willowisp: (Angry)
[personal profile] willowisp
Any woman who uses birth control (especially those who, like me, need to do so for medical conditions), or anyone who believes his female friends/relatives/SOs have the right to do so, should read this article. Maybe I should demand that they underwrite the hysterectomy I will need if I end up unable to get pills around here.

Date: 2004-07-01 08:08 pm (UTC)
From: [identity profile] aardvarklf.livejournal.com
The line that says it all: "Imagine a pharmacist asking a customer whether his Viagra prescription is to enhance sexual performance in his marriage or in an extramarital affair. Never!"

I've also heard that some insurance companies refuse to cover the Pill, claiming it's some kind of luxury treatment, but have no problem paying for Viagra.

Date: 2004-07-01 08:32 pm (UTC)
From: [identity profile] willowisp.livejournal.com
IIRC, and [livejournal.com profile] callicrates can probably give actual dates and timelines, Japan held up approving birth control on the order of decades, but approved Viagra more in the order of weeks. They definitely approved Viagra before birth control, though.

Date: 2004-07-02 08:31 pm (UTC)
From: [identity profile] tyee.livejournal.com
That's definitely true. Although the flip side is that some of those companies that used to refuse to cover the pill if you didn't need it for a medical condition other than contraception now cover it because of the outcry over them covering viagra and not the pill. While I'm infuriated that the companies didn't cover it to begin with, I'm at least gratified that occasionally irony works out in a positive way.

Date: 2004-07-01 08:12 pm (UTC)
From: [identity profile] dnabre.livejournal.com
Luckily in New Mexico at least (as with 33 other states) health care providers are legally obligated to provide it, and health insurers are required to cover it the same as any other prescription.

Interesting article though.

Date: 2004-07-01 08:13 pm (UTC)
From: [identity profile] dnabre.livejournal.com
Oh, though individual doctors and pharmists can deny it, which never made sense in terms of such laws.

Date: 2004-07-01 10:45 pm (UTC)
From: [identity profile] echoweaver.livejournal.com
Yes, you can always pick a different doctor or pharmacist, which is definitely annoying. If I were burned by this, I would definitely ask my next doctor up front about his/her opinions on birth control.

An unrelated thing that seriously pissed me off a couple of months ago -- I'm on blood pressure medication, and I briefly had a doctor who I never saw, and who later decided I wasn't actually her patient. She changed my medication. So, when I get a new doctor, he says, "You know this stuff you're taking causes birth defects?" Not can cause but causes. I'm a 28-year-old married woman, and someone thought it was a good idea to prescribe me a medication that definitely causes birth defects??? Without even asking me my fertility status? That goes to the pharmacist too. DAMN.

Date: 2004-07-03 09:20 pm (UTC)
From: [identity profile] turnberryknkn.livejournal.com
Something most of the anti-abortion community has yet to fully get a grip on is that, very shortly, abortion will become utterly unbannable. There is no law in the world that could possibly stop women from taking completely legal, over-the-counter drugs in the proper combination to cause an at-home abortion, and those drugs are imminent. Very shortly, the entire process from pregnancy testing to abortion can and will happen completely in private.

The most vocal and active portion of the anti-abortion community --dare say, even the rank and file-- have essentially wasted thirty years on a useless fight. Banning abortion didn't cause fewer abortions then, and all their efforts are soon to be rendered by technology utterly ineffective. There has always been, and always will be, only one real way to reduce abortions --and that is by creating a society where there is enough support for preganant mothers that abortion no longer needs to be a seriously considered option. That takes social programs. That takes major societal reforms. That's *hard*, a heck of a lot harder than the holier-than-thou most anti-abortion activists feel perfectly happy doing. But it's also the only way.

Did I miss the topic?

Date: 2004-07-06 02:50 pm (UTC)
From: [identity profile] batzel.livejournal.com
Did I miss a topic change? We're not talking about banning abortion in this thread, we're talking about doctors and pharmacists not wanting to prescribe drugs which, in their opinion, have a serious potential side-effect (specifically, death of a human, since they believe that life begins at conception(fertilization)).

How about this question instead: Should these medical professionals be put in a situation where they have to either violate their moral beliefs or they have to lose their career? Is that reasonable?

And this isn't the last time it'll come up. What about euthanasia? Will doctors be required to prescribe meds for that? Should they be required to quit their career if society approves of it and they believe it wrong? The situation is coming.

This is just the other side of the 'You shouldn't write laws that don't allow me to do what I want and make me do what you want' coin -- 'You should write laws to make the doctors do what I want, not what they want.'

So give the doctors a break. They're trying to follow their beliefs. Don't try to force them to follow yours. We can yell back and forth, or we can find acceptable alternatives. I suggest the search for alternatives.

Re: Did I miss the topic?

Date: 2004-07-06 04:01 pm (UTC)
From: [identity profile] turnberryknkn.livejournal.com
Sincere apologies --I skipped ahead a few levels in my discussion, forgetting that not everyone is as familiar with my own views as [livejournal.com profile] willowisp is. To backtrack a bit: the issue you raise --the border between personal ethics and professional duties-- is a very good and important one, one my own experiences cause me to agree are critically important. I was a medical student member of the Michigan State Medical Society's House of Delegates during the contentious and explosive debates regarding attempting to craft a stand on Euthanasia and a response to Michigan's ballot initiative to that effect. I've been humbled to have had a tiny part to play in many other similar ethical questions in my involvement with other medical activist issues. And in a few months, upon the completion of my PhD and my return to medical school, I intend to exercise my right of conscience, granted by federal and state law, regarding refusing to participate in abortions as part of my Ob/Gyn training as a third year medical student. Your questions are very important ones, something my own experiences and service cause me to agree with you on.

As I saw it, the specific issue here does tie directly into the abortion question. The reason why physicans and pharmacists are refusing to perscribe birth control pills is because they can terminate life --in essence cause abortions, and they oppose this. I can understand this viewpoint, as at the root of a fairly complex constellation of personal positions around this issue, I fundamentally believe abortion is the termination of life, and is wrong. (To swiftly thumbnail and for brevity's sake overgeneralize highlights of my opinions on abortion: I also think laws attempting to ban abortion are counter-productive, that saving the life of the mother is a legitimate justification for abortion, and that it is our responsibility as those opposed to abortion to make, in our personal lives and in our goverment policy choices, decisions that encourage options other than abortion.)

However, unlike the specific act of surgical termination of pregnancy, birth control pills --perhaps more accurately described as hormonal supplements-- do have specific, widely-accepted medical uses besides preventing or terminating pregnancy, which is what [livejournal.com profile] willowisp was referring to, I think. Furthermore, the decision by some pharmacists and some physicans to elect to not provide those pills in many underserved medical areas effectively eliminates access to those medications. In essence, physicians and pharmacists, by choosing to refuse to provide birth control pills because they can be used for abortions, are also making difficult to get those exact same pills for use in non-abortion purposes. And that is a very difficult and complex problem. An analogous situation would be physicans and pharmacists refusing to provide pain-killers because they could be used for euthanasia, and in doing so making access to painkillers extremely difficult.

This is an intensely complex problem, one activists in many of the circles I've had the privelege of serving in have wrestled with, and one without good answers. As a committed Christian and a physican in training, the challenges you point out are very real to me. I have been a part of very heated debates arising from the fact that what constitutes right and wrong --what constitutes ethical behavior-- is an extremely varied and spread question in our diverse culture. I do believe that there are absolutes in right and wrong. The challenge of merging that with my duties as defined by law is a difficult problem, as you point out. As is trying to build public policy that reflects those problems. In this case, the challenge of practitioners who believe the risks and moral peril of perscribing oral contraceptives outweighs the benefits of their non-contraceptive use, vs. the patients who believe otherwise and because of lack of medical access can't get them. Who should win? Damned hard question.

Re: Did I miss the topic?

Date: 2004-07-06 04:17 pm (UTC)
From: [identity profile] turnberryknkn.livejournal.com
Which is what I was trying to get at in my original post --what I saw as the futility and the harm of this particular tactic to try to reduce the number of abortions --a goal I entirely support, even if I think the means are a net harm. A practitioner could ask his patients whether they want to use oral contraceptives for abortificent purposes or other purposes and only perscribe to the latter --but my guess as to why practitioners go for total bans is because they feel --and logically so-- that it would be too easy for patients to simply claim the latter and then use the pills for the former, and thus the only truly guaranteed way to make sure it doesn't happen is to give no pills at all. Except this ends up harming the patients who *do* need the pills for non-contraceptive purposes --and on top of that is ultimately, in my opinion, a losing battle. Technology will allow *over-the-counter* methods of using drugs approved and used for other purposes to be combined appropriately to terminate a pregancy. At which point the whole issue will be moot.

My contention is that in order to reduce the number of abortions, measures that simply make abortions harder to get are ultimately ineffective for a constellation of reasons; the way to save babies is to make changes to society that cause pregnant women to choose for themselves to carry babies to term rather than aborting them. That's what we who oppose abortions I think needed --and need-- to concentrate on, I think. Because our goal is to save babies. And we can't do that effectively by bans and boycotts, and especially when those boycotts can reduce access to virtual inaccessibilty and thus hurt women who don't want to have anything to do with abortion at all.

It's a disorganized ramble of thoughts, I apologize; it's a tough subject, and I appreciate your forbearance and understanding.

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