Tuesday, February 09, 2010

Since they won't let it go...

As I've already noted, and other bloggers are noticing, the abortion lobby just isn't able to let go of the Tebow Superbowl ad. Ostensibly, their concern is that other women might be inspired by Pam Tebow to reject their doctor's advice to submit to unwanted abortions, and that some of those women might not be as lucky as Pam was.

As Hakeem the Bunny Muncher would say, "Well, if you insist!" (Long story. If you're interested, ask me.)

Let's look at this idea of abortions to save the mother's life.

First of all, they're exceedingly rare. As far back as 1960, Planned Parenthood Medical Director Mary Calderone wrote "[M]edically speaking, that is, from the point of view of diseases of the various systems, cardiac, genitourinary, and so on, it is hardly ever necessary today to consider the life of a mother as threatened by a pregnancy." Dr. Alan Guttmacher, another former leader of Planned Parenthood, said in 1967, "Today it is possible for almost any patient to be brought through pregnancy alive, unless she suffers from a fatal illness such as cancer or leukemia, and if so, abortion would be unlikely to prolong, much less save life."

With the advances that have been made in medicine since then, how much more true are Calderone's and Guttmacher's observations?

But what about those rare cases? I searched for conditions in which the prescribed treatment is abortion, and I've not been able to find any. Here's what I have found:

This Spanish study of women with lupus during pregnancy found no maternal deaths, and of the 8 patients who had "therapeutic" abortions, six of them requested the abortions themselves, and two had abortions performed because their treatment medications were presumed to have harmed the fetuses. None of them was aborted as a live-preserving measure for the mother.

The research these doctors in the UK did is worth noting. I'll bold the particularly important parts:

Between 1967 and 1990, only 151 abortions have been carried out to save the mother's life, a figure amounting to 0.004% of all abortions.

In 1992, a group of Ireland's top gynaecologists wrote: "We affirm that there are no medical circumstances justifying direct abortion, that is, no circumstances in which the life of a mother may only be saved by directly terminating the life of her unborn child."

When Dublin's National Maternity Hospital (where 10% of all births in Ireland occurred) investigated the 21 deaths of pregnant women there between 1970-1979, they found that not a single one of those deaths could have been avoided by abortion.

Ireland, a country where the unborn child is constitutionally protected, has the lowest maternal death rate in the world. The UK, where abortion is available practically on demand, has over five times Ireland's maternal death rate.

Developments in medicine mean that the 'abortion to save the mother's life' argument is becoming harder and harder to justify. It is now possible for women with heart defects to carry a baby to term with expert help and life-threatening conditions such as cancer can often be treated without harming the unborn child. Women facing difficult pregnancies have a right to the best available medical support.

Direct abortion is the deliberate killing of an unborn child. Treatment to save the life of the mother that results in the death of the child as an expected but not intended side effect is not a direct abortion, e.g. in the case of an ectopic pregnancy. In this situation, the baby begins to develop in the woman's fallopian tube and has to be removed or the tube will rupture and cause the death of the woman. This involves the unavoidable death of the unborn baby but the aim of the operation is to save the mother not to kill the baby.

Let me reiterate the most important points:

  • Between 1967 and 1990, only 0.004% of abortions performed in the UK were done with the intent of preserving the mother's life. (I've been unable to find comparable statistics in the U.S., where the only data is on self-reported maternal health concerns among aborting women.)

  • Not a single one of the deaths in Dublin National Maternity Hospital between 1970 and 1979 could have been avoided by abortion. (I've been unable to find a comparable study in the U.S.)

  • Ireland, where abortion is illegal, has the lowest maternal death rate in the world. The UK, where abortion is available practically on demand, has over five times Ireland's maternal death rate. (This can be attributed to the increased risk of complications in subsequent pregnancies caused by abortions.)

    In fact, the successful treatment of high-risk pregnancy is measured in terms of length of gestation and fetal survival; maternal survival is expected. You start seeing maternal mortality when you look at studies of women who suffer catastrophic injuries during pregnancy. The medical literature on these cases mentions "abortion" (miscarriage) as an undesired effect of these injuries, not as a treatment.

    Pro-life physicians note that doctors often recommend abortions for ailing patients because they fear that treatment for the mother might harm the fetus. Aborting the baby to prevent his possible injury or death makes sense from a legal standpoint, for the doctor to avoid a lawsuit, but these abortions are to protect the doctor's malpractice rates, or to avoid the possible birth of a child with a disability, not to preserve the mother's life.

    An example is breast cancer. Doctors would give the women a choice between having the baby killed, and delaying chemo until after birth, risking their own lives. But it turns out that there are treatment regimens that can be administered during pregnancy.

    Even if the woman had uterine cancer, requiring a hysterectomy, doctors would deliver the baby live first if he or she was viable. If the baby was not yet viable, the hysterectomy would indeed kill him or her, but would not be the same as performing an abortion -- which is a procedure performed with the primary intent of killing the fetus.

    Yes, there are sometimes situations in which a mother develops health problems that require the pregnancy to be terminated. My friend had to have three pregnancies terminated in the third trimester due to life-threatening problems. These terminated pregnancies are named Daniel, Becky, and Mary; they were delivered by emergency c-section.

    Do these rare, tragic cases mean that we need a "life of the mother" exception in abortion bans? I think not. Let the doctor take whatever measures he thinks necessary to preserve the mother's life, and allow such cases to simply go unprosecuted, as they were before legalization, and just as doctors are not prosecuted in those rare cases where they kill one conjoined twin to allow the other to survive.

    See also “What if the Mother’s Life is in Danger?”

    Now, let's cut to the chase.

    I'm sure that though your average, ordinary citizen is unaware of these facts, the high mucky-mucks at NARAL and Planned Parenthood no doubt are aware of these facts. (If they're not, they're failing to do proper research before taking a strong public advocacy position, which is inexcusable.) So what is it that they're really afraid of?

    I think it's that women will be inspired, like Pam Tebow, to question their doctors. And if they do that, we'll get more cases of women learning that their doctors were pushing for unnecessary abortions.

    If women who are told that their lives are in danger, or who are facing other serious medical problems, start doing research and finding that there are better ways, imagine the ripple effects.

    If the "hard cases" turn out to be situations in which there are better options that women would freely choose if given the information they need, what next? Might not other women, in less drastic situations, also start questioning whether abortion really is so necessary?

    There could be a backlash of outraged women wanting to know why they were abandoned to the heartbreak of abortion, when other avenues were available to them. Other avenues that they weren't told about, because to open other doors might cause women to choose unchoice choices.

    That would be a disaster for the abortion lobby. And I think the prospect terrifies them.

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    Kathy said...

    One birth-blogger that I read mentioned the Tebow ad before it aired -- just the basic pro-abortion talking points direct from NARAL and PP and whoever else was talking about it. One of the things she brought up was the point about *gasp* women seeking second opinions and/or otherwise not just blindly following their doctor's recommendations (my words, not hers). The thing that struck me the oddest is that most of us who talk about birth (liberal and conservative alike) frequently talk about going against the doctor's advice, and finding another care provider who will agree to what you want. For example, finding someone who will attempt a vaginal breech birth, or allowing a VBAC instead of a mandatory repeat C-section, or having a home birth instead of a hospital birth, or declining an induction if not medically indicated, etc. -- there are numerous such examples I could cite. Yet this blogger was suddenly up in arms about women not following lock-step with what their doctor recommended, when it was killing their child. Hypocrisy.

    Wesley Wilson said...

    Thank you so much, Christina. It is important for people to realize the difference between treating the mother with possible side effects to the baby and the deliberate killing of the baby.

    Taking an innocent life with the goal of saving another isn't right. But saving one with an unfortunate result of another dying is another matter.

    Christina Dunigan said...

    More to the point, Wesley, is what ought to be a huge scandal, and that's the business of doctors referring for unnecessary abortions. And frankly, PP and NARAL and so on are terrified that ordinary women will wise up to this and stop complying. Because if the "hard case" moms start demanding better, then the other moms will start demanding better as well.

    Once women realize that they've been sold out for political gain they're not gonna be happy campers.

    Wesley Wilson said...

    At www.pregnantwithcancer.org there are a number of stories of women who survived cancer and received treatment while pregnant--and their babies were fine. Many of these women say they were urged to abort.

    OperationCounterstrike said...

    Wesley, are there any NUMBERS? What are the ODDS of damaging unborn babies with the various cancer-treatments?

    Christina Dunigan said...

    OC, totally aside from the numbers, shouldn't it be offensive to prochoice sensibilities to know that women are led to believe that abortion is being prescribed to prevent their deaths, when it's actually being prescribed because the DOCTOR thinks the risk of injury to the fetus is too high?

    Shouldn't the WOMAN be given the information -- X% of babies are born with such-and-such type birth defects after this treatment, as compared to Y% of babies of mothers who do not undergo the treatment -- and being allowed to CHOOSE?

    When I got my rubella vaccine, the doctor and her nurse both told me, "If you get pregnant in the next three months, you will have to have an abortion." Not "We believe there is a high risk of birth defects from this vaccine." (which, it turns out, is perfectly safe to administer in pregnancy; it doesn't harm the baby at all.) "You will have to have an abortion." How many women ended up having abortions because of a vaccine that was perfectly safe for their babies, because their doctors didn't even want to get accurate information on the risks, much less pass that information along to the mother?

    Wesley Wilson said...

    GrannyGrump, your point is well taken. Even the "pro-choice" advocates should want women to know the facts about the risks to their babies. But they don't.

    The position of doctors who urge abortion to prevent injury to the baby has to be based on liability. It just doesn't make sense to say, "I don't want to hurt the baby, so I'll kill it instead."

    OperationCounterstrike, considering you openly endorse murder (even of college professors, not just babies), I'm not sure why you would care about harm to babies from cancer treatments. While I don't know what the numbers are, doctors should reveal those numbers to their patients. And regardless of the numbers, killing a baby deliberately to avoid a potential miscarriage is murder.

    Anonymous said...

    Christina - You are amazing. Thanks for keeping us armed with truth. I aspire to be as knowledgeable and bold as you are. If every individual in our movement had the facts that you dish out daily at the ready and combined that knowledge with prayer, we would win this war much more quickly. I hate the fact that we have to fight against the killing of infants every single day of our lives, but I love the fact that God has given us resources like you to help us in the battle. You are in my prayers.

    Kathy said...

    Here's an article calledWith Child, With Cancer which discusses the issue, including some numbers and percentages of birth defects of women who take chemotherapy while pregnant. It's lengthy (5 pages), and I didn't read it all today, but on the second page it says, "Among the 84 cases in his study, all the fetuses survived and, astonishingly, only 5.8 percent had birth defects, most of them minor. In a follow-up study, Avilés examined 43 children born to mothers who received chemo from 1970 to 1986. At the time of assessment, the children’s ages ranged from 3 to 19, and all had normal physical, neurological and psychological development. The children did fine in school, and among those who had reached adolescence, sexual development was normal." And "In fact, according to a 2007 Norwegian study of 45,511 women diagnosed with cancer between 1967 and 2004, matched for age and stage, pregnancy does not affect survival either way. Two small studies even suggest that terminating a pregnancy may decrease a woman’s chance of fighting the disease. Some women say that being pregnant increases their will to survive."Yet many doctors still believe what they were taught in med school, which is that cancer during pregnancy is an automatic reason for abortion.

    OperationCounterstrike said...

    GG, no, there's no reason for the doctor to load the patients up with details they don't need to know and (mostly) are not qualified to understand.

    When you go in for say bowel surgery, should the doc have to tell you EVERY known fact about your illness? Should the doc have to make you read EVERY known study of your condition, plus EVERY known study of the particular procedure to be used, plus EVERY known study of the anaesthesia to be used? Of course not. YOu have neither the time nor the training to read these studies. The Doc's JOB is to read them and condense the knowledge into a brief big-picture which can be conveyed to you in an office visit.

    OperationCounterstrike said...

    Kathy, if your doctor told you it's ok to have the cancer-treatment while you're pregnant, and you went ahead and kept the pregnancy, and your baby came out with a terrible birth-defect, would you sue the doc? If not, why not?

    5.8% is WAY to high a risk to take for your religious fetish.

    OperationCounterstrike said...

    The fact is, Kathy, most patients don't know or care about how or why or about making their own decisions. This was one of the things I hated most about med school. I like explaining things! When you try to explain something to a patient, the patient's eyes glaze over. They just wanna know two things: WHAT'S GONNA HAPPEN and WHAT SHOULD I DO.

    Sad but true.

    Christina Dunigan said...

    OC, so you're saying instead of telling the patient the truth -- say, "There will be about a six percent chance that your baby will have a birth defect such as cleft lip, a heart murmur, or mild to moderate hearing loss" -- e should just dismiss her as an idiot with neither the brains nor the will to make her own decision, and say, "You have to have an abortion or you'll die from the cancer."

    If the patient goes all MEGO (My Eyes Glaze Over), maybe there's something wrong with how the doctor is explaining things. All filled with inexplicable jargon.

    I know the informed consent process my oral surgeon put us through -- and though both my friend and I were annoyed at the time, we were grateful, and ended up satisfied with our very different choices. I know the informed consent process my co-worker went through. It was very frustrating and drawn out (it involved trying several different less invasive treatments and gauging her response to them). But when it was over she was very confident of her choice to go through with the surgery.

    A doctor who lacks communication skills might explain things to rapidly or with too much medical jargon or in too much detail (Every single stinking study published in the the last ten years, instead of summarizing them in laymen's terms) A doctor who is lazy might just tell the patient what to do. But it's part of his responsibility. But a RESPONSIBLE doctor will ensure that the patient understands everything a reasonable patient would need to understand in order to make an informed choice. EVEN IF THIS ANNOYS OR FRUSTRATES THE PATIENT.

    Yeah, for minor things you can give informed consent short shrift. (Well, we can freeze the wart off; that has about X% chance of success, and the worst case scenario is a miniscule chance of Y, or we can cauterize the wart, which has an A% chance of success, and the worst case scenario is a miniscule chance of B." Maybe the risk of a permanently stiff finger is something a professional violinist won't want to risk, whereas a possible scar is something a hand model won't want to risk.)

    With things that are potentially mutilating, or that like abortion are life or death for the patient's child, much more is in order.

    Christina Dunigan said...

    OC, if the doctor told the patient there is a certain risk of something, and the patient believes the risk is worth it, then *as long as the doctor doesn't do something careless* the patient has no grounds to sue.

    If, on the other hand, the doctor is trying to use "But I did informed consent!" as an excuse, the patient still has grounds to sue if the doctor is screwing up.

    We've seen this in abortion malpractice cases, where some attorneys refused to take a case, saying, "Well, a perforated uterus is a known risk. He told her that she was risking a perforation." Which is only a valid defense IF THE ABORTION WAS PERFORMED ACCORDING TO A REASONABLE PHYSICIAN STANDARD OF CARE. If, on the other hand, he used instruments that were too large, he rushed dilation, or he failed to do an ultrasound to visualize the position of the uterus, the patient still has a case, regardless of having warned her that perforation is a risk.

    And even 100% risk that my baby will have something wrong with him is not worth killing him over. I wouldn't have my granddaughter just shot if she developed bacterial meningitis and ended up losing her limbs. Why would I have my child pulled apart and killed because the mishap befell him when he was younger?

    OperationCounterstrike said...

    GG, you clearly have not worked in a health-profession. You sound like I sounded before I went to med school! Idealistic and wide-eyed and totally without a clue.

    You wrote: "If the patient goes all MEGO (My Eyes Glaze Over), maybe there's something wrong with how the doctor is explaining things. All filled with inexplicable jargon."

    Unfortunately, the only words we have to describe health are "inexplicable jargon" to those who don't know the lingo. That's why we make you go to med school--to LEARN the jargon.

    There is no time to tell patients stuff they don't wanna know. It's not because the doc is irresponsible; it's cos the patient doesn't know "epidemiology" from "oysters on the half-shell".

    More than half the patients you see don't know what the word "uterus" means.

    Christina Dunigan said...

    If the doctor can't explain it in laymen's terms, maybe he doesn't understand it himself and is just parroting a medical journal!

    You don't have to use words like "epidemiology" or "etiology" -- you can say "When we study the spread of this illness" or "This condition is caused by". You don't have to say "patella" when "kneecap" will do the job. Why say "Cardiac tamponade" to a patient? You can describe it as "Blood in the sac around the heart".

    Doctors go to medical school to learn to practice medicine, not to use big words when they're talking to non-physicians. Any doctor who says "cephalopelvic disproportion" to a patient instead of "the baby's head is bigger than will fit through your pelvis" needs a course in speaking like a normal human being. You don't need to say "disseminated intravascular coagulopathy" when "serious clotting disorder" will do the job.

    When I read in the PDR that some of my MH clients' medications were associated with an increased risk of fatal bronchopneumonia, I didn't use those words, or the words explaining the etiology, when talking to the clients. I said, "When you take this medicine, it suppresses your cough reflex. This means that gunk you would normally cough out of your lungs might stay there. This gives you a higher risk of getting pneumonia and dying from it. So if you have any kind of congestion in your chest, make sure that you remind your doctor that you're taking this medicine, and it has a high risk of pneumonia."

    See? Laymen's terms. It's not rocket science. The goal needs to be to communicate with the patient, not to dazzle him with your highly specialized vocabulary.

    OperationCounterstrike said...

    RE: "Blood in the sac around the heart" Most patients don't KNOW there's a sac around the heart. And they wouldn't understand WHY blood in it is dangerous. And if you tried to explain it to them, they might nod but they still wouldn't understand after you were done.

    OperationCounterstrike said...

    Again, it's refreshing to hear you talk about this--it reminds me of myself, before my first clinical rotation. "Tell them what they need to know! EMPOWER the patients!" Suuuuure. Then the patient complains to your boss that you're spouting gobbledy-gook and expecting them to go along.

    OperationCounterstrike said...

    Christina, how about this: every pregnant patient who plans to keep the baby must be warned of EVERY POSSIBLE COMPLICATION of pregnancy, no matter how likely or unlikely, and must further be advised that an abortion would prevent these complications. If the patient chooses to keep the pregnancy, she must read EVERY SINGLE STUDY OF PREGNANCY ever published in the history of mankind, and if she doesn't, then we do the abortion even if she wants the baby.

    Whaddaya think? Would you support this? Why or why not?

    OperationCounterstrike said...

    I mean, the patient has the right to make an informed decision, doesn't she? So inform her! Make her read all the studies. Never mind the fact that it would take the rest of her life for her to do so.

    Yeah, I remember when I thought this way.

    Kathy said...

    OC, no, I wouldn't sue because I was told the risks. Now, if I were given Cytotec to start labor and told, "This is just a little something to soften your cervix and make you go into labor," and instead I had a uterine rupture and my baby died, you better believed I'd sue the doctor!

    The fact that some people only want to be told what to do does not negate the fact that many others want to be told the pros and cons of this and other courses of action, and that it is a violation of their right to informed consent not to be told of the risks of the procedure. No, this doesn't mean that the patient must read every medical journal. The doctor is to explain to the patient the risks and rewards -- in layman's terms, so that the patient is truly *informed* so that she can actually *consent* or *refuse* a procedure.

    It's not too hard to "translate" between jargon and layman's terms, or sometimes even very simplistic terms that children can understand. If a patient doesn't know what a uterus is, it's not that hard to say, "where the baby grows when you're pregnant." In fact, it probably takes 2 seconds.

    I like explaining things, too; and I like having things explained to me, rather than the paternalistic "doctor knows best" attitude that many in the medical profession display. And telling patients that "there is a risk of birth defects to your baby if you have chemotherapy, so you can have an abortion or risk the birth defects," should not be too hard. And it's a lot better than lying to them, and telling them that they "need to" or "must" have an abortion.

    Christina Dunigan said...

    I see when OC realizes he's losing the debate he resorts to setting up a straw man.

    OperationCounterstrike said...

    Straw man or not, the point remains. You CAN'T translate anatomical details to "layman's terms". You can't even explain how measuring blood-pressure works unless your listener understands the difference between laminar flow and turbulent flow. Your ideas are very typical for someone who is thinking about health-care in abstract terms rather than in real experience-terms.

    Christina Dunigan said...

    OC, perhaps you, personally, don't know how to explain things in laymen's terms. That doesn't mean that other people lack the skill. And if you really think that you need to explain laminar flow and turbulent flow to explain to a patient why high blood pressure can screw him up big time, you probably ought to just go into pure research and not deal with patients at all. You don't know how to talk to them.

    OperationCounterstrike said...

    GG, there are only two choices. Either you make the patient read everything herself (which you called a straw man), OR you decide what she needs or does not need to know. There's no third alternative!

    Kathy, I agree the docs should present the alternatives. The problem is if the patient mothers a defective kid you will get sued anyway.

    You may not realize teh absurd state of our laws. In Pennsylvania for instance Jehovah's Witnesses can refuse life-saving blood transfusions, but if the patient dies you the doc are still liable because you should have called a judge and gotten an override!

    OperationCounterstrike said...

    OK, GG, just explain to me, in "layman's terms", how and why AZT prevents HIV from replicating. Remember your decision has to be detailed enough for the listener to participate intelligently in the decision whether or not to take AZT.

    You may begin now.

    Wesley Wilson said...

    -- "[J]ust explain to me, in "layman's terms", how and why AZT prevents HIV from replicating"

    OC, since you think it is impossible, your solution is--tell the patient, "You have to take AZT"?

    Too many doctors need to figure out that they aren't God and don't have the authority to dictate what course of action patients must take.

    And yes, we need to revise our laws so that doctors can't get sued over so many stupid things. We are at the place where liability (i.e., lawyers) controls medical procedure, rather than what is best for the patient.

    OperationCounterstrike said...

    Here's a better question: GG, just explain to me, in layman's terms, the difference between Sinemet and Requip. How does each of the two relieve the symptoms of Parkinson's Disease? What's the difference? Remember, your explanation has to include enough detail so that your listener can participate intelligently in a decision which of the two to take for his/her PD.

    OperationCounterstrike said...

    And Wesley, your suggestion: just tell the patient "You have to take AZT", is what the very large majority of patients WANT to hear. And no more than that!

    You all live in this fantasy world where patients are educated and intelligent, where they want explanations along with instructions. That's an upper-middle-class fantasy. The very large majority of patients don't want the extra info, cannot understand it, and will not listen if you try to give it. All they wanna know is WHAT TO DO, and WHAT'S GONNA HAPPEN, not how and not why.

    Besides, you the doc do not have time to give extra info. Docs are having enough difficulty trying to find time to tell teh patients the things they DO need to know!

    As I said, it's sad but true. Welcome to planet Earth! You have to climb out of your tower and get your hands dirty a little bit.

    Christina Dunigan said...

    You all live in this fantasy world where patients are educated and intelligent, where they want explanations along with instructions

    Thank you! You have just admitted that you think the typical patient -- including the typical abortion patient -- is an idiot who should just shut the fuck up and do what you tell her to do.

    Christina Dunigan said...

    By the way, OC, the AMA disagrees with you. They don't think that patients are a bunch of fucking morons who should just shut up and do what Brilliant Dr. OC tells them to do.

    Evidently this "You can't explain this to those morons that come to you for care" is your own personal opinion of patients.

    I wish I knew your name so I could report you to the medical board.

    You need to be in an area of medicine -- lab research, perhaps -- that doesn't involve contact with the patients who you hold in such utter contempt.

    OperationCounterstrike said...


    1. Recognizing that patients are not qualified to understand medicine is NOT "holding them in contempt". If they COULD understand medicine, they wouldn't need to hire doctors! Not their fault.

    2. I'm waiting for your explanations of AZT, also of the difference between Sinemet and Requip. Remember, the explanations must be IN LAYMAN'S TERMS, understandable by a TYPICAL PATIENT, but must also be complete enough for the listener/patient to participate intelligently in the decisions whether/which drug to take.

    You can't do it, because it cannot be done!

    Christina Dunigan said...

    It's holding them in utter contempt to say, as you've said repeatedly, that they're just too fucking stupid to understand or even care.

    YOU CHOOSE to stick with high tech gobldygook because it makes you sound ever so impressive. The AMA holds that you CAN and SHOULD explain diagnoses and treatment protocols to patients.

    Like I said, I wish I knew who you really were so I could report you to the medical board. You shouldn't be allowed near a patient.

    Christina Dunigan said...

    Requip in laymen's terms by people who, unlike you, don't glory in looking on patients as morons who should be kissing your ass in gratitude that an uber-genius like you even deigns to be in the same room with them.

    It can be done. It's done all the time. By doctors who aren't arrogant egotistical assholes.

    OperationCounterstrike said...

    GG, your link doesn't seem to work. I click and nothing happens.

    In any case, I'm waiting for YOUR explanation of the DIFFERENCE between Sinemet and Requip, which explanation must be both layman-accessible AND sufficient to enable the listener to participate intelligently in the decision which to take. You claim you're good at explaining medicine to laypersons, so go ahead and explain! I want YOUR explanation, in your own words, not something you copy off the web.

    How would you feel about a plumber who insisted on telling you all about the different things that go wrong with pipes and different ways of fixing your problem, and wanted you to make the plumbing decisions? You'd say: "Fix the pipes and keep the shop-talk to yourself.". That's more or less what patients say when you try to teach them about medicine.

    It's not arrogant to say so, and it's not egotistical. It makes the patients happier if you DON'T try to explain things. It's when you try to explain things that they complain you're making them feel stupid or whatever.

    You are NOT a typical patient. As I say, typical patients wanna know WHAT TO DO and WHAT'S GONNA HAPPEN and basically nothing else. That's not because they're dumb or whatever, it's because they spend their time doing other things besides medicine.

    Kathy said...

    Too bad you can't talk to people without talking down to them. Maybe then you could have explained things *without* making them feel stupid. Which would have made both you and them happier.

    OperationCounterstrike said...

    Kathy, the problem is, Anything you tell a patient either 1. is wrong or 2. uses vocabulary they don't know.

    Kathy, help me out. I need to explain to a patient the difference between how Sinemet works and how Requip works. The patient is a typical patient whose scientific/technical education ended shortly after high school. What should I say? I have about ten minutes in which to do this.

    OperationCounterstrike said...

    The explanation must be detailed enough for the patient to make an intelligent decision which of the two to take for his Parkinson's Disease.

    Wesley Wilson said...

    OC, the point here is that what you are advocating is that the doctor should lie to patients.

    My wife and I have had an arrogant OB doctor tell us what we had to do. We asked him for the evidence, which he could not produce. Then we did our research and found a published study showing his advice, although not dangerous, was inaccurate.

    You are way out of touch with standard medical advice, which tells patients to be responsible for their medical decisions.

    I realize a lot of patients want someone to just tell them what to do. But for those who want the truth (such as what are the odds of a birth defect if I take this med) doctors have a responsibility to tell the truth.

    Christina Dunigan said...

    Requip in layman's terms.

    And we expect laymen's explanations from all sorts of experts. We expect the plumber to tell us "It's just a bad washer. That lets the water leak out around it. You don't need a whole new faucet." We don't expect him to just replace the faucet because, after all, when we called we said "My faucet is broken." Ditto for mechanics, dentists, eye doctors, etc. We don't expect the minute technical details; we want to be explained in terms that tell us if we need a new distributor cap or just a tune-up, if we need a crown or a filling will do, etc.

    I read dental journals when I was getting my orthodontia done, because the only other reading material in the waiting room was aimed at teenagers. A lot of it went over my head. That didn't make it impossible for my orthodontist to explain what he was planning to do and make sure I understood it well enough to consent to it. He didn't need to explain the technical details of the risk of tooth discoloration in order to convey to me the importance of very careful dental hygiene to prevent the problem.

    There is a middle ground between so overloading them with jargon that they shut down (Which was Carol Everett's strategy for avoiding any real informed consent with her abortion clients) and just assuming that they're too dumb and uninterested to care. Conscientious doctors -- and yes, plumbers and electricians and dentists and appliance repairmen and mechanics and satellite dish installers and all other manner of experts -- manage to convey to laymen what they need to know to make an informed choice.

    Your inability to even imagine a way to explain things to patients is like your inability to grasp that most women love their babies. It's a personal blind spot. One I think you choose because it suits you.

    Christina Dunigan said...

    Requip link try again!

    OperationCounterstrike said...

    GG, you are atypical. Most people just want the plumber to fix the problem and then go away.

    OperationCounterstrike said...

    GG: Your REQUIP link is inadequate. First of all, it uses all kinds of words patients do not understand, like "deficit" when applied to something other than money, also "dopamine". Most patients have no idea what these words mean, and if they had to guess they'd think "dopamine" is an illegal recreational drug.

    Secondly, it does not explain the MECHANISM whereby Requip works--the fact that Requip is a dopamine agonist not a dopamine precursor like Sinemet. That's essential info, without it you're not explaining the drug at all.

    Thirdly, it does not give enough info for the reader to make an intelligent decision whether to take requip, or something else. It mentions allergies but that's only one consideration in choosing a Parkinsons's Disease regimen.

    YOUR GRADE SO FAR as an explainer: F.

    Wesley Wilson said...

    OC, your demands for an explanation of random medical information is a pathetic attempt to divert attention from the issue at hand.

    The issue is: Doctors are telling women they have to abort when it isn't true. It isn't required for the mother's health, and in the vast majority of cases, the woman can be treated without harm to her baby.

    Your position is that the doctor should lie to the patient, rather than giving her any information about the actual risks. That is a reprehensible position, regardless of the medical issue--but doubly so when it pertains to life and death.

    OperationCounterstrike said...

    WW, no, GG said docs should be able to explain stuff to patients so the patients can participate in their own medical decisions. I'm just asking her to do what she says everyone should be able to do!

    And my position is NOT that the doc should lie to the patients. It's that the doc should do what (s)he is paid for: digest the info and give the patient the best possible advice. Not give the patient a medical education which the patient does not want.

    Christina Dunigan said...

    OC, so you're saying you think most people would rather be ripped off by a plumber than have him explain the situation and do the less costly repair?

    Clearly you think everybody who isn't you is a moron.

    Kathy said...

    GG said docs should be able to explain stuff to patients

    Last time I checked, GG never claimed to be a doctor nor anything close. She has no need to explain Requip, Sinemet, Prozac, Restoril, Zyprexa or Zithromax to anyone, so it little matters whether she or I can explain how a drug works. But doctors should.

    OperationCounterstrike said...

    GG, no I do not say most people would prefer "to be ripped off". The reason we have LICENCES for technical professionals like plumbers and doctors is so that if one is a ripper-off, his licence can be yanked and he can be shut down.

    Bah. You're just putting nonsense in my mouth and arguing against the nonsenese. ("Straw man"). You are doing this because you know I am right about the real argument.

    Christina Dunigan said...

    But how could anybody ever know that a plumber ripped him off if, as a layman, he's incapable of understanding (plumbing -- ha!) the depths of a specialist's knowledge?

    Christina Dunigan said...

    But how could anybody ever know that a plumber ripped him off if, as a layman, he's incapable of understanding (plumbing -- ha!) the depths of a specialist's knowledge?