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religious veiws in medicine

 
 
Reply Sat 15 Jul, 2017 06:54 pm
Young registrar in O&G is ordered by his supervisor to conduct sterilization on patients request. The registrar refuses on the ground of his church beliefs. The senior doctor is threatening the registrar of removing him from training in O&G if he does not do sterilization.
Is it ethical for the registrar to say no? and why?
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Type: Question • Score: 1 • Views: 599 • Replies: 3
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tibbleinparadise
 
  2  
Reply Sat 15 Jul, 2017 07:43 pm
@Jackson Baru Remel,
If the patient is requesting the procedure, the doctor or nurses ethical concerns are a moot point. They are there to provide the care that the patient is seeking. So long as that care is legal and appropriate the staffs primary concern should be serving those needs in a professional and caring manner.
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centrox
 
  2  
Reply Sun 16 Jul, 2017 02:05 am
The aforesaid doctor would be wise to consult not only his or her conscience or church, but also his or her contract of employment, relevant legislation, and any guidance offered by the medical registration body which allows him or her to practise. Doctors need to know this stuff as much as they need to study anatomy and physiology!

The British General Medical Council, which registers doctors and can de-register them, offers this guidance:

Quote:
About this guidance

1. In Good medical practice we say:

15. You must provide a good standard of practice and care. If you assess, diagnose or treat patients, you must:

a. adequately assess the patient’s conditions, taking account of their history (including the symptoms and psychological, spiritual, social and cultural factors), their views and values; where necessary, examine the patient

b. promptly provide or arrange suitable advice, investigations or treatment where necessary

c. refer a patient to another practitioner when this serves the patient’s needs.

48. You must treat patients fairly and with respect whatever their life choices and beliefs.

52. You must explain to patients if you have a conscientious objection to a particular procedure. You must tell them about their right to see another doctor and make sure they have enough information to exercise that right. In providing this information you must not imply or express disapproval of the patient’s lifestyle, choices or beliefs. If it is not practical for a patient to arrange to see another doctor, you must make sure that arrangements are made for another suitably qualified colleague to take over your role.

54. You must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress.

57. The investigations or treatment you provide or arrange must be based on the assessment you and your patient make of their needs and priorities, and on your clinical judgement about the likely effectiveness of the treatment options. You must not refuse or delay treatment because you believe that a patient’s actions or lifestyle have contributed to their condition.

59. You must not unfairly discriminate against patients or colleagues by allowing your personal views to affect your professional relationships or the treatment you provide or arrange...

2. In this guidance, we explain how doctors can put these principles into practice. Serious or persistent failure to follow this guidance will put your registration at risk.

Personal beliefs and values in medical practice

3. We recognise that personal beliefs and cultural practices are central to the lives of doctors and patients, and that all doctors have personal values that affect their day-to-day practice. We don’t wish to prevent doctors from practising in line with their beliefs and values, as long as they also follow the guidance in Good medical practice. Neither do we wish to prevent patients from receiving care that is consistent with, or meets the requirements of, their beliefs and values.

4. Doctors may practise medicine in accordance with their beliefs, provided that they act in accordance with relevant legislation and:

do not treat patients unfairly
do not deny patients access to appropriate medical treatment or services
do not cause patients distress.

If any of these circumstances is likely to arise, we expect doctors to provide effective patient care, advice or support in line with Good medical practice, whatever their personal beliefs.

Legal issues

5. As Good medical practice makes clear, doctors must keep up to date with and follow the law relevant to their work. For example, the Equality Act 2010 and parallel legislation in Northern Ireland prohibit doctors from discriminating, directly or indirectly, against others, or from harassing them, on grounds of a protected characteristic, when they provide medical services. In addition, some legislation:

a. specifically entitles doctors to exercise a conscientious objection to providing certain treatments or procedures

b. allows or prohibits particular treatments or procedures.

6. The law does not require doctors to provide treatments or procedures that they have assessed as not being clinically appropriate or not of overall benefit to the patient.

7. The legal annex provides information about some relevant legislation. You should seek legal advice if you are unsure whether, by exercising a conscientious objection, you are contravening the law in the country where you work.

Conscientious objection

8. You may choose to opt out of providing a particular procedure because of your personal beliefs and values, as long as this does not result in direct or indirect discrimination against, or harassment of, individual patients or groups of patients. This means you must not refuse to treat a particular patient or group of patients because of your personal beliefs or views about them. And you must not refuse to treat the health consequences of lifestyle choices to which you object because of your beliefs.

9. Employing and contracting bodies are entitled to require doctors to fulfil contractual requirements7 that may restrict doctors’ freedom to work in accordance with their conscience. This is a matter between doctors and their employing or contracting bodies.

10. If, having taken account of your legal and ethical obligations, you wish to exercise a conscientious objection to particular services or procedures, you must do your best to make sure that patients who may consult you about it are aware of your objection in advance. You can do this by making sure that any printed material about your practice and the services you provide explains if there are any services you will not normally provide because of a conscientious objection.

11. You should also be open with employers, partners or colleagues about your conscientious objection. You should explore with them how you can practise in accordance with your beliefs without compromising patient care and without overburdening colleagues.

12. Patients have a right to information about their condition and the options open to them. If you have a conscientious objection to a treatment or procedure that may be clinically appropriate for the patient, you must do the following.

a. Tell the patient that you do not provide the particular treatment or procedure, being careful not to cause distress. You may wish to mention the reason for your objection, but you must be careful not to imply any judgement of the patient.

b. Tell the patient that they have a right to discuss their condition and the options for treatment (including the option that you object to) with another practitioner who does not hold the same objection as you and can advise them about the treatment or procedure you object to.

c. Make sure that the patient has enough information to arrange to see another doctor who does not hold the same objection as you.

13. If it’s not practical for a patient to arrange to see another doctor, you must make sure that arrangements are made – without delay – for another suitably qualified colleague to advise, treat or refer the patient. You must bear in mind the patient’s vulnerability and act promptly to make sure they are not denied appropriate treatment or services. If the patient has a disability, you should make reasonable adjustments8 to your practice to allow them to receive care to meet their needs. In emergencies, you must not refuse to provide treatment necessary to save the life of, or prevent serious deterioration in the health of, a person because the treatment conflicts with your personal beliefs.

14. You will not necessarily need to end a consultation with your patient because you have an objection to a treatment or procedure that may be appropriate for them. However, if you feel (or the patient feels) that your conscientious objection prevents you from making an objective assessment, you should suggest again that the patient seeks advice and treatment elsewhere.

15. You must not obstruct patients from accessing services or leave them with nowhere to turn.

16. Whatever your personal beliefs about the procedure in question, you must be respectful of the patient’s dignity and views.
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kk4mds
 
  2  
Reply Sun 16 Jul, 2017 01:46 pm
If your religious beliefs prevent you from properly doing your job, find another job, one that does not conflict with your beliefs.
0 Replies
 
 

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