PAs and Religion

[HMtoPA]

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

 

And were there no ethics before Judeo-Christian values?  They didn't come from nowhere.  If it makes you feel better to say that they came to mankind by divine intervention, fine, but that's hardly an objective fact.  Just because someone wrote them down and said they came from on high does not make it so.  

 

Another view is that morality is a human construct, and one that religious folks don't have a monopoly on.  We are conditioned by societal values from the day we're born, and a belief in a god is not necessary to have an intrinsic sense of right or wrong or strong moral compass.

 

Not trying to belittle anyone's religious beliefs, but if you want to talk about foundational values, you have to go further back than the Judeo-Christian variety. 

 

Also, since some of you have metioned the Hippocatic Oath: did you take one?  I certainly did not.  Thought that was reserved for physicians?

[HMtoPA]

Again, it is funny how the left is now the intolerant side of the spectrum.

 

Only by twisted logical gymnastics is this a true statement.  Liberals are intolerant because they refuse to tolerate blatant discrimination?

[acozadd]

Rev- There are potential legal ramifications that cannot be overlooked when prescribing narcotic pain medications to minimize suffering vs. a medication that will terminate life. We live in a sue-happy world, as I'm sure we are all aware. If you prescribe a medication with the sole intent on ending a patient's life, and document it as such, you are "protected" legally if this is a legal practice in that state. However, if a patient vocalizes depression and suicidal ideation, and you offer them a supply of narcotics large enough to end their life but with the intent that they will take it as prescribed to minimize suffering, would it not be possible that lawyers come knocking on your door claiming malpractice?

 

As someone who prescribes a lot of narcotic medications in an orthopedic practice, I hope it would never come to that... but there are no guarantees.

[cinntsp]

Like Rev said, a single provider not writing a script (or performing an abortion, or performing FGM) is not personally denying that patient access. The patient can go find someone else.

 

Kinda like the Christian baker who refused to put his artwork in a gay wedding. He in no way denied that couple a cake. He just chose not to be part of it.

 

Don't you think it is more intolerant to FORCE someone to do something they feel is morally wrong? If you don't feel that way, then I suggest you look at areas of the world that are truly intolerant. There ARE cultures in this world where young women are forced into FGM, where they are forced into arranged marriages, where they are not allowed to go to school, or drive, or leave the house without a male family member. There are places in the world where Christians are marched to the seashore and beheaded simply because they are Christians. There are places in the world where homosexuals are thrown from rooftops simply because they are homosexual.

 

THAT is intolerance, and it is not found anywhere in America (except for some small enclaves of immigrant culture where these actions carry over).

 

INTOLERANCE would be a provider who doesn't just choose to not write the script, but instead pulls that patient into the public square and whips them.

 

INTOLERANCE would be shutting down a business simply because the store owner did not agree with your political or social beliefs.

 

The Christian store owner tolerated the homosexual couple, he just refused to do business with them. The homosexual couple was INTOLERANT of the existence of a Christian store owner, so sought to shut them down.

 

 

Please forgive me if this comes across as a personal attack, because I really don't mean for it to be one....but maybe that's because you (and many of your "generation") have not been exposed to anything other than liberal ideology. Well, you probably have been "exposed" to conservative/right wing ideas, but only as a classroom example of what is "bad".

 

Those poor Christians and conservatives...always getting bullied.

 

Sent from my Nexus 5 using Tapatalk

 

 

[rev ronin]

Rev- There are potential legal ramifications that cannot be overlooked when prescribing narcotic pain medications to minimize suffering vs. a medication that will terminate life. We live in a sue-happy world, as I'm sure we are all aware. If you prescribe a medication with the sole intent on ending a patient's life, and document it as such, you are "protected" legally if this is a legal practice in that state. However, if a patient vocalizes depression and suicidal ideation, and you offer them a supply of narcotics large enough to end their life but with the intent that they will take it as prescribed to minimize suffering, would it not be possible that lawyers come knocking on your door claiming malpractice?

 

As someone who prescribes a lot of narcotic medications in an orthopedic practice, I hope it would never come to that... but there are no guarantees.

Were I actively working in hospice, rather than just answering a hypothetical question as part of an abstract, patientless dialogue, I would probably have a better and more nuanced answer.  Every patient facing death is going to face depression, as the nominal 4th of 5 stages.  I'm not going to shovel a ton of high-caliber narcs at someone who articulates suicidal ideation, but nor would I withhold legitimate and appropriate pain medications just because someone with mets has a bad day. Within those extremes lies the balance point we strive for in the 'art' of medicine.

[BruceBanner]

Rev ronin,

 

You'd shied away from the suffering, dying patient question. Abortion is a separate life that others are making choices for, used in your examples. But what of the terminally ill, greatly suffering patient who wants to end THEIR own life?

 

Would you not refer them, if they somehow came to you? (Assuming legality in your state practice) Would you offer them no help at all because of what they desire for themselves?

 

 

We are under no obligation to do so.

 

You certainly could if it was legal and you wanted to.

 

 

All the scenarios being posed here are not medical necessities---in other words, if you didn't do X procedure, or refer them for X procedure, the patient would not suffer certain morbidity or mortality as a direct result of your inaction. They are free to seek service elsewhere. These are elective things we are talking about---abortion, assisted suicide, FGM, contraception. A provider does not have to agree to do ANY elective procedure or Rx an elective drug.

 

People get caught up in their own value holdings and feelings when these arguments are posed. True rationality is removing your personal leanings from the question at hand. Yes, I know that few decisions happen in an emotional vacuum, but often what we think is "rational" is really just us applying a logic to the problem using our own values as a guide. 

[jtmathew]

Like Rev said, a single provider not writing a script (or performing an abortion, or performing FGM) is not personally denying that patient access.  The patient can go find someone else.

 

Kinda like the Christian baker who refused to put his artwork in a gay wedding.  He in no way denied that couple a cake.  He just chose not to be part of it.

 

Don't you think it is more intolerant to FORCE someone to do something they feel is morally wrong?    If you don't feel that way, then I suggest you look at areas of the world that are truly intolerant.  There ARE cultures in this world where young women are forced into FGM, where they are forced into arranged marriages, where they are not allowed to go to school, or drive, or leave the house without a male family member.  There are places in the world where Christians are marched to the seashore and beheaded simply because they are Christians.  There are places in the world where homosexuals are thrown from rooftops simply because they are homosexual. 

 

THAT is intolerance, and it is not found anywhere in America (except for some small enclaves of immigrant culture where these actions carry over).

 

INTOLERANCE would be a provider who doesn't just choose to not write the script, but instead pulls that patient into the public square and whips them. 

 

INTOLERANCE would be shutting down a business simply because the store owner did not agree with your political or social beliefs. 

 

The Christian store owner tolerated the homosexual couple, he just refused to do business with them.  The homosexual couple was INTOLERANT of the existence of a Christian store owner, so sought to shut them down. 

 

 

Please forgive me if this comes across as a personal attack, because I really don't mean for it to be one....but maybe that's because you (and many of your "generation") have not been exposed to anything other than liberal ideology.   Well, you probably have been "exposed" to conservative/right wing ideas, but only as a classroom example of what is "bad". 

Oh and your "generation" is so clearly morally superior. I dont buy it. My "generation" has your "generation" to thank for a lot of the mess we are currently in regarding healthcare, the economy, etc, etc, etc. Just because you qualify your personal attack by saying "this is not a personal attack", it doesnt make it less offensive. Get off your high horse and go read a history book about Jim Crow and segregation.

[cbrsmurf]

I'm glad this thread evolved from a slightly controversial topic to an even less controversial topic

[Boatswain2PA]

Oh no, not at all, I've had plenty of exposure to both. I hold some beliefs that are considered traditionally "conservative" and some that are "liberal". My point being, I feel that my generation is less likely to toe a party line and subscribe to all the "traditional" values of that grouping just because, be it conservative or liberal as you say.

 

More emphasis on free thought, less on conformity.

I think every "generation" thinks they are "less likely to toe a party line".  I know I certainly did.  And maybe they do, or maybe as the generation ages they change their minds. 

 

The problem is not where the owner's objection stems from, but that fact that he is running a public business.

 

Under that logic, the owner of a public business should be allowed to tolerate a black or interracial couple, but also be able to refuse to do business with them. Regardless of where his beliefs stem from.

Personally, my very libertarian self says that any business should be able to refuse any other person.  If some racist or bigoted scumbag wants to deny service to a person or color, or homosexual, they should legally be able to.  Likewise, a business should be able to deny service to members of the Westboro Baptist Church.  While I find this morally reprehensible, but it should be legal because nobody is actually "harmed" by it (as long as they can go get those services elsewhere.  I do understand the need for the civil rights movement of the 60's.  Widespread racism that was written into laws (Jim Crow laws) needed a "movement" to sweep away these laws.  

 

In the case of the Christian baker and the lesbian couple....the baker did not refuse to sell them "anything", he refused to create a cake with a message that was against his religious beliefs.  Had they wanted to buy the cupcakes off the shelf, I'm sure he would have sold to them.  But they wanted him to CREATE something he felt inappropriate. 

 

 

 

 

And were there no ethics before Judeo-Christian values?  They didn't come from nowhere.  If it makes you feel better to say that they came to mankind by divine intervention, fine, but that's hardly an objective fact.  Just because someone wrote them down and said they came from on high does not make it so.  

 

Another view is that morality is a human construct, and one that religious folks don't have a monopoly on.  We are conditioned by societal values from the day we're born, and a belief in a god is not necessary to have an intrinsic sense of right or wrong or strong moral compass.

 

Not trying to belittle anyone's religious beliefs, but if you want to talk about foundational values, you have to go further back than the Judeo-Christian variety.

You are right, I meant to type that our societal ethics come THROUGH the Judeo-Christian values.  And of course, many of these are derived from previous cultures (Greco-Roman, etc).  I didn't infer that you must believe in God to have these values, but I think it is self-evident that our society was founded upon those values. 

 

Only by twisted logical gymnastics is this a true statement.  Liberals are intolerant because they refuse to tolerate blatant discrimination?

We all discriminate, it is human nature and we will never be able to get away with it.  You choose some people to be friends over others, which is discrimination.  You chose one job over another, one car brand over another, one neighborhood over another, etc.  Discrimination should be illegal when it harms someone.  I don't care that the Westbboro Baptist Church hates homosexuals and won't let them into their "church".  I do care that they interrupt the funerals of American soldiers which harms the family. 

 

A baker, a singer, a musician, or a wedding planner who refuses to allow their art work to be part of a ceremony they do not believe in may be discriminating, but they are not harming anyone in that ceremony. 

 

Liberals are indeed tolerant.  As I get older, I find myself more and more liberal which, I think, helps me practice EM.  The proto-typical "liberal" of the 60's was the peace-n-love flower child who "just wanted to be left alone"...the whole "live and let live" mentality.  Much of this is gone now, replaced by leftist mentality of "You don't agree with me, so I must shut down your business/ruin your personally".

 

Those poor Christians and conservatives...always getting bullied.

 

Sent from my Nexus 5 using Tapatalk

The pendulum is swinging that way.

 

Oh and your "generation" is so clearly morally superior. I dont buy it. My "generation" has your "generation" to thank for a lot of the mess we are currently in regarding healthcare, the economy, etc, etc, etc. Just because you qualify your personal attack by saying "this is not a personal attack", it doesnt make it less offensive. Get off your high horse and go read a history book about Jim Crow and segregation.

I never insinuated my "generation" is superior in any way to any other generation. 

 

It was not a "personal attack", and PACDan was mature enough to see it for what it was.  If you lack that ability, then perhaps you can ask PACDan to help you attain it. 

[jtmathew]

Pardon me for my assertion that my "generation" ought not be classified as a bunch of mindless, koolaid drinking, leftist drones. Although it may have not been a personal attack, it was still offensive and undermines the excellent points you made in the above post. I apologize for the biting sarcasm.

 

IMHO, separation of church and scalpel.

[Boatswain2PA]

Nobody has classified your, or any, generation as anything.  Go back and read what I wrote again, and if you are still upset, go drink a glass of wine and relax.  Then come back and read it again.

I suggested that some people may not be exposed to conservative ideologies (other than when these ideologies are being ridiculed).  This is especially true for young people just finishing a very lengthy college education. 

[jtmathew]

Advice taken. Point understood.

[SHU-CH]

Interesting thread. I think that it is a credit to our profession that people can have disagreements - and relatively sharp ones at that - but still keep things civil. I have seen similar threads in similar boards degenerate into a hot mess in short order. This is why boards usually ban politics and religion. Thanks for keeping it classy.

 

I am probably even more libertarian that Boatswain. If I do not want to do business with someone, I see no need for the government to intrude into my decision. Our government does essentially nothing well except defend our borders. Everything else they touch - without regard to political party - eventually turns into a clownshow.

 

Regarding the mix between religion and medicine, I approach it like this, and ask my students to consider this view:

 

I have absolutely no right to force a patient to do something they find morally objectionable. A patient should therefore have no right to place such a demand upon me.

[Guest JMPA]

education is discrimination. (not sure if the liberals will understand this)

[Guest JMPA]

And let me be clear that I'm taking about emergencies here. Elective procedures allow for plenty of time for them to find other care.

since when is pregnancy an emergency whether planned or related to rape? pregnancy is never an emergency especially for someone just traumatized. imagine them regretting murder after being coerced into it by a medical provider because the liberal left demands it.

[LT_Oneal_PAC]

since when is pregnancy an emergency whether planned or related to rape? pregnancy is never an emergency especially for someone just traumatized. imagine them regretting murder after being coerced into it by a medical provider because the liberal left demands it.

Meh

[cinntsp]

since when is pregnancy an emergency whether planned or related to rape? pregnancy is never an emergency especially for someone just traumatized. imagine them regretting murder after being coerced into it by a medical provider because the liberal left demands it.

 

Yeah, they should just skip the plan B and sit on it a while so that when they decide an abortion is what they want, the evangelical conservatives can say "whoops, we closed all the abortion clinics in your state."

[Boatswain2PA]

Yeah, they should just skip the plan B and sit on it a while so that when they decide an abortion is what they want, the evangelical conservatives can say "whoops, we closed all the abortion clinics in your state."

If that is what the patient chooses to do, then that is fine.  If she chooses to go to another provider who will write the plan B, then that is fine too. 

 

I've been giving this thread a lot of thought, and I want to bring up another point.  Much of this discussion is about acts of Omission versus acts of COmission.  An act of Omission is, of course, not doing something that you, or others, feel that you should have done.  An act of COmission is DOING something that you, or others, feel you should NOT have done. 

 

Two people COmmit an act which may bring forth a child.  Then an ED provider chooses an act of Omission by not providing emergency contraception because it is against his religion.  Will someone be medically harmed by his act of Omission?  No, therefore this should be an acceptable act on the provider's part.  The patient is FREE to go find a provider who will perform the act of COmission she wants performed, and the provider is FREE to perform this act of Omission.  If the patient were to have an ectopic pregnancy, and the ED provider chose to not play their part in the removal of the ectopic fetus, then that act of Omission would indeed medically harm the patient, so therefore their action would be unethical. 

 

With the Christian bakers vs the lesbian couple:  The baker chooses an act of Omission by not creating a unique cake for an event that is against his religious beliefs.  Is he physically harming anyone by his act of Omission?  No, he is not, therefore it should be an acceptable act on the baker's part.  The customers are FREE to go to another bakery that would give them what they want, and the baker is FREE to perform that act of Omission.

 

In medical malpractice it is considered "more wrong" (if you will) to perform a harmful act of COmission than a harmful act of Omission because of the "First do no harm" approach, which could also be thought of as "First do no wrong".  This is not to say that every act of Omission is acceptable, but just that we rightly have a much higher standard for proving an error due to an act of Omission than we do an act of COmission. 

 

We should take the same approach with society and our laws.  We should be quicker in outlawing potentially harmful acts of COmission than we are in outlawing potentially acts of Omission. 

 

Taking this a step further with the Christian bakers and the lesbian couple.  The Christian baker, again, performed an act of Omission by choosing not to create a unique cake for a ceremony he disagreed with.  The lesbian couple, along with their leftist friends, performed many acts of COmission against the business (vandalism, threats of violence, hateful speech, and legal action) which has now put the family business out of business,

 

There is a big difference between the government telling you what you CAN'T do (Can't murder, can't drive drunk, can't scream fire in crowded movie theater) and the government telling you what you MUST do (Must create a piece of art, must buy medical insurance, etc).  I would rather we live in a land of the FREE, where people are not forced to do things against their beliefs. 

[rev ronin]

Two people COmmit an act which may bring forth a child.  

The original example involved a reported rape.  I'd be extremely hesitant to characterize that in such a manner.

[Boatswain2PA]

The original example involved a reported rape.  I'd be extremely hesitant to characterize that in such a manner.

Thank you....we have gotten so far away from the OP that I forgot that, and it certainly adds another layer of complication to the issue.

 

However, my point still remains.  Society (and therefore the government) should be very, very hesitant to prohibit acts of Omission. 

[Guest JMPA]

Yeah, they should just skip the plan B and sit on it a while so that when they decide an abortion is what they want, the evangelical conservatives can say "whoops, we closed all the abortion clinics in your state."

someone who is so pro ending life should not be permitted to practice medicine.

[Guest JMPA]

The original example involved a reported rape.  I'd be extremely hesitant to characterize that in such a manner.

since when does rape justify the taking of an innocent life? do 2 crimes equal a right?

[rev ronin]

since when does rape justify the taking of an innocent life? do 2 crimes equal a right?

I was politely objecting the (inadvertent, per the follow-up post) confusion of rape with an act involving two consenting individuals.

 

I think if you'll review my earlier posts, in this and the sister thread, you'd find they highlight the same moral dilemma you're raising here.

[jtmathew]

since when does rape justify the taking of an innocent life? do 2 crimes equal a right?

You, obviously, are not a woman and have never dealt with the pain and suffering associated with rape. I urge you, spend some time mulling over this issue. It isnt as cut and dry pro life v pro choice. 

[Guest JMPA]

You, obviously, are not a woman and have never dealt with the pain and suffering associated with rape. I urge you, spend some time mulling over this issue. It isnt as cut and dry pro life v pro choice. 

pain and suffering does not justify murder