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greytone · 11-10-2004, 06:06 PM

OK, it is time for me to step into it. I am a physician an I have no moral problem with contraception. However, I have absolutely no doubt as a biologist and as a physician that an embryo and later a fetus is maintaing homeostasis and is undergoing cellular reproduction. I am also convinced that at no point will it change species. The point is, leaving religion out of the thought process, but objectively looking at professional ethic, taking any action to avoid pregnancy after conception is not something I am willing to do as a physician. More importantly, no one can force me to.

When oral contraceptives where introduced they worked by preventing ovulation. In other words, they did allow for conception to occur. Over the years, the hormone dosages have been cut the least effective dose. This is important to reduce the risk of side effects. Eventually we came to realize that even though these doses were preventing pregancy, they were not preventing ovulation. Ovulation frequently does occur, but the homonal effects of the newer pills causes changes in the endometrium that does not allow for implantation. While I understand that many of you will disagree with me (and I respect that) this leads me to conclude that precsribing oral contraceptives is the moral equivalence of performing an abortion. There are many nuances that are worthy of discussion but are not relevent to this thread.

I now refuse to write scripts for the Pill. I know that there are other reasons to take it, but because I don't write for it most of the time, I don't keep up with all the changes. These women benefit from seeing ther gynecologists anyway, so just refer them anyway. I have never made a women feel uncomfortable about using the Pill and I only explain why I don't if a patient really pushes the issue.

I may loose patients because of this. I don't think that has had any real effect, but it is possible. I also understand that, as an employee, the organization that owns my practice could choose to terminate me for this.

I came to this conclusion after I spent eleven years in training and had several years of experience in practice. I work hard and I think I am an above average primary care physician. My patients seem to think I am providing a valuable service for them. Do some of you really believe that the government should make it illegal for me to continue in my current practice and find another career?

For the record, I think CVS should force this pharmacist to fill the prescription. She is not in a position to know the reasons the patient is taking it. That is between the doctor and the patient. CVS carries the drug. If the pharmacist owns her own pharmacy and is willing to take the financial hit of not carrying a given drug or class of drugs, she should be free to do so. But it is clear that CVS has not made that choice, and the pharmacist should follow company policy.

11-10-2004, 06:06 PM	#28 (permalink)
greytone Junkie	OK, it is time for me to step into it. I am a physician an I have no moral problem with contraception. However, I have absolutely no doubt as a biologist and as a physician that an embryo and later a fetus is maintaing homeostasis and is undergoing cellular reproduction. I am also convinced that at no point will it change species. The point is, leaving religion out of the thought process, but objectively looking at professional ethic, taking any action to avoid pregnancy after conception is not something I am willing to do as a physician. More importantly, no one can force me to. When oral contraceptives where introduced they worked by preventing ovulation. In other words, they did allow for conception to occur. Over the years, the hormone dosages have been cut the least effective dose. This is important to reduce the risk of side effects. Eventually we came to realize that even though these doses were preventing pregancy, they were not preventing ovulation. Ovulation frequently does occur, but the homonal effects of the newer pills causes changes in the endometrium that does not allow for implantation. While I understand that many of you will disagree with me (and I respect that) this leads me to conclude that precsribing oral contraceptives is the moral equivalence of performing an abortion. There are many nuances that are worthy of discussion but are not relevent to this thread. I now refuse to write scripts for the Pill. I know that there are other reasons to take it, but because I don't write for it most of the time, I don't keep up with all the changes. These women benefit from seeing ther gynecologists anyway, so just refer them anyway. I have never made a women feel uncomfortable about using the Pill and I only explain why I don't if a patient really pushes the issue. I may loose patients because of this. I don't think that has had any real effect, but it is possible. I also understand that, as an employee, the organization that owns my practice could choose to terminate me for this. I came to this conclusion after I spent eleven years in training and had several years of experience in practice. I work hard and I think I am an above average primary care physician. My patients seem to think I am providing a valuable service for them. Do some of you really believe that the government should make it illegal for me to continue in my current practice and find another career? For the record, I think CVS should force this pharmacist to fill the prescription. She is not in a position to know the reasons the patient is taking it. That is between the doctor and the patient. CVS carries the drug. If the pharmacist owns her own pharmacy and is willing to take the financial hit of not carrying a given drug or class of drugs, she should be free to do so. But it is clear that CVS has not made that choice, and the pharmacist should follow company policy. __________________ I was there to see beautiful naked women. So was everybody else. It's a common failing. Robert A Heinlein in "They Do It With Mirrors"