Morality … The Medical Board of Australia stipulates that doctors are within their right to refuse to provide a prescription for the pill if they morally object. Picture: Supplied. Source: News Limited
IT IS apparently OK for a woman living in 21st century Australia to be denied the pill, based on nothing more than a doctor’s “morals”.
This is something I found out the hard way when I went to my local clinic for a general check up, and an incidental renewal of a prescription I have been on for years.
My local clinic is a bulk-billed one, where you can select to see a particular doctor or join the general queue to see the first doctor available.
After an hour’s wait, I was told to follow a doctor I have never been to before — and, as I was about to find out, for good reason.
As we sat down to business, she asked me what she could do to help.
“I would like to refill my pill prescription,” I started, and she shook her head.
“Oh, I don’t do those. I don’t write prescriptions for the pill.”
And, as quick as lightning, she said she’ll put me back in line for the next available doctor who could help.
I was shocked; still am. Unfortunately, former Victorian Health Services Commissioner and women’s rights advocate, Dr Beth Wilson AM, is not.
“I think it’s very humiliating for a woman to go to a clinic, expecting to receive a legitimate health service, only to be humiliated by being told, ‘sorry I don’t do that’,” Dr Wilson told me.
“I would invite doctors to think about how their patient feels, especially a young woman who has come seeking help.”
All politics … Former Victorian Health Services Commissioner Dr Beth Wilson AM, says that the issue of doctors morally objecting to writing out a prescription for the pill is a political issue. Picture: Supplied Source: News Limited
No stranger to this issue, officially called the “Conscientious Objection”, Dr Wilson has written myriad articles about the issue, notably one featured by The Wheeler Centre.
In it she cites examples of doctors — and pharmacists — objecting to providing women with something as important as a morning-after pill — resulting, in one case, in a women being forced to get an abortion because a pharmacist thought his or her view was more important than the freedom and wellbeing of their patient.
Which brings me to the crux of the issue: a doctor’s personal beliefs should never trump a woman’s right to reproductive health, and there exist no acceptable circumstances in which the (minority) moral views — which are subjective — of a medical professional should interfere with a woman’s freedom to access scientifically verified medication.
Unjustified … Doctors in Australia are able to deny a health service based on their “conscientious objection”. Picture: Supplied Source: News Limited
In my case, the consequences were negligible. It took only 10 minutes to see another doctor and the prescription was eventually given and filled.
However, what if a young, vulnerable woman, seeking to take control of her reproductive health or simply wishing to reduce painful menstruation or cure her acne, enters a doctor’s office, only to be told that doctor is opposed — on no scientific ground — to helping her even discuss the possibility of going on the pill?
Four months ago, a cross-national study (by Canadian and Austrian researchers) called “Dishonourable disobedience: Why refusal to treat in reproductive healthcare is not conscientious objection”, found that: “in medicine, the vast majority of conscientious objection is exercised within the reproductive healthcare field — particularly for abortion and contraception”.
“Healthcare professionals who exercise conscientious objection are using their position of trust and authority to impose their personal beliefs on patients, who are completely dependent on them for essential healthcare,” authors Christian Fiala and Joyce H. Arthur write.
An overwhelming majority of conscientious objections made by doctors are in the “reproductive healthcare field”, a study has found. Picture: Supplied Source: ThinkStock
Which begs the question: is it about a doctor’s right to morally object to any medicine, or only to those deemed significant primary to women?
What if a doctor decided he or she did not believe in vaccinations? Or prescribing antidepressants? Referring a patient to a psychiatrist? Did not believe in blood transfusions?
“Because there’s a lot of politics in this,” says Dr Wilson.
“We have to acknowledge that [if we got rid of this exception] … it would cause incredible backlash, and strengthen the argument of the anti-contraceptive or anti-abortion people.”
Dr Wilson says the issue of conscious objection is political, and that the government has struck a compromise with certain “religious or ideological viewpoints — not by any means what the majority people expect or want”, which enables doctors who refuse to deliver a health service to refer the patient onto someone who will.
Legally sanctioned … The Australian Medical Association dictates that doctors are “are entitled to have their own personal beliefs and values” — even when they are working. Picture: News Corp Australia Source: News Corp Australia
So where, exactly, does the law stand on this issue?
The Australian Medical Association says that “doctors are entitled to have their own personal beliefs and values, as are all members of society.
“There may be times, however, where a doctor’s personal beliefs conflict with their peer-based professional practice.
“Inexceptional circumstances, and as a last resort, a doctor may refuse to provide, or participate in, certain medical treatments or procedures that conflict with his or her own personal beliefs.”
How is refusing to issue a script for the pill — without even giving the patient the curtesy of asking why they would like to take it — an “exceptional circumstance”?
The Medical Board of Australia’s (AHPRA) definition of “conscientious objection” is also vague: it argues that “a conscientious objection is based on sincerely-held beliefs and moral concerns, not self-interest or discrimination.”
However, there is no criteria or regulation that distinguishes the discrimination from moral concerns, once again basing a fundamental human right — medical access for all — on a subjective matter.
Shock … Young women today are often shocked when they come upon a doctor who refuses to write a script for the pill, says Dr Wilson. Picture: Supplied Source: ThinkStock
Nicole Newton, spokeswoman for the Medical Board of Australia, says that all doctors are held to account “against the standards set down in Good medical practice, a code of conduct for doctors in Australia, which stipulates that while doctors are not allowed to “deny patients access to medical care … based on [their] moral and religious views”, they are permitted to “recognise that you are free to decline to personally provide or participate in that care.”
However, where do we draw the line when it comes to “moral or religious views”? Why is a doctor’s personal and private inclination elevated above that of a patient’s right to medicine which has, for decades, been deemed scientifically safe and beneficial?
It is clear this issue is not about health: it is about the state using a woman’s body and reproductive welfare as a political tool, encased in the rhetoric of morality and carried out by the profession which most people trust, and few would question.
Originally published as Shocking power doctors have over women