| Posted by Bel | The time is 4.32pm here in Wellington NZ |
A commenter on this recent post brought up the issue of when a doctor makes a judgement call, rather than giving medical advice.
Patients are in a vulnerable position when they enter a doctor's clinic, whether it be for the 'flu or a pregnancy scare, or a weird spotty rash that came up after gardening. It's our own bodies doing something we don't really understand and we're relying on someone else to tell us what to do next. Doctors are in such a position of authority, and we have to trust that all their years of training, and ability to pronounce the labels on prescription bottles, means that they have our best interests at heart.
There are times when a doctor's own interests overrule though. Rather than presenting a patient with the most relevant medical options for their situation, they may withhold information or services because of their own judgements. Not professional ones, but personal.
Storytime, folks: I went to my doctor to get the emergency contraceptive pill (ECP, or "morning after pill"). Yes, I know, you can get it at most pharmacies, sometimes even for free (although only recently in some regions, such as the Manawatu, where it has been SPOILER ALERT hugely popular).
But I am on medication for epilepsy and that messes with all kinds of other drugs, even just simple stuff like that panadol with caffiene in. Same as how plenty of anti-depressants can't be mixed and matched with just anything off the shelf.
Anyway, I decide to be comprehensive in my paranoia and make the doctor's appointment. It turns out to be a locum (what is with them, Valleygurl??) and after explaining why I'm there (*blush*), have her tell me that she won't prescribe me the contraceptive. Because of her morals. Which apply to her. But she decided that in this case, they also applied to me. And the medical services that I needed. She told me I should go elsewhere and suggested a nearby pharmacy that would be likely to prescribe the ECP. I wasn't charged for the appointment.
The Medical Council of New Zealand is revising their guidelines to ensure that patients are not caught up in doctors' personal conflicts. Earlier this year, it specifically revised its standards for doctors, a guide called "Good Medical Practice", to state that women who come to a doctor expressing doubt about continuing with a pregnancy must be given objective information on all available options - regardless of what your own beliefs are on the matter. If your personal judgement call is not in support of her choice, you still must act as a professional and inform her of her medical service options.
It's on page 4 of this pdf entitled "Beliefs and Medical Practice" if you want to read it yourself.
This level-headed and pragmatic approach to a sensitive situation has, of course, been trashed by the conservative anti-choice camp. But most scarily, it is doctors themselves that are against these guidelines. A High Court application was filed for a review of the standards, so that doctors could, on grounds of conscience, could not just refuse to prescribe contraceptives or referrals for abortions, but also withhold any information or advice on the subject.
The NZ Herald states that one of the doctors involved in this is Dr Mary English. As in, wife of Deputy Prime Minister and Minister of Finance, Bill English. Great. Chances of this group of over-opininated retrogrades having influence at a high level of government, then...? Ughhh.
Mrs & Mr English, looking glam, plotting to take over your uterus.
If you have not yet had your fill of fun pro-choice reading, then check out Boganette's recent post, triggering an email stating: "I saw your comment and how can you be pro-abortion? Your infertile. Doesn't that make you not want abortions?" (And high five for the Handmaid's Tale reference. I just read that book and DAMN it's good.)
