Doctors vs. Doctrine: Where Does Religion End and Medicine Begin?

[cbayer]

http://www.huffingtonpost.com/patricia-miller/doctors-vs-doctrine-where-does-religion-end-and-medicine-begin_b_6424364.html

Patricia Miller
Patricia Miller is the author of Good Catholics: The Battle Over Abortion in the Catholic Church.

Doctors vs. Doctrine: Where Does Religion End and Medicine Begin?

Posted: 01/07/2015 3:01 pm EST Updated: 01/07/2015 3:59 pm EST

Thanks to the debate over the "contraceptive mandate" in the Affordable Care Act, which requires health insurance policies to cover prescription birth control at no cost, it's not a secret that many Catholic institutions and employers object to providing contraceptives. A key point of their "conscience" objection to providing contraceptives is that they aren't medically necessary and are easily available elsewhere.

But what about types of reproductive health care where that isn't the case? What if a service to which the Catholic Church objects is necessarily for a woman's health and well-being and she can't easily get it elsewhere? In that case, where does the right of conscience leave off and the responsibility of Catholic institutions to provide women with medically appropriate care begin?

As I recently reported in The Atlantic, a new study of doctors working at Catholic hospitals finds that they have serious concerns about the denial of medically indicated contraceptive sterilization to women who are already having C-sections. Catholic hospitals technically aren't allowed to provide tubal ligations--which is the technical term for tube-tying--under the rules that govern Catholic hospitals. But it's been common practice for many hospitals to provide the procedure if a woman's health would be threatened by another pregnancy and she is already having a C-section. That's because it's not in the woman's best interests medically speaking to put her through another surgery at a later date when the sterilization can easily be done at the same time as the C-section.

The doctors interviewed say the denial of medically indicated sterilizations put women at "a risk of harm" and violates the standard of care. "[If] someone who's had four C-sections before has to have another operation to get her tubes tied, that's not what's in her best interest by any stretch of the imagination," said one doctor who was interviewed for the study.

more at link

[cleanhippie]

1. Religion ends where Medical Science begins.

[trotsky]

2. When someone once tried to point out how bad this was...

and that the RCC should not be in the business of buying up hospitals and dictating what procedures were available, you accused them of "proposing genocide."

Are you concerned now? Perhaps you should apologize to that person for such an outrageous accusation.

[edhopper]

3. Maybe underlying beliefs

can do harm.
And maybe we should confront those beliefs.
Maybe?

[cbayer]

4. The fact is that liberals and progressives

challenge those beliefs all the time, including some people here with profound religious beliefs.

And as the article shows, religious people within the medical community, including those in catholic institutions, are also challenging it.

So I'm not sure what your point is.

[edhopper]

16. I agree that they do

but some here, and I won't name who, says that we should only challenge actions and not beliefs.

That's my point.

[cbayer]

17. Feel free to name names, but I ask that you be accurate when "quoting" me.

I do take the position that beliefs are personal and should not be subjected to attack up to the point that they result in actions that impinge on the rights of others.

Clearly there is action in the situation being discussed and those beliefs have real impact on others.

My distinction has always been clear and it is simply cbayer meme #112 that you are mouthing here. It's a distortion based on a caricature.

That's my point.

[edhopper]

18. But I think

the beliefs need to be challenged, not just the actions.

[cbayer]

19. I realize that is what you think, and this is where we fundamentally disagree.

You want to challenge people's personal beliefs even when they have no effect on anyone. And my take on why this is so is that you think they are someone damaged or wrong or stupid or unenlightened or, at the very least, need someone (you) to save them.

This would be the equivalent of a fundamentalist challenging your lack of beliefs just because. They might even feel they were doing you a great service.

It's proselytizing and it's hogwash, whoever is doing it.

[edhopper]

20. Well

I rarely see beliefs having no impact on anyone or anything.

Once made public, beliefs have an effect.

If I open it for discussion, I have no problem defending my atheism.

[cbayer]

21. Well

that's because when they don't have an impact, you are unlikey to see them.

You should not have to defend your atheism, but if you impose it on others, then you are open to challenge.

The same is true of religious beliefs, but you think you have some reason to challenge them even when they impact nothing.

Most believers and non-believers are private unless asked. But there are billions out there waiting to be saved. Just ask them.

[edhopper]

22. I am talking about open public discussions like this

I don't go door to door and ask people if they have found atheism.

[cbayer]

23. That's fine, but you have taken he position that you should

challenge people's beliefs whether they are spoken or unspoken or whether they result in some detrimental action or not.

And then you pervert my position into saying that people's religious beliefs should never be challenged, which couldn't be further from my actual position.

Why is that?

[trotsky]

25. It is true that you don't think beliefs should ever be challenged.

"UNLESS" they are acted upon.

But that means you think we shouldn't challenge the belief that drawing Mohammed is wrong (and deserves punishment) until someone acts on that belief and harms someone. I.e., you think the cartoons shouldn't have been drawn. Because simply drawing them challenges the belief. Do you see how that works?

I don't know if you have me on ignore today or not but this is a fatal flaw in your position.

[edhopper]

27. How can I challenge unspoken beliefs?

I wouldn't know what they are if unspoken.

Don't you say challenge the actions, not the beliefs?

[cbayer]

30. Exactly my point. You take the position that beliefs should be challenged.

I take the position that actions should be challenged. If beliefs underlie those actions, then they are fair game.

Your position is different because you see some nefarious, lurking actions behind beliefs even when none are in evidence.

If a person believes that abortion is wrong and chooses not to have an abortion but never tries to impose their belief on anyone else, why would think you have a right to challenge that? That's what choice is all about, right?

[edhopper]

31. I don't think

I would challenge someone who said that.

[cbayer]

33. Then perhaps we make the same distinction. Actions that impose

one's beliefs on others or cause harm to others should be challenged.

[edhopper]

35. yes

but I would also challenge the underlying beliefs.

[cbayer]

36. I think we agree on that as well.

If their underlying beliefs lead to actions that cause harm, then that is exactly what should be challenged.

I love it when we reach common ground.

Now stop saying that I don't think beliefs should ever be challenged. Leave that to those who don't have the character that you do.

[edhopper]

41. Will do

[cbayer]

42. We are two wild and crazy guys!

[rug]

24. Why?

[edhopper]

26. I feel certain beliefs

lead to harm and challenging those beliefs can bring about change.

[rug]

29. Whence the need?

[edhopper]

32. I'll restate

I feel that certain beliefs should be challenged along with the actions.

[AtheistCrusader]

5. There's one hospital in the Seattle area that hasn't been acquired by the Catholic Church.

Either outright acquired, or joint operating partnerships, and it's affecting the types of care offered by the hospitals.


But hey, there's lots of 7-11's nearby, so we're good, right?

[trotsky]

6. "But hey, there's lots of 7-11's nearby, so we're good, right?"

Yup, all good.

[AtheistCrusader]

7. Oh holy shit, I had the quote wrong!

My bad.

[Warren Stupidity]

14. Does a 7-11 actually sell condoms?

I can't actually remember the last time I was in a 7-11, but that store is just about the last place I would go in search of birth control.

[AtheistCrusader]

15. Actually it does.

I thought I couldn't find that post because it was hidden. Different post. I couldn't find it because I kept searching for 7-11.

Or were there two? He is fond of doubling down.

[rug]

8. This is a really interesting post.

Bioethics is an important subject, regardless of the sources of the ethics.

[cbayer]

9. And bioethics in religiously run hospitals are even more interesting

than normal.

When I was affiliated with catholic hospitals, we were always finding ways to work around problems that doctrine presented when it came into conflict with good medical practice.

It's been done forever, but we always had the alternative of moving a patient to another facility if we had to.

With the growth of catholic hospitals, that is becoming a tougher issue in some communities.

[rug]

10. I was thinking also of entirely nonreligious bioethics, such as transhumanism.

[cbayer]

11. I don't know much about transhumanism, but that would be a

fascinating bioethical discussion at a purely academic level at this point. Most of what goes on at the hospital level is much more mundane, but still one of the most challenging parts of hospital work.

[rug]

12. And, consciously or not, it permeates a hospital's daily routine.

When I help someone prepare an advance health care directive it's impossible to anticipate every scenario. I sympathize with the medical staff, following their own ethical imperatives, trying to determine both a patient's wishes and who can express them.

[cbayer]

13. You are absolutely right - it is impossible to anticipate every scenario.

Then there are the family members that surface unexpectedly, issues around the estate, questions about competency at the time the documents were drawn up, and on and on.

I have a lot of respect for the health care workers on the front lines that have to make hard decisions in an instant…

and very little for the medical liability lawyers who are advertising for clients on daytime tv.

[Leontius]

46. The issue is simple hospitals are a part of the community they provide a public service

whether they are for profit, non-profit, religious institution owned or not, private owned or publicly owned they should be held to the standard that they provide all services to all the people of the community without any restrictions.

[cbayer]

47. It is far from that simple.

Hospitals can not be expected to provide all services to all people without restrictions. This is just not possible. Certain services are highly specialized and can not be supported. Some hospitals have financial issues that prevent them from providing certain services. There are regulations and oversight rules that can't be met by some facilities and they can not provide those services.

There are community hospitals that have been funded by bonds in which restrictions were a part of the deal, including restrictions regarding abortion services.

As I said below, we will hopefully have a single supplier in the US someday and this will not longer be an issue. But the "simple" solution you suggest is a pipe dream.

[immoderate]

28. Religion centered medicine is wrong.

We should not be so primitive as to favor religious dogma over medical efficacy.

--imm

[cbayer]

34. I think you will find no disagreement there, but

the relationship is not always so clear.

[immoderate]

37. I can't envision where that relationship wouldn't be clear.

Doctors apply medical procedures to patients. Religion is there to inform us if the deity is pleased or offended by the action. It requires some divination and maybe revelation. Those are not medical procedures.

--imm

[cbayer]

38. The organizations that oversee the accreditation of hospitals and medical practitioners

in the US would never permit religion to override medical "efficacy".

But medicine is highly complex and there are very important factors to take into account, including a patient's religious beliefs. And "efficacy" can be a difficult term to precisely define.

The problem here is that the catholic church is acquiring more and more health care facilities, and that creates problems with access, particularly when it comes to reproductive services.

The health care providers, their professional organizations and the accrediting agencies need to take a hard stand here, and I am hopeful that they will.

[immoderate]

39. Word games aside. The wishes of religious institutions should not supersede those of patients.

Can hospitals that deny access to abortions and birth control be accredited?

--imm

[cbayer]

40. Word games? Why resort to insults? Did I insult you?

Yes, hospitals are not required to perform any particular services. They might not have a pediatrics program or a psychiatric unit. They might not have an emergency room, which rules out all kinds of services. They may not do obstetrics at all, and they do not have to provide for abortions or birth control. This is the standard and it recently came in to the limelight because the ACA mandates that certain things be covered by insurance, including birth control.

Now the issue becomes much more complex when an emergency arises. If someone needs an emergency abortion in order to save the life of the mother or prevent irreparable damage, then the obligation to provide that service or provide for transfer to a facility that can supersedes.

Birth control is generally not an emergency, but there are some medical conditions that require the use of medications that might otherwise be used for birth control. This presents a more complex situation.

In addition, as religious hospitals become predominant in an area, a patient's choices become much more limited, and that is clearly very problematic.

These are issues that need to be addressed and I am hopeful that courts will carefully consider the medical implications when making their decisions.

[immoderate]

44. I chose not to argue about what "efficacy" means.

And I still can't see any circumstance where religious beliefs would promote or enhance efficacy. It can interfere with efficacy, as you point out. Are there hospitals that don't do surgery? How do they decide what kinds of surgery are "efficacious?" Should they consider what would please the lord?

I don't see any difficulty with the definition.


--imm

[cbayer]

45. I have never said that religious beliefs promote or enhance

medical efficacy.

There are hospitals that don't do surgery. There are hospitals that only do some kinds of surgery.

Economics play a hugely greater role in a hospitals decisions about these things than religion generally does.

You may not see any difficulty with the decision because these are processes you are not familiar with. Efficacy has to do with achieving a result, but what determines what that result should be is highly complex.

There are many factors that go into the decisions made by hospitals about what they will and will not provide. Those may include the philosophy or religion of whoever owns the hospital, but that would only be one of many. You would probably object to many of them, particularly for the for profits, where religion doesn't play any role at all.

All of this will go away if we get a single payer and bet rid of privately owned facilities.

[Warren Stupidity]

43. wait - you've supported exorcism in the past.

because you know "placebo" and such.