Jump to content

PAs and Religion


Recommended Posts

Tonight I came across another thread how an SP, the only one in the ED, wouldn't sign off on plan B in a rape case. It frustrated me to read as well as several others so..do you think religion has a place in medicine? I am agnostic and was extremely surprised to find out how many PA classmates are actively religious. Like medical students against stem cell therapy and that are pro-life-could I trust them to become competent providers and address my needs as a patient without their views interfering? Just hoping for a discussion.

Link to comment
Share on other sites

  • Replies 125
  • Created
  • Last Reply

I think it is troubling to impose religious belief structures onto objective patient care. As practitioners we should deal in the science of medicine, and when we cannot reconcile our feelings/emotions/beliefs/faiths with the execution of that care, we should examine our true intent. Is the intent to provide the care the patient requires or to uphold our personal tenets no matter what. Is it just, in the practice of science-based, not faith-based, medicine to insert our individual religious viewpoints into the delivery of care for all? 

 

 

I'm not advocating to be a robot or a Vulcan. All of those quirky little things are what make us uniquely human. And I too have my own beliefs. But if we cannot disentangle them from coloring our treatment of others not like us, what a great disservice we are doing. Why did we engage in a profession in which we knew we would be faced with such dilemmas, if we are unable to be objective in our care? That's why we standardize the education, practice, and research of medicine; so that fact, not belief, is pursued for the good of others.

Link to comment
Share on other sites

Try substituting ethnic, gender, or sexual orientation labels--any protected class, really--into your original post and see how offensive that posed question becomes.

 

Here's a counter-question for you: Why was Dr. Kent Brantly in Liberia?

 

Again, the issue is not having religious beliefs, it's having them alter the care you provide. Faith and belief can be great, powerful forces in peoples' lives.

 

But your gay doctor isn't altering his treatment of patients because of his homosexuality. Because ethnicity, gender, and sexuality are not external belief structures.

Link to comment
Share on other sites

  • Administrator

Faith and belief can be great, powerful forces in peoples' lives.

You can't have it both ways.  Faith causes people like Dr. Brantly to work as volunteers in Liberia and to stay and treat Ebola rather than flee back to the US (to answer the question you skipped), but that same above-self conviction also can compel a provider to be intransigent over things you don't like or agree with, because faith doesn't work the way you might want it to--it's not a conscienceless energizing force, it's a specific desire to do *good* in the world, as defined by that practitioner's belief system.  If society tries to say "Act on your faith when it meets my definition of standard of care, but keep your religion to yourself when it does not", it can only alienate providers who hold one or more beliefs that would place their practice of medicine at odds with the prevailing culture's current standard of care.

Link to comment
Share on other sites

You can't have it both ways.  Faith causes people like Dr. Brantly to work as volunteers in Liberia and to stay and treat Ebola rather than flee back to the US (to answer the question you skipped), but that same above-self conviction also can compel a provider to be intransigent over things you don't like or agree with, because faith doesn't work the way you might want it to--it's not a conscienceless energizing force, it's a specific desire to do *good* in the world, as defined by that practitioner's belief system.  If society tries to say "Act on your faith when it meets my definition of standard of care, but keep your religion to yourself when it does not", it can only alienate providers who hold one or more beliefs that would place their practice of medicine at odds with the prevailing culture's current standard of care.

 

That's a nice example of strong faith, but what about the atheist docs doing the same thing? I know a few. I'm sure there are a handful in MSF. Disaster relief groups, etc. There are plenty of people that hold the same high convictions, stand in the face of things others would away turn from. They do it various reasons; empathy, compassion, love, other inexplicable, internal driving forces. If you want to argue that those things are "god", then I won't disagree. But these individuals don't hold any stringent systematized beliefs or adhere to specific scriptures. They do some of the greatest good in the world too, guided by their morals, their feelings, their humanity, love.

 

They do exactly the same as Dr. Brantly.

Link to comment
Share on other sites

  • Administrator

I would never impugn the motives of non-religious providers, and my sincere apologies if anything I've said up to this point has come across as doing so.

Rather, I seek to highlight that the differences in motivation that can prompt acts of heroism in the name of that provider's faith, also come with a "gotcha" in that those same providers are not going to do things that violate their own consciences.  In a way, they are fundamentally un-reasonable people, because it's not "reasonable" to put one's self at risk for a belief system, regardless of whether one is practicing in a personally dangerous situation like Liberia, or risking one's livelihood by bucking the prevailing opinion on what standard of care means when it's at odds with one's own moral code.

Link to comment
Share on other sites

No offense at all. I understand the intensity of belief your point is illustrating, how it just can't be switched off so to speak. It's the crossroads of strong personal convictions with a "standardized" system of medicine that I think is causing the fray. On one hand you have position "follow the evidence and do no harm" and on the other you have "follow your beliefs and do no harm". And then they get put in the blender of life together.

 

It's quite interesting.

Link to comment
Share on other sites

Guest Paula

Tonight I came across another thread how an SP, the only one in the ED, wouldn't sign off on plan B in a rape case. It frustrated me to read as well as several others so..do you think religion has a place in medicine? I am agnostic and was extremely surprised to find out how many PA classmates are actively religious. Like medical students against stem cell therapy and that are pro-life-could I trust them to become competent providers and address my needs as a patient without their views interfering? Just hoping for a discussion.

I am "religious" (whatever that means).  I am extremely surprised to find out how many PA students are agnostic and believe in physician assisted suicide.  Could I trust them to become competent providers and address my needs as a patient without their views interfering?  What if they think I should be disposed of because my illness is terminal and I am a drain on "society"?  Will they try to convince me to die? How could I trust that provider to do no harm?  Just hoping for a discussion. 

Link to comment
Share on other sites

I am "religious" (whatever that means).  I am extremely surprised to find out how many PA students are agnostic and believe in physician assisted suicide.  Could I trust them to become competent providers and address my needs as a patient without their views interfering?  What if they think I should be disposed of because my illness is terminal and I am a drain on "society"?  Will they try to convince me to die? How could I trust that provider to do no harm?  Just hoping for a discussion. 

Physician assisted suicide is nothing like that... It's for people with a terminal illness that convince their physician they are in constant agony and have tried countless alternative methods of treatment and medication. The physician NEVER brings suicide into the discussion unless the patient or his/her family brings it up. It's a last resort decision that requires a lot of requirements and preparation for. It requires more planning than taking a loved one off life support who is in constant pain, which seems to be very common in this world.

 

I don't think religion should be discussed on this forum because many people have too many strong feelings about their religion or other religions. Either side has significant reasons or motivation to be kind and considerate to the world they live in. Also, you pretty much made it sound like anyone who is agnostic believes in physician assisted suicide, is a non competent provider, and is a not trustful. That's a pretty arrogant statement to say just based on someone's beliefs in my opinion... Some of the nicest people I know are agnostic. They don't let their "religion" dictate their behavior.

Link to comment
Share on other sites

When physician assisted death comes up, I encourage everyone to please, please watch How to Die in Oregon. It is an amazing documentary that deals with the state's adoption of death with dignity laws, but more importantly it follows Cody Curtis and her battle with recurrent and eventually metastatic cholangiocarcinoma, a terrible, painful cancer (is there any other kind?) with essentially a 0% 5-year survival rate (avg. 6 months). It follows her decision to obtain a lethal prescription and keep it with her until the bad days became too numerous and pain too unbearable. It is an honest, personal portrait involving her family and Cody's year long journey to the very end of her life.

 

Physician assisted death, Death with Dignity, whatever you want to call it, is about giving back to the patient the thing that terrible diseases stripe away: control of their lives, and of their bodies. It is certainly not to be taken lightly, and it always exists as the patient's choice AND ONLY AS the patient's choice, when or if ever to take the medication.

 

As a pediatric cancer survivor, I can say without reservation that I am very reassured that several states now allow for patients to seek this kind of help. The thought of going through a slow, agonizing death from an irreversible cause does not appeal to me. Not after my experiences. And although I might not opt to do so, having the option, having the control; I think, is the most important aspect for those suffering.

Link to comment
Share on other sites

Religion has little to do with having morals and the need to help other people. Just being agnostic doesn't mean I have some warped belief system of what's right or wrong. In fact, I have done a medical mission in Tanzania and plan to do several more but I also believe in medical missions just for that-medical care. Not trying to change their religious beliefs and to save them from alternate religions or "hell." Are you helping an underserved community to help or to put you one step closer to god? Oddly enough (or is it?), a study done a few years ago shows non-religious doctors were slightly more likely to help out such populations than religious doctors.

On an additional note, I find it troubling and a bit archaic now to not support assisted suicide for terminal patients who are in pain with no chance of recovery. Why let them or their family members see them like that at the end when they could go peacefully and comfortably IF that is what they want? If your only reason to not follow a patient's wish is for fear of disobeying the Bible or because they will go to hell then I only hope that in some case down the road you'll see the light.

 

 

 

 

(Here is an overview from the study)

http://www-news.uchicago.edu/releases/07/070730.curlin.shtml

Link to comment
Share on other sites

  • Administrator

Physician-assisted suicide is clearly outside the scope of the Hippocratic Oath:

 

http://www.nlm.nih.gov/hmd/greek/greek_oath.html

 

So, for that matter, is inducing abortion.  Hard to argue that any particular physician unwilling to perform either one is following their own faith rather than a precedent or consensus, unless anyone happens to actively worship Apollo today.  Looking briefly at revisions to the Hippocratic Oath, it looks to me like dropping the prohibitions against killing patients (born or unborn) was dropped in the last 50 years.

 

So if the Hippocratic Oath doesn't govern the scope of practice for a physician, what does? Contemporary value systems?  Should we (gah) retroactively pardon Mengele, Reiter, and the rest of the Nazi physicians who profaned their oath by experimenting on captive human subjects?  Of course not!  So... where do we draw the line about what constitutes the practice of medicine, and what constitutes crime against humanity?

Link to comment
Share on other sites

Guest Paula

You guys did not get my post.  It surprises me. Just being religious doesn't mean I have some warped belief system of what's right or wrong. etc., etc., etc. 

Link to comment
Share on other sites

I completely agree LTJ and that was my primary reason of making this thread. I would be interested to hear some challenges that people have faced going against their religious beliefs and following their medical duties.

 

 

On an unrelated note, it's interesting that we will must follow an oath under Greek gods. I know it's tradition but I bet something more relevant to modern science with clear definitions of what qualifies as a fetus/human and helping/hurting patients like physician assisted suicide could be of use. I can't even begin to imagine the voting process on it though!

Link to comment
Share on other sites

Physician assisted suicide is nothing like that... It's for people with a terminal illness that convince their physician they are in constant agony and have tried countless alternative methods of treatment and medication. The physician NEVER brings suicide into the discussion unless the patient or his/her family brings it up. It's a last resort decision that requires a lot of requirements and preparation for. It requires more planning than taking a loved one off life support who is in constant pain, which seems to be very common in this world.

 

I don't think religion should be discussed on this forum because many people have too many strong feelings about their religion or other religions. Either side has significant reasons or motivation to be kind and considerate to the world they live in. Also, you pretty much made it sound like anyone who is agnostic believes in physician assisted suicide, is a non competent provider, and is a not trustful. That's a pretty arrogant statement to say just based on someone's beliefs in my opinion... Some of the nicest people I know are agnostic. They don't let their "religion" dictate their behavior.

TODAY's physician assisted suicide is like you describe....but what about tomorrow?  What about history's examples?  It is, indeed, a slippery slope.

 

Some of the nicest people I know are also agnostic.  Of course, the rest of them are "religious".

 

It is strikingly funny how those who consider themselves liberal are becoming less and less tolerant to those with different belief systems.  Liberalism in America is dead, being replaced by illiberal leftists. 

Link to comment
Share on other sites

I completely agree LTJ and that was my primary reason of making this thread. I would be interested to hear some challenges that people have faced going against their religious beliefs and following their medical duties.

 

I have never faced that challenge.  I try my best to treat everyone with the utmost in respect whether they are the Catholic soccer mom of 10 kids, the lesbian with her self-described "wife", the Muslim woman in the hajib, the 19 yo pregnant woman with track marks all over her arm, the attorney, the prisoner, the agnostic, etc.  (Well, maybe not the attorney! lol). 

 

God loves them all, and I doubt any of their "sins" are much greater than mine.  It certainly isn't my job to judge them. 

Link to comment
Share on other sites

A trend I've been noticing a lot lately up here north of the 49th is physicians within certain belief groups are refusing to prescribe OCP's, injections or other forms of contraception based on their religious beliefs.  The provincial Colleges of Physicians and Surgeons are treading very gingerly around this issue, which I personally believe is actually a bit unethical.  I was trained to leave my personal prejudices and beliefs at the door when I went to work - you treat each patient to the best of your ability to the standard of care as defined FULL STOP.  If someone comes in looking for contraception, you lay out ALL options on the table and discuss what's best for that person...or you refer them to someone who can fit the bill for them.  The current requirements are that if you're going to do this, you have to be able to refer said patient to someone who can/will accommodate their needs...which in areas that are low on family docs to begin with, much less with appointment lead times stretching into the months, could be cause for problems.  Some areas have issues with not enough "Doc in the Boxes", much less PCP's.

 

The thing I fear is an issue that was a black eye in the Canadian medical system up until not all that long ago, might start creeping back.  Outside of Quebec, it was illegal to prescribe any form of contraception up until a court case in the early 1930's in Toronto that overturned that.  In Quebec, where the Roman Catholic Church had a very firm grip on a lot of the teaching hospitals and medical schools, it was forbidden to even TEACH contraception until about 1956 IIRC.  The problem with our laws at those times was that they were largely written by very religious folk, and in those times, you often needed a lot of kids just to ensure a couple lived beyond their young years.  The problem of course in medicine is the premise of the patient first, not the practitioner...but practitioner first is starting to creep back in a lot.  Despite the Hippocratic Oath mentioning words to the effect of "I will not do anything to help a woman procure methods for abortion" and such, everything still comes back to "First do no harm" principles.  The court case I mentioned in Toronto was the result of a physician who was treating a lot of immigrant women who were prematurely aging and dying young due to them essentially being baby factories coupled with running rapidly expanding households.  He had a nurse go around to some of these families with spermicidal jelly and encouraged the women to use it, since the men refused to use condoms - she was charged as a result.  When the physician concerned testified on her behalf and expressed his concerns, the case resulted in the contraception laws being overturned.

 

In this case, Primum non nocere means preventing not only potential harm to the woman concerned - your initial patient - but also to any potential unwanted new patients that may present themselves in an untimely fashion.  In the OP's case, that very much applies, as well as taking away at least one psychological stressor this person doesn't need and that will impede them healing.   On a personal note, I'd likely be inviting the SP concerned out back for a one way conversation followed quickly by a complaint to their College or regulating agency, cc'd to the ER director and Chief of Staff.  Luckily in Canada, Plan B is a behind the counter product now that a pharmacist can dispense, though in a rape case, I doubt that the woman concerned would be able to bring herself to going to get it - we keep a couple packages in our med room in the ED.

 

$0.02 (Cdn).

 

SK

Link to comment
Share on other sites

Physician-assisted suicide is clearly outside the scope of the Hippocratic Oath:

 

http://www.nlm.nih.gov/hmd/greek/greek_oath.html

 

So, for that matter, is inducing abortion.  Hard to argue that any particular physician unwilling to perform either one is following their own faith rather than a precedent or consensus, unless anyone happens to actively worship Apollo today.  Looking briefly at revisions to the Hippocratic Oath, it looks to me like dropping the prohibitions against killing patients (born or unborn) was dropped in the last 50 years.

 

So if the Hippocratic Oath doesn't govern the scope of practice for a physician, what does? Contemporary value systems?  Should we (gah) retroactively pardon Mengele, Reiter, and the rest of the Nazi physicians who profaned their oath by experimenting on captive human subjects?  Of course not!  So... where do we draw the line about what constitutes the practice of medicine, and what constitutes crime against humanity?

 

The same Greeks who developed the Hippocratic Oath also practiced abortion, infanticide, and mercy killings. Yes the physicians, not just random people. As well as waging a few wars here and there. Rarely in history does something remain unchanging through all of time, because as humans, we change. I think that the preservation of life of all kinds, not just human, is one of the greatest of goals. But I do not consider forcing others to suffer, when they express rational wishes to the contrary, a noble act. In fact I consider it torture and murder of their mind & spirit. That's my belief system, it is different from your own. Neither of us is exclusively right nor wrong. The Japanese view it all differently as well, and so on...

 

 

There is nothing wrong with inserting your religious faith into your practice, but if a patient desires something that is a legal service and you won't provide it, you have an obligation to refer them to someone who will.

 

You said it better in one sentence than I've been trying to spit out in many paragraphs.

 

 

 

TODAY's physician assisted suicide is like you describe....but what about tomorrow?  What about history's examples?  It is, indeed, a slippery slope.

 

Some of the nicest people I know are also agnostic.  Of course, the rest of them are "religious".

 

It is strikingly funny how those who consider themselves liberal are becoming less and less tolerant to those with different belief systems.  Liberalism in America is dead, being replaced by illiberal leftists. 

 

Slippery slope is a fallacious argument used in this context.

 

If the beliefs of the people reflect the adoption of death with dignity laws, then that is the will of the populous. People have their beliefs and you have yours.

 

And it's not as if the terminal, suffering cancer patient cannot end their own life without a script for seconal. It's just not as messy and distressing as a gun.

Link to comment
Share on other sites

Tonight I came across another thread how an SP, the only one in the ED, wouldn't sign off on plan B in a rape case. It frustrated me to read as well as several others so..do you think religion has a place in medicine? I am agnostic and was extremely surprised to find out how many PA classmates are actively religious. Like medical students against stem cell therapy and that are pro-life-could I trust them to become competent providers and address my needs as a patient without their views interfering? Just hoping for a discussion.

 

Your post is naive.

 

That's like me saying, "how could I trust this provider to be a compassionate (whatever that means to me) provider when he is an agnostic?!?" 

 

You cant completely separate beliefs and professional decision-making. And that goes for theists and atheists equally, because they are both beliefs. Every provider believes that what they are doing is rational and *right*, but what is the arbiter of *right* in that person's world?

 

Again, substitute any belief structure for "religious" and see how relative it is. We're all cool with someone else's beliefs until they infringe upon what we think should be the standard of care. Maybe you think your grandmother needs physician assisted suicide. Maybe you think your 14 y/o daughter needs birth control. Maybe you think abortions are OK until X weeks. For every statute of morality you have in your mind there is someone who thinks differently, or who interprets "do no harm" and medical ethics differently than you do, based on their own belief system. 

 

Ultimately the patient always has a choice. If they want a service (legal) that you will not provide, you can send them to someone who will, or tell them they can find someone who will. 

Link to comment
Share on other sites

And it's not as if the terminal, suffering cancer patient cannot end their own life without a script for seconal. It's just not as messy and distressing as a gun.

I can attest to that! My aunt went that route -- sent husband to the store first and pulled out the shotgun.

Link to comment
Share on other sites

Slippery slope arguments are never fallacious arguments when it comes to societal discussions. Unless, of course, it argues against your personal point of view.

 

Of course people will always commit suicide. They will also murder, rape, and rob. Doesn't mean I will help them do such things.

 

Agnostics/atheists forget that the foundation of western ethics and culture flows from Judeo-Christian religion.

Link to comment
Share on other sites

I can attest to that! My aunt went that route -- sent husband to the store first and pulled out the shotgun.

 

A very ill elderly couple in my community committed suicide together. Married for 67 years, they wrote a letter describing their choice, dressed in their Sunday best, parked on hill watching the sunrise and died together. I did not see tragedy in their death, I saw love & compassion.

 

Physician assisted death is a very strict process. Palliative care and hospice care may be the more appropriate choice for many who must face such situations. But I do believe people should have the choice.

 

 

Slippery slope arguments are never fallacious arguments when it comes to societal discussions. Unless, of course, it argues against your personal point of view.

 

Of course people will always commit suicide. They will also murder, rape, and rob. Doesn't mean I will help them do such things.

 

Agnostics/atheists forget that the foundation of western ethics and culture flows from Judeo-Christian religion.

 

And I don't think that you should ever have to. Your beliefs should be protected and you will never have to write a script for someone wishing to end their own life. But should that choice be denied to others with different beliefs from you?

 

Even in the teachings of Judeo-Christian religion, "thou shalt not kill" is not an absolute. War, self-defense, and mercy killings are all prescribed exceptions in various historical and religious teachings.

 

I find it hard to support the taking of human life in some contexts such as for war or capital punishment while absolutely opposing it in others such as mercy/suicide.

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.


×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More