Letters to the Editor - Nov. 17, 2008

Doctor-patient relationship goes both ways when judgment is at issue

Regarding "Case pits anti-bias laws against doctors' rights" (Column, Oct. 13): I respect my patient's rights, but I expect them to respect mine as well. A doctor-patient relationship goes both ways.

My fellow physicians and I frequently sacrifice our time to provide the best medical care for our patients. But I do not tolerate mistreatment of my staff and fellow workers. If a patient is abusive verbally or physically, he is terminated from our clinic.

As a physician, I am also put in a judgment role. I must discern if a patient asking for narcotics is truly in pain or wants them to sell or abuse. I do prescribe pain medications, but am careful whom I give them to -- not only for my own conscience, but to keep my license to practice medicine.

I wholeheartedly agree that a doctor should not be "forced" to do a procedure that is against his or her religious beliefs. I believe the physicians at the North Coast Women's Medical Care Group made the right choice to refer a patient to another group.

I volunteer my time to do ultrasounds along with counselors to encourage pregnant women to deliver healthy babies and consider adoption if they do not want to raise a child. If a patient wants an abortion, I refer her to another physician. As a medical student I had long discussions with an OB resident who tried to belittle my faith. He and I saw a patient in the ER who had been raped, and he gave her the equivalent of a "morning after" pill without telling her what she took. I had concerns that if the patient were pregnant and believed differently than the resident, she may feel guilty when she learned what she took. At least the choice should have been hers to make.

This resident described himself as a "non-devout Catholic" and did not think a physician could be trained properly as an obstetrician if he or she did not do tubal sterilizations. I know thousands of patients and physicians in Catholic hospitals who would differ with him in that belief.

I guess my point is that as a physician, I am human. I make mistakes and misjudgments, but to have a relationship with a patient, especially one that requires a very personal procedure such as an in vitro fertilization, I would have to make a judgment call before doing the procedure -- for both her health and the health of the potential patient in her womb.

Does she have a support system through the pregnancy and for raising the child? Is she a drug abuser or does she have multiple STDs? Lots of other questions must be answered, of course, but a single woman without any support is in for a surprise when she learns how much work these precious babies are to grow and raise. I see lots of depressed single mothers already that have experienced a "sperm-donor-only" father.

Several physicians I know have given up performing in vitro fertilization because of the fear they would be sued by a patient who they did not agree should have the procedure. I suppose this case proves those doctors made a good decision. An elective procedure like this is not "lifesaving," but many couples have benefited from it. It saddens me that for those who could benefit from it, it is less accessible now because those trained to do the procedure may no longer perform them for fear of litigation.

--Laura Satcher, MD, Huntsville, Ala.

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