Some years ago I filled out a prescription for Yasmin, a birth control pill that is often prescribed, as in my case, to control acne for young women. Luckily the warning label scared me enough that I ended up throwing those pills in the garbage. I felt a bit foolish but followed my gut against the assurances of my doctor, who considered those pills the equivalent of Tylenol.
If we strip our doctors of their conscience in order to do our bidding, we’ll be chasing away the very doctors who might protect us most.
He was wrong. Yasmin made headlines last year when it was linked, together with another birth control pill, to the deaths of 23 women in Canada. This February the European Medicines Agency also admitted that the blood clot risks of Yasmin and similar newer birth control pills are much greater than previously thought.
The EMA’s statement came on the heels of a French report showing that about 20 French women per year died between 2000 and 2011 as a result of fatal blood clots from such ‘third-generation’ pills. All British physicians have now been ordered to warn their patients about the potentially fatal risk of blood clots associated with these pills.
But all this is apparently not enough. Nor is it enough that the World Health Organization has classified oral contraceptives as “carcinogenic to humans.”
It may never be enough for certain people, like Konrad Yakabuski of The Globe and Mail who recently criticized three Ottawa doctors for refusing to prescribe or refer for artificial contraception, saying: “The safety and effectiveness of popular government-approved contraceptives is not generally considered a matter of ‘medical judgment’ these days.”
Tell that to the families of the women who died on Yasmin, Mr. Yakabuski. The truth is, scientists are still studying the risks associated with our methods of artificial birth control, and the drugs that are legal and seemingly safe today might be history tomorrow.
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Family doctors are often the first ones to see the red flags, and they should be free to stick to their medical judgements. After my Yasmin scare, I want doctors like that – doctors who haven’t been silenced by fear of feminist backlash, who dare to refuse to pump dangerous chemicals into my body. Such doctors might make me think twice about asking for that chemical cocktail, and they could save my life.
But medical judgement is not the only good reason why doctors might refuse to prescribe or refer. We should never require doctors to participate in treatments that would leave them feeling like they (sometimes quite literally) just killed a baby.
Why would we want to crush and destroy the spirit of our doctors by forcing them to cooperate with what they believe to be deeply wrong?
Here's why: because the technical abilities of medicine have outgrown the moral limits of most world religions, and many people now feel entitled to treatments that their doctors might find abhorrent.
So the College of Physicians and Surgeons of Ontario is reviewing their policy on the freedom of doctors to refuse to provide or refer for treatments that violate their deepest moral and religious convictions.
Are we willing to make doctors into mere robots who won’t be allowed to question, much less refuse, our ethically precarious requests? Some people argue that since doctors work on the public dime, they should be like medical vending machines that dispense any legal service on demand.
But if we strip our doctors of their conscience in order to do our bidding, here’s the price we pay. First, expect an exodus of principled doctors from the profession. We’ll be chasing away the very doctors who might protect us most, those who are willing to take a stand against bad medicine. Not to mention that practising Christians, among others, will effectively be barred from applying to medical schools.
Second, we will be left with doctors who are either willing to do things they consider unethical, or who have few ethical limits to begin with. I get creepy visions of the darkest moments of history repeating, as we find one day that nothing remains to protect us from those same doctors when we are weak and vulnerable.
With euthanasia knocking on Ontario’s door from neighbouring Quebec, now would be a good time to think about how personal ethics and integrity should be valued, not discouraged in our physicians.
The deadline for public input on the CPSO review is August 5, 2014. To add your comment to the public consultation, go here.
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