A January 13, 2007 editorial in the New York Times is titled "Doctors Who Fail Their Patients." One might think it would be about American medical doctors with drug addiction problems, doctors who commit insurance fraud, or doctors who treat their patients as billing accounts more than as people.
But that is not what the editorial is about.
Instead, the editorial is a complaint about the doctors who do act on conscience. The editorial states its complaint as follows:
"Now a new survey . . . by researchers at the University of Chicago, was published
last week in The New England Journal of Medicine. The researchers
mailed questionnaires to some 2,000 doctors asking whether they had
religious or moral objections to three controversial practices. Of the
1,144 who responded, only 17 percent objected to “terminal sedation” to
render dying patients unconscious, but 42 percent objected to
prescribing birth control for adolescents without parental approval,
and 52 percent opposed abortion for failed contraception.
"The encouraging news is that substantial majorities thought that
doctors who objected to a practice nevertheless had an obligation to
present all options and refer patients to someone who did not object.
But that left 8 percent who felt no obligation to present all options
and an alarming 18 percent who felt no obligation to refer patients to
other doctors. Tens of millions of Americans probably have such doctors
and are unaware of their attitudes."
Well, do atheist doctors ever refer Christian, Jewish or Muslim patients to doctors who do object to the procedures that many people of faith do not want? Do they refer patients of faith to doctors who share the patient's opposition to birth control, for example, or do they, instead, give them a polite (or annoyed) look and a bill? Whenever I have stated my religious preference in a medical office or hospital, I have never once had a health care office respond that the doctor I was about to see did not share my religion's views on an issue and that they could refer me to someone who did.
The medical journal article mentioned in the editorial is Religious, Conscience and Controversial Clinical Practices, authored by Farr A. Curline, M.D., et al, in the February 8, 2007 issue of the New England Journal of Medicine. The article actually points out that medical doctors, under the laws of most states, are legally protected in their ability to act on their conscience in refusing to provide such controversial procedures as abortion. Some of those protections now face challenges from people who do not want doctors to be free to act on conscience in modern medical care. Of course, those people's concern is that they, as patients, want to have a doctor who will act in accordance with the patient's values. So do I, and in my case that means I want to have a doctor who has a conscience and will act on it, not a doctor who feels as if he has to deliver a soul-less form of medical care with the exception of that pretense of holistic medicine that throws in a dose of touchy-feeliness with any bad news.
But aren't there more important aspects to the information shown in the journal article in question?
For one thing, how do the Portuguese pro-abortion advocates get away with telling the Portuguese people that if they want to be modern, they must legalize abortion for any reason up to 10 weeks of pregnancy when the New England Journal of Medicine shows that 52% of modern U.S. doctors oppose abortion for failed contraception? Are 52% of American doctors all that backward?
Isn't it more likely the case that if 52% of the people most highly educated in life and death medical issues consider this procedure to be immoral, that society should take take notice, at least to the point of considering that view as a respectable educated opinion on a topic informed by medical expertise?
And do a majority of American doctors hold a somewhat pro-life view because people of faith are more likely to become doctors? If so, then isn't that too worthy of comment? If children who grow up in families of faith that hold pro-life views (including many Christian, Jewish and Muslim families), are more likely to become doctors, that presents a powerful message about the stability and motivation of such families.
Of the doctors shown in the survey, 36% were categorized as having high "intrinsic religiosity". 46% of the surveyed doctors attend religious services twice a month or more, while only 10% never do so. The breakdown of religious groups was 38% Protestant, 22% Catholic,16% Jewish, 14% other, and 10% none. In comparison, about 20% of Americans reported that they had no religion, or that they were unwilling to answer a question about what their religion was, in the latest U.S. Census.
Of great importance, the journal article reports that most physicians support a balance involving both full disclosure and open dialogue with their patients about options, in a manner that respects both the doctor's own values and those of the patient:
"This balance resembles the interactive models proposed by Emanuel and Emanuel, Quill and Brody, Siegler, and Thomasma. These ethicists have all recommended models for the doctor–patient relationship that retain the moral agency of both the physician and the patient by encouraging them to engage in a dialogue and negotiate mutually acceptable accommodations that do not require either of the parties to violate their own convictions. . . . [These models] allow physicians to explain the reasons for their objections to the requested procedures."
In addition, the study found that the differences among doctors about whether to refer patients to other doctors who are willing to provide a controversial treatment that they themselves are not willing to provide reflects the disagreement on that same issue within the field of bioethics.
The New York Times editorial, saying that such physicians "fail their patients", does not accurately reflect the journal article in question. Other issues raised by that article merited more attention, including as the disagreement among physicians of what they can ethically do when handling controversial contemporary issues, and its affirmation that 52% of physicians are pro-life in the case of abortion for contraceptive failure.
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