Abortion Discussion, Part the Fourth

ohnonotgmail

https://www.boards.ie/discussion/comment/119430376#Comment_119430376

both are healthcare. Do doctors get to choose what healthcare procedures they are willing to carry out?

Uriel.

For a considerable period of time in history, perhaps even as far back as the begining of the written history of medicine doctors have been able to conscientiously object to carrying out certain procedures. The do no harm principle is often, but not always the a primary anchor point.

Many codes of ethics and/or guidance for doctors reference this and also contain a range of safeguards to mitigate the impact. See for example section 49 of the Guide to Professional Conduct and Ethics for Registered Medical Practitioners This is the case in Ireland today and existed prior to the 2018 Referendum.

Conscientious objection is enshrined also in our laws - the 2018 Act and the now repealed protection of life during pregnancy Act 2013 are the obvious and explicit ones.

These issues are rarely black and white and both the academic literature, laws and codes of practice present important nuances. That said, the answer to your question (notwithstanding the fact that it's probably not the correct question) is yes, to a degree doctors can choose the procedures they carry out, but certain rules are attached to that. I think the more appropriate formulation of an answer is: Doctors can refuse to take part in or provide treatments on conscientious objection grounds (subject to nuances/rules).

While abortion, sterilisation and circumcision tend to be the most obvious treatments that sit at the heart of public debate on conscientious objection, conscientious objection as a concept is not just about or confined to those treatments.

Hotblack Desiato

https://www.boards.ie/discussion/comment/119429834#Comment_119429834

If these people are really so concerned about what "God's will" supposedly is, how do they know that practising medicine at all is in accordance with it? Shouldn't they be performing an exorcism or saying another mass or something?

As usual, it's only sex and women's reproductive issues in particular that they have problems with... quelle surprise.

aloyisious

https://www.boards.ie/discussion/comment/119430350#Comment_119430350

Ref your two mentions that doctors are being forced to carry out abortions and terminations against their will, is this here in Ireland or elsewhere? I understood the law does not allow for such activities in Ireland.

Uriel.

https://www.boards.ie/discussion/comment/119431159#Comment_119431159

You'd have to ask those doctors those questions. I would say also that it isn't always purely religious grounds upon which CO is based.

I'd also say that women's health certainly isn't the only issue in this space and you should look beyond the narrow focus you have. This winter and I'm sure into next year the public debate on assisted dying is about to be reignited (through a new Oireachtas Committee) and conscientious objection is entangled in that debate in every way that it is with regard to abortion.

Uriel.

https://www.boards.ie/discussion/comment/119431175#Comment_119431175

Have you been following the thread of discussion? I've never said that doctors are being forced to carry out abortions in Ireland. In fact I've said the exact opposite. I've also said that changing the current approach and instead forcing them to do so is not likely to solve service gap issues as some people here seem to advocate for.

aloyisious

https://www.boards.ie/discussion/comment/119431216#Comment_119431216

Ah, I stand corrected. Your point is that you think there is an assumption on the part of some person/s that doctors might be forced against their will to perform abortions that you had in mind. I understood doctors with conscientious objections merely had a legal obligation to refer female patients seeking abortions on to another doctor. I wasn't aware that it might be future Govt policy to force doctors with anti-abortion beliefs to perform abortions. Would you have any person/s, body or group in mind which you believe would be likely to try and force doctors to do so?

Hotblack Desiato

https://www.boards.ie/discussion/comment/119431215#Comment_119431215

Not the same at all. Can never fall under the heading of emergency medicine, can it? Having to choose a particular facility to make a one-way trip to is less of an issue. People already do this with hospices (which aren't supposed to assist with dying, but do make people "comfortable")

As for opposition to abortion being based on religious grounds? The usual suspects always deny this then have a round of the rosary for the "unborn".

uptherebels

https://www.boards.ie/discussion/comment/119430350#Comment_119430350

They have a right to object, not obstruct. If they are unable to perform the duties their position requires then they need to step aside.

Uriel.

https://www.boards.ie/discussion/comment/119431557#Comment_119431557

Again, I'm not saying that it is or will be future government policy, all I'm saying is that some posters here feel it is the solution, whereas I simply disagree

Uriel.

https://www.boards.ie/discussion/comment/119431784#Comment_119431784

For those doctors, whether on religious or other grounds, feel termination a fetus is ending a life, assisted suicide often is one and the same, at least from a principle/moral perspective...

Most terminations don't fall under emergency medicine either and if you truly understood the nuances of conscientious objection you'd know that in the case of emergency situations affecting the life or health of the pregnant woman there is sever limitation on conscientious objection both legally and ethically

As for your last paragraph, all I'd say is let's not confuse a discussion on conscientious objection with the wider anti abortion perspective

Uriel.

https://www.boards.ie/discussion/comment/119431916#Comment_119431916

Its weird that your responding to an argument that no one, expecially me, had made. I haven't seen any argument made that doctors can, do or should be able to obstruct abortions. That's not what conscientious objection allows and the code of ethics is very clear on this - you should read it some time.

Hotblack Desiato

Just as an example, there is no consultant in Kilkenny hospital who will perform an elective abortion

So the effect is to obstruct.

uptherebels

https://www.boards.ie/discussion/comment/119433977#Comment_119433977

I wasn't really responding to an arguement I was stating a point.

Considering you were talking about filling "gaps" in services, why would my comment be weird? You must not have been paying attention then. There are plenty of instances doctors not wanting to refer patients, hospitals where no elective abortions are performed, because they are blocked by the very people required to perform them.

I never said conscientious objection allowed it, I said that is was some "objectors" are using it for.

Funny how you managed to digest the code of ethics but not my very short and concise post🙄

Uriel.

https://www.boards.ie/discussion/comment/119434253#Comment_119434253

No it's not. The effect is a lack of service. But one shouldn't conflate action and effect in such a way.

Uriel.

https://www.boards.ie/discussion/comment/119434316#Comment_119434316

Can you provide evidence of situations where a doctor has refused to make a referral to another medical practitioner?

You are mixing up fundamentally different issues, either through ignorance or on purpose.

uptherebels

https://www.boards.ie/discussion/comment/119434438#Comment_119434438

I haven't mixed up anything, you have a right to object not obstruct, your deflection won't work.

Only the referral? So you accept the obstruction in hospitals?

uptherebels

https://www.boards.ie/discussion/comment/119434413#Comment_119434413

A lack of service is not having positions that provide abortion. Those positions being filled by people who refuse to perform abortions is obstruction of access. Your mental gymnastics isn't going to change this

Igotadose

https://www.boards.ie/discussion/comment/119436263#Comment_119436263

Unless instructed by the Dail (and even then) the HSE would never prioritize hiring OB/GYN who would, at their interview, agree to provide abortion. If this all about difficulty in hiring, make it a job requirement and heck, pay more. Fire a few percent of the administrators (plenty hired at high salaries during Covid) to balance the salary need.

This isn't difficult, just a matter of will. If you can't get Irish OB/GYN to provide the service, hire from overseas.

Uriel.

https://www.boards.ie/discussion/comment/119436263#Comment_119436263

Doctors have a legal right to conscientiously object. That is, to not partake in a healthcare procedure/treatment that conflicts with the doctors sincerely held ethical and moral values. A doctor refusing to undertake abortions on those grounds is permissable. This is not obstructinist. The only one doing mental gymnastics is you.

The HSE has already said it would making abortion procedures a condition of employment contracts. This wasn't the case until now.

Uriel.

https://www.boards.ie/discussion/comment/119436760#Comment_119436760

But it is difficult. Recruitment challenges generally in the health sector are well documented. Obstetrics has been a traditionally difficult specialism to recruit into for a long time nationally and internationally. In the US alone projections show a gigantic shortfall in obstetricians in the coming years.

Firing "administrators" to pay for more obstetricians is an immature response and shows a complete lack of genuine understanding of healthcare systems management

Hotblack Desiato

https://www.boards.ie/discussion/comment/119434413#Comment_119434413

What is this other than semantics. Women in KK and everywhere else in Ireland have a legal right to abortion services. After 10 weeks GPs will refer to the local maternity hospital. Half of these hospitals are refusing to provide the service they are legally obliged to. Conservative catholic and muslim consultants are hiding behind "conscientious objection" to continue to obstruct the provision of services.

But every forced birth is a life saved, eh!

Hotblack Desiato

https://www.boards.ie/discussion/comment/119437300#Comment_119437300

Doctors have a legal right to conscientiously object. That is, to not partake in a healthcare procedure/treatment that conflicts with the doctors sincerely held ethical and moral values.

Resignation is of course an option...

Hotblack Desiato

 In the US alone projections show a gigantic shortfall in obstetricians in the coming years.

Due to massive liability claims.

Ireland's health system is (thankfully) very very different from that of the US.

Uriel.

https://www.boards.ie/discussion/comment/119438972#Comment_119438972

Hospitals can't refuse to provide a service.

Uriel.

https://www.boards.ie/discussion/comment/119438979#Comment_119438979

Why would they resign?

Why would we want them to resign?

Uriel.

https://www.boards.ie/discussion/comment/119438985#Comment_119438985

What?

So Ireland is insulated against the challenges of recruitment? Is that what u are saying?

aloyisious

https://www.boards.ie/discussion/comment/119437300#Comment_119437300

https://www.boards.ie/discussion/comment/119434413#Comment_119434413

Should a doctor with conscientious objections to the provision of abortion services remain in a position in a hospital where it is a clear requirement of his/her employment to provide abortion services or should the doctor leave and let another doctor with no conscientious objection to abortion to take up the job, given that to remain in the position is ending with the abortion services not being provided as required? There would definitively be no issue of conflation of action and effect.

Uriel.

https://www.boards.ie/discussion/comment/119439185#Comment_119439185

Is this a legal, moral, ethical, hypothetical, [insert] question?

What I would say is this, irrespective of the basis for your question, it's an entirely flawed question coming from, as far as I can tell, an ideological position and not a rationale position (no surprises there)

But let's deal with your question and use the aforementioned Kilkenny hospital example. Let's sack our consultant obstetrician who conscientiously objects to carrying out an abortion, even though her contract of employment does not require her to carry them out, even though there's both a legal and medical code of ethics acknowledgment of her right to maintain such a position.

And then let's replace her with...

What exactly?

Congratulations, women of Kilkenny now have a long list of Health care services not available to them because they don't have ready access to a consultant obstetrician.

y0ssar1an22

the prospect of a middle ground in this debate becomes more and more unlikely.

my belief is, once a baby can be supported outside of the womb, you cant kill that baby.

and as science advances more and more, a baby will be able to live from inception.

based on my own reasoning above, i dont think abortions should be allowed while the baby cant be kept alive and healthy (unless live of mother at risk)