Doctors’ personal beliefs can hinder care

hippiemom

PaperPlates wrote:

No, all three are human. If you want action without emotion or personal beliefs coming into play, hire a fucking robot.

How about this ... if you can't fulfill the job description, get another job.

trappedinmyradio

it's called a second opinion...go find one.

hippiemom

trappedinmyradio wrote:

it's called a second opinion...go find one.

Do you go and get a second opinion every time your doctor tells you something, just to make sure he's not withholding information from you?

soulsinging

PaperPlates wrote:

And alot of cops let the potsmokers go with a warning. And alot of ad's choose to not press charges. And alot of judges give probation rather than maximum penalties. Your comparision is a lousy one. THOSE people are using THEIR beliefs as much as any doctor out there, in determining what they feel is appropriate. Thanks.

i think you're wrong on all 3 of these counts. a cop might opt for a warning, but he still lets the offender know he was in violation of the law. he doesn't just say "oh, just wanted to say hi... no no, no problem with smoking pot here." he gives the offender full information but refuses to act in opposition to his conscience to a small extent. i disagree with that, if pot is illegal cops should be enforcing it and your violation of the law shouldn't depend on how sympathetic the arresting officer is. regardless, as i said, they still know where they stand with the law. if a doctor feels he cannot in good conscience prescribe x medicine or perform an abortion, that is one thing (akin to not arresting a pot smoker)... but he is still professional obligated to inform the patient of their options to pursue other treatments elsewhere (akin to giving a warning instead of arrest).

however, if you don't like that... what about teachers and professors? i know you neocons love to bitch about liberal professors spouting off their ideology to a captive student audience. should a teacher be using their position as a pulpit to select what parts of the curriculum are communicated to students? if a teacher is, say, a holocaust denier, should they be allowed to ignore large chunks of history about ww2 just becos of their personal beliefs? should a staunch atheist use his biology or physics class to talk about the evils of religion instead of science?

surferdude

Just two questions;

Are doctors ethically and/or professionally bound to tell a patient of all possible courses of treatment?

If not, should they be professionally and/or ethically bound?

decides2dream

hippiemom wrote:

How about this ... if you can't fulfill the job description, get another job.

exactly.

i don't think anyone is expecting or asking a doctor to go against his/.her personally held beliefs. sharing ALL available information and courses of treatment is part of their job description. actually administering such does not have to be. a doctor can, and should, be expected to offer the information and beyond that....suggest seeing another physician for said treatment if the patient wants it but the doctor does not want to provide such service. anything else to me is negligence on the part of the doctor.

SuzannePjam

surferdude wrote:

Just two questions;

Are doctors ethically and/or professionally bound to tell a patient of all possible courses of treatment?

If not, should they be professionally and/or ethically bound?

I personally believe it's unethical, but don't know what the law is on that. I think if a doctor knowingly withholds treatment options from the patient because they don't agree with the treatment, in areas other than reproduction, everyone would agree that it's wrong. For example, if a woman has breast cancer, just because a certain doctor doesn't necessarily agree with chemotherapy doesn't mean he shouldn't give her the option of it. The same should apply to birth control and the morning after pill and abortions.

chopitdown

surferdude wrote:

Just two questions;

Are doctors ethically and/or professionally bound to tell a patient of all possible courses of treatment?

If not, should they be professionally and/or ethically bound?

Doctors should make patients aware of different treatments for certain diseases. But doctors are also reading and finding out new information all the time and what may work for some people doesn't nec work for everyone. Sometimes a doctor doesn't mention a treatment b/c he's fairly sure that the said treatment isn't what the patient needs...not every clinical picture is the same. There are also doctors who won't offer options based on values.

The hard part about the second question is teh professional leway and professional judgement that comes into play with each patient and with each treatment. Should I voluntarily tell a patient every option available and then place the onus on the patient to make the decision? I think that depending on the case you should provide a couple of reasonable options that the physician is 1. comfortable with and 2. confident with for treatment...if the patient asks about new or controversial treatment the doctor is at least obligated to address it then and refer if the patient wants to explore that avenenue.

hippiemom

chopitdown wrote:

The hard part about the second question is teh professional leway and professional judgement that comes into play with each patient and with each treatment. Should I voluntarily tell a patient every option available and then place the onus on the patient to make the decision? I think that depending on the case you should provide a couple of reasonable options that the physician is 1. comfortable with and 2. confident with for treatment...if the patient asks about new or controversial treatment the doctor is at least obligated to address it then and refer if the patient wants to explore that avenenue.

I think that's fine if you're treating cancer or diabetes or something of that nature, but where most of these "value" judgments come into play is not over new or controversial treatment. In reproductive and end of life issues, the options are known to every doctor, they are relatively standard, and they should be addressed. No one disputes the safety and effectiveness of Plan B pills, for example. A refusal to discuss them is not based on a professional determination of what is best for the patient's physical well-being, and that should be the only criteria used by a doctor.

End of life issues are another area. Some doctors will agressively manage pain even if it might hasten death, others will not. Doctors need to be very upfront with their patients about which type of doctor they are. This is a very serious and very final decision that only the patient (or her designated agent) should be making.

chopitdown

hippiemom wrote:

I think that's fine if you're treating cancer or diabetes or something of that nature, but where most of these "value" judgments come into play is not over new or controversial treatment. In reproductive and end of life issues, the options are known to every doctor, they are relatively standard, and they should be addressed. No one disputes the safety and effectiveness of Plan B pills, for example. A refusal to discuss them is not based on a professional determination of what is best for the patient's physical well-being, and that should be the only criteria used by a doctor.

End of life issues are another area. Some doctors will agressively manage pain even if it might hasten death, others will not. Doctors need to be very upfront with their patients about which type of doctor they are. This is a very serious and very final decision that only the patient (or her designated agent) should be making.

I agree that the physicians should be up front with the patients re: their stance on those issues, no doubt. I think communication is something that is lacking on the doctors parts a lot of the time, b/c of the vast amount of people they see in a given day. That's a poor reason, but that's the reality right now. I also think ( and know from conversations) that docs are frustrated with the amount of information and disinformation out there (internet / ads etc..) people spend 5 minutes online and come in and "know" the best treatment already...but that's a different topic.

soulsinging

chopitdown wrote:

Doctors should make patients aware of different treatments for certain diseases. But doctors are also reading and finding out new information all the time and what may work for some people doesn't nec work for everyone. Sometimes a doctor doesn't mention a treatment b/c he's fairly sure that the said treatment isn't what the patient needs...not every clinical picture is the same. There are also doctors who won't offer options based on values.

The hard part about the second question is teh professional leway and professional judgement that comes into play with each patient and with each treatment. Should I voluntarily tell a patient every option available and then place the onus on the patient to make the decision? I think that depending on the case you should provide a couple of reasonable options that the physician is 1. comfortable with and 2. confident with for treatment...if the patient asks about new or controversial treatment the doctor is at least obligated to address it then and refer if the patient wants to explore that avenenue.

should public defenders deprive their clients of legit defenses becos they don't feel comfortable helping someone they think might be guilty?

chopitdown

soulsinging wrote:

should public defenders deprive their clients of legit defenses becos they don't feel comfortable helping someone they think might be guilty?

only if they're educated at northwestern

no, you do the job to the best of your ability. And sometimes the best of your ability and best treatment is to not throw the "kitchen sink" so to speak, at the problem. There are things that work, and different clinical pictures do help guide care. What works for one person may or may not work for someone else. We're making steps in the medical field with evidence based medicine so we know which treatments are more ideal than others and which ones have more "merit" but medicine should never, and can never, but turned into cookbook medicine (where you do A and B to get C...b/c it doesn't happen).

soulsinging

chopitdown wrote:

only if they're educated at northwestern

no, you do the job to the best of your ability. And sometimes the best of your ability and best treatment is to not throw the "kitchen sink" so to speak, at the problem. There are things that work, and different clinical pictures do help guide care. What works for one person may or may not work for someone else. We're making steps in the medical field with evidence based medicine so we know which treatments are more ideal than others and which ones have more "merit" but medicine should never, and can never, but turned into cookbook medicine (where you do A and B to get C...b/c it doesn't happen).

now explain to me how denying information about perfectly safe and tested and widely accepted medical practices due to your personal moral beliefs qualifies as providing your patient with the best individualized care? it has nothing to do with what's best for the patient and everything to do with the doctor's moral agenda. no one is talking about kitchen sink approaches, we're talking about providing info about widely accepted and established practices for the benefit of patients. we're not talking about mentioning new, experimental treatments that are unproven or homeopathic remedies... we're talking about the plan b pill or abortion. public defenders probably should not throw out every crazy defense they can think of even fi untested, but if they fail to discuss valid and proven defenses they can be sued for malpractice and the decisions appealed. however, since it's kinda impossible to "appeal" a child's birth becos no one told the mother about plan b, i dont think it's unreasonable to mandate that doctors are ethically obligated to inform patients about such options, even if they are not comfortable providing the treatment themselves.

chopitdown

soulsinging wrote:

now explain to me how denying information about perfectly safe and tested and widely accepted medical practices due to your personal moral beliefs qualifies as providing your patient with the best individualized care? it has nothing to do with what's best for the patient and everything to do with the doctor's moral agenda. no one is talking about kitchen sink approaches, we're talking about providing info about widely accepted and established practices for the benefit of patients. we're not talking about mentioning new, experimental treatments that are unproven or homeopathic remedies... we're talking about the plan b pill or abortion. public defenders probably should not throw out every crazy defense they can think of even fi untested, but if they fail to discuss valid and proven defenses they can be sued for malpractice and the decisions appealed. however, since it's kinda impossible to "appeal" a child's birth becos no one told the mother about plan b, i dont think it's unreasonable to mandate that doctors are ethically obligated to inform patients about such options, even if they are not comfortable providing the treatment themselves.

i never said in re: to plan B that it shouldn't be offered...i'm quite for it and think it should be offered AND i think physicians should either discuss it with their patients directly or direct them to somone who can help fulfill that need. Abortion I'm not touching today b/c my day is going fairly well. The quesiton i responded to was a very vague and general question re: physicians requirements to tell ALL options. I agree with you on the specifics of reproduction (at least plan ...and most everyone knows abortion is an option so if a doctor doesn't mention it it's not like someone will be caught off guard that it's an option.

soulsinging

chopitdown wrote:

i never said in re: to plan B that it shouldn't be offered...i'm quite for it and think it should be offered AND i think physicians should either discuss it with their patients directly or direct them to somone who can help fulfill that need. Abortion I'm not touching today b/c my day is going fairly well. The quesiton i responded to was a very vague and general question re: physicians requirements to tell ALL options. I agree with you on the specifics of reproduction (at least plan ...and most everyone knows abortion is an option so if a doctor doesn't mention it it's not like someone will be caught off guard that it's an option.

fair enough. i was thinking of this specific situation and doctors witholding valid and pertinent medical information due to moral agendas. i think that is clearly unethical.

chopitdown

soulsinging wrote:

fair enough. i was thinking of this specific situation and doctors witholding valid and pertinent medical information due to moral agendas. i think that is clearly unethical.

i concurr...esp if it goes against the standard of care / practice of the AMA or the place of employment.

Jeanwah

In my experience with having a daughter with Down syndrome and her advocate for getting the same services as anyone without disabilities, I have found that multiple doctors are not giving the facts to pregnant women concerning the possibility of having a baby with DS. Many doctors are quick to concentrate on the nagatives of the disability and actually encourage women to terminate. Meanwhile, my daughter is a bright, beautiful and happy little girl. Forget about giving facts to pregnant women, doctors are too quick to point out that they "don't want a baby with a birth defect". Those with Down syndrome now, through many treatment options available are living their lives to the fullest, but these doctors don't seem to know that...or care.