PAs and Religion

[jtmathew]

Neither does "freedom" but conservatives sure do trumpet that song when it comes to sending people to war.

[cinntsp]

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

Troll on!

 

Sent from my Nexus 5 using Tapatalk

 

 

[rev ronin]

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 fear that the last few posts have started to stray away from this.  Likewise, the topic has drifted away from medical ethics and into broader societal topics, in which I won't directly be participating.

 

As I've been an active participant in this thread, I think it's important to note that I am saying this with my 'participant' hat on, rather than any 'moderator' functionality, but I think this thread would be better served by focusing on medical ethics-related religious issues rather than broader societal topics, if it continued to be conducted with the same scrupulous respect for others' perspectives, and if overly simple labels and name-calling were avoided.  Else, I fear degeneration into the 'hot mess' that SHU-CH credited us for avoiding.

[True Anomaly]

I fear that the last few posts have started to stray away from this.  Likewise, the topic has drifted away from medical ethics and into broader societal topics, in which I won't directly be participating.

 

As I've been an active participant in this thread, I think it's important to note that I am saying this with my 'participant' hat on, rather than any 'moderator' functionality, but I think this thread would be better served by focusing on medical ethics-related religious issues rather than broader societal topics, if it continued to be conducted with the same scrupulous respect for others' perspectives, and if overly simple labels and name-calling were avoided.  Else, I fear degeneration into the 'hot mess' that SHU-CH credited us for avoiding.

 

Agreed, which is why in the past when these hot-button political topics have veered towards this area in the past they have been locked, and in rare instances resulted in bans.

 

Please keep it civil everyone

[Boatswain2PA]

Charity goes a long way.  Charity is not simply giving of something you don't need (ie: donating stuff), or giving of things you kinda need (ie: donating money).  Charity means understanding that everyone, even those who you most vehemently disagree with, have a great deal of worth as a human being so therefore they are worthy of being treating with respect. 

Does the victim of rape have the "right" to kill a fetus?  I don't think she should because the baby is already a "victim" of the rape as well, and certainly has done nothing wrong to deserve it's death.  However I certainly understand the emotional agony of a woman who is carrying a rapist's child to term inside her womb, and I would go through great lengths to help her..  Fortunately this is a very, very, very rare occurrence in life.

[jtmathew]

I apologize, again, for my previous sarcasm. I guess, for me, I am more prone to empathize with the mother of said fetus because I can communicate with her and visualize her pain. I cannot say, definitely, that an embryo can experience emotion. These issues are difficult to discuss because they force those involved in the discussion to enter into a catch 22 moral dillemma. Do i carry out "murder", as some have insinuated, by prescribing plan B or do I legitimize an unwanted, violent, sexual act carried out on an individual. Hypothetical; imagine a mother brings her 13 yr old daughter into your clinic. You perform your exam and find that she has signs of sexual assault and is pregnant. Further investigation uncovers that her father is the perpetrator. What do you do? Far fetched, i know, but these things happen. It certainly isnt cut and dry. I absolutely do not have all of these answers to these difficult questions but painting everything in black and white is unwise and makes us look foolish.

[acozadd]

How about the situation where the patient presents the same day as the rape. The odds that the sperm + egg have even met is quite low... is it murder in that case to prescribe plan B? In that case you aren't committing murder, but preventing a life from forming. This is much the same as taking birth control. wearing condoms, etc. Are those opposed to plan B in this scenario also opposed to prescribing birth control of other forms?

[rev ronin]

How about the situation where the patient presents the same day as the rape. The odds that the sperm + egg have even met is quite low... is it murder in that case to prescribe plan B? In that case you aren't committing murder, but preventing a life from forming. This is much the same as taking birth control. wearing condoms, etc. Are those opposed to plan B in this scenario also opposed to prescribing birth control of other forms?

That will vary by provider.  I don't know of any provider who objects to Plan B on the basis of the potential prevention of implantation of a fertilized egg who is OK with it given within an immediate window, but not OK with it after that window, but since Plan B is over-the-counter in my state, the providers have largely been removed from that loop.

 

Nor am I familiar with any providers who would not prescribe any birth control at all based on their own belief system, but I do know of those who will pick and choose modalities of birth control based on their mechanism of action.  Just a guess here, but I'd suspect that providers who have a total prohibition against birth control prescription based on their own belief system are unlikely to be working in primary care medicine or similar fields where it would be expected on a regular basis.

[PAMEDIC]

On a similar note regarding PAs and religion...

After taking a bunch of biology and genetics classes during undergrad (where evolution was the guiding framework for almost all the academics), I was amazed at how many PA students in my class were completely opposed to the idea of evolution. After asking around, I realized that many of them never took biology outside of cell biology and A&P.  I understand that some people may have some questions about the TOE, but what I saw was people who were driven by their faith to never explore these aspects of science and biology. Some even explicitly stated thay didn't want to take any classes that ran counter to their religious beliefs.

 

I am sure they will be excellent clinicians, but this willful ignorance struck me as both strange and unsettling.

[Boatswain2PA]

I apologize, again, for my previous sarcasm. I guess, for me, I am more prone to empathize with the mother of said fetus because I can communicate with her and visualize her pain. I cannot say, definitely, that an embryo can experience emotion. These issues are difficult to discuss because they force those involved in the discussion to enter into a catch 22 moral dillemma. Do i carry out "murder", as some have insinuated, by prescribing plan B or do I legitimize an unwanted, violent, sexual act carried out on an individual. Hypothetical; imagine a mother brings her 13 yr old daughter into your clinic. You perform your exam and find that she has signs of sexual assault and is pregnant. Further investigation uncovers that her father is the perpetrator. What do you do? Far fetched, i know, but these things happen. It certainly isnt cut and dry. I absolutely do not have all of these answers to these difficult questions but painting everything in black and white is unwise and makes us look foolish.

Terrific post.  Thank you for bringing it down a notch and engaging with your peers in a respectful manner.

 

I believe that the Catholic faith would allow Plan B to be used in case of rape or incest because #1) the woman is the victim of rape/incest, never willingly engaged in intercourse, and #2), most importantly, it is (supposedly) not an abortifacent.  The Church believes contraception is immoral because sex is supposed to be within the marriage and "open to life".  But if a woman is raped, the sex wasn't consensual, so therefore there is no expectation for it to be "open to life". 

 

And I would agree with that.  Of course, we could add another layer of difficulty to this situation by saying she was raped by her husband.....NOW WHAT?!?!?  I don't know, I would have to think long and hard, and seek guidance and council. 

 

As to your 13 yo incest survivor who is pregnant.  This is a terrible situation, but should the fetus/baby pay the price for its father's sins?  Should YOU pay the price for YOUR father's sins?  I certainly don't want my teenage children paying the price for MY sins.  Yes, the mother-to-be is in a terrible situation, but not a situation that would morally allow her to take someone's life. 

 

PAMEDIC - I agree, I don't see how someone can be a clinician without seeking to understand how these things work, but to each their own.  On the flip side, thee are many clinicians with deep understanding of all things biology/chemistry/science who are devoutly religious. 

[Guest JMPA]

to demand that a clinician(md,pa,np,ect) separate themselves from there religion while practicing medicine is bigotry, bias, discrimination at the least. this is a very good thread because i am sure there are many people , novice and advanced, that would like to have this discussion but were unable to. medical ethics is a broad field and does not only apply to the caregiver. respect is a two way street. if i have a patient that does not respect me, i refuse to treat them. there is no otherway. just the same for patients, if they feel that they are not respected, they look for someone else. as far as evolution, that still remains a theory.

[Guest JMPA]

I apologize, again, for my previous sarcasm. I guess, for me, I am more prone to empathize with the mother of said fetus because I can communicate with her and visualize her pain. I cannot say, definitely, that an embryo can experience emotion. These issues are difficult to discuss because they force those involved in the discussion to enter into a catch 22 moral dillemma. Do i carry out "murder", as some have insinuated, by prescribing plan B or do I legitimize an unwanted, violent, sexual act carried out on an individual. Hypothetical; imagine a mother brings her 13 yr old daughter into your clinic. You perform your exam and find that she has signs of sexual assault and is pregnant. Further investigation uncovers that her father is the perpetrator. What do you do? Far fetched, i know, but these things happen. It certainly isnt cut and dry. I absolutely do not have all of these answers to these difficult questions but painting everything in black and white is unwise and makes us look f

 

refusing abortifactants does not in anyway legitamize the illegal/sinful/horrible act of rape. it adds to it

[PAMEDIC]

as far as evolution, that still remains a theory.

 

This misuse of the word "theory" in a scientific context is the kind of statement that always surprises me... especially when coming from supposedly scientifically-literate clinicians.

[cinntsp]

This misuse of the word "theory" in a scientific context is the kid of statement that always surprises me... especially when coming from supposedly scientifically-literate clinicians.

 

If you go back through his post history, you'll see that the majority of what he says is trolling or makes no sense.  This is the internet. Anyone can claim to understand science.

[PACdan]

I like Boatswain's exploration of COmission vs. Omission. I would posit you, or anyone, this: If enough coordinated acts of omission come together, does that then become COmission?

 

If all the clinics willing to help are a 1,000 miles away, that places undue and maybe insurmountable burden on this patient. If everyone can legally raise their hands and say "Not I" and omit themselves from a legal service by virtue of their beliefs, then really they may be committing harm if no other help is then feasible. How do we evaluate when that harm threshold is reached? Surely one doctor refusing to prescribe the Plan B is, by his omission, not doing harm, because as you say there are alternatives. But what if all the doctors in town refuse, or in the state? We have then created a system by which a service can be so widely omitted as to make it harmful.

 

If every bakery said no to the lesbian cake (didn't they just want a regular cake, but were denied because it was for a lesbian wedding?), is there no harm done by that collective omission? Of course that example is a bit extreme, and there was probably a bakery within a reasonable distance that would gladly have made their cake. The point being, they were asking for something legal and quite common, that if omitted collectively, essentially makes it reasonably unattainable.

 

There was a time when every place in a reasonable distance could and did refuse service. Every hospital, and every school, and every restaurant, and every pool, and every bakery could say no. And many did so in wide regions across this country. Their collective acts of omission, their denial of service, while not necessarily harmful in their own immediacy, merged into acts of harmful commission. That's why they were required to integrate. Required to provide the service. Because enough "omission" of those services was harmful to a group of people.

 

I think when viewed through the lens of history, that is the frightening aspect to many people. Can I be denied something just because I'm ___________?

[cinntsp]

 

If all the clinics willing to help are a 1,000 miles away, that places undue and maybe insurmountable burden on this patient. If everyone can legally raise their hands and say "Not I" and omit themselves from a legal service by virtue of their beliefs, then really they may be committing harm if no other help is then feasible. How do we evaluate when that harmn threshold is reached? Surely one doctor refusing to prescribe the Plan B is, by his omission, not doing harm, because as you say there are alternatives. But what if all the doctors in town refuse, or in the state? We have then created a system by which a service can be so widely omitted as to make it harmful.

 

 

This is exactly what the conservatives, or more specifically the Republican party, do/does every day.  Abortion is the best example.  Since the supreme court says abortion itself is legal, Republicans find ways to make it insanely prohibitive for abortion clinics to even exist and ultimately wipe them out.  Now we have states that have only 1-2 clinics that are likely to go the way of the Dodo(to add to our conversation on evolution) soon.  Suuuuuure you can do whatever you want with your body(as long as you can get a ride hundreds of miles to another state and pay for gas in addition to the few bucks you scraped together to afford the procedure).  

 

Let's not kid ourselves into thinking that the oppressed people in these crazy scenarios within this thread are those being "forced" to prescribe against their beliefs.  Religious folks have the biggest victim complexes.

[PACdan]

This is exactly what the conservatives, or more specifically the Republican party, do/does every day.  Abortion is the best example.  Since the supreme court says abortion itself is legal, Republicans find ways to make it insanely prohibitive for abortion clinics to even exist and ultimately wipe them out.  Now we have states that have only 1-2 clinics that are likely to go the way of the Dodo(to add to our conversation on evolution) soon.  Suuuuuure you can do whatever you want with your body(as long as you can get a ride hundreds of miles to another state and pay for gas in addition to the few bucks you scraped together to afford the procedure).  

 

Let's not kid ourselves into thinking that the oppressed people in these crazy scenarios within this thread are those being "forced" to prescribe against their beliefs.  Religious folks have the biggest victim complexes.

 

Unfortunately, most of the public discourse today is presented with a polarizing narrative. These narratives are easy to latch onto, easy to repeat, and don't require a lot of complex dissection. And they come from both sides. It's the preverbal "my dad is stronger than your dad" argument on the 2nd grade playground. Where the fight becomes not about the humanistic aspect of what we're doing, but just about "winning" it and being superior.

 

The prohibitive barriers being erected in some states, forcing the clinics out, are wrong. It's a circumvention of our legal system. I think time will show that, and sadly, probably some very bad outcomes from it.

 

I am the son of an adopted, immigrant child. Abortion was not legal in the country at the time, nor was realistically keeping your child if unwed. I might not be here if it was. So I will always encourage a pregnant woman to keep a pregnancy if it is medically safe for her to do so. However, as a human being, in my heart of hearts I could never require a woman to keep something inside her for 9-months that was a product of a violent, torturous, disgusting act. This not even in relation to studies that show the psychological harm and negative future outcomes. It's just my heart. There is a difference in consciousness between a raped woman who must be reminded every day of what's inside her and a blastocyst. I would rather give Plan B a thousand times and prevent even that stage, prevent fertilization, than to have a patient go through an abortion later. I don't believe abortion should be an option once survival outside the womb is possible; unless we are taking about the imminent death of the mother, in which case we have the Trolley Problem and no good answer.

 

It seems an impossible choice. Which is why I tell all my friends, everyone I meet that is sexually active and NOT trying to have a child: Condoms, BC, don't be stupid.

I wish humans laid eggs, things would be a lot easier...

[Guest JMPA]

If you go back through his post history, you'll see that the majority of what he says is trolling or makes no sense.  This is the internet. Anyone can claim to understand science.

typical wackedout liberal response is to call someone they disagree with names. you obviously do not understand the meaning of theory.

[Boatswain2PA]

I like Boatswain's exploration of COmission vs. Omission. I would posit you, or anyone, this: If enough coordinated acts of omission come together, does that then become COmission?

 

If all the clinics willing to help are a 1,000 miles away, that places undue and maybe insurmountable burden on this patient. If everyone can legally raise their hands and say "Not I" and omit themselves from a legal service by virtue of their beliefs, then really they may be committing harm if no other help is then feasible. How do we evaluate when that harm threshold is reached? Surely one doctor refusing to prescribe the Plan B is, by his omission, not doing harm, because as you say there are alternatives. But what if all the doctors in town refuse, or in the state? We have then created a system by which a service can be so widely omitted as to make it harmful.

 

If every bakery said no to the lesbian cake (didn't they just want a regular cake, but were denied because it was for a lesbian wedding?), is there no harm done by that collective omission? Of course that example is a bit extreme, and there was probably a bakery within a reasonable distance that would gladly have made their cake. The point being, they were asking for something legal and quite common, that if omitted collectively, essentially makes it reasonably unattainable.

 

There was a time when every place in a reasonable distance could and did refuse service. Every hospital, and every school, and every restaurant, and every pool, and every bakery could say no. And many did so in wide regions across this country. Their collective acts of omission, their denial of service, while not necessarily harmful in their own immediacy, merged into acts of harmful commission. That's why they were required to integrate. Required to provide the service. Because enough "omission" of those services was harmful to a group of people.

 

I think when viewed through the lens of history, that is the frightening aspect to many people. Can I be denied something just because I'm ___________?

If everyone was able to omit acts, and everyone omitted the same act, then that would certainly be a problem.  If EVERY bakery said they wouldn't create a cake for a lesbian wedding, then the lesbians wouldn't be able to buy a special cake for their event.  But that is not the case. 

 

The best example of this, of course, is the Jim Crow era.  But the difference between the Jim Crow era and today is that the Jim Crow discrimination was codified into law.  In many places blacks HAD to go to the back of the bus, or eat at the "colored table", or drink from the "colored water fountain", and they HAD to go to the "colored school".  They HAD to take a written test before they were allowed to vote.  They were unable to own firearms.  Discrimination was codified into law (by the way, virtually all these laws were passed by Democrats).  It took a federal law (Civil Rights Act) to break the local/state discriminatory laws. 

 

These times have passed. 

 

Oh, and to clarify, the lesbian couple didn't want to "buy a cake."  They wanted the baker to bake, and decorate (ie: create a piece of art) their wedding cake.  That is the crux of the issue.

 

Wutthechris - Big difference between not serving someone cake and aborting a fetus/baby.  You apparently don't think a fetus/baby is a "person" until some time after conception, and that's okay.  But many of us do believe that a person is created at conception, and therefore it is wrong to willingly kill that child.  Your continued attacks on people who believe other than you indicates that you are likely less of a liberal than you probably profess to be, but more of an intolerant leftist. 

 

 

[PACdan]

If everyone was able to omit acts, and everyone omitted the same act, then that would certainly be a problem.  If EVERY bakery said they wouldn't create a cake for a lesbian wedding, then the lesbians wouldn't be able to buy a special cake for their event.  But that is not the case.

 

I think that this concept is the root of fear and reactions of people in the face of such events. They react to the one incidence as a perceived attempt to prevent a future cascade of service denial. It may be slippery slope-ish in terms of logic. However, I do understand that a history of persecution, service denial, and violence towards homosexuals could make them pretty pissed off in the first place.

 

Thank you for your thorough responses. I have definitely gained a broader insight from the discussion.

[True Anomaly]

typical wackedout liberal response is to call someone they disagree with names. you obviously do not understand the meaning of theory.

What is your understanding of the term "theory" in the scientific area?

[rev ronin]

If everyone was able to omit acts, and everyone omitted the same act, then that would certainly be a problem. 

No, actually, you'd have a society voting with its actions.  I'd love a society where no provider at all would entertain the idea of doing FGMs at the request of parents... but we live in a world where elective labiaplasty is, if not common, then available in large enough markets, so I have little hope of that ever happening.

 

Abortion was legalized by judicial fiat, forcing more-or-less universal laws when the issue was far from settled societally.  In the intervening decades, support for pre-birth personhood has increased, and support for abortion on demand has decreased. There's a great big muddle in the middle, as 'fringe' minorities on each side oppose Plan B's potential secondary mechanism of action or alternatively defend so-called "partial birth abortion"

 

If all the providers got together and said that terminating a genetically unique individual organism with human DNA, having the potential to develop into an unquestionably self-sustaining human being, was something they would not participate in, what would that look like?  Would that be wrong?  What if physician-assisted suicide went the same way?  Is it OK for providers to be ethical thought leaders, rather than servants for hire?

[SHU-CH]

Abortion was legalized by judicial fiat, 

 

It is important to keep this in mind. Some people ascribe near-divine wisdom to the Supreme Court. They are a bunch of partisan political hacks. They are explicitly appointed based upon their political beliefs. The appointment of a single new justice could potentially cause the reversal of 50 years of decisions.

 

The Supreme Court held that slavery was legal for a long time. 

[jtmathew]

If all the providers got together and said that terminating a genetically unique individual organism with human DNA, having the potential to develop into an unquestionably self-sustaining human being, was something they would not participate in, what would that look like?  Would that be wrong?  What if physician-assisted suicide went the same way?  Is it OK for providers to be ethical thought leaders, rather than servants for hire?

You would see a rise hotel room and back alley abortion, ultimately resulting in more maternal death.

[Boatswain2PA]

You would see a rise hotel room and back alley abortion, ultimately resulting in more maternal death.

Hasn't happened yet in the states that put heavy restrictions on abortions. Could be because women who are determined will travel, or could be a false premise.

 

I think there would be a slight bump in these events, but a big drop in abortions.

 

And for those who argue about "women's rights"....what about the rights of the 51% of babies aborted who should have grown up into women?

 

"Life, liberty, and pursuit of happiness"....there is a reason "life" was listed first.