Category — medicine

At least, that’s what the College of Physicians and Surgeons of Ontario say (see the National Post article here).

A new draft proposal by the college is looking to strip Ontario doctors of their right to exercise their religious or moral conscience when practicing medicine.

As it is now, a doctor can refuse to do things like prescribe the morning after pill, give a patient an abortion and can refuse to refer a patient to another physician who will do those things if the treatment being asked for goes against their religion or conscience.

I think the college is making a mistake with this approach.

I do agree that doctors should have to refer a patient they will not treat themselves – I don’t think it’s for a doctor to decide a patient shouldn’t be treated at all simply because the treatment goes against the doctor’s conscience or religion. Those patients the doctor will not treat should be referred immediately to a doctor who will.

Forcing a doctor to treat a patient when the doctor has made it clear the treatment in question goes against everything he believes in is a bad idea. I think no matter how careful the doctor is to treat that patient’s physical needs - the quality of care and compassion that is normally involved in medical treatment drops off pretty sharply when the doctor actively disagrees with a patient’s own moral or religious decision.

For instance, if I went to a doctor for an abortion and the doctor told me “My conscience and religion forbid this treatment, but since I don’t want to be disciplined or sued, I’ll do it.” Could I really trust that doctor to then be careful with my physical and mental well being? Do I want an important decision and procedure like that handled by a doctor who has made it clear he does not respect my right to have the procedure in the first place?

I’m pretty sure the answer is no.

Force these doctors to simply refer the patient elsewhere and, if necessary, end the physician-patient relationship so the patient can seek appropriate care with a physician who supports their right to the treatment they need or want.

The proposal states that ending a physician-patient relationship based on personal beliefs could “contravene the Code and/or constitute professional misconduct.” I think this is fairly asinine. I would much prefer my doctor say “I am going to refer you to another doctor who is accepting new patients, as my religious and moral beliefs are making it difficult for me to treat you with the respect, compassion and level of care you deserve.”

Instead, those cases where a doctor does want to terminate his relationship with a patient, refuse care of an existing patient or refuse to take on a new patient, the doctor must do so “for reasons related to his or her own clinical competence” according to the proposed code.

It seems to me that this approach encourages doctors who wish to live by their personal beliefs to lie. If a doctor lies about his “clinical competence”, does this mean the College can examine whether he should hold a medical licence?

The code also says the first step in ending a physician-patient relationship should be a referral to specialist – and in the case of a GP not wanting to do heart surgery or something equally specialized, this makes sense. I don’t want a GP trying his hand at a triple bypass surgery. Where the doctor in question does not want to provide a young girl with birth control pills because he thinks she’s too young to be sexually active or his religious and moral beliefs brand her as an adulterous slut- what specialist could you possibly refer her to?

The code advises the following in those cases: “…proceed cautiously.”

The well being of the patient should always come first – I agree with the College on that completely. However, sometimes the well being of the patient is best addressed by the physician admitting “I’m not the right doctor for you because of my religious or moral beliefs. Let me refer you to a doctor I think you’ll connect with better.”

That sort of honesty is what makes a physician good – that honesty ensures the patient will always come first.

The feeling of being processed is already rampant in doctor’s offices across the country. Patients get a maximum of 15 minutes and two issues to bring to the table before they are ushered out the door. If the doctor is spending any of those minutes giving poor quality care to a patient he was forced to treat, his ability to do his job is severely compromised.

Forcing a doctor to treat a patient they cannot be objective about or kind to will only serve to highlight and compound existing issues in the health care system. Make it a rule that no doctor can refuse a to refer a patient – if the doctor in question loses many of his patients because he refuses to treat them, he has no one to blame but himself. 

You can read the proposed code here. Click View Backgrounder under the Human Right Consultation section (this will allow you to view a .PDF file) scroll to the Physicians and the Ontario Human Rights Code link and click that for the full version of the proposed code.

If you wish to comment on the proposed code, do so no later than August 15, 2008 by sending a letter to:

Andrea Foti
College of Physicians and Surgeons of Ontario
80 College Street
Toronto, ON, M5G 2E2

or email Andrea at: afoti@cpso.on.ca

Anything done in Ontario can easily be adopted by other Provinces – so speak up now!

Yes, you read that title correctly.

Yesterday I was browsing around Chapters waiting for Joe and I found a copy of Details magazine. The story on the cover – “Forget condoms – Young, single guys are getting vasectomies” – caught my eye.

I assumed the tone of this article would be a horrified one. That some older and wiser man had written an article to say “Getting snipped might be the latest thing in sexcapades, but you can still get the clap you moron. Use a condom.”

Nope. No mention of STD’s or responsible use of condoms at all. In fact, guys worrying about “their partners’ vigilance with the Pill” are getting snipped rather than using condoms because condoms are “less than ideal in terms of pleasure” and are not 100% guaranteed to prevent pregnany. Worse, the article implies that lots of women lie about taking birth control and are looking to “oops” a guy into fatherhood and collect hefty child-support payments.

The first guy the article mentions, Marcus Whitlock, got a vasectomy when he was 23 (he lied to the doctor and said he was 30) because sex was a “tense, fraught ordeal” due to the possibility of pregnancy. Whitlock says “Now I can never have a girl say I made her pregnant. I don’t have to worry about being tricked.”

Tim Vass – another poor guy who nearly fell victim to evil, baby-craving women – also got snipped. He made the decision after “a half-dozen pregnancy scares, including what he says were two attempted oopsings. Both of the latter were one-night stands.” Tim is now a free bird and has “swinging-from-the-chandelier sex”.

My first thought was “Don’t flatter yourselves, you assholes.”

What I get from these two guys is not just “Women are tricky bitches.” (though their statements reek of that sentiment) but also “I plan on having a lot of sex and I can’t be bothered to use condoms.”

I hope these two studs have good health care plans that will pay for a lot of penicillin and Valtrex.

Sure, condoms might make things feel a little less sensitive than they could – but you could always check out what Trojan has available. I counted no less than six types of extra-sensitive condoms on their site. Don’t tell me they’re too expensive either – Trojan will send you a free sample.

You could also just resort to good, old-fashioned, solo masturbation. Not quite as fun as sex with a partner, but the paranoia surrounding possible “oopses” drops to exactly zero percent.

I have to admit, there ARE women who trick guys into being fathers – and the people who suffer most in those instances are the child. I don’t feel sorry for the woman who tricks a guy into fatherhood, nor do I feel particularly sorry for the guy who got tricked (you could have chosen the solo stuff dude); I feel sorry for the kid. 

This article was probably read by other men like Marcus and Tim – paranoid guys with a sense of entitlement to all the free-wheeling sex they want – so why is there nothing in this article to educate them about being responsible?

Guys like that are going to get vasectomies anyway. Trojan could dump a lifetime supply of condoms – free of charge – in their laps and they’d get snipped and use the condoms for balloons. This article had a responsibility to tell these idiots that getting snipped does not entitle you to become a man-whore and collect STDs to pass along to other people. A vasectomy is not a guard against syphilis, chlamydia, gonorrhea, genital herpes, HIV or any other nasty little infections.

I have to give the author a tiny bit of credit – he does mention the fear of “sneak pregnancies” is “irrational”, but then goes on to say that many of the guys getting vasectomies are doing it so they have control over when and if they have kids. They are sick of it being “only the woman’s opinion” that matters.

Uh, guys, you already HAVE control. It’s called condoms – sometimes it’s called abstinence. Your opinion matters, and you can express your opinion by wearing a condom. In fact, if you’re sleeping with a woman who you feel would trick you into fatherhood – maybe you shouldn’t sleep with her at all. Why not do the solo thing until you meet a woman you can trust and respect?

That’s the sort of control that is directly within your means – and there are no unpleasant side-effects.

I have just finished reading Neil Gaiman’s novel Anansi Boys.

If you haven’t read anything by Neil Gaiman, get yourself to the bookstore already! I doubt Neil (Mr. Gaiman?  Is there a correct way to refer to an author in your blog without sounding like a pretentious twit?) will ever read this, and if he does I hope this will please him: I really, really enjoy your books and you’re in my top 10 of favourite authors.

Reading Anansi Boys got me to thinking about life and death – mostly death, but not in a morbid way.

This is a bit of a spoiler here, so skip this part if you want. At one point in the novel Fat Charlie’s (the main character) mother is dying in the hospital. Fat Charlie is sitting at her bedside when she suddenly says “Yellow bird.” Charlie doesn’t get it at first, but soon enough he hears a New Orleans jazz band marching through the hospital corriders playing “Yellow Bird“. The band comes to his mother’s room led by Fat Charlie’s father. Fat Charlie’s mother is utterly delighted and her hospital room is transformed. It is no longer just a place to die, but a place to celebrate life.

I think this is a pretty cool idea.

I’ve volunteered in hospitals and for the most part they are not terribly cheerful places. Things are clean and orderly (generally) and the staff is competent and usually kind and decent but it’s still a hospital. You’re still sick, maybe dying, and it can be a joyless job in such a silent and sterile place.

I looked into the jazz funeral or “funeral with music” and I think it’s a great idea – moreso if they bring it to the hospital and cheer the place up a little. Why should death be so dreary and silent? Why can’t it be met more bravely with some measure of joy? Who says giving up a sick body and moving on has to be sad?

For myself, I’m hoping to be cremated and scattered over the ocean with a piper walking up and down the beach playing something suitably somber – and then after I want a big spread of food, whisky, beer, more food and lots of great music to send me off to whatever hereafter there is. I want photos of me and my friends and family all around, I want stories exchanged, toasts to me, to a life well lived, to love and everything else worth having. I want people to just do what they need to grieve and celebrate; cry, laugh, sing, dance, scream, whatever it takes.

I want the people I leave behind to not feel as though they’ve been left behind and to keep living. I’m not sure what comes after; maybe I’d still be able to see everyone and hear things. If that’s how it is, then I’ll be making my presence known if the people I love stop living just because I did.

This is all sort of macabre I guess, but I don’t mean it to be. I fully intend to live a good long time – I just want my send off to be as interesting and fun as getting to the end was.