Author Topic: Survey: Doctors' personal beliefs can hinder care
Kimball_Kinnison 
Registered: Oct '01
6249_Veers
Date Posted: 8/6/07 11:09am Subject: RE: Survey: Doctors' personal beliefs can hinder care
DeathStar1977 posted:
But as you know this isn't absolute. A business needs a state license (or some variance) to operate, and must operate under those laws. What I (and others) seem to be saying is that part of what should be required for a pharmacy to obtain/sustain a license would be that all legit prescriptions should be filled. Yes, there is freedom of religion, but there isn't freedom to pick and choose what job you want. One has to fulfill the qualifications and obligations that are required by the employer AND as required under law.
Except, even that isn't absolute. Not all pharmacies carry every drug. Some drugs are requested far too frequently, or have too short of a shelf life to keep in stock, and so they either have to be ordered or have the patient sent elsewhere.

And notice something that you said there: "[P]art of what should be required for a pharmacy to obtain/sustain a license". There's even significant wiggle room in that to allow for quite a bit of compromise. For example, it could require simply that the pharmacy have alternate arrangements available. That doesn't force the pharmacy to require its pharmacists to dispense the prescription, but it does make sure that the business is responsible for making sure that the patient has access to it. Under that sort of thing, a pharmacy could have a policy allowing some of its pharmacists to pass off such prescriptions to a coworker.

There is a big difference between placing such a requirement on a business and placing it onto an individual.

Finally, what does that have to do with emergency contraceptives? Plan B is OTC, which means that it doesn't require a prescription to get it. Would you require pharmacies to carry every OTC medication? What if they don't face enough demand for "Plan B" at the pharmacy to warrant carrying a product costing $41.99 per unit (using Master_Sweetpea's earlier quoted price)? Many stores have stopped carrying pseudoephedrine because the cost of compliance with the newer laws relating to it made it less profitable. Would you require them to start carrying those OTC drugs as well as a requirement of their license?

In addition to that, if you are going to require them to carry all of those drugs (which greatly increases their overhead), are you also going to give them financial aid when they face going bankrupt because of the additional costs? Or will you institute price controls when they have to raise prices to cover the increased overhead? (After all, if you increase the price, you will reduce the accessibility to the drug.) Remember, the pharmacies most likely to be affected by such demands are the smaller, mom-and-pop stores, not the big corporate chains.

Or are you instead going to admit that as it applies to the emergency contraceptives (the main thrust of this issue), it is almost purely ideology driven?

DeathStar1977 posted:
Anyway, I'm kinda surprised that the change in laws regarding abortion clinics in Missouri generated such little discussion.
Probably because it would fit better in the Abortion thread, which has also been bumped recently. While the two threads are related, they aren't the same topic.

Kimball Kinnison

 

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SkyeLightrider 
Registered: Jan '03
41993_Tyber Zann
Date Posted: 8/6/07 11:18am Subject: RE: Survey: Doctors' personal beliefs can hinder care
DeathStar1977 posted:

Anyway, I'm kinda surprised that the change in laws regarding abortion clinics in Missouri generated such little discussion. For a change of pace, I thought I'd repost it:

Mo. tightens abortion clinic regulations

By DAVID A. LIEB, Associated Press Writer Fri Jul 6, 6:05 PM ET
JEFFERSON CITY, Mo. - Missouri abortion providers will face new regulations for their clinics and new restrictions on teaching sex education classes under a bill Gov. Matt Blunt signed into law Friday.


The measure places more abortion clinics under government oversight by classifying them as ambulatory surgical centers. Planned Parenthood has said the law could force it to spend up to $2 million to remodel one of its clinics and halt medical abortions at another site.

The law also bars people affiliated with abortion providers from teaching or supplying materials for public school sex education courses, and it allows schools to offer abstinence-only programs.

Blunt proclaimed the law "one of the strongest pieces of pro-life legislation in Missouri history" as he spoke from a cross-shaped lectern during a signing ceremony in the sanctuary of Concord Baptist Church.

The Republican governor said he has no qualms if the stricter state oversight causes hardships for abortion clinics.

"I say if they can't meet the same basic requirements that other (medical) providers do, then they should shut down," Blunt said.

Missouri Right to Life, which backed the measure, argued that groups like Planned Parenthood have a conflict of interest in supplying sex education materials because they could make money if female students go to their clinics. Blunt echoed that concern, saying sales of material to public schools were a "significant source of revenue" for the group.

Planned Parenthood said it provides sex education materials to schools for free and its staff members who teach sexual health and education lessons in 41 Missouri schools are trained not to discuss abortions. An official with Planned Parenthood, which has several staffers who visit public schools, called the profiteering assertion "political propaganda."

"Essentially, what Governor Blunt and the Legislature is doing is saying that teens need to be protected from information, not from sexually transmitted infections or unintended pregnancies," said Peter Brownlie, chief executive officer of Planned Parenthood of Kansas and Mid-Missouri.

The state already licenses facilities that get at least half of their revenue or patients from abortions. Only one, a Planned Parenthood clinic in St. Louis, falls under that licensing requirement.

The Department of Health and Senior Services said the new law would require three other clinics to be licensed. The department didn't identify them, but Planned Parenthood said its offices in Columbia and Kansas City would be affected.

The organization is considering a legal challenge.




Couple of questions/comments:

1. It says the abortion clinics are reclassified into "ambulatory surgical centers" which based on the terminology is technically corrent. My question is what was the previous classification and what are the differences?

2. I understand the whole "banning of abortion providers from teaching safe-sex practices." An abortion clinic teaching safe-sex with emphasis on abortion is like Nicorette teaching kids to not smoke by offering their gum. It could pertain a conflict of interests, depending on how the material is sent to kids. If the emphasis is first and foremost prevention (condoms, pill, etc.) rather than correction (abortion) then I have no problem with it. Planned Parenthood, by my understanding, does try to teach their clients in a prevention first manner, however, as evidenced by the material sent to schools free of charge and the non-mentioning of abortions in the classes.

Having said that...

Wow, this is agenda pushing at the other extreme. C'mon, signing the bill in front of a church on a podium shaped like a cross? Hello! Talk about not being subtle. Also as stated both in the article and my analysis, Planned Parenthood isn't saying "get pregnant then have abortions to make us money!", it's trying to keep kids informed.

Still... it did get passed into law, so I suppose it's what the state wants. I guess Missouri is more pro-life than other states. The governor doesn't have to be a smug jerk about it though. In any case, forcing absolute one ideology over the other is wrong.

 

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DeathStar1977 
Registered: Jan '03
7850_Luke Skywalker
Date Posted: 8/6/07 12:25pm Subject: RE: Survey: Doctors' personal beliefs can hinder care - Date Edited: 8/6/07 12:26pm (1 edits total) Edited By: DeathStar1977
Except, even that isn't absolute. Not all pharmacies carry every drug. Some drugs are requested far too frequently, or have too short of a shelf life to keep in stock, and so they either have to be ordered or have the patient sent elsewhere.

Inventory issues are different than whether or not a legit prescription should be filled based on whether or not the pharmacist deems it moral.

And notice something that you said there: "[P]art of what should be required for a pharmacy to obtain/sustain a license". There's even significant wiggle room in that to allow for quite a bit of compromise. For example, it could require simply that the pharmacy have alternate arrangements available.

Of course there ‘could be compromise’. To be clear (or perhaps you missed my point mischief ), I am voicing my opinion as to what the requirement should be, not that it is the only opinion/option out there.

But again, I don’t see the need to compromise when it is not necessary. After all, if someone stole my bike, I don’t think the compromise is that we should share it. mischief tongue

Regarding OTCs and inventory and such…I think malkie and/or V03 addressed this, but it is an issue to be honest I haven't really thought much about. What, if any, are the current laws?

Or are you instead going to admit that as it applies to the emergency contraceptives (the main thrust of this issue), it is almost purely ideology driven?

Me? No. I’ve made it clear that my opinion is that legit prescriptions should be filled (from insulin to contraceptives).

But the ‘ideology’ accusation has been addressed several times as well…what some consider reproductive health, others consider ‘ideology’…what some consider freedom of religion, others would consider ideological. I gave my view a few pages back.

And I think the Missouri Law would be good here, for a number of reasons, not the least of which new ground would be covered.

SL

The answer to #1 is that I believe the reclassification means there are now different staffing and equipment requirements. V03 will hopefully magically appear and explain it to us.

I think most clinics that provide abortion services also provide a variety of reproductive services. I have no problem with them distributing information regarding reproductive health, nor would I have a problem with someone distributing information regarding abstinence, provided all information was factually accurate.

Wow, this is agenda pushing at the other extreme. C'mon, signing the bill in front of a church on a podium shaped like a cross?

Ya think? wink happy

Still... it did get passed into law, so I suppose it's what the state wants. I guess Missouri is more pro-life than other states. The governor doesn't have to be a smug jerk about it though.

Agreed. Its really an end-around abortion laws. Rather than confronting the issue directly, they are using other, sneakier methods to end abortion rights.

But my guess is that this is legal. I would guess that if the state changes the rules/requirements of an abortion clinic, that they can do so, as long is it doesn’t violate federal law yes?

 

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SkyeLightrider 
Registered: Jan '03
41993_Tyber Zann
Date Posted: 8/6/07 2:13pm Subject: RE: Survey: Doctors' personal beliefs can hinder care
DeathStar1977 posted:
SL
The answer to #1 is that I believe the reclassification means there are now different staffing and equipment requirements. V03 will hopefully magically appear and explain it to us.

I think most clinics that provide abortion services also provide a variety of reproductive services. I have no problem with them distributing information regarding reproductive health, nor would I have a problem with someone distributing information regarding abstinence, provided all information was factually accurate.

Wow, this is agenda pushing at the other extreme. C'mon, signing the bill in front of a church on a podium shaped like a cross?

Ya think? wink happy

Still... it did get passed into law, so I suppose it's what the state wants. I guess Missouri is more pro-life than other states. The governor doesn't have to be a smug jerk about it though.

Agreed. Its really an end-around abortion laws. Rather than confronting the issue directly, they are using other, sneakier methods to end abortion rights.

But my guess is that this is legal. I would guess that if the state changes the rules/requirements of an abortion clinic, that they can do so, as long is it doesn’t violate federal law yes?



Okay, well I'll wait for information on how the classifications have changed the business operations. I also agree with you regarding the distribution of material regarding sexual protection, so long as it was truthful and the advocation of abortion wasn't a part of it (because then it would be a conflict of interests in the form of really terrible "advertising"), which Planned Parenthood assures it isn't. Good for them.

We also both seem to agree that as long as federal law is not violated, the state retains the right to change the law regarding these clinics and it is legal.

Now, here's where it gets sticky.

You and I both agree that this law in Missouri is the state's attempt to put pressure on the current federal abortion laws (but so far doesn't appear to eliminate the fundamental right to an abortion), and we both agree it's policy pushing based on an agenda (in this case fundie religious right). We both seem to agree that it is wrong.

How then, may I ask, that forcing pharmacies to carry OTC drugs of post-sexual contraceptive purpose only (as in there is no law forcing every drug, just the contraceptive ones) not be construed as laws pushed by the liberal pro-choice left? Thus doing so, how is this not just as wrong as the Missouri governor's agenda?

I think that was Kimball's arguement.

 

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DeathStar1977 
Registered: Jan '03
7850_Luke Skywalker
Date Posted: 8/6/07 2:45pm Subject: RE: Survey: Doctors' personal beliefs can hinder care - Date Edited: 8/6/07 2:46pm (1 edits total) Edited By: DeathStar1977
In terms of pushing an agenda? I agree, both are pushing an agenda, an ideology, trying to get their way…however one wants to phrase it.

 

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malkieD2 
Title: EuroMod™-JCC - FFUK-RSA Emeritus
Registered: Jun '02
6241_R2-D2
Date Posted: 8/7/07 12:33am Subject: RE: Survey: Doctors' personal beliefs can hinder care
Kimball_Kinnison posted:
malkieD2 posted:
..............................at the expense of healthcare for the patient, which is unacceptable. It doesn't matter than a referral can be obtained.
You position is at the expense of a free society, which is unacceptable. It doesn't matter that the patient would be temporarily inconvenienced.

See? Two can play that game.

Kimball Kinnison


but we don't live in a free society, but we do live in a society where best healthcare possible is a number one priority.

 

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Kimball_Kinnison 
Registered: Oct '01
6249_Veers
Date Posted: 8/7/07 2:32am Subject: RE: Survey: Doctors' personal beliefs can hinder care
malkieD2 posted:
Kimball_Kinnison posted:
malkieD2 posted:
..............................at the expense of healthcare for the patient, which is unacceptable. It doesn't matter than a referral can be obtained.
You position is at the expense of a free society, which is unacceptable. It doesn't matter that the patient would be temporarily inconvenienced.

See? Two can play that game.

Kimball Kinnison


but we don't live in a free society, but we do live in a society where best healthcare possible is a number one priority.
Wow. Just wow.

Last I checked, the purpose of government was to secure the rights and liberties of its citizens, not to provide the best healthcare possible.

Of course, since you don't think we live in a free society, I guess you don't care about any of your civil liberties anymore. As long as you get the "best healthcare possible", they don't matter, right?

Kimball Kinnison

 

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Jedi_Keiran_Halcyon 
Registered: Dec '00
17824_Kieran Halcyon
Date Posted: 8/7/07 3:12am Subject: RE: Survey: Doctors' personal beliefs can hinder care
Kimball_Kinnison posted:
Once more, let's use my death row example. It's not allowed to force organ donation from condemned prisoners in the US or the UK. In fact, in places where that is done, it is looked down upon as being highly unethical. Why is that? After all, it saves lives, and the prisoners are being executed, so they don't need those organs anymore.

The answer is simple. Because the harm to society in violating the rights of those prisoners if far greater than the benefit that comes from fixing the physical health of a few patients. That's why the Allies destroyed much of the medical data collected by Nazi doctors in the various concentration camps. The unethical means used to produce that data taints it, and makes any further use of it contributory to the crimes against humanity that spawned it.


Out of curiosity, does anyone know whether or not scientists in the former Allied nations have used the sites of Hiroshima and Nagasaki to study the effects of nuclear radiation?

Shouldn't the pyramids be destroyed and no longer studied by historians and archaeologists, since they were undoubtedly built by slaves?


BUT,

How's this for a solution?

Create a licensing requirement for all pharmacies to have a stated policy on these prescriptions. If you will not fill such prescriptions, you will not be hired by pharmacies that have a policy of filling them. However, even if you work at a pharmacy that will not fill such prescriptions, you still must give a referral to a pharmacy that will. And a provision should exist requiring at least one pharmacy within x number of miles to have a policy of filling these prescriptions, to ensure that anyone in need of it has reasonable time to get their prescription and use it.

Then let the market sort things out.

 

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malkieD2 
Title: EuroMod™-JCC - FFUK-RSA Emeritus
Registered: Jun '02
6241_R2-D2
Date Posted: 8/7/07 4:01am Subject: RE: Survey: Doctors' personal beliefs can hinder care
Kimball_Kinnison posted:
malkieD2 posted:
Kimball_Kinnison posted:
[quote=malkieD2]..............................at the expense of healthcare for the patient, which is unacceptable. It doesn't matter than a referral can be obtained.
You position is at the expense of a free society, which is unacceptable. It doesn't matter that the patient would be temporarily inconvenienced.

See? Two can play that game.

Kimball Kinnison


but we don't live in a free society, but we do live in a society where best healthcare possible is a number one priority.
Wow. Just wow.

Last I checked, the purpose of government was to secure the rights and liberties of its citizens, not to provide the best healthcare possible.

Of course, since you don't think we live in a free society, I guess you don't care about any of your civil liberties anymore. As long as you get the "best healthcare possible", they don't matter, right?

Kimball Kinnison[/quote]

we're governed by laws and rulings; we don't live in a free society

 

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Kimball_Kinnison 
Registered: Oct '01
6249_Veers
Date Posted: 8/7/07 4:27am Subject: RE: Survey: Doctors' personal beliefs can hinder care
malkieD2 posted:
we're governed by laws and rulings; we don't live in a free society
malkie, you are either a lot dumber than you've claimed to be, or you are intentionally missing the point.

Go read pretty much any political philosophy used to build up the British and US systems of government. The existence of laws and rulings in and of itself does not make it so we don't live in a free society. A free society is one in which the basic rights of all people are secured against infringement. The purpose of government is to secure those rights for its citizens.

You find that throughout the writings of Locke, Jefferson, Burke, and many others.

The absence of laws and rulings to govern society is anarchy, which may or may not lead to a free society (it depends on the people within the society). Laws don't necessarily infringe on rights. For example, a law against assault isn't an infringement of anyone's rights because your right to swing your fist ends at my face. Therefore, while laws and rulings can infringe upon rights, the existence of them does not prove that we do not live in a free society.

Yes, a perfect free society is impossible because humans are imperfect, but the purpose of government is still to get as close to a free society as humanly possible. Because the purpose of government is to secure the rights and liberties of its citizens, any action that the government takes should be targeted at minimizing the infringement on rights.

Therefore, even if we were to accept every single one of your claims about the purpose of healthcare, that still would not justify using the government to enforce your view, because such actions would be a violation of the purpose of government (at least as much as you claim that refusing to dispense a prescription is a violation of the purpose of healthcare).

Kimball Kinnison

 

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Kimball_Kinnison 
Registered: Oct '01
6249_Veers
Date Posted: 8/7/07 4:34am Subject: RE: Survey: Doctors' personal beliefs can hinder care
Jedi_Keiran_Halcyon posted:
Out of curiosity, does anyone know whether or not scientists in the former Allied nations have used the sites of Hiroshima and Nagasaki to study the effects of nuclear radiation?
There's a difference between studying the effects of Hiroshima and Nagasaki and using the Nazi medical data.

Hiroshima and Nagasaki were not done for the purpose of gathering medical data on nuclear radiation. The Nazi medical experiments were done for the express purpose of medical experimentation.

That does make a big difference in the ethics of the situation.

Kimball Kinnison

 

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malkieD2 
Title: EuroMod™-JCC - FFUK-RSA Emeritus
Registered: Jun '02
6241_R2-D2
Date Posted: 8/7/07 5:17am Subject: RE: Survey: Doctors' personal beliefs can hinder care
KK posted:
malkie, you are either a lot dumber than you've claimed to be, or you are intentionally missing the point.

Go read pretty much any political philosophy used to build up the British and US systems of government.


Can you highlight where I've ever claimed to be an expert on either politics or philosophy ? (I'm not conceeding your point, just trying to get you to justify your "you are dumb" comment)

KK posted:
Therefore, while laws and rulings can infringe upon rights, the existence of them does not prove that we do not live in a free society.


I completely disagree. The government quiet clearly controls many aspects of our lives and impose a multitude of laws, rules and policies. As such, we are not free to make any choice that we wish to make.

KK posted:
even if we were to accept every single one of your claims about the purpose of healthcare, that still would not justify using the government to enforce your view, because such actions would be a violation of the purpose of government


But the goverment already does this in healthcare, and a whole host of other services.

 

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Kimball_Kinnison 
Registered: Oct '01
6249_Veers
Date Posted: 8/7/07 5:27am Subject: RE: Survey: Doctors' personal beliefs can hinder care
malkieD2 posted:
I completely disagree. The government quiet clearly controls many aspects of our lives and impose a multitude of laws, rules and policies. As such, we are not free to make any choice that we wish to make.
Since you have shown a fondness for quoting yourself, let me repeat what I said:
Kimball_Kinnison posted:
Yes, a perfect free society is impossible because humans are imperfect, but the purpose of government is still to get as close to a free society as humanly possible. Because the purpose of government is to secure the rights and liberties of its citizens, any action that the government takes should be targeted at minimizing the infringement on rights.
Just because we don't live in a perfect free society today doesn't make it appropriate for the government to take a step farther away from a perfect free society by increasing its infringement of civil rights, as you are advocating.

The purpose of government is to protect the rights of its citizens, not to infringe them. Just because you can point to places where the government has failed in its purpose in the past doesn't justify advocating continued or increased failure in that purpose today or in the future.

Kimball Kinnison

 

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malkieD2 
Title: EuroMod™-JCC - FFUK-RSA Emeritus
Registered: Jun '02
6241_R2-D2
Date Posted: 8/7/07 6:33am Subject: RE: Survey: Doctors' personal beliefs can hinder care
malkieD2 posted:
Can you highlight where I've ever claimed to be an expert on either politics or philosophy ? (I'm not conceeding your point, just trying to get you to justify your "you are dumb" comment)

 

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Kimball_Kinnison 
Registered: Oct '01
6249_Veers
Date Posted: 8/7/07 6:55am Subject: RE: Survey: Doctors' personal beliefs can hinder care
malkieD2 posted:
malkieD2 posted:
Can you highlight where I've ever claimed to be an expert on either politics or philosophy ? (I'm not conceeding your point, just trying to get you to justify your "you are dumb" comment)

Considering I didn't call you dumb, there's no need to answer that.

I said either you are dumber than you have claimed to be, or you were intentionally missing the point. Seeing as you haven't claimed to be dumb, that leaves the implication that you were specifically missing the point, as you just did once more.

I take it that you simply don't have a response on my point about how your position goes against the purpose of government, and so even if your were 100% right about your positions within the field of healthcare, you still would not be justified in using the government to enforce it. Thank you for conceding the point.

Unless, of course, you'd actually like to address the points that I've made.

Kimball Kinnison

 

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