Pediatrician Shuts Down Leftists on Puberty Blockers

[Unidentified 2,930]

2 minutes ago, IDWAF said:

So what happens to the mantra of “her body, her right” if mental health docs have to be asked to approve?

I am not saying they need to approve anything. I am just saying that they should help the person figure out if this is really what they want and there's not something else going on that could cause them to feel that they want to transition. Is it really gender dysphoria or something else. There are people who regret transitioning, it's important to know before you go through with it. 

[TBoneTX 45,551]

2 hours ago, bcking said:

We have a responsibility to take what we do seriously and not just do whatever a patient asks. It's reasonable to make sure that a person requesting such a massive and irreversible procedure is confident

An Arkansas hillbilly couple had 9 children.  They went to the doctor to see about getting the husband "fixed."

The doctor gladly started the required procedure and asked them what had finally caused them to make the decision -- why, after 9 children, would they do this?

The husband replied that they had read in a recent newspaper article that one out of every 10 children born in the United States was Mexican, and he and his wife did not want to risk having a Mexican baby, because neither of them spoke Spanish.

[Voice of Reason 10,298]

6 hours ago, Unidentified said:

I am not saying they need to approve anything. I am just saying that they should help the person figure out if this is really what they want and there's not something else going on that could cause them to feel that they want to transition. Is it really gender dysphoria or something else. There are people who regret transitioning, it's important to know before you go through with it. 

Is there a magical way to predict if you will regret something BEFORE you do it?  I know people who do regrettable things all the time.  Without some “un”common sense, they will do it and regret it, regardless of what others tell them.  That is part of growing and maturing as a person.  Be it a tattoo or a surgical removal of body parts.

[bcking 3,157]

7 hours ago, IDWAF said:

So what happens to the mantra of “her body, her right” if mental health docs have to be asked to approve?

Sorry I've been busy today so just getting back to this.

 

Medicine is governed by more than one ethical principle. One is Autonomy (of the patient), and yes if we were purely driven by patient Autonomy then whatever the patient wants, the patient gets. 

 

However, we are also governed by Beneficence, Justice and Non-Maleficence. We have to balance those four. There isn't a "perfect equation". Generally speaking Autonomy is the "over-riding" principle when we are talking about REFUSING care (patients can decline, and we need their consent). However, when we talk about receiving care Autonomy cannot act alone. You cannot force a physician into doing a procedure if they feel it may violate the other principles (primarily Beneficence and Non-Maleficence). An obvious example would be opioid administration. Patients don't have the right to just come to the ED and ask for narcotics and get them. Physicians can say no because doing so would violate our principles of Beneficence and Non-Maleficence (definitely Non-Maleficence, Beneficence is a little more murky).

 

In this case, it is reasonable for physicians to attempt to address both beneficence and non-maleficence before undertaking a procedure like this. In particularly given that it is elective and irreversible. The requirements to undergo the procedure all essentially fit into this "due diligence". 

[bcking 3,157]

36 minutes ago, IDWAF said:

Is there a magical way to predict if you will regret something BEFORE you do it?  I know people who do regrettable things all the time.  Without some “un”common sense, they will do it and regret it, regardless of what others tell them.  That is part of growing and maturing as a person.  Be it a tattoo or a surgical removal of body parts.

There is never certainty. That is partly why we need some due diligence when we are talking about elective and irreversible procedures. One potential risk/harm is "changing your mind", and that can do serious harm.

 

It's not something that should be taken lightly. At the same time though, since we cannot ever be completely certain, we eventually need to fall back on "Autonomy" as a principle. If we have done our due diligence towards the principles of Beneficence and Non-Maleficence, ultimately we will defer to Autonomy unless we have strong concerns. That is where it is an art, and not a "mathematical equation" that we can somehow plug in and give us an answer. 

Edited June 27, 2018 by bcking

[Voice of Reason 10,298]

Makes sense, thanks for the additional input.

[Steeleballz 7,550]

48 minutes ago, IDWAF said:

Is there a magical way to predict if you will regret something BEFORE you do it?  I know people who do regrettable things all the time.  Without some “un”common sense, they will do it and regret it, regardless of what others tell them.  That is part of growing and maturing as a person.  Be it a tattoo or a surgical removal of body parts.

 

  I use the 3 beer rule myself, but I'm sure there are other ways.

[bcking 3,157]

7 minutes ago, IDWAF said:

Makes sense, thanks for the additional input.

I actually think this is an excellent example of some of the ethical principles and how it can be difficult to reconcile them at face value. We end up "meeting in the middle" when dealing with these more complex ethically "murky" issues.

 

Elective procedures in general are all a bit murky when related to our ethical responsibilities. They all do some "harm" so at least Non-Maleficence needs to be adjusted a bit. Most people think it needs to balanced with Beneficence. You can do harm, as long as in the end you are doing a "greater good" and the patient benefits. Cosmetic procedures you also have to add a bit of autonomy in there and figured if the patient really wants it, and you can minimize the risk (and they are aware of the risks and they still want it), then you can still do "good" or at the very least you aren't violating any of our principles. Some would argue that in purely cosmetic cases (transgender surgery would NOT be included), you aren't really "treating" the patient, you are providing a different kind of service. If that's the case, you can be a bit more flexible with medical ethics (not my opinion, but I think that is how some cosmetic surgeons probably help themselves sleep at night...that and stuffing their pillow with piles of money).

[Voice of Reason 10,298]

After talking about all of this, I am just very glad I am happy with myself just the way I am.  Only thing I would change is to become a billionaire, and send all of my VJ friends some sweet, free money!

[TBoneTX 45,551]

8 hours ago, Satisfied said:

I know people who do regrettable things all the time.

"Remember:  we are judged on our past.  Therefore, be careful what you do in your past."

[The Nature Boy 7,659]

10 hours ago, Satisfied said:

After talking about all of this, I am just very glad I am happy with myself just the way I am.  Only thing I would change is to become a billionaire, and send all of my VJ friends some sweet, free money!

I would use my fortune to buy VJ and make Kip head mod. Fly down all my chest buddies for a weekend of fishing and watching the Chest show meltdown televised on PPV