[article] 'Catholic' Hospitals and Secular medicine.

mike65 · 03-10-2005 2:34pm #1

from iol.ie

A leading cancer specialist today vowed to bypass hospital ethics committees which refuse to advise women on potentially life-saving cancer drug trials to use contraception.

Two Dublin hospitals, the Mater and St Vincent’s, have blocked radical new treatments because encouraging contraception was at odds with their religious ethos.

Dr John Crown, consultant oncologist at St Vincent’s, said denying access to information on preventing pregnancy while being treated with radical new medicines was sectarian.

“I don’t believe it is a flash in the pan, I believe it is part of a more systematic problem,” Dr Crown said.

“If patients were going to be denied access to anti-cancer treatments for reasons which, well-meaning though they may have been, and I have no doubt they were well- meaning, ultimately were sectarian in a hospital which is funded in its entirety by the State and which provides services to Catholics, Protestants, Jews, Muslims and people of no faith, that it was not appropriate.”

Dr Crown said doctors were being denied the unique opportunity to offer radical smart-bomb drugs in the treatment of cancer.

But he revealed that ethics committees had insisted patient consent forms for drug trials should not contain references to contraception.

The first major problem at St Vincent’s arose 18 months ago when the committee was asked to agree that contraception should be a pre-condition for treatment. Dr Crown said he could not believe their refusal.

“I was told that it was not consistent with the ethos of the owners of the hospital,” he said.

St Vincent’s, while funded by the Government, is owned by the Religious Sisters of Charity.

Dr Crown said it happened on a number of occasions.

St Vincent’s and the Mater are the only two hospitals where it is known to have occurred, while other trials are under way at Beaumont and Tallaght hospitals in the Irish capital.

“There have been delays and attempts and deferrals of some research studies which specified that patients could not get pregnant while they were on research drugs because of the risk to the unborn child or indeed the risk to the mother of a pregnancy occurring,” he told RTE Radio.

“It could not be allowed to happen.”

He went on: “The tragedy of sitting down with a young woman who has got cancer and who is pregnant and who is asking you what do I do is one of the ones that any thinking person will try and avoid at all costs.”

Dr Crown said steps had been taken to bypass the ethics committees. Using rules governing European clinical drug trials he said they were would be able avoid ethics committees in hospitals with a strong religious connection in favour of others.

Is'nt it about time the state decided what was ethical in our 'public' hospitals?*

Mike

*yes!

Rev Hellfire · 03-10-2005 2:57pm

No.

It is the medical profession which should determine what is ethical.

amp · 03-10-2005 4:15pm

I think Mike65's point is that religion should not be a factor in the ethical decision making process.

mike65 · 03-10-2005 4:27pm

Okay what i should have said is that the state should have the power to give docters the freedom to decide ethics policy in public hospitals.

Mike.

AndyWarhol · 03-10-2005 11:24pm

Rev Hellfire wrote:

No.

Surely the woman could be advised to abstain from sex, and let her decide whether contraception was appropriate based on her own moral framework?

Sangre · 03-10-2005 11:52pm

But its a public hospital run by a religious order who like to maintain a certain ethos. Sure I don't agree with it but its ironclad protected in our fair Constitution and would need some serious referendum work to change.

Its the same reason a school can fire a teacher who gets pregnant outside of wedlock.

Can I put this to you, what if the State decided abortions prevented cancer? Should a religious hospital just accpet this? Or is it because contraception is such a tame topic for modern Ireland ( I do realise one is legal and one isn't but I'm taking about a public morality standpoint)

nesf · 04-10-2005 1:21am

AndyWarhol wrote:

Rev Hellfire wrote:

No.

Surely the woman could be advised to abstain from sex, and let her decide whether contraception was appropriate based on her own moral framework?

The two, in my opinion, are different things.

You could be told to abstain from sex, and that means abstain, or you could hurt/damage yourself or whatever.If you decide to use the phrase to mean contraception then this will just confuse people.

Plus, tbh, I don't think a doctor should be speaking unclearly just to pander to religious beliefs. If he said, "you should either abstain from sex or use contraception" then I don't see the issue. He isn't favouring either approach, just making his medical advice very clear. Which, in my opinion, can only be a good thing.

Dades · 04-10-2005 11:09am

Can't the doctors just tell the patients to use contraception, or to not get pregant? Of course they can and do.

Therefore this purely a hypothetical power issue. Can the Church dictate practices in our hospitals that in line with their ethos, when the public who they are treating would almost certainly consider them archaic?

It's just a domestic instance of the Vaticans anti-contraception practice in Africa. Disgraceful, both.

I would have thought the relevant question is who pays the bills?
I don't know the answer to that however.

mike65 · 04-10-2005 4:35pm

The Atheist wrote:

I would have thought the relevant question is who pays the bills?
I don't know the answer to that however.

The hospital is funded by the state. Except for the BUPA/VHI private work of course!

But its a public hospital run by a religious order who like to maintain a certain ethos. Sure I don't agree with it but its ironclad protected in our fair Constitution and would need some serious referendum work to change

Exactly, and who would have the balls to propose such, to free both schools and hospitals from the 'oppression' of Catholic church ethos? If the state pays for it, the state should run it/allow it to be run, on behalf of ALL of us.

If Catholics want catholic medicine they should fund a hospiotal for that purpose.

Mike.

Sangre · 04-10-2005 5:37pm

I disagree mike65, there should be religious schools like catholic, protestant etc., Be should be allowed to send their children to a denominated school if they wish but they shouldn't have to pay for it.
Remember the Constitution was made when a vast majority of schools and hospitals were run by religious orders.

Basically if the State agrees to fund a denominational school (e.g if there are a reasonable amount of muslims in an area the state has to provide a school for them if its not feasible to setup a program in another school) then it can't change it's mind when it doesn't like the teachings.

The state is secular so it should stay out of religious run organisations even if it disagrees.

How would you like it if, as a devout catholic, you send your child to a catholic public school in your area only to learn the state has decide to push abortion on children in sex ed..

These religious institutions have to be protected from general and often secular views if they are to have a function in society.

mike65 wrote:

Exactly, and who would have the balls to propose such, to free both schools and hospitals from the 'oppression' of Catholic church ethos? If the state pays for it, the state should run it/allow it to be run, on behalf of ALL of us.

But you're wrong in assuming all these religious institutions are catholic, even chrisitan.

And just because you have a diffrent belief doesn't make theirs oppressive.

Dades · 05-10-2005 8:44am

Sangre wrote:

These religious institutions have to be protected from general and often secular views if they are to have a function in society.

Let's not lose sight of the point in question in a flurry of self defence.

A hospital is not a religious institution.
If I'm in an accident - the nuns aren't going to heal me; state-paid surgeons are.

If the nearest hospital to you was owned by Jehovah's Witnesses but paid for by the state - and they refused to give you the blood transfusion that would save your life, would you still oppose secular hospitals?

hairyheretic · 05-10-2005 9:52am

Do doctors still take the Hypocratic Oath? I did a quick google for it, and the one I found had this as part of it.

" I will prescribe regimen for the good of my patients according to my ability and my judgement and never do harm to anyone. To please no one will I prescribe a deadly drug nor give advice which may cause his death."

Not giving the advice / offering the treatment because of these ethics committees would seem to be a violation of that oath.

(Full text is here, in case anyone is interested:
http://www.hal-pc.org/~ollie/hippocratic.oath.html )

What happens if the patient does not share the beliefs of the ethics committee and has no problem with contraception? Would that open the hospital up to any kind of legal action?

ArthurDent · 05-10-2005 7:45pm

mike65 wrote:

from iol.ie

Is'nt it about time the state decided what was ethical in our 'public' hospitals?*

Mike

*yes!

Of course it is, same as in our national schools - but no politician is going to have the balls to secularise either. The catholic church and other denominations picked up the slack in providing medicine and education for those in this country who couldn't pay and becuase the state abdicated this responsibility for so long i doubt you're going to see an orderly queue forming on denominations ready to hand it all back over to the state now - even though the state (ie we) pay for almost everything in these institutions.

I have no problem with denominational hospitals, schools, laundromats

, but not paid for by public funds - just can't see anyway of wrestling control back after 60 odd years (or a couple of hundred years if you take pre-independence time into consideration)

black_jack · 05-10-2005 8:29pm

ArthurDent wrote:

Of course it is, same as in our national schools - but no politician is going to have the balls to secularise either. The catholic church and other denominations picked up the slack in providing medicine and education for those in this country who couldn't pay and becuase the state abdicated this responsibility for so long

Oh I get the state capping church liability on the sex abuse scandal was just a backhander for all those years of education and health care.

Tell us, exactly how does a church garner so much cash, how much has this church gained in the sweat of Magdeline laundry and workhouses and labour from boys schools? Slave labour.

The Catholic church has over 20billion euro in liquid assets, right now. Never mind real estate, and hard assets. The suggestion that church has just be shouldering the burden, out the goodness of it's heart when the rattle of collection plates echos throughout mass, and the interest keeps rolling on in, in their own bank is another in a long litany of jokes.

Vincents and The Mater recieve millions in state funding some archaic "ethic" which has no place in a modern western civilisation should be stamped out. It's the public health service it's called that for a reason.

ArthurDent · 06-10-2005 6:39am

black_jack wrote:

Oh I get the state capping church liability on the sex abuse scandal was just a backhander for all those years of education and health care.

Tell us, exactly how does a church garner so much cash, how much has this church gained in the sweat of Magdeline laundry and workhouses and labour from boys schools? Slave labour.

The Catholic church has over 20billion euro in liquid assets, right now. Never mind real estate, and hard assets. The suggestion that church has just be shouldering the burden, out the goodness of it's heart when the rattle of collection plates echos throughout mass, and the interest keeps rolling on in, in their own bank is another in a long litany of jokes.

Vincents and The Mater recieve millions in state funding some archaic "ethic" which has no place in a modern western civilisation should be stamped out. It's the public health service it's called that for a reason.

I'm not saying the situation whereby or education and health services are effectively controlled by religious denominations is right- I'm saying that is the reality of the situation - and as pointed out by another poster above, it is a constitutionally protected situation. I explained the background of why we find ourselves in this position (historically alack of state funding for provision of services for those that could not pay and that the churches moved in to fill this void) and I questioned whether any politican (or political party) will have the balls to stand up and say this needs to change.

I totally agree with you re govt cop out on liability of catholic church for sex abuse cases (and think Woods should be at the very least jailed for this) - but if that despiciable arrangment was allowed through our govt - do you really think there would be any stomach their for pushing through a referendum to make this a truly secular state - it'd be political suicide.

Sangre · 06-10-2005 1:49pm

The Atheist wrote:

If the nearest hospital to you was owned by Jehovah's Witnesses but paid for by the state - and they refused to give you the blood transfusion that would save your life, would you still oppose secular hospitals?

Why would I oppose a secular hospital?

I just don't oppose ones with a religious ethos.

Dades · 06-10-2005 2:03pm

Sangre wrote:

Why would I oppose a secular hospital?

I just don't oppose ones with a religious ethos.

Well then allow me to rephrase:

If the nearest hospital to you was owned by Jehovah's Witnesses but paid for by the state - and they refused to give you the blood transfusion that would save your life, would you still accept hospitals run with a religious ethos?

parsi · 06-10-2005 2:17pm

"The first major problem at St Vincent’s arose 18 months ago when the committee was asked to agree that contraception should be a pre-condition for treatment. Dr Crown said he could not believe their refusal."

Is this not a right-to-choice issue - the choice being whether to use contraception or not without it being a pre-condition ?

Whats wrong with saying to people - "if you go on this trial you should not get pregnant (and its up to you to sort out how you achieve that)" rather than "if you go on this trial you must use contraceptive methods".

Sangre · 07-10-2005 4:15pm

If the nearest hospital to me was a Jehovah's witness then the area would be probably be pre-dominantly of that demonination and therefore I would probably be too so I wouldn't care.
If I wasn't that should be a consideration in moving there if there wasn't sufficient Christians to warrant such a hospital (which is never going to happen....ever)

You have to remember Doctors aren't amoral, they have beliefs aswell and I'm sure some want to work in such hospitals so there isn't any pressure to perfrom procedures that is against their faith...I'd imagine.

netwhizkid · 07-10-2005 5:59pm

I agree with you completely Mike65, Religion should have no hand, act nor part, in any decisions on science or medicine. They are so anti everything from the year 1000 on. I am sure they would let a person die (even if he/she wasn't of their faith rather than administer drugs say made from aborted foetuses (Stem Cells) for instance. They would then say it is in god's good hands. As posted earlier Jehovah's Witness' do not allow blood transfusion, This is another form of religious ethics getting in the way of standard medical practice.

Rev Hellfire · 08-10-2005 9:14am

Good point parsi.

It's also worth looking at this topic from another perspective.

The first major problem at St Vincent’s arose 18 months ago when the committee was asked to agree that contraception should be a pre-condition for treatment. Dr Crown said he could not believe their refusal.

So basically here we have a situation where the treatment is been refused on the grounds that you must use contraception. Maybe all those who are rushing to defend a persons right to free choice will explain to me how this is been done when the choice to use or not use contraception is been removed. Sounds like hypocrisy to me. I personally have no problem with contraception, but I do have a problem been told I must use it to avail of potentially lifesaving treatments.

hairyheretic · 08-10-2005 10:31am

Then shouldn't the decision be the patients? Shouldn't they be informed that there is a treatment, but there are prerequisites for it?

ArthurDent · 08-10-2005 2:43pm

Rev Hellfire wrote:

Good point parsi.

It's also worth looking at this topic from another perspective.

So basically here we have a situation where the treatment is been refused on the grounds that you must use contraception. Maybe all those who are rushing to defend a persons right to free choice will explain to me how this is been done when the choice to use or not use contraception is been removed. Sounds like hypocrisy to me. I personally have no problem with contraception, but I do have a problem been told I must use it to avail of potentially lifesaving treatments.

Why would you have a problem with being told this - if you are receiving many cancer treatments (and not only experimental ones) there are huge risks to both mother and child - in most cases agressive treatment of cancer is not compatible with fetal survival. surely if this was being presented to you the only option to you would be to prevent pregnancy (either by contraception or abstinence).

annR · 12-10-2005 4:59pm

I wouldn't like to be told I had use contraception either to avail of treatment, however I'm presuming that the clause is in there because in the past, people have gotten themselves pregnant while undergoing cancer treatment, as the doctor refers to in his quote.

This is probably their way of *ensuring* that patients do not get pregnant, before embarking on a course of treatment, as they would do with other procedures or prescriptions to increase the chances of any serious treatment or operation being a success. Can hardly blame them for that, especially if they've had to deal with that situation of a pregnant woman with cancer.

Those women probably did end up wishing they were forced to use contraception for their own good. I wonder what words the Church had for them in the end.

parsi · 12-10-2005 5:12pm

But the whole battle all down through the years has been against the fact that the Church suppsoedly tells people what to do or else.

Now we have a situation where an institution with a Catholic ethos is saying "you can't tell people to do it only this way" and they are getting hammered and told that they should make something which they don't agree with compulsory.

sheesh - damned if they do and damned when they don't. It really comes back to this whole "right-to-choice" really only means "right-to-make the choice we want to make" So much for tolerating other views and other beliefs.

This case the patients can make their own informed choice and decide whether to use contraception or indeed abstinence. The moralists whining about this have no problem with the fact that if it went ahead as propsoed then many people who had their own deep personal faith beliefs would be "bullied" into taking a step that they didn't believe in just to receive treatment. What words would Liz Mc manus and co have then ?

ArthurDent · 12-10-2005 6:37pm

parsi wrote:

This case the patients can make their own informed choice and decide whether to use contraception or indeed abstinence. The moralists whining about this have no problem with the fact that if it went ahead as propsoed then many people who had their own deep personal faith beliefs would be "bullied" into taking a step that they didn't believe in just to receive treatment. What words would Liz Mc manus and co have then ?

This is not a right to choice issue - the type of treatment discussed is known to cause catastophic effects on a feotus - end of story. An informed choice is to choose this treatment and agree not to become pregnant (either through abstience or using artificial methods of cotraception) or to choose not to have this treatment. Doctors make demands on their patients all the time ( for justifiable medical not moral reasons) - if you are to receive a liver transplant you cannot drink alcohol, if you are to receive a heart transplant you need to be medically fit to receive it. If you are going to have IVF multiple eggs will be implanted not single eggs etc. If these treatments require you to do something that you find morally unacceptable then it is up to you to choose not to have this treatment.

Victor · 12-10-2005 8:21pm

parsi wrote:

This case the patients can make their own informed choice and decide whether to use contraception or indeed abstinence. The moralists whining about this have no problem with the fact that if it went ahead as propsoed then many people who had their own deep personal faith beliefs would be "bullied" into taking a step that they didn't believe in just to receive treatment. What words would Liz Mc manus and co have then ?

I'm not quite sure on your slant here, but what the hospital owners appear to be saying is that the doctors can't even mention, never mind advocate contraception. The doctors wanted to be able to say "we recommend you use contraception, because if you get pregnant, the complications will be extreme". Its going a little too far.

ArthurDent wrote:

If you are going to have IVF multiple eggs will be implanted not single eggs etc.

Actually there are moves away from multiple implantations. Delivery costs in hospitals rise exponentially with the number of births something like:

One - €10,000
Twins - €30,000
Triplets - €100,000
Quads - €300,000

It worked out cheaper to do IVF multiple times than risk large pregnancies.

The delivery of the quads in Cork recently took 30+ staff.

Dades · 13-10-2005 9:07am

parsi wrote:

This case the patients can make their own informed choice and decide whether to use contraception or indeed abstinence.

Except the church doesn't want them informed at all.

gom · 13-10-2005 2:49pm

AndyWarhol wrote:

Rev Hellfire wrote:

No.

Surely the woman could be advised to abstain from sex, and let her decide whether contraception was appropriate based on her own moral framework?

There are numerous incidences where sexual intercourse is good for your long-term health. It carries that most (except cervical) cancers will be less likely to develop the more sexually active the woman.

Victor · 14-10-2005 3:09pm

gom wrote:

There are numerous incidences where sexual intercourse is good for your long-term health. It carries that most (except cervical) cancers will be less likely to develop the more sexually active the woman.

But! The PATIENT already HAS CANCER.

parsi · 14-10-2005 3:32pm

Victor wrote:

I'm not quite sure on your slant here, but what the hospital owners appear to be saying is that the doctors can't even mention, never mind advocate contraception. The doctors wanted to be able to say "we recommend you use contraception, because if you get pregnant, the complications will be extreme". Its going a little too far.
.

The proposal was that contraception was mandatory and not optional.

Mortmain · 14-10-2005 4:35pm

Am I wrong or is the issue arising from the fact that the Hospital is owned by the religious order. Whether or not it is funded by the Government, I'm sure the proprietors have a right to say what goes.

Personally I don't agree with it, I'm sure a righteous God wouldn't want to see anyone die over a contraceptive issue - but the alternative is that if forced, the order refuses to let the Doctors practice medicine on their premises - it'sa no win outcome.

Of couse, if this happened the state could threaten to withdraw funding - if the order refused to back down, the hospital closes - No winners again (except Mary Harney who now can commission another private vnture)

These problems arise due to the close ties forged between Church and state in the DeValera years - the State was happy for the Church to run schools and hospitals as thy were singing from the same Hynm book (literally) - now thatthings are becoming increasingly secular, the fact that the church owns most of the buildings is causing major friction. The only real solution is for the State to build and run their own Hospitals/Schools etc. and for that to happen we'll just have to pul up some seats and make sure they are verrrrrrry comfy...

parsi · 14-10-2005 7:42pm

Yes the Church run schools and hospitals were a major boon for the first Government - they had a ready-made network that probably had good credentials and wasn't tainted by any britishness. So the gov was happy to run with it after all it saved it having to provide an alternative State system at a time when money was in short supply.

[article] 'Catholic' Hospitals and Secular medicine.

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