Abortion Discussion, Part Trois

ohnonotgmail wrote: »

so you want to tag all the GPs that do participate? Because we all know how that will end up. If certain doctors are conscientious objectors to abortion they should have no problem making that public knowledge.

Every time I hear the term "opt-in scheme", I get visions of red letters daubed on surgery walls, baying mobs of protesters outside, and No-siders with pursed lips -- the better to try to conceal a self-satisfied smirk -- saying "I told you all along it would play into the hands of The Abortion Industry(TM)!"

(And yes, an 'opt-in scheme' is indeed what both the government and the GPs' association are currently saying.)

ohnonotgmail wrote: »

so you want to tag all the GPs that do participate? Because we all know how that will end up. If certain doctors are conscientious objectors to abortion they should have no problem making that public knowledge.

they may face the exact same problems it's feared gps who do provide the service would face, if they were listed instead.

end of the road wrote: »

ohnonotgmail wrote: »

so you want to tag all the GPs that do participate? Because we all know how that will end up. If certain doctors are conscientious objectors to abortion they should have no problem making that public knowledge.

they may face the exact same problems it's feared gps who do provide the service would face, if they were listed instead.

You spent a chunk of yesterday defending the rights of people to harrass gps and patients where the service is available so bringing up this fear for GPs who don't provide is rank hypocrisy.

Also the pro-choice campaign engaged in nothing like that kind of behaviour during the referendum campaign so stop projecting.

Calina wrote: »

You spent a chunk of yesterday defending the rights of people to harrass gps and patients where the service is available

no i did not. i defended people's right to protest. nothing more. i also stated that if they caused actual problems during their protests the gardai already have the facility to deal with them, as they have done so to anyone who caused problems during any protest.

Calina wrote: »

Also the pro-choice campaign engaged in nothing like that kind of behaviour during the referendum campaign.

the pro-life campaign as a whole didn't engage in anything like that kind of behaviour either. a small minority of them did as did a small minority of the yes campaign. you only need to look at parts of this site where a small minority of yes voters engaged in abusing, twisting of what no voters said and more. thankfully a vast majority of yes voters don't want to be associated with that minority as the majority on the pro-life side don't want anything to do with the minority of trouble makers on their side of the debate.

ohnonotgmail wrote: »

You mean protests by the opposite side designed to intimidate and harass?

doctors who provide the service wouldn't receive such protests in my view. they might receive the odd anti-abortion protester but intimidation and harassment are unlikely.
it's doctors who don't provide the service who would be more likely to receive protests designed to intimidate and harass in my view. even then that would only be from a very very tiny minority who nobody would want anything to do with anyway.

end of the road wrote: »

the pro-life campaign as a whole didn't engage in anything like that kind of behaviour either. a small minority of them did as did a small minority of the yes campaign. you only need to look at parts of this site where a small minority of yes voters engaged in abusing, twisting of what no voters said and more.

You need only look at this site, right enough. This clumsy pivot from the well-documented shameful antics of No, to attempting to portray yourself as the Silent Majority of the, as it turns out, fairly small No minority, would be pretty jaw-dropping. Were it not simply standard fare by this point.

Cabaal wrote: »

I suppose no side never used the term murder and neither did you... Which you claimed was the case.

that's correct yes

Cabaal wrote: »

Of course we know your claim was false, much like so many stuff from the no side during this ref.

we don't as it wasn't false. nothing the no side stated was false. the no side were truthful and factual throughout the campaign.

end of the road wrote: »

that's correct yes



we don't as it wasn't false. nothing the no side stated was false. the no side were truthful and factual throughout the campaign.

Apart from all the claims that you yourself refused to provide any evidence for!
Allllllllll truthful of course

Loafing Oaf wrote: »

Seriously? You envisage pro-choice protestors turning up with placards outside the surgeries of conscientious objector GPs?

oh absolutely i believe it's a possibility. i would never rule out such happening.

nozzferrahhtoo wrote: »

Just because something is the easiest solution, does not mean it should be the sole solution. It also does not mean it is a good solution.

For example why stop there? Why single out the topic of abortion? Why not list every other service each doctor does or does not do? That would be an interesting database to build, even if it could be maintained in on ongoing basis.

Further your solution is 2 dimensional and does not actually consider the patient. Just because there is one service that a persons doctor does not perform, that does not automatically mean they will want to pick another one from the list. They might still want to go to their own doctor to consider options, the general state of their health, and all the other factors that might go into the decision to abort or not abort. They might then trust their own doctor to offer a referral in a more competent and informed way than merely picking a name of a HSE list.

The patient will be perfectly free to go to her own GP for advice/consultation if she wishes. And a GP who is not willing to provide the procedure will be perfectly free to refer to another GP who does. Nobody is suggesting that this should be forbidden. The question is whether it should be compelled.

If it is to be compelled, then there has to be a database of GPs who provide the service, for how else are GPs who don't provide it to know those who do? But if such a database exists, why should patients not be able to consult it directly, if they wish to, thus avoiding the time, expense, inconvenience and possible embarrassment of consulting a GP who may have a conscientious objection to abortion? And if patients can consult it directly, where is the need to compel GPs who have a conscientious objection to doing so to consult the database and relay the information in it to the patient face-to-face? I remain unclear as to what problem is sought to be solved by compelling the participation of conscientious objectors.

Obviously women in need of abortions should have ready access to information about where they can get it. Equally obviously, a system for disseminating this information which relies on compelling the participation of people who have a conscientious objection to participating is not a good system. It has an elevated risk of not working smoothly, or well, or reliably; it involves compelling reluctant encounters that can only be at best embarrassing for both parties; it is burdensome to the consciences of at least some people. In what world is this considered to be a good system? And in what world do pro-choice advocates favour a sub-standard system to serve women in need of abortions?

I have to say that I don’t buy the distinction between providing a surgical abortion and writing a prescription for a pharmaceutical abortion. In both cases you are using your medical expertise/experience/qualifications to assist in bringing about the same outcome. If somebody has an objection to the outcome, it’s the outcome they object to; not the methods used to achieve it. I find it hard to say that we should accommodate their objection in one case, but not in the other.

In this case, of course, we’re talking not about either performing a surgical abortion or writing a script for a pharmaceutical abortion, but simply about referring someone to a practitioner who will do one or other of these things. Still, people who have a conscientious objection to those things are quite likely also to have a conscientious objection to the referral, so we have to work out what to do about it.

I take your point about the practical issues that arise out of maintaining a database. (Although those practical issues don’t seem to have prevented the HSE from maintaining its current publicly-available database of health facilities, and if anyone has sued them for, e.g., having a listing for a dental practice that had in fact closed, I haven’t read about it.)

But the practical issues arise either way. We need a database that patients can consult or we need a database that objecting GPs can consult but, either way, we need a database. We just have to deal with the practical issues.

And I completely get that a woman contemplating an abortion wants more than just a name and address; she wants to be able to consider her options; to understand what an abortion involves; to look at all this in the light of her own medical history/condition, etc.

Still, I can’t get around the fact that she’d probably rather be getting this from a GP who was willing to offer the service, who didn’t have a conscientious objection, and who she wouldn’t have reason to suspect might be judging her adversely for raising the issue. (Not that I am suggesting that an objecting GP would necessarily make such a judgment. But you can see how the woman involved might worry about that.) So I see the database as a gateway to the services - the full range of services, not just the actual abortion - that women require, not an alternative to the services.

Women should be able to find a GP practice or other facility that is abortion-friendly, so to speak. They shouldn’t have to negotiate their way there via their own GP, if they don’t choose to. And they especially shouldn’t have to negotiate their way there via a GP who they fear is opposed to what they want to do.

The way I see it working, any woman who cares to can check the database to see whether her usual or nearest GP practice provides abortion services. If it does, grand. If not, she can go there anyway, if she wants to seek their advice, or (more likely) she can go directly to another GP practice which indicates that it provides the services.

But, once you put in place a system whereby women can do this, the argument for saying that it’s necessary to impose an obligation on GPs to refer them looks very thin. Why would we compel somebody to do something they find conscientiously objectionable when we’ve already taken steps to ensure that they don’t need to do it for women’s needs to be met?

nozzferrahhtoo wrote: »

. . . As for having to "negotiate their way there via their own GP"..... I do not think people HAVE To do this. But many people WANT to do it. As I said to AntiSkeptic above many people want their own GP as a first port of call. Not merely for a referal, but quite often we the public are too ignorant to even know what questions to ask on a given subject. And many of us trust our own GP. So we WANT, not need or have to, go to our own GP to break things down for us, arm us with the knowledge we need to move forward.... or even just the questions we need to go to the next doctor armed with to get that knowledge.......... and we trust our GP to do that. I honestly do not care if my own GP offers, or even wants to offer, a given thing. I just care that if I need that given thing, and I need the first step knowledge on the road to getting that thing........ I trust him to start me on that path rather than my first step being to start a dialog from the outset with a complete stranger.

And that's fine. Nobody is suggesting that you should be prevented from consulting your own GP, from seeking treatment by him, or from seeking his recommendation as to where else you might obtain treatment. Nor is there any suggestion that the GP should be prevented from offering you advice, treatment or referrals.

The issue is whether he should be obliged to assist you in bringing about an outcome who which he has a conscientious objection. And while I appreciate that you may not analyse the ethics of the situation in terms of outcomes, it's his conscientious problem we are addressing, not yours. If he has a problem with the outcome, and an objection to assisting with it, the fact that in his situation you wouldn't have the same problem is not really relevant.

Well yes of course it is their problem we are addressing, not mine. I never suggested otherwise. But I am discussing whether we should be allowing or pandering to that at all. Should their problem be relevant? And if so when and why?

I do not think it should be about "outcomes" in many cases. I think it is about a doctor being licensed and mandated to mediate access to knowledge and drugs. And their job should be to apply that knowledge and expertise to evaluate A) the drug and the patient in order to say A) the drug is applicable and the drug is safe for the given patient to take.

So it is not about whether I evaluate it in terms of outcomes, but me questioning if AND why we as a society should be evaluating it in those terms.

What about creationist teachers for example. Their job is to apply the curriculum and teach it. Their conscientious objection to the material OR the outcome of students leaving school believing the facts of evolution should have nothing to do with it. Their job is to be a mediation point between the knowledge, and the target of that knowledge. Issues with the outcomes be damned.

But it is not a non-medical need.

The patient is about to take a drug. They need the doctors expertise on what that drug is, what it does, how it works, and what conditions can it exacerbate or cause. They need the doctors expertise to evaluate their own medical state in terms of allergies, medical conditions. They need the doctors expertise on the influence this new drug can have on or with existing drugs.

The entire process is a medical need, and the doctors role to my mind should be to mediate access to drugs not on the basis of mere outcomes, but on the basis of applying their licensed expertise on evaluating the drug, the patient, and the effect of one on the other.

Peregrinus wrote: »

A doctor who prescribes does more than simply mediate access to drugs, in the sense of confirming that they are safe for the patient to take.

Did I not include that explicitly in what I was writing numerous times? I only ask because the way your sentence comes across is as if you were adding something or correcting something in what I wrote.

Peregrinus wrote: »

By prescribing a drug, a doctor positively recommends the patient to take it, and furthermore does so precisely because of the outcome that taking the drug is expected to have.

And I think that narrative is your own and not a real one. I do not think it includes a recommendation to take it really, and certainly not in every case.

What I think a prescription should be seen as is solely as a doctor saying, in their professional opinion, that the drug does do what the patients requires to do or thinks that it does, and the drug is in fact safe for the patient to take.

And as such what is required of the doctor here is not to partake in anything, but solely to apply their knowledge in an evaluation. And as such moral objection is not something I have much sympathy for.

We live in a society that has decided access to a drug should only be done through a doctor. And I agree with this. But I do not think the doctors personal morality should be any more part of that than, as I said in an earlier post, a teachers moral opinion should come into teaching evolution in a science class.

But certainly describing it as "not a medical need" when the patients wants and needs a medical opinion on a drug, it's effects, and it's safety to take..... is an error on description.