Is it legal for a doctor to refuse treatment of a condition

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Latest post 11-08-2012 4:01 PM by Taxagent. 16 replies.
  • 02-06-2012 4:23 AM

    Is it legal for a doctor to refuse treatment of a condition

    because of the patient's refusal to have a separate, non-related test performed?

    My doctor will no longer renew my oral contraceptives that are used only to treat slight menstrual problems without my having a pap smear. I told the doctor I would not be having the test done, now or ever, and therefore my prescription is being withheld.

    I have found proof from the WHO, ACOG, and FDA that this test is not required for the prescription, and that nothing found in the test would prevent the pills from being able to be prescribed. I am willing to accept responsibility and sign a waiver that the doctor was not at fault if somehow I were to develop this cancer, but the doctor will not allow it.

    It seems to me like this is an example of consent by coercion. If this is not illegal, it is unethical at the very least. I'm not sure if this falls under malpractice because there is no actual injury, even though I have had undue pain and sickness from not having the pills, but I wasn't sure what other category this would fall under.

  • 02-06-2012 5:45 AM In reply to

    • DOCAR
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    Re: Is it legal for a doctor to refuse treatment of a condition

    He is free to stop treating you if you do not follow his recomendations, just as you are free to choose a new doctors because you do not like his recomendations or for any reason at all.  We did away with slavery 150 years ago.

  • 02-06-2012 6:15 AM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condition

    AmandaSmith12:
    I have found proof from the WHO, ACOG, and FDA that this test is not required for the prescription, and that nothing found in the test would prevent the pills from being able to be prescribed.

    At a basic level any physician can write a prescription for a medication without doing any testing what so ever as long as they are a licensed physician with a DEA number.  However, the standard of care in medicine is that prior to writing for certain medications there are tests that must be done to ensure the patient is healthy in particular ways to take that medication.  Writing for medication without following the standard of care is exactly what gets pill mills in trouble.  

    When it comes to OC medication, the standard of care is to do a pap smear and a pelvic exam. In young teens they will prescribe them without doing the exam if the risk of the patient being sexually active is low.  I know of no ethical physician that will write for the medication for an older teen or adult without having a baseline exam on the patient.  

    AmandaSmith12:
    If this is not illegal, it is unethical at the very least. I'm not sure if this falls under malpractice because there is no actual injury

    Even if you signed a waiver it could be considered malpractice and a violation of the standards of care if he were to prescribe them without doing the necessary work up prior to writing for the pills.  

    AmandaSmith12:
    I am willing to accept responsibility and sign a waiver that the doctor was not at fault if somehow I were to develop this cancer, but the doctor will not allow it.

    Because there is more involved with oral contraceptives than just screening you for cervical cancer.  Certainly you have seen the ads on TV from law firms advertising for those who have taken oral contraceptives and had issues with them?  They are looking for class action status to sue pharmaceutical companies that manufacture OC.  There are risks of stroke, hypertension, blood clots, and heart attack, especially if you are a smoker.  Given the suit happy climate of this country no responsible physician would prescribe a medicatio with these risks without doing a work up on the patient to document their health prior to taking it.  

    AmandaSmith12:
    It seems to me like this is an example of consent by coercion.

    No, this is their practice policy and if you are unhappy with that then your option is to find another physician who may be willing to lower their standard of care to provide it to you without doing the proper care first.  

    "That's just my opinion, then again I might be wrong."  Dennis Miller

     

  • 02-06-2012 9:49 AM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condition

    AmandaSmith12:
    I told the doctor I would not be having the test done, now or ever,

    How foolish.

    If I decided never to have a colonoscopy again, I'd be downright stupid.

    AmandaSmith12:
    I am willing to accept responsibility and sign a waiver that the doctor was not at fault if somehow I were to develop this cancer

    Until you actually got the cancer, got a lawyer, and sued the doctor's pants off.

    AmandaSmith12:
    It seems to me like this is an example of consent by coercion

    No. It's the doctor practicing self-preservation.

     

    • The right of the people 
    • to keep and bear arms,
    • shall not be infringed.
  • 02-06-2012 11:43 PM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condition

    neither of you are clearly not informed about this issue at all.

     

    • About 12,170 new cases of invasive cervical cancer will be diagnosed.
    • About 4,220 women will die from cervical cancer.
    • About 240,890 new cases of prostate cancer will be diagnosed
    • About 33,720 men will die of prostate cancer

    from cancer.org

    http://www.cancer.gov/cancertopics/types/commoncancers

    Cervical cancer is not listed on the government's list of common cancers, yet I'm not being forced to be tested for any of these cancers yearly for the next 50 years of my life.

    Cervical cancer nearly ALWAYS comes from HPV. Therefore, I have a pretty much ZERO chance of developing it. Also, like I said in the post, there is nothing that can be found with a pap smear that will prevent the doctor from being able to prescribe the pills, so they are UNRELATED.

    The doctors are witholding a prescription that most women are not willing to give up in order to have an unrelated test done that the doctors know most women would refuse otherwise. It is a bribe.

    I'm fine with doctors RECOMMENDING the test, explaining the risks, ect., but requiring a test for something I know I cannot have is just plain dumb.

    Lastly, why is that women are allowed to KILL their unborn children and they supposedly have the right to choose this, but I don't have the right to refuse a test that I am well informed about?

  • 02-07-2012 12:08 AM In reply to

    • DOCAR
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    Re: Is it legal for a doctor to refuse treatment of a condition

    No, you miss the point.

    You have the right to refuse the test.

    The doctor has the right to cancel you as a patient.

    You have the right to select another doctor.

  • 02-07-2012 12:43 AM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condition

    I completely agree that a pap smear should not be required to get the BCP.  That's ridiculous.  What other tests are required?  Maybe some that actually have something to do with birth control pills, hopefully??

    DO find another doctor.  One that does not REQUIRE a pap smear to prescribe birth control.  I know they exist because I used to have one!  Nor did she require a pelvic exam.

  • 02-07-2012 3:17 AM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condition

    AmandaSmith12:
    The doctors are witholding a prescription that most women are not willing to give up in order to have an unrelated test done that the doctors know most women would refuse otherwise. It is a bribe.

    It certainly is not a "bribe" as that term is meant in the law. Clearly you don't like the doctor's position, but it won't help to distort what's really going on here.

    It's no different than any other business situation. You go into a store and want to buy just one product, let's say a shampoo,  but the store insists on selling the shampooh as a package with a conditioner. You don't want the conditioner, you think it's worthless. You don't have to buy the package deal, of course. You can go to another store that sells just the shampooh you want. What you can't do is FORCE the store to break the combination deal and sell you just the shampooh because no law requires that. 

    Your situation is exactly the same, only in this case the "products" are the birth control pills and the pap smear test. You want to buy just the pills; the doctor wants to sell you the package product. Just as with the shampooh, you are free to go to another doctor who will give you the birth control prescription w/o the pap smear, if you can find one to do so. But like the circumstance of the store selling shampooh, you cannot FORCE the doctor to do what he doesn't want to do and give you just the birth control pill prescription without the pap smear test. The principle in the both cases is the same. The fact that this is a doctor's office and not a retail store doesn't radically change the law here and give you the power to dictate to the doctor how he provides his services. Bottom line, if you don't like the doctor's position, walk out and go to a different doctor.

    AmandaSmith12:
    Lastly, why is that women are allowed to KILL their unborn children and they supposedly have the right to choose this, but I don't have the right to refuse a test that I am well informed about?

    You are comparing tomatoes to moon rocks here. A woman's right to an abortion as decided by the Supreme Court in Roe v. Wade, 410 U.S. 113 (1973) was a decision that held the GOVERNMENT could not prevent a woman from getting an abortion. Prior to Roe, many states had criminal laws against abortion—after Roe, those laws could not be enforced. But the Roe decision does not compel doctors to provide abortions if they choose not to engage in that practice. A woman cannot FORCE any doctor to give her an abortion against the doctor's wishes. What the Roe decision simply says is that once she finds a doctor willing to do it, the government cannot lock her or the doctor up in prison for doing the abortion procedure. Similarly, you cannot FORCE a doctor to give you a birth control pill prescription against his wishes. What you can do is look for another doctor willing to do it, just like the woman seeking an abortion can go to another doctor if her present doctor will not do the abortion procedure. Yours is not a case of the government criminalizing birth control pills. If it was, then Roe and the abortion issue might be an apt analogy. As it is, Roe and the right to an abortion simply have nothing at all to do with the issue you are presenting here.

    I understand you feel strongly that your doctor is wrong. But both you and your doctor have the freedom to decide with whom you will deal in your business relationships, and that is what this is, a form of business relationship. Just like the shampooh example, you both have the right to walk away from the deal—no law forces either one of you to deal with the other. That's about as fair as I think it can get.

  • 02-07-2012 7:27 AM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condition

    AmandaSmith12:
    neither of you are clearly not informed about this issue at all.

    I am a WOMAN, I work in the medical field and I am VERY informed about this issue.  Cervical cancer is the third most common cancer in women.  Outside of the US more women die from cervical cancer than any other cause and the reason the US is low is because of the use of the pap smear.  One of the first symptoms of cervical cancer is abnormal bleeding which is what you want the OCP for.  Any doctor that would prescribe them to you without screening you for this disease is irresponsible.  

    AmandaSmith12:
    The doctors are witholding a prescription that most women are not willing to give up in order to have an unrelated test done that the doctors know most women would refuse otherwise.

    Actually you are wrong.  MOST women prefer not to die from cervical cancer.  

    AmandaSmith12:
    I'm fine with doctors RECOMMENDING the test, explaining the risks, ect.

    Then you should also be fine with the fact that it is that doctor's practice NOT to prescribe the medication unless you have the work up done.  If you don't like that policy you find another doctor.

    AmandaSmith12:
    but requiring a test for something I know I cannot have is just plain dumb.

    If you wish to buy into the feminist propaganda on some of the non-medical sites touting that GYN medical care for women is unnecessary that is your right.  What you cannot do is force ANY doctor to go along with it and prescribe medication for you.  Keep searching for a physician who is willing to work with your demands.  Eventually you will find one.  From my own perspective I wouldn't trust ANY doctor willing to violate the standards of care and would seriously question their judgement and ability to provide the bare minimum let alone excellent care.  

    "That's just my opinion, then again I might be wrong."  Dennis Miller

     

  • 02-07-2012 1:50 PM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condition

    Truffles4me:
    I completely agree that a pap smear should not be required to get the BCP.  That's ridiculous.  What other tests are required?  Maybe some that actually have something to do with birth control pills, hopefully?

    The problem with this thought process is that oral contraceptives are prescribed for several legitimate medical reasons other than birth control.  The chief one being abnormal bleeding which is also a primary symptoms of cervical cancer.  While being sexually active raises a woman's risk of contracting HPV which can increase the chance of developing cervical cancer, there are other conditions that share the same symptoms as cervical cancer that OCPs are used for.  

    It is your right to play roulette and refuse to have the test done.  What you cannot expect is a physician to deviate from the standard of care to provide a hormone medication that could mask the symptoms of a developing cancer without screening for it.  Again, any physician that is willing to deviate from the accepted standard of care should be seriously questioned as to their abiltiy to practice safe and prudent medicine.  The first rule of the Hippocratic Oath is "do no harm." Most if not all intelligent and sound physicians would not prescribe a medication to a patient without doing the proper assessment and testing first.  

    I am certain however, you will not have too much difficulty in finding a doctor who put profit before patient safety to accomodate you.  There is at least one in every city.

    "That's just my opinion, then again I might be wrong."  Dennis Miller

     

  • 02-07-2012 2:03 PM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condition

    Young people are rarely worried about cancer; yet it often begins during the years we deny it.  Smoking, early use of synthetic hormones, sun exposure, etc.

    Hormones almost surely cause cancer, judging by the results of study of hormones on menopausal women - it had to be stopped midway as so many women began getting cancer.  Imagine how it affects your body if you start now.  I would try to find OTHER less dangerous remedies for your issues.  For instance, extreme cramps are often caused by lack of magnesium, which relaxes muscles.  I'd go another route, first...though I know it is tempting to pop a hormonal pill instead.

    Can't imagine why you'd be so worked up about a mere test, but you may find another doctor out there willing to do it your way..but I wouldn't trust one who did.

  • 02-07-2012 2:09 PM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condition

    I certainly wouldn't use a carcinogen for "slight" menstrual problems.

  • 11-08-2012 12:51 PM In reply to

    • mary8888
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    Re: Is it legal for a doctor to refuse treatment of a condit...

    Of course if a doctor forces you into a procedure, then they are fully liable for any adverse outcomes. Considering the high false positive rate of pap smears compared to the actual incidence of cervical cancer, your doctor is taking a risk by taking this stand. If you have an abnormal pap result and you are then required to have treatment, which could lead to damage to the cervix which could lead to a miscarriage then I would be guessing your doctor is resposible for this because he forced you into have the pap test.

    And what if the woman is turned away from her doctors without a script for BCPs and she gets pregnant that evening because she does not have the time to see another doctor to get BCPs. Is that doctor liable to support that child for the next 18 years considering he was responsible for her getting pregnant?

    And of course if the others agree that the doctor is within their rights to force an unrelated test onto a person, why stop at pap smears? Why not demand a mamogram, EKG,CAT scan, MRI, x rays, spirometry, colonoscopy, etc??

  • 11-08-2012 12:55 PM In reply to

    Re: Is it legal for a doctor to refuse treatment of a condit...

    Please don't reopen really old threads.  :)

  • 11-08-2012 12:56 PM In reply to

    • mary8888
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    Re: Is it legal for a doctor to refuse treatment of a condit...

    Exept that in most other countries of the world women don't have well women exams because they are of no clinical value, they just lead to overdiagnoses, hence your high hysterectomy rates comapred to other parts of the world.

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