Monday, May 16, 2016

When Healthcare Providers Don’t Follow Their Code Of Ethics

I am a card carrying member of the National Association of Social Worker and as such I am required to follow their Code of Ethics. Professional organizations usually have a CoE and all medical associations do and most of them have a LGBT nondiscrimination clause in their code.

Questions arise about what happens when a state gives healthcare providers the option to violate those codes.
When Doctors Refuse to Treat LGBT Patients
A new law in Mississippi makes it legal for physicians and therapists to opt out of care on religious grounds. What does this mean for medicine?
The Atlantic
By Emma Green
April 19, 2016

Being lesbian, gay, bisexual, or transgender is not a disease. It took a long time, but nearly all medical organizations now agree that queerness is not a “sociopathic personality disturbance,” as the American Psychiatric Association once maintained.

“Nearly all” is an important caveat, though. There are still a few organizations—which most doctors and scholars would likely consider part of the fringes of medicine—that challenge this view. Some are dissenting offshoots of mainstream associations. Others are the de-fanged descendants of ex-gay-therapy groups. They’re often accused of outright bigotry, but these doctors tend to frame their dissent differently, placing an emphasis on “choice.” Patients have a right to choose a therapist who will help them with unwanted same-sex attractions or feelings of gender dysphoria, they say. And physicians and therapists have a right to choose not to provide treatments that conflict with their religious beliefs. These treatments might include sex-change operations, hormone-replacement therapy for transgender people, fertility treatments to same-sex couples, or counseling for patients who are in non-heterosexual relationships.

Some legislators agree. In the first week of April, Mississippi passed a new law making it expressly legal for doctors, psychologists, and counselors to opt out of any procedure or choose not to take on any patient if doing so would compromise their conscience. The law is specifically designed to protect medical professionals who object to gay marriage and non-marital sex. Tennessee’s general assembly just passed a similar law, which would only apply to counselors, and a now-dead Florida bill would have protected religious health-care organizations from having to “administer, recommend, or deliver a medical treatment or procedure that would be contrary to the religious or moral convictions or policies of the facility.”
In Massachusetts a doctor lost his privilege at a hospital because he spoke out against the hospital support of a Gay pride parade,
Paul Church is an evangelical Christian who attends services at a Congregationalist church in Massachusetts. He’s a urologist—a surgical specialty focusing on pelvic, urinary-tract, and male reproductive disorders—and has been practicing as a staff doctor and affiliate of various Boston hospitals for nearly three decades. He even had a joint appointment as an assistant clinical professor at Harvard Medical School. After coming into conflict with staff over statements he made about homosexuality, he lost his privileges at two area hospitals, effectively ending his ability to perform surgeries.
He said that as a doctor he had,
Church framed his objections to homosexuality in moral and religious terms, but he also argued that he has a medical obligation to talk with gay patients, for example, about the risks associated with men having sex with other men. “We are supposed to counsel patients about self-destructive habits like smoking and overeating,” he said, “but we’re not supposed to place any judgment on behaviors that involve these sexual practices, for fear that we’ll be accused of being discriminatory or bigoted.”
Yes, it is true but the talk should be about safe sex and not about being LGBT and that is where I think he was wrong. It is not about being LGBT; it is not their sexual preferences that put them at risk but having unsafe sex.

I said most “most of them have a LGBT nondiscrimination clause in their code” because,
Church resigned his membership in the AMA based on its positions on LGBT issues. He’s now involved with an organization called the Alliance for Therapeutic Choice and Scientific Integrity, a former gay-conversion-therapy group known as NARTH that reconstituted itself in 2014. A long-time member of its board, Michelle Cretella, is also the president of the American College of Pediatricians, a group that broke off from the American Academy of Pediatrics in 2002 in protest of the organization’s support of adoption by same-sex couples. These groups are part of a small network of medical-professional associations that have formed largely in opposition to mainstream groups like the AMA. They say, like the Mississippi legislature, that physicians should have the choice to not participate in a procedure that violates their conscience.
So they totally disregard their Hippocratic Oath that they took upon graduating from medical school.
I swear to fulfill, to the best of my ability and judgment, this covenant:...
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

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