Trump Admin Will Protect Health Workers Who Refuse Services On Religious Grounds

[Voice of Reason 10,298]

Just now, Nature Boy Flair said:

and dat is what I been saying

So they have the right, based on their religious convictions, to refuse care to people who choose to do things outside their religion. 

[-Trinity- 513]

1 minute ago, Nature Boy Flair said:

and I agree 100%. and for the record it was 12 nurses. 

 

However they were told when hired and it had been the policy for sometime, that they would not have to provide abortion care of any kind.  They changed the policy. Grandfather them in, move them, but in the future if you go to work  there you know the deal.

Agree, if someone gets hired and they start working based on a policy, which they change along the way, they should at least give them the option to move them somewhere else or having the conversation about how to be professional. At that time I think the wellbeing of the patient should be the focus.

 

I'm not a nurse, but don't they teach them that they can encounter working situations where they have to deal with circumstances that are against their beliefs?

 

 

[The Nature Boy 7,659]

Just now, IDWAF said:

So they have the right, based on their religious convictions, to refuse care to people who choose to do things outside their religion. 

They have the right under the policy under which they were hired, that allowed them the freedom to accommodate their beliefs. 

 

I have said approaching 20 times now. If you dont want to participate in abortions dont take the job. If you dont want to handle pork products dont take a job that requires you to handle them.

 

 

If target had told the clerks they would not have to handle pork products, which they didn't, they should not have to handle them.

[bcking 3,157]

The only way medical professionals should be able to refuse to provide treatment is if they can offer an alternative source of the treatment.

 

If that nurse absolutely needs to care for the patient and there is no one else, it is her responsibility. That is the job and role she signed up for. Now in a busy hospital she could be a post-op nurse and communicate with her charge nurse/nursing manager so they know she is not comfortable with that type of patient. Honestly it would be in the patient's best interest to have a different nurse. But at the end of the day, if there is no one else she can't say no.

 

Abortion isn't a "medically necessary" treatment so you technically have to offer an alternative if you don't offer the service. Post-op care is medically necessary. I'd say the same with pediatric care. They have to be able to receive care elsewhere (within a reasonable distance). If you are the only doctor for 100 miles you can't refuse to see their child just because they are lesbian. 

 

Those are my 2 cents.

[bcking 3,157]

34 minutes ago, -Trinity- said:

What do you do if you're a doctor and you're against circumcision, but patients demand it. Are you allowed to say no, it's against my beliefs?

A doctor is not required to offer circumcisions. It isn't a medically necessary procedure. Most places are big enough such that if someone doesn't perform them (for whatever reason), there is someone else available. For sure when you were hired your contract would have specified what you would be performing. When you get credentialed you have to put down what procedures you do. Whoever is responsible for hiring a Pediatrician to see newborns would undoubtedly ask if you can do them, and you could tell them that you don't do them and don't intend to be trained. They can choose to hire you or not. If you are a private pediatrician seeing newborns with hospital credentials, you aren't required to be able to do them either. There is usually someone else in the hospital, but honestly you can work it out with your patient however you like. I'm sure some pediatricians send all of their kids to a specialist for it, and as long as the patients are fine with that then no problem.

 

If you are at a hospital where you are truly the only person and you don't do them, you still don't have to. Their pediatrician can do it (if they are trained), the OBGYN often times is trained to do them (and like to do them because they can bill for a procedure), and ultimately a urology referral would take care of it (though it would be a waste of the urologists expertise and time).

 

A hospital would lose significant amounts of business if they did not perform circumcisions. I'm not that well versed in the accreditation system for hospitals, but it may also be a requirement for certain things. 

[smilesammich 10,727]

8 minutes ago, bcking said:

The only way medical professionals should be able to refuse to provide treatment is if they can offer an alternative source of the treatment.

 

If that nurse absolutely needs to care for the patient and there is no one else, it is her responsibility. That is the job and role she signed up for. Now in a busy hospital she could be a post-op nurse and communicate with her charge nurse/nursing manager so they know she is not comfortable with that type of patient. Honestly it would be in the patient's best interest to have a different nurse. But at the end of the day, if there is no one else she can't say no.

 

Abortion isn't a "medically necessary" treatment so you technically have to offer an alternative if you don't offer the service. Post-op care is medically necessary. I'd say the same with pediatric care. They have to be able to receive care elsewhere (within a reasonable distance). If you are the only doctor for 100 miles you can't refuse to see their child just because they are lesbian. 

 

Those are my 2 cents.

there are circumstances where an abortion is medically necessary.

[bcking 3,157]

5 minutes ago, smilesammich said:

there are circumstances where an abortion is medically necessary.

Yes there are, I left that part out. 

 

If it's medically necessary then a provider, if qualified and available, has an obligation if there is no one else immediately available to fulfill the obligation. If you are the OBGYN on call in house and someone comes in and the mother's life it at significant risk, you can't just say no. I'd imagine most medical providers who refuse to perform abortions wouldn't see that procedure as an abortion. A complete severe placental abruption at 20 weeks with DIC in the mother for example may necessitate delivery which would be effectively terminating the pregnancy at a non-viable stage. In that case though the placental abruption has basically ended the pregnancy, not the actual delivery.

Edited January 18, 2018 by bcking

[-Trinity- 513]

8 minutes ago, bcking said:

A doctor is not required to offer circumcisions. It isn't a medically necessary procedure. Most places are big enough such that if someone doesn't perform them (for whatever reason), there is someone else available. For sure when you were hired your contract would have specified what you would be performing. When you get credentialed you have to put down what procedures you do. Whoever is responsible for hiring a Pediatrician to see newborns would undoubtedly ask if you can do them, and you could tell them that you don't do them and don't intend to be trained. They can choose to hire you or not. If you are a private pediatrician seeing newborns with hospital credentials, you aren't required to be able to do them either. There is usually someone else in the hospital, but honestly you can work it out with your patient however you like. I'm sure some pediatricians send all of their kids to a specialist for it, and as long as the patients are fine with that then no problem.

 

If you are at a hospital where you are truly the only person and you don't do them, you still don't have to. Their pediatrician can do it (if they are trained), the OBGYN often times is trained to do them (and like to do them because they can bill for a procedure), and ultimately a urology referral would take care of it (though it would be a waste of the urologists expertise and time).

 

A hospital would lose significant amounts of business if they did not perform circumcisions. I'm not that well versed in the accreditation system for hospitals, but it may also be a requirement for certain things. 

Thanks for the clarification, I'm not sure how it works here in America. In Europe you do have to go to a specialized doctor or hospital.

 

So that wasn't a great example.

 

I wonder how that works for something like euthanasia. I know it is not common/allowed here, but when that happens it defenitly will be controversial. How are doctors and nurses going to deal with someone who voluntarily wants to end his/her life with medical help? 

[smilesammich 10,727]

6 minutes ago, bcking said:

Yes there are, I left that part out. 

 

If it's medically necessary then a provider, if qualified and available, has an obligation if there is no one else immediately available to fulfill the obligation. If you are the OBGYN on call in house and someone comes in and the mother's life it at significant risk, you can't just say no. I'd imagine most medical providers who refuse to perform abortions wouldn't see that procedure as an abortion. A complete severe placental abruption at 20 weeks with DIC in the mother for example may necessitate delivery which would be effectively terminating the pregnancy at a non-viable stage. In that case though the placental abruption has basically ended the pregnancy, not the actual delivery.

and in this sort of case, this new department would advocate for a nurses' perceived right to not "assist" with the abortion in refusing to provide after care to the patient. 

[bcking 3,157]

11 minutes ago, smilesammich said:

and in this sort of case, this new department would advocate for a nurses' perceived right to not "assist" with the abortion in refusing to provide after care to the patient. 

I'm not really talking about hospital policy, I'm just talking about medical ethics.

 

If there is no other nurse available to provide the care, I would argue the nurse is ethically responsible to provide the care. It is her duty as the sole provider of that kind of care available. That rarely happens though and if the hospital hired them with that prior knowledge, the hospital should be responsible for making accommodations (never scheduling all of those nurses together such that someone wouldn't be available to provide care). 

 

I would also question those nurses overall professionalism if they equated the example I provided with an voluntary abortion. They shouldn't be nurses at that point. The woman has no control, it wasn't her choice. You'd be punishing/judging someone for something they didn't decide. While I don't agree with their view, I would hope that they would see the difference between that and judging someone who chooses to have an abortion.

 

14 minutes ago, -Trinity- said:

Thanks for the clarification, I'm not sure how it works here in America. In Europe you do have to go to a specialized doctor or hospital.

 

So that wasn't a great example.

 

I wonder how that works for something like euthanasia. I know it is not common/allowed here, but when that happens it defenitly will be controversial. How are doctors and nurses going to deal with someone who voluntarily wants to end his/her life with medical help? 

It happens in a few states. Oregon is one of them (Where I am from, though I haven't practiced medicine there).

 

Doctors can refuse to offer it. Since I haven't practiced there (and it wouldn't even be in my job description, I care for babies) I'm not 100% sure on the details. My guess would be you would look to find a colleague in your hospital that is willing to offer it. If there absolutely no one, you would help facilitate a transfer to a doctor who is capable at a different hospital. That is what we do if we refuse to offer a particular procedure or care to a neonate and the parents are insistent.

Edited January 18, 2018 by bcking

[smilesammich 10,727]

7 minutes ago, bcking said:

I'm not really talking about hospital policy, I'm just talking about medical ethics.

 

i wasn't talking about hospital policy either, i was talking about DHHS. 

[The Nature Boy 7,659]

46 minutes ago, bcking said:

A doctor is not required to offer circumcisions. It isn't a medically necessary procedure. Most places are big enough such that if someone doesn't perform them (for whatever reason), there is someone else available. For sure when you were hired your contract would have specified what you would be performing. When you get credentialed you have to put down what procedures you do. Whoever is responsible for hiring a Pediatrician to see newborns would undoubtedly ask if you can do them, and you could tell them that you don't do them and don't intend to be trained. They can choose to hire you or not. If you are a private pediatrician seeing newborns with hospital credentials, you aren't required to be able to do them either. There is usually someone else in the hospital, but honestly you can work it out with your patient however you like. I'm sure some pediatricians send all of their kids to a specialist for it, and as long as the patients are fine with that then no problem.

 

If you are at a hospital where you are truly the only person and you don't do them, you still don't have to. Their pediatrician can do it (if they are trained), the OBGYN often times is trained to do them (and like to do them because they can bill for a procedure), and ultimately a urology referral would take care of it (though it would be a waste of the urologists expertise and time).

 

A hospital would lose significant amounts of business if they did not perform circumcisions. I'm not that well versed in the accreditation system for hospitals, but it may also be a requirement for certain things. 

so in other words. A person can choose to do whatever they think is right, the result may be they have very limited employment choices or very few patients. 

[bcking 3,157]

6 minutes ago, Nature Boy Flair said:

so in other words. A person can choose to do whatever they think is right, the result may be they have very limited employment choices or very few patients. 

I mean depending on your beliefs, you would probably have plenty of patients. Abortions are not the majority of post-op cases, not even close. They are a tiny minority, you would have plenty of patients.

 

Employment choices you're right. Probably quite limited just because it's a hassle to ensure proper coverage if everyone has a list of "do's and don'ts".

[The Nature Boy 7,659]

1 minute ago, bcking said:

I mean depending on your beliefs, you would probably have plenty of patients. Abortions are not the majority of post-op cases, not even close. They are a tiny minority, you would have plenty of patients.

 

Employment choices you're right. Probably quite limited just because it's a hassle to ensure proper coverage if everyone has a list of "do's and don'ts".

Agree.

 

I am sure you could make a big fuss about being a anti abortion OB and get lots of patients 

[bcking 3,157]

6 minutes ago, Nature Boy Flair said:

Agree.

 

I am sure you could make a big fuss about being a anti abortion OB and get lots of patients 

You mean publicly say you don't perform abortions and get business for patients who agree with you? You're probably right, it would likely increase your business from a certain clientele.

 

While I don't share their beliefs, if I was anti-abortion I would still preferably look for an OB based on their skill, ability, reputation, bedside manner and less on whether they would perform that procedure for others. But some people may put that top of their list.

 

No abortions > Technically skilled obstetrician, I guess.

Edited January 18, 2018 by bcking