Mandated referrals for abortions.

[Least_Original_User_Name_Ever]

I was also listening to the same thing.

I think that it’s not out of bounds to refer someone to do a medical procedure that you choose to not do. The penalty is the only sticking point for me. I think that having your medical license taken away is probably too stiff of a penalty, but I can’t think of a better alternative.

[DoctorJ]

If they don’t want to do abortions, then they shouldn’t become doctors.

I’m a doctor, and I don’t do abortions. Then again, I’m an internist.

Please correct me if I’m wrong, but I doubt there are more than a handful of GYNs out there who do elective abortions as part of a general OB/GYN practice. Most states have so many rules and regulations and (IMO) bullshit hoops to jump through that it almost requires a dedicated center.

[Eureka]

@WhyNot

Since at least two (professional organization and reasonable person) and probably three in most states (scope of practice) include “abortion” for obstetricians, then I think we can hold them to, if not providing services, at least providing referrals for the service.
[snip]
I’m willing to extend the “choice” part of pro-choice to doctors very grudgingly; the least they could do is to extend the “choice” to me in return - at someone else’s office if need be.

There is also a timelyness issue, in my opinion. Even in a world with fewer hoops involved in setting up an abortion clinic or simply providing abortion services as part of a larger Ob/Gyn practice, a woman who wants an abortion has a limited window of time when that option is available to her. De-gaying, well, if you’ve struggled all your life, what’s another 6 months or so? But with abortion, the time factor is significant, so it makes much more sense to me to require doctors who refuse to perform abortions to provide information about accessing abortion services.

And really, while de-gaying is on the eyebrow raising side, if someone asked for referrals to more general mental health treatment, wouldn’t you expect it to be provided?

[Bryan_Ekers]

@AHunter3

Abortion is serious, it is heavy, it is killing, it is a solemn act decided upon, hopefully, with appropriate gravity by the gravid person who gets to make the decision. She’s the one who gets to live with having made it, one way or the other, more centrally than any other human.

Out of curiosity, does it make any difference if the woman views the procedure with a shrug, like any minor medical nuisance or, for that matter, as just a slightly more-involved version of her regular OB/GYN visit?

It doesn’t to me, I should point out, but I’ve always felt her motive and her attitude were of no relevance.

[Voyager]

@Tastes of Chocolate

Unfortunately, we’re talking about doctors that refuse to do a requested procedure. How can I be sure that that doctor will give me a referral? Sure, I’d rather a referral, but I’d also like for there to be a backup list for use when that referral isn’t available.

The point is that the doctor should be ethically bound to give a referral. If we choose to allow them not to, then I do agree a backup list would be good. However, in the current environment, how many doctors who do perform abortions would want to be on such a list?

@sarahfeena

I’m sure there are plenty of doctors who prefer not to do abortions for religious reasons who would never, ever call a patient a murderer. Your assertion that she would “no doubt” be called one is ridiculous hyperbole.

I was actually thinking about receptionists or nurses. How often do you get a doctor when you call for an appointment about anything?

I think it’s a good idea to have a state-compiled list or website. If the list is of doctors who provide abortions, then she wouldn’t HAVE to call multiple physicians and be called a murderer. That’s the whole point. And if her alternative is calling around the yellow pages, then how does she know the referral is being given by a “trusted physician?” She doesn’t even know the person.

My step-brother who is a doctor assures me that not all doctors are created equal. Any state created list, besides having the problem I mentioned above, has the additional problem of not giving any indication of the quality of the doctor. I’d hope that any physician, even if they do not want to do abortions, wouldn’t refer a woman to a butcher just to show her. And I agree that a yellow pages search is the worst option.

Even if a person’s OB-Gyn provides abortions, he or she may refer them to someone else. If I wanted to get one today, I doubt I could walk into my doctor’s office and expect him to do it, even if he does provide them (I’m not sure if he does or not, as I’ve never asked). For one thing, he doesn’t have the equipment to do surgical procedures in his office, so he would have to send me to the hospital. If he wasn’t available to run over there to do it, he would no doubt refer me to someone. Or, he might be on a month’s vacation, in which case I’m sure his office would refer me to someone. I think whatever the reason a doctor can’t provide a certain (legal) service is irrelevant…I would still expect a doctor to give a referral to somone who can/will.

How many procedures of any degree of severity get done on that day? The problem is certainly not the time delay. I don’t think that anyone wants to force a doctor to do a procedure that he or she is opposed to. Say Ob-Gyns not wishing to do abortions provide their nurse/receptionist with the name of a referral. Then, a woman calling in would get the referral immediately, and there would be basically no delay. Our clinic has advice nurses who can direct you to the right specialist immediately. This isn’t that hard.

[Voyager]

@DoctorJ

But in the interest of the devil’s advocacy, let me offer another situation that might compare. (This isn’t a hypothetical–it has happened to me more than once.) Say a young man comes to me who says he has been struggling with homosexuality for years. He has heard that there are doctors and camps and such out there who claim to have “converted” gay people, and asks me to refer him to such a place. Should I be ethically required to do so?

I wouldn’t, and the short reason why not is that abortion is a recognized and legitimate medical procedure while de-gaying therapy is rejected by all the major medical authorities as ineffective and potentially psychologically damaging. But there are people who claim to have been coverted by such therapy. The patient may think that his homosexuality is so morally unacceptable that even if there’s only a 1% chance of conversion and a much bigger chance of psychological damage, it might be worth it to him. I believe he should have that choice, but I want no part in it. Truth be told, even if such therapy were actually effective I’d have trouble making the referral.

Just a thought for comparison.

Isn’t your example more like being asked by a cancer patient for a referral to someone who uses quack “cures” - like the clinics in Mexico? (I’m not sure if they are still there.) I assume you wouldn’t do that either. On the other side, would you give a referral for a gender change operation? It is in a sense turning that small portion of the population who is gay for this reason not-gay (and I know full well the differences). The difference, I think, is that you should not be ethically obligated to refer people for solutions you are sure are ineffective.

I’d expect there would be required psychological counseling - would that make a difference?

[AHunter3]

@Bryan Ekers

Out of curiosity, does it make any difference if the woman views the procedure with a shrug, like any minor medical nuisance or, for that matter, as just a slightly more-involved version of her regular OB/GYN visit?

It doesn’t to me, I should point out, but I’ve always felt her motive and her attitude were of no relevance.

Make a difference to what, exactly? Certainly I prefer to think that the decision is being made with some consciousness, but then I also prefer to think that jurors in the jury room take what they are doing seriously, and that my elected congresscritter has some sense that reading bills and voting constitutes an act of some weight.

When they don’t… I feel that is unfortunate. But it’s not something you can test for. 'You, sir, are not allowed to express an opinion on this court case because you are obviously not taking jury duty seriously!" “Hey, that chick is just using abortion as a form of birth control, she shouldn’t be allowed to do that!”

[AskNott]

@Voyager

…
Sorry. I’d much rather get a referral from a trusted physician than from some state compiled list or a web site. Why would a state list be better than the yellow pages? And why would we want to make a woman under stress have to call multiple doctors and no doubt be told that she is a murderer several times?

In the Yellow Pages of some cities, looking up “abortion” will find you a listing for “free abortion counseling and pregnancy testing.” What you’ll find there is really a fake clinic run by the local anti-abortion group. The pregnant woman is given a free test, all right, but before she can see the result, she is put in a room (in some cases, locked in) where she is shown a heavy-handed pro-life propaganda video. The only “abortion counseling” she can get there is, “don’t kill your baby!”

Reproductive rights orgs have persuaded the phone companies in some places to list these joints under “abortion alternatives,” as the one in my city is. It’s not universal.

@panda meat

Doctors need to pay for 18 years of child support for any fetus they won’t abort, if an abortion is what the woman wanted. And if the government is going to force pregnancy onto unwilling brood mares, then the government needs to pay for it, including 18 years of child care – otherwise it’s forced employment without compensation, which fits the legal definition of slavery.

Ethically, I feel the same way, but as far as I know, courts still rule against such suits (for example, in a failed vasectomy case.)

@Sarahfeena

Even if a person’s OB-Gyn provides abortions, he or she may refer them to someone else. If I wanted to get one today, I doubt I could walk into my doctor’s office and expect him to do it, even if he does provide them (I’m not sure if he does or not, as I’ve never asked). For one thing, he doesn’t have the equipment to do surgical procedures in his office, so he would have to send me to the hospital. If he wasn’t available to run over there to do it, he would no doubt refer me to someone. Or, he might be on a month’s vacation, in which case I’m sure his office would refer me to someone. I think whatever the reason a doctor can’t provide a certain (legal) service is irrelevant…I would still expect a doctor to give a referral to somone who can/will.

Before Roe vs. Wade, a lot of abortions were disguised as D & Cs. The Dilation & Curettage is used to treat a variety of “female troubles,” but it has the side effect of removing any fertilized eggs from the uterus. These days, most abortions are either drug-induced or done by vacuum aspiration (I may have the wrong terminology. I’m not a doctor.) Standard post-rape procedure in most ERs includes one of these procedures.

Every OB-GYN can do a D&C at the drop of a hat, and so can many general practitioners. It’s not a matter of limited availability of equipment or knowledge.

[Sarahfeena]

@AskNott

Before Roe vs. Wade, a lot of abortions were disguised as D & Cs. The Dilation & Curettage is used to treat a variety of “female troubles,” but it has the side effect of removing any fertilized eggs from the uterus. These days, most abortions are either drug-induced or done by vacuum aspiration (I may have the wrong terminology. I’m not a doctor.) Standard post-rape procedure in most ERs includes one of these procedures.

Every OB-GYN can do a D&C at the drop of a hat, and so can many general practitioners. It’s not a matter of limited availability of equipment or knowledge.

I don’t know if that’s true, because I had a D and C after a miscarriage and my doctor did not do it in his office…he did it at the hospital.

[Bryan_Ekers]

@AHunter3

Make a difference to what, exactly? Certainly I prefer to think that the decision is being made with some consciousness, but then I also prefer to think that jurors in the jury room take what they are doing seriously, and that my elected congresscritter has some sense that reading bills and voting constitutes an act of some weight.

When they don’t… I feel that is unfortunate. But it’s not something you can test for. 'You, sir, are not allowed to express an opinion on this court case because you are obviously not taking jury duty seriously!" “Hey, that chick is just using abortion as a form of birth control, she shouldn’t be allowed to do that!”

Well, good, I guess, because if I’m reading you right, it doesn’t really matter if abortion isn’t serious, heavy, solemn, or viewed with appropriate gravity.

I mean, it’s easy to defend abortion rights if you feel sorry for the woman. Defending them even if she’s unsympathetic is, for some, a challenge.
Personally, I don’t care if she is using it for birth control, though I’d hope her doctor would offer to advise her about less risky methods.

[AHunter3]

@Bryan Ekers

Well, good, I guess, because if I’m reading you right, it doesn’t really matter if abortion isn’t serious, heavy, solemn, or viewed with appropriate gravity.

I mean, it’s easy to defend abortion rights if you feel sorry for the woman. Defending them even if she’s unsympathetic is, for some, a challenge.
Personally, I don’t care if she is using it for birth control, though I’d hope her doctor would offer to advise her about less risky methods.

Oh, when it comes to plain old legality, the right to HAVE an abortion without legal obstructions? Up unitl the moment of birth, for absolutely any reason she finds sufficient. Hand her a pair of ceremonial scissors to cut the umbilical cord, figuratively if not literally, and she, not the doctor, declares it to be alive. Or doesn’t.

That’s because she’s the arbiter here. If we’re talking ethics and whatnot, that’s where I draw a thinner plank, as previously described. But I don’t pretend I’m in any position to make that assessment and divide the callous airheads from the deserving womenfolk, etc etc.