Ethics of withholding medical test results?

Parent Cafe
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<p>Shrink, I’ve seen it. In fact, I just wrote my paper for an honor’s option about it. </p>

<p>I think there are things I would control for. If I could save my children from PCOS, I would (not possible yet). If I could save my children from UC, I would. I wouldn’t go as far as making sure that only children who didn’t have my boyfriend’s color deficiency gene were conceived because I don’t believe that’s too detrimental of a defect. I also wouldn’t abort a child with either of the first two conditions, as they can be managed, but I might prevent them from being implanted if I used IVF. </p>

<p>I would be furious if my doctor didn’t tell me about what my child was going through or what abnormalities he/she might have. Are THEY going to pay for the medical care for that child for the rest of his/her life in case of a severe deformity? I hate to put it in money terms, but it’s the truth.</p>

<p>Gattaca is disturbing but not a future we’re heading to rapidly. Maybe in some far-off time but there’s too much of a religious strong hold and fear of technology to get there any time soon. I’m really not worried about it at least in my lifetime. (Sorry, I didn’t realize you weren’t looking for a response).</p>

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<p>romani, it’s perfectly valid to question the financial aspects of anything related to medicine. In this case, a doctor who’s personally squeamish about abortion can condemn a family to financial ruin, without their permission or even their knowledge.</p>

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<p>Note that red-green color vision or deficiency of such is encoded by genes on the X chromosome. Inheritance is described [url=<a href=“http://en.wikipedia.org/wiki/X-linked_recessive_inheritance]here[/url”>X-linked recessive inheritance - Wikipedia]here[/url</a>] and [url=<a href=“Color blindness - Wikipedia”>Color blindness - Wikipedia]here[/url</a>].</p>

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<p>I had a gyn who, when I went to him to get fitted for a diaphragm, asked me with contempt in his voice: “Are you going to marry this boy?” I was ~22 years old and it was 1970. It was soooooo clear that he didn’t approve. However, he completed his task of fitting me and prescribing it.</p>

<p>There is a scene in the early MadMen when Peggy goes to a gyn to get an exam and a prescription for the pill. He’s smoking while he examines her, which was a rather nice touch. He then tells her the pill is going to cost her around $10 a month, but “that doesn’t mean you need to make sure you get your money’s worth from this.”</p>

<p>Yes, they certainly were judgmental, weren’t they.</p>

<p>I’m just wondering – especially for the younger posters on here – has anyone had a similar experience in the last decade or so??</p>

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<p>ucb, notice I said “gene”, not deficiency. All of our daughters would be carriers. I could ensure that I had only sons to kill the gene in our family.</p>

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<p>Everyone I know goes to female OBGyns</p>

<p>On another note . . . DS15 and I were watching TV the other evening and an ad for Andro-gel 1.62% came on. He noted the flurry of men’s ads interspersed with all the news coverage of restricting women’s access to birth control (good boy!). When did “Low-T” become a treatable disease (or is it a syndrome?). Why do they give the male issued cute names like ED and Low-T? It’s like Micky-D’s and SunnyD only trying to make impotence cute and friendly instead of high fructose corn syrup. Maybe poly-cystic ovarian disease needs a cute acronym.</p>

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<p>Roly-Poly-Ovly disease?</p>

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<p>The message: If men have trouble having sex, they have a disease we can fix. If women want to control what that sex does to their bodies, they’re sluts.</p>

<p>This is the right-wing fundamentalist vision for America. Scary.</p>

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<p>Wrongful birth lawsuits are relatively new (past 30 years or so) and very few have been won. In a wrongful birth lawsuit, parents sue a doctor for reading a test wrong or for failing to tell them that their child has Down’s syndrome or some other birth defect and that if they had been told they would have aborted the child and been spared the costs of raising that child with the associated medical costs of a child with birth defects. </p>

<p>If the child died or is very severely affected, maybe a jury could be convinced, that the parents would have been better off and that there is no value in love or compassion in having the child here. But if the parents claim is that they would have aborted a healthy child for the ‘defect’ of being a girl, good luck. There isn’t a jury in the country that would award a penny in such a case. In fact, in those cases, the state’s child services should come in and remove the girl from the home.</p>

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<p>This might have some effect on the subject: <a href=“http://abcnews.go.com/blogs/health/2012/03/10/parents-get-2-9m-in-down-syndrome-girl-wrongful-birth-suit/[/url]”>http://abcnews.go.com/blogs/health/2012/03/10/parents-get-2-9m-in-down-syndrome-girl-wrongful-birth-suit/&lt;/a&gt;&lt;/p&gt;

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<p>There’s a difference between a mistake and an all out lie because the doctor doesn’t believe in abortions.</p>

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<h1>39-Shrinkrap:Yes! We are testing and don’t know where it’s going. Or really discuss it.</h1>

<p>Obviously women should have the results of any medical tests performed on them, if they request those results. And the right not to have testing they don’t request. I started thinking a lot about this in the 80s when my most friends were childbearing age. It occurred to a few of us there was no reason to have prenatal testing if you were very sure you wouldn’t terminate and if most genetic tests carried some risk of miscarriage. On the other hand one friend had CVS, when it was a very new procedure, saying she could deal with a child perhaps missing fingers but not with Down’s Syndrome.</p>

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<p><a href=“http://www.asha.org/Publications/leader/2006/060228/f060228b.ht[/url]”>http://www.asha.org/Publications/leader/2006/060228/f060228b.ht&lt;/a&gt;&lt;/p&gt;

<p>I am absolutely pro-choice but think we need to have more discussion, as women, of what all these new choices mean to us. High school age seems about right to me to start deciding how you feel about these choices. It is a little too late imho to wait till you’re pregnant.</p>

<p>edit: off topic - sorry - although I do think this has to do with the large issue of how women are treated by the medical establishment.</p>

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<p>although I do think this has to do with the large issue of how women are treated by the medical establishment.</p>

<p>Pregnancy may be the first time since childhood where women see a Dr. more than occasionally. They generally are young and inexperienced in being an informed patient.
I think these things really need to be considered when we are looking at legislation that will impact the Dr/patient relationship.</p>

<p>I am also wondering what insurance companies think about these bills. Are the insurance companies dictating required tests & how do they make their determination? What do they think about patients potentially not receiving the results of testing? On a strictly monetary basis, it seems that an insurance company would pay out more money to a family who has a child which requires a high level of care, than if that couple decided to terminate the pregnancy.
(not that I think money should be used as sole criteria- still, it is a factor for many)</p>

<p>However, most terminations are performed at less than 8weeks, this is several weeks before all but the most rudimentary pregnancy testing is performed. Woman who make a decision to end a pregnancy before two months aren’t doing so because of the results of a genetic test.</p>

<p>I really do feel for Drs who see their patients terminate pregnancies for reasons like an unwanted sex, or a non-fatal genetic disorder. I hope that education & counseling is provided for everyone involved so the best choice can be made. But that includes test results including results of pre-conception testing.</p>

<p>The better prepared potential parents are to * make the decision to conceive*, the better prepared they will be to deal with the ups & downs of the pregnancy ( & the inevitable ups & downs of raising a child).</p>

<p>But oddly enough, this comes back to teaching accurate sex ed. About contraception, sexually transmitted diseases, about personal responsibility & resources for support.</p>

<p>Why is it that those who want to decide what a woman can do during her pregnancy, are also often the same people who promote abstinence only education?</p>

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Sez who? I think you will find that there are many people who would be comfortably morally with some reasons for choosing to abort, but not with others. Whether, and how, to take account of that legally is the hard part.</p>

<p>As for the “wrongful birth” issue–well, it’s not simple. Even if you agree that a doctor should be absolutely required to provide the results of all medical tests to the patient, what should his liability be if he fails to do so? Should he, for example, be liable for the costs of raising a Downs-syndrome child? In other words, what should the money damages be for preventing a person from exercising her right to an abortion–assuming she can prove that she would have chosen one if she’d had the withheld information? It’s not obvious to me what those damages should be.</p>

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<p>If we support a woman’s right to choose, don’t we have to support her right to choose for any reason, even if we find it morally repugnant?</p>

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<p>"If we support a woman’s right to choose, don’t we have to support her right to choose for any reason, even if we find it morally repugnant? "</p>

<p>Yes, we do, the key problem is morality is not an absolute, moral values vary from culture to culture, from person to person, from religion to religion. Most jews have no problems with abortion from a religious perspective from what I understand, because in Jewish tradition a fetus is not considered human unless it is viable outside the mother (basically, if you think about it, it becomes human when it is born). A lot of people are troubled by abortion, but also believe that has to be up to the mother/parents. The problem with the anti abortion argument is there is no clear, definitive test you can give to say something is human; evangelicals and the Catholic Church believe even a fertilized embryo is human, even though it is basically a collection of cells looked at logically. We know someone doesn’t become self aware without higher brain functions, yet that ability happens pretty far into the gestation process. The religious go by the idea that even a fertilized embryo is human because it has been in effect ‘touched by god’ or ‘given a soul’ at conception, yet there is no test for that, it is simple belief…</p>

<p>The problem with beliefs is if you choose to enforce one person’s belief over another, you are taking away their choice and their beliefs. I personally am troubled by abortion in the sense that as a form of birth control it is idiotic, when there are so many choices out there to prevent pregnancy, but I also respect the right of people to decide their own futures, and I also know how tough some of those decisions are. I don’t know if we found out when my wife was pregnant that our unborn child had some major issue like down’s or tay sachs or whatever, that would lead to a lot of things, but I also know that decision would have to be ours, not someone else’s. </p>

<p>What disturbs me about this is a doctor playing God like that, deciding what someone else’s decision should be. I can see a doctor refusing to do abortions, I can see doctors that refuse to prescribe birth control that is the prerogative, but not giving the parents information they need to make serious decisions like this? It would be like a doctor not telling a patient they had AIDS, because he wanted them to die horribly from ‘the wages of sin’, it is in effect doing what doctors are not supposed to do, cause harm.</p>

<p>It is funny, I remember stories of when NY decided to legalize abortion, and one of the big votes was from a State Senator at the time (I think his name was Marchi or some such), guy was Catholic. He voted to make it legal, and was absolutely excoriated for it, was villified by the church, got death threats, etc. Anyway, when he was asked why he voted for it, he told the story, his married daughter had a child with some sort of mental retardation (might have been Downs, I don’t remember), and he described how the strain of caring for that child caused all kinds of issues in her marriage (ended up with the husband walking away, sadly) and so forth. He said his daughter would never think of getting an abortion, that she like he felt it was the wrong thing to do, but he also said having seen the agony of his own daughter, he couldn’t force others to go through that in good faith. The real problem with this law is it takes the matter out of the hands of those who have to deal with it, whatever the situation is, and assumes that their moral position, their beliefs are the only ones that matter, and more importantly, also shows how little they care about the impact of their moral beliefs. It reminds me a lot of the ban on condoms in the Church and debates in a country with a heavy Catholic Presence (Uganda), where thanks to pressure from the church and from the election of a Catholic president, programs to teach sex ed and distribution of condoms were stopped and other anti AIDS initiatives…and new infections, which had plummeted since the advent of those programs, skyrocketed once again…it is about looking at the moral evils and thinking which is worse, and what the impact is on others about something I believe.</p>

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<p>I see no moral evil in condoms, birth control, or in terminating an unwanted pregnancy, so I dismiss the notion that it is about choosing among moral evils.</p>

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<p>In terms of another thread, on viagra and the religious, none of them, including the RC, have problems with viagra, even thought like birth control pills, it is artificial…which says a lot about their mindset. According to Catholic Church statements, as long as viagra is used in a marriage and it is ‘open to life’ it is fine (the latter being somewhat ambiguous. What is interesting is in couples where they are post child bearing years, they say "as long as the couple is open to life’ it is okay to use viagra…but how can they be open to life, when they can’t have kids…at that point, they are having sex for the pleasure of it, since they can’t have kids… meanwhile, according to self same church’s teachings, women taking fertility drugs, IUI and IVI, etc, are all ‘immoral’, yet those are used to create life, but that is ‘artificial’…</p>

<p>Basically, if something is about male sexuality (disclaimer, I am male), it is okay even if <em>nod nod wink wink</em> the primary reason is to let men have sex for pleasure, if it is anything to do with women’s sexuality, that makes sex easier (like condoms or birth control) it is ‘wrong’ since of course women’s sexuality doesn’t matter…as a poster once put it, 80% of the leadership of the anti abortion movement are men, 0% of them can get pregnant.</p>

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<p>"I see no moral evil in condoms, birth control, or in terminating an unwanted pregnancy, so I dismiss the notion that it is about choosing among moral evils. "</p>

<p>Neither do I, but the fact is among those who claim these are evils, they can’t see that, they can’t see the concept that maybe, just maybe, what they see as an evil may be less evil then the consequences of not having condoms, abortion, birth control, etc.</p>

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But their comfort or discomfort has nothing to do with the woman’s right to make a choice. We have set the bar at the idea that these decisions are strictly between a woman and her doctor/God/husband/SO/family. Not the government, and not people who find her reasons morally uncomfortable. She should not even have to give a reason.</p>