Monday, 25 August 2014

Guestie: No Shame

By Terry Bellamak

Guest Post
It’s been a week since the MyDecision website launched. The response has been surprising and weird. The Dom asked lots of anti-abortion people for comment, though the site is not just about abortion. Most of those folks have tried to frame MyDecision as a ‘name and shame’ operation.

I find that mystifying. What exactly is shameful about having it generally known that you have taken a moral stance?

There are, however, a few possible reasons why a provider might actually feel defensive about ‘conscienciously objecting’.

First, it is impossible for a health care provider to tell a patient he or she will not provide a service on CO grounds without implying that the patient is morally inferior to the provider. That premise may have sounded reasonable back in 1977 when the law was passed, but in 2014 it’s just bizarre. Who thinks like that anymore?

Second, the way CO is applied here in New Zealand, the patient’s interest in getting care is sacrificed to the provider’s interest in leaving out the parts of their profession they find objectionable. Think about it. You make an appointment, ask for a service, the doctor tells you no. The doctor is not required to refer you to someone else, so you may have to start the process of finding a doctor and waiting for an appointment all over again, but you may be a few dollars poorer if you just paid for a consultation in which you received nothing of value. The doctor benefits but the patient pays the freight. How is that fair?

I would feel embarrassed if my exercise of conscience insulted and burdened my patients, so maybe CO health care providers feel that way too. If so, MyDecision can help. We have a page especially for providers who agree that ethical CO requires disclosure. Providers can put their names on the voluntary list, along with what services they do and do not provide. This list exists to support ethical CO providers who agree that the status quo is unfair.

Even providers who do not report themselves are not criticised. They are listed without comment. Patients need this information to avoid wasting their time and money on providers who won’t give them the services they need. I have yet to hear a convincing argument why patients should be kept in the dark about health care providers’ CO intentions.

The site’s ultimate purpose is consumer protection.

Some coverage so far:
Marlborough Express: Health Website Not 'Sinister'


Anonymous said...

Forgive me asking what you may see as a stupid question but if you are really referring to people who object to contraception or abortion on moral grounds why not name the register in a manner that cuts to the point? Calling it "reproductive health" appears to me to be a bit misleading even though you may say its not just about abortion. I'm not aware of professionals declining to treat STD's or other reproductive health illnesses on moral grounds - it seems to be all about babies and issue of when or if its OK to terminate them.

I suspect that people who object don't feel morally superior to anyone else but the fact of someone such as a professional saying "no" to a procedure on moral grounds may challenge the person seeking the procedure. I don't see a way around that - a stance on moral or ethical grounds by a professional appears to be something the parties just have to deal with.

Your list will help avoid problems by enabling early selection of professionals who don't object to what the patients want.


Terry said...

We chose ‘reproductive health’ because it’s a broad term. We did not want to limit the discussion to abortion.

Enabling early selection of doctors who provide the treatment sought is exactly the reason we created the site. Why is it fitting that a person should be challenged about the medical care they seek? Why should a patient ‘just have to deal with it’? What is so special about reproductive health care that doctors and pharmacists get an automatic pass if they don’t want to provide it?

If you have never heard of problematic treatment of STDs by the medical establishment, google ‘Tuskegee’. If you think such unethical medical treatment could not happen in NZ, google ‘Cartwright Inquiry’.