedure - have bitten many of them in ass before.

Then you have the fact that in this setting, a doctor cannot just give a patient any type of medication without first examining them. Yes, EC is available over the counter, but in this scenario, the liability for any possible negative outcome rests with the dispensing MD. If she takes it at home, that's one thing. If a doctor in a hospital just gives it to her, he is held responsible for it's effects. Almost all hospitals have written policies that their "house" staff (meaning a doc that doesn't "know" the patient) must see and examine them before giving any medication - even a tylenol. The purpose of this is to decrease the chances of medication errors and preventable untoward reactions/outcomes. As ridiculous as this sounds to those of you who do not work in healthcare, there is actually sound evidence to support this protocol, and it has been effective in decreasing negative outcomes from casually dispensed meds. In practice, there is no denying that it can be a pain in the ass, and just giving a med is now a much more involved, time-consuming affair.

You can think it's ridiculous, and that's fine. Just remember, every time you say something along the lines of "I'd be suing them for every last penny they own", that right there is a huge part of why things have to be the way that they are. Today's society doesn't just say crap like that all the time - a number of them actually do. Any physician who wants to stay in practice is not going to ignore the rules. Apparently, even if they feel it is the morally right thing to do, that's indefensible, since so many of you feel that they should not bring their morality into the workplace.

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/03/2012

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LMCBW---I would like to know what would happen if you, as a Vet assistant decided it was against your moral beliefs to spay/neuder an animal? Or you refused to give a blood transfussion or to euthanize for serious complications? What if these were all emergency situations and if the animal did not get the service, they may DIE?

Do you think your boss would happily keep you as an employee? Do you think, you just may begin losing clients? Do you seriously think that your moral/religious beliefs would have a place in these situations?

MeMe - Raises Her Hand (-_-) (Mommy Of A Toddler And Teen) - posted on 06/03/2012

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EC is NOT going to affect the evidence collection. What IS going to affect the evidence collection is TIME! The longer she has to run around trying to find a SANE (SAFE) nurse the less evidence will be available. You have 72 hours to collect the physical evidence left from the perpetrator and the longer you wait from the time the nightmare occurred, the less evidence and harde for collection. There may be a 72 hour window BUT of course it is best to get it immediately. In the case of rape, the sooner the better.



ETA:

These cases when there is no SANE/SAFE nurse, there should be referrals and a phone call by the hospital to the place of referral, so that when the patient arrives, everything is ready to go for her. Not, well I don't believe in this, so GO AWAY!

Lady Heather - posted on 06/03/2012

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I have high moral standards and I do believe in abortions, whatever that means.

I think the most disturbing thing here is the lack of professionals available for a rape kit. Yes, the EC thing is a huuuuge issue. But ummm...how do you prosecute a rapist without evidence? Were the police involved? This whole thing is really messed up. Although I don't see how giving her EC would affect the rape kit. If there is a biological reason for that someone please correct me.

Happy - posted on 06/03/2012

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Little Miss, I think we actually agree on something! ;) Morals and religion do not go hand in hand. I know many non-religious who have very high moral standards and many religious who are as wicked as the devil. Just because you are sitting in a garage doesn't make you a car!

~♥Little Miss - posted on 06/03/2012

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Morals and church do not HAVE to go hand in hand. Sorry, but there are plenty of atheists and agnostics that do not believe in abortions, so please don't make this about religion.

♥♪Megan♫♥ - posted on 06/03/2012

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Amanda, if the doctor is more concerned with his or her rights and beliefs than the rights and well being of his or her patient then he or she should not have taken their oath to do no harm and to attend to the patient with the best of their abilities. In stead he or she should have gone and become a member of their church where their morals wouldn't have to be put into practice and possibly harm someone who doesn't share their beliefs.



The way I see it if I believed in God I would be down on my knees every night thanking Him that I live in a country where my members of provincial and national government place more vaule on the free will of others than on their own personal beliefs. They realise that they were elected to do their job not to convert the general populace to their out dated beliefs and extreme standards. Sometimes I feel as though I removed myself from the US just before the GOP started the entire country on a time warp back to the early 20th Century.

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