About this GP

[slightlyconfused85]

Now before I start I generally think Gps are amazing people, I'm not dissing the profession. Today, however, I booked an appointment to get the contraceptive pill after the birth of my 2nd child. I was given an appointment with a locum who explained my options to me, then said he didn't prescribe contraception for ethical reasons. I then had to wait 45 minutes for another gp to be able to fit me in to prescribe this for me. Aibu to think that if the gp surgery is going to have locums that won't do this then they could have let me know on the phone when I booked? I know the receptionist didn't know what I wanted but they could say if it's an appointment to discuss contraception then say and we will find a different GP. Had loads of time wasted today and feeling (probably irrationally) irritable about it!

[ElkeDagMeisje]

CatWithKittens Did we not hang people at the end of the war because they had followed the dictates of law without stopping to ask if it was right? People have to be entitled, especially perhaps where life and death is concerned, to say I will have nothing to do with this, even if the law permits it, even if the law requires it.

Ahem, we have rather a lot more protections in place in modern day society that ensure a certain basic fundamental minimum standard of respect for human rights is observed. As a country, the UK is a member of a number of international conventions and organisations which ensures respect for these, and which effectively removes law-making power outwith the State's hands ie it is dictated by those international organisations set up to deal with the consequences of a lack of respect for the rule of law and fundamental rights. There are very effective mechanisms which swing into place as soon as a country shows signs of endangering those rights - except in countries such as Ireland which are routinely ignored for religious reasons.

So in other words, we permit religious exemption above and beyond all other respect for fundamental rights and basic minimum standards, which to my mind is much more dangerous than harping on about the second world war as if no lessons have been implemented from it. Its a kind of wilful and deliberate ignorance which I don't find very truthful. ie I find it immoral in itself as it puts the holder of those religious views at a higher level than the ordinary person, as the consequences of their decisions have more than personal implications.

[CatWithKittens]

There are an awful lot of people on here assuming that their moral perspective is the only one with any validity - in just the same way as religious fundamentalists do and with about the same amount of bigotry in some cases. Those attitudes can be just as undermining of human rights and individual freedoms as some of the old fashioned attitudes to illegitimacy and homosexuality were. I note that ElkeDagMeeisje descends to mere vulgar abuse, accusing those who disagree with her of dishonesty, ignorance and immorailty, but does not answer the questions I posed or address the fundamental problem about law and principles - what happens when law departs from principles? If she thinks that only happened in the Second World War, she should look around much of the world. (In any case even here, it really will not do to say that 5 years later, if you can afford it, you might be able to bring a case in the ECHR, assuming you are still permitted access to it.) I suspect there is such a gulf between people like her and people like me, who believe in debate without abuse and that freedom is preserved only with the utmost vigilance, that there is little point in putting forward any argument inconsistent with her prejudices.

[didyouwritethe]

I think we too often forget that GPs surely are agents of the state - aren't they? They have all sorts of legal powers, to commit you to a mental institution, to recommend that your children are removed, and all manner of other things. Committing people to institutions has always been a very useful way for the state to deal with dissenters.

[PurpleDaisies]

I'm not quite sure what your point is didyouwritethe. For someone to be sectioned, unless there are exceptional emergency circumstances two doctors are required to detain someone for treatment under the mental health act. One is usually a psychiatrist.

[didyouwritethe]

Well, people are talking about doctors acting within the law, and indeed carrying out what is required by law, yet different laws are made by different regimes. So the Dachau experiments were entirely legal under the Third Reich.

[didyouwritethe]

Also, the GP refers to the psychiatrist, in the example you cite - the GP is often the gatekeeper for mental health services; not exclusively, obviously, sometimes it's the police.

[Lurkedforever1]

The fact is though that nobody is forced to become a gp. If their own beliefs stop them doing their job, then they should jog on.
I saw something ages ago about the ethics of saving some very prem babies. I stand to be corrected on whether the law has changed, but under 28 weeks at the time there wasn't an actual right to life, so in theory at any time they could choose whether or not to resuscitate. I know that in itself is a huge ethical field. But what some doctors were saying is that it's usually post 28 weeks when it becomes apparent whether early resuscitation was in the babies best interests, by which point you can't just make an ethical decision it's a legal one. And that in a minority of cases the two aren't the same. Yet nevertheless you don't hear of cases where hcps make an ethical decision on their beliefs to let a severely ill post 28 weeks but short lived baby die, despite legally not being allowed to. Nor do many hcps make a stand on their pro euthanasia beliefs and carry them out. Because regardless, they accept the law in their role comes before personal ethics. Why should the pro life lobby be allowed to put their ethics above all else? Get a job in philosophy instead of health care.

[bumbleymummy]

I've never met anyone who had problems getting contraception from NI and I lived there for several years and have plenty of friends/family there. You can get the MAP from pharmacies. People are not travelling to Scotland from NI for contraception.

[bumbleymummy]

Lurked, it's 24 weeks now. Although many doctors will attempt to keep babies alive if they are born earlier and are showing signs of life. The youngest premature babies to be born and survive with no serious long term medical issues were born at 21+5.

[ElkeDagMeisje]

CatWithKittens There are an awful lot of people on here assuming that their moral perspective is the only one with any validity - in just the same way as religious fundamentalists do and with about the same amount of bigotry in some cases. Those attitudes can be just as undermining of human rights and individual freedoms as some of the old fashioned attitudes to illegitimacy and homosexuality were. I note that ElkeDagMeeisje descends to mere vulgar abuse, accusing those who disagree with her of dishonesty, ignorance and immorality

There was certainly nothing vulgarly abusive about my response. I think a quid pro quo - you arguments lack logic and you seem to be turning yourself in circles in an attempt to defend the indefensible. I also don't think you really understand what human rights are or the difference between them and fundamental rights, the way they are enforced and their relationship with the rule of law.

but does not answer the questions I posed or address the fundamental problem about law and principles - what happens when law departs from principles? If she thinks that only happened in the Second World War, she should look around much of the world. (In any case even here, it really will not do to say that 5 years later, if you can afford it, you might be able to bring a case in the ECHR, assuming you are still permitted access to it.) I suspect there is such a gulf between people like her and people like me, who believe in debate without abuse and that freedom is preserved only with the utmost vigilance, that there is little point in putting forward any argument inconsistent with her prejudices.

I attempted to explain to you how the rule of law and its relationship with fundamental rights, as enshrined in treaty law vis a vis the EU Charters, ECHR and Charter of Fundamental Rights prevent such departures. We are fortunate in Europe, if that is indeed where you live, that access to contraception is legal.

By the way, its important to understand this relationship so that you can understand how fundamental (and human rights - you appear to think they are the same thing) are enforced. They create a acquis which is enforced at a higher level, with only rare test cases requiring individual appeal to the ECHR. Otherwise, moot points would proceed on a preliminary ruling.

I think you need to educate yourself a little more, and then you might find the answers to the questions you are seeking, because at the moment, I don't think you have the knowledge to understand the answers.

[ElkeDagMeisje]

As an aside, can anyone tell me if Cat's style of argument is something that is taught in maybe the lower level universities in the UK? Or is it encouraged at school? i.e. where proper traditional discourse, of making a point and proving/disproving it is supplanted by dismissing any argument contrary to your own with personally critical remarks, e.g. the "vulgar abuse" mentioned above? I'm qualified and have published in the field of human/fundamental rights and have never before been accused of "vulgar abuse" when simply discussing my subject!

Or perhaps its something that is simply learnt by example via the internet when the obsession to push a particular personal (as opposed to global) interest takes over? So that the opposite side is stymied from further response, for fear of being accused of being all sorts of things when offering their point of view. Either way, it won't get you very far in any chosen field.

[Anniesaunt]

cat I'm not the one thinking my moral stance is the only one. That is why I believe I shouldn't impose my views on patients.

I'm answer to your question on trials. If I was asked to participate in concentration camp like trials or like Tuskogee etc I'd quit.

[bumbleymummy]

Annie's, wasn't her point that those were examples of things that were legal at the time. Therefore 'legal' doesn't necessarily equal 'right' and people should be allowed to exercise their own judgement - yours being that you would rather quit than participate?

[bettyberry]

Round and round in circles.

• I am a patient. I am able to make a decision about my care especially when the doctor gives me the full facts NOT his or her religious/ethical Speil.
  

• by refusing me that basic, legal care, where I am provided with medications or procedures I need is removing my basic human rights that is discrimination masked as religious objection.
  

A doctor refusing to provide me care that not only do I pay for but I am legally entitled to it goes against everything doctors go into medicine for.

• abortion has been around for centuries. Safe abortion and contraception since last century. We have had plenty of time, research and scientific papers to show that legal, safe abortion for women who choose it is in their best interests and to not do so causes more harm. Inc mental health and in some cases seeking out alternatives.
  

• a woman has the right to define her pregnancy how she chooses. If de wishes to call it a baby at 10 weeks or a foetus that is her right and no person has a right to tell a woman how to define it.
  

• using the argument that babies are born at 21 weeks and survive is moot because without intensive medical care and probably an awful awful lot of care through life those babies survive. Only a tiny tiny % of those babies survive. Using a few examples as a reason to decrease the abortion limit will do nothing but harm women and their families.
  

The abortion limit for personal reasons is reasonable and just. It should not be changed.

• a doctor would be seriously reprimanded if he refused to treat a gay man. It should be the same of it is a women. It is discrimination.
  

• no HCP should refuse a service or procedure because of their own personal choices to anyone.
  

Doing so places their own objections onto the patient and that just isn't professional nor is it fair.

• contraception should not be something GPs can opt out of. It is a fundamental part of general practice. I'd personally change the rules to see this never happened.
  

I'd be interested to know if those same doctors refused to refer for vasectomies or sterilisation too.

Apologies for the ramble.

[bumbleymummy]

"using the argument that babies are born at 21 weeks and survive is moot because without intensive medical care and probably an awful awful lot of care through life those babies survive. Only a tiny tiny % of those babies survive. Using a few examples as a reason to decrease the abortion limit will do nothing but harm women and their families. "

Was this aimed at me? This was not what I was doing. I was addressing Lucy's point: I stand to be corrected on whether the law has changed, but under 28 weeks at the time there wasn't an actual right to life, so in theory at any time they could choose whether or not to resuscitate. I know that in itself is a huge ethical field.

[grassroots]

This link to the GMS guidance might be useful?
www.gmc-uk.org/guidance/ethical_guidance/21177.asp

[Lurkedforever1]

Bumbley- yes and even at the time I saw it they were saving babies under 24 weeks. And I don't want to give the impression the hcps were talking about the ethics of keeping alive a prem baby with possible long term implications, whether physical or mental, anything but. It was in very severe cases only. The point is though, despite extensive experience proving to them that their personal ethics didn't always match their role and the law, they still did their job.

I'm still waiting for anyone to explain why a gp would even need to tell the patient about their opinion on abortion.

[bettyberry]

No bumble it wasn't aimed at you. You just mentioned a baby born early and many arguments previous (other forums) use it to decrease abortion limit. Just reinforcing the point our limits are perfectly adequate and those you made. I'd read further up someone using that argument against abortion. That's all. Not an attack.

[bettyberry]

Lurked - they don't need to but many have done because they a) feel their belief is superior b) are condescending twits to even put a vulnerable woman through that.

It reminds me of the time I went to get sterilised at 28. My female doctor was really put out even after I had explains 6mcs traumatic birth etc that I was really looking forward to getting my life back at 40 and not having to worry about getting pregnant. She put her own views (having her first at 40) as a reason to deny me having the surgery. I even knew the risks, complications of the procedure but was refused because she believed I'd change my mind. Still haven't although partner wants a child.

[bumbleymummy]

Thanks for the link grassroots.

"If, having taken account of your legal and ethical obligations, you wish to exercise a conscientious objection to particular services or procedures, you must do your best to make sure that patients who may consult you about it are aware of your objection in advance. You can do this by making sure that any printed material about your practice and the services you provide explains if there are any services you will not normally provide because of a conscientious objection."

I'm not sure how printed material would have helped in the OPs situation though!

"I'm still waiting for anyone to explain why a gp would even need to tell the patient about their opinion on abortion."

From the link up thread they aren't supposed to discuss their opinions with patients.

Ok Betty :)

[Lurkedforever1]

Exactly. They don't need to tell the patient. It's not like even a competent gp refers you from an initial appointment straight in for an abortion, so there's no need for some incompetent pro lifer gp to be sharing their thoughts. Unless maternity care has changed if you turn up saying your pregnant they do their own test first, so easy enough to pass on to another gp when the results come back.
Yy on the sterilisation. Years ago, my friend, 5 planned kids and a warning after the last not to have more from the consultant, discussed sterilisation with the idea once past the newborn stage she'd ask for a referal, a decision that made no difference to their family planning, health aside 5 was enough. The locum gp who was going through ivf wouldn't refer her cos she decided mid 30's was too young.

[bettyberry]

It's common lurked. Women denied family planning because of doctors personal views.

I did complain about my doctor. Review of my case meant I could have the surgery because of the evidence in my medical records. It took 8mths for tha but by the. I couldn't have the surgery due to childcare issues (I was a single parent) it was unethical of that doctor to refuse me because other methods of contraception were not suitable (DVT risk, migraines and major probs with both coils, latex allergy) and I was adamant no more babies.

Instead I had to put off having any kind of relationship because of my fear of getting pregnant. I'm pro choice but repeat abortions of condom fails isn't great esp with needing general anaesthetic. its not great for your body!

thats the reality of refusing contraception. Damage to a woman's personal life. Mental health and relationships.