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The Pill

22 replies

Uhu · 13/09/2004 13:06

On the Jeremy Vine show this afternoon, the first topic of discussion was the fact that more and more doctors in the USA are refusing to prescribe the pill because they believe it to be a form of abortion. A British doctor spoke on the show in support of this view and she herself will not prescribe the pill. Her view is that doctors are suppose to give medication to treat illnesses and that the pill is given to perfectly healthy women to prevent a natural process. Her argument was countered by the Head of some organisation (Family Planning I think) who said that the implantation of the fertilise egg into the womb was the legal definition of conception and that once the egg is implanted, the pill is rendered ineffective.

In my opinion, a fertilised egg is not viable unless it is implanted in the womb (I know there have been exceptions to this and ectopic pregnancies are one example) and even then, most are not viable for natural reasons which in many cases leads to miscarriages. In addition, doctors in the UK who work for the NHS are paid by the taxpayers and should therefore, treat their patients according to the wishes of that patient and not force their moral opinions on them. According to this doctor's view, if she will not give the pill to women because they are healthy and it prevents a natural process, will she also not treat a woman suffering a miscarriage because that itself, is a natural process?

I personally do not use the pill but I do worry that people with fundamental views like this would transport us back 50 years when women were saddled with unwanted children and had no say over their bodies.

OP posts:
marialuisa · 13/09/2004 13:08

Heard this on R4 this morning. found it very worrying, but suspect that the chances of most British GPs following in this woman's footsteps are slim to non-existent, thank goodness!

NomDePlume · 13/09/2004 13:09

I agree with you Uhu, on all counts.

MeanBean · 13/09/2004 13:12

I don't care whether eggs are fertilised, viable, in or out of the womb, I think the only people who should have control over my body is me. And all other women (and men) should have control over their bodies too. It's just basic human dignity.

Having said that, I see no reason why someone who has strong ethical objections to adminstering a treatment should be forced to. I wouldn't like to live in a state where people are denied work unless they agree to act against their consciences.

aloha · 13/09/2004 13:34

I disagree. I think that state-funded doctors should not be able to impose their moral/religious views on their patients.

Heathcliffscathy · 13/09/2004 13:36

hear hear aloha. god forbid we should go the way of some states in the US

iota · 13/09/2004 13:38

I can't really agree with the argument that it's a form of abortion - would have thought that she'd have more of a problem with the IUD as that prevents implantation not conception

bizarre

MeanBean · 13/09/2004 13:44

But they are not forcing their views on their patients. They are just refusing to write a prescription for a specific drug which you can get from another clinic. I think as long as the pill is freely available from a number of sources, individual doctors should be allowed to earn a living without having to go against their consciences. The state doesn't have the right to require you to do something which is morally repugnant to you just because it funds you.

lou33 · 13/09/2004 16:39

I thought the pill mimicked pregnancy so no egg was released? Can't see how that can be a form of abortion myself.

wobblyknicks · 13/09/2004 16:42

Part of the function of the pill is to try and stop any released eggs from implanting but thats only ONE of its functions - its main IS to stop egg release so its hardly major abortion!!! It also helps to stop sperm reaching the egg so hopefully the egg won't be a fertilised one anyway.

MummyToSteven · 13/09/2004 16:44

agree with lou. afaik the main effect of the pill is to stop ovulation.

hmb · 13/09/2004 16:53

The main effect iof the combined pill is to stop ovulation. However if do do ovulate it helps to block implantation.

The main effect of the mini pill is to cause changes in the cervical mucus to stop fertilisation. In some women it can also block ovulation (more likely to happen if you are older and/or breast feeding)

To my mind this is the thin end of the wedge for these people who would like all forms of contraception banned. I'm only surprised that it has taken them this long to be honest about it.

aloha · 13/09/2004 17:22

I'm afraid I think that if giving women contraception is morally repugnant to you you have absolutely not place as an NHS GP. It's a very important, and I would say essential, part of your job. It's a woman's right.

hmb · 13/09/2004 17:25

Agree 100%. Without contraception sexual equality would only have been a pipe dream. If you lack your ability to control your fertility you can't control anything else.

susanmt · 13/09/2004 17:41

What about other fertility issues? My dh is a dedicated NHS GP who works long hours, provides such services as terminal care at home, has changes his practice vaccination policy when he found out the issues surrounding thimerosal (from mumsnet!!!) and is very dedicated to the community in which he lives and works.

BUT - he does not refer for abortion, nor prescribe the morning after pill, as he beleives life begins at conception. He prescribes contraception to anyone who requires it, but does not fit IUDs (though he his happy with mirena as it also stops ovulation in most women) partly as they prevent implantation but also as he would not do enough to keep his skills up - he refers women to the family planning clinic for coil fittings. Women who want terminations or the MAP he informs of their rights to see another doctor who will do so.

If you got rid of all the doctors who dont refer for termination (as is their right under the 1967 Abortion act) then you would lose a lot of GPs, and there is enough of a staffing crisis in GP as it is.

hmb · 13/09/2004 17:48

I tnink that doctors have a moral right not to carry out procedure that they find ethicaly wrong, as long as they are prepared to refer. But to deny women the right to the pill, the major type of BC in the UK is something else I think

KateandtheGirls · 13/09/2004 17:56

I always found it incredible that in the US contraception is not covered by health insurance companies (although I think that is changing), because it's not medically necessary. Completely different to the UK where the pill is free (or at least it used to be IIRC).

Agree with you Uhu. The pro-life lobby in the US is very scary to me.

marialuisa · 13/09/2004 18:10

SusanMT, if I remember correctly you live ina remote part of Scotland? Unless it's much less remote than I'm imagining I'm pretty horrified that he won't refer for abortion etc. To me he's forcing his views on his patients and thatbisn't on IMHO. Obviously if his stance is well known and there are 10 other GPs a woman could go to the effects of his refusal may not be so catastrophic.

Uhu · 13/09/2004 18:13

I think this is an important issue because if you are not careful, it will lead to doctors with other strongly held views not wanting to treat patients. If a doctor strongly believes that sex belongs within the confines of marriage, would he refuse to look after an unmarried pregnant woman? If he abhors smoking, would he refuse to treat a patient suffering from lung cancer which was brought on by smoking? If he hates homosexuals, would he refuse to treat one suffering from AIDS as a result of their lifestyle? If it was a white doctor and he hated black people, would he be allowed to refuse them treatment? If doctors are allowed to pick and choose which treatments they want to provide, then where does that leave the patient? Scanning the local papers to find someone who will treat him?

I respect anyone who has strong views but they have no right to impose their morals on others within a professional capacity. Yes, they can refer them to another doctor who will treat them but if this happened for all the strongly held beliefs, I think the NHS would descend into chaos and it will ultimately be the patients who suffer.

OP posts:
susanmt · 13/09/2004 23:28

Contraception and maternity services are seperate from the main services a GP provides, though. No GP is required to provide contraceptive services. Most, but not all, do it, as they get paid for it, but there is no legal requirement for any GP to provide contraception. You can sign on with any practice for your contraceptive services and some surgeries specialise in this.

I had a great chat with my dh about this after the children went to bed tonight. He is very happy in his position that he is not required to refer for abortion under the legal situation of the Abortion Act and any rewriting of that Act is bound to include another conscience clause. If a woman in his surgery wants the morning after pill, his partner will prescribe it. He also does not refer for abortion but the woman is fully counselled about how to access the service and can sign on with another practice, about 45 mins away. Yes it seems far but people here will make that trip to visit the dentist or do their shopping (closest supermarket), and the termination would be carried out at the hospital which is in the same town. Part and parcel of rural life!

My dh provides a same day appointment for all patients who wish to be seen, for whatever reason. He still provides an on-call service staffed by the doctors who work in the practice, not a cooperative, or on call centre. He does not provide all services, no doctor does. His example - he cannot do joint injections, which can be very important to people who suffer from arthritis. People in his practice who need them have to go to the outpatient clinic for the steroid injection. My own practice (we are registered seperately) does not provide coil fitting - I had to go tot he family planning clinic to have a new mirena inserted a few weeks ago. Its just the way things are. If you live where we do, you cannot have a home birth, no matter how much you want it, as there are not local doctors who offer intrapartum care. But it is unlikely that many people on Mumsnet could expect the kind of 'home hospice' care that my dh and his partner provide, allowing people to die with dignity in their own homes.

He also said that there is actually a very low demand for the services which he doesnt provide. In the last year he has seen one patient who wanted a termination, and she was understanding of his views (which are widely known in the community, we live within the practice area and are well known locally). He doesn't have to refer patients who want the morning after pill to his partner very often at all.

Dh has thought all this through in great detail. He agonises over decisions like this. He has to make decisions about life and death on a daily basis, between caring for pregnant women (and no, he doesn't beleive in sex before marriage but provides a full and caring service to unmarried pregnant women) to choosing between two badly injured people at a road accident, (he could only treat one of them at a time when he happened across them earlier this year), to sitting down as he has had to do in the last week and explain to a man who's wife is dying of breast cancer that his 'bad chest' is also cancer, and probably inoperable. There is SO much more to being a GP and providing a good service to the community than whether or not you refer for termination of pregnancy. To say that someone who wont do that, but does all the other things that my dh does, is not fit to be a doctor paid by the NHS is frankly offensive. I'm sure almost all of you, who live where you have to wait to see a doctor, and those of you who have to phone NHS 24 for advice because you can never get through to the surgery, and those of you whos doctor will never do a house call, would love to have the service that my dh provides on a daily basis, regardless of his views on abortion.

Thats where we are coming from on this.

hoxtonchick · 14/09/2004 14:27

What a great post susanmnt, your dh sounds like a fantastic doctor .

marialuisa · 14/09/2004 15:16

SusanMT, I didn't say he wasn't "fit to be an NHS doctor" and yep, he's obviously dedicated. You have explained that patients are not disadvantaged by his views, which is exactly how it should be, however if all GPs were to follow this route things would become very difficult for some women.

susanmt · 14/09/2004 16:03

But there is no way that all doctors would follow that route, marialuisa, thats why there can be such things as a conscience clause because different people have different things they are worried about.

Within the medical profession, the only thing it is regarded OK to have astrong view about is abortion. Any of the other things that were mentioned would be abhorred by other doctors and dh said if you refuse to treat a person because of prejudice about that person, not because you have a moral objection to the actual treatment, you would very likely be struck off or disciplined by the GMC. There'a a difference between looking after and individual (which he does all the time, whether or not he likes their lifestyle or the situation they are in) and prescribing one specific treatment with which he has an ethical problem.

No, you didn't say he wasn't fit to be a doctor, I'm sorry, but that is how he took some of the posts on this thread. Sorry, I know you would not mean it that way.

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