Um...I was instructed to start going to the gyno annually once I turned 18 whether or not I was having sex.

Liza, my thoughts exactly.

Paps shouldn't be covered by a conscience clause (nothing should). They check for more than just things caused by having sex. This is definitely endangering young women.

At 15 if I had gone to my doctor and they had refused to perform an intimate exam based on the fact I was unmarried, I think I would have been too shaken to seek help elsewhere.

This really frightens me. Are they equally allowed to refuse pregnant unmarried women access to pre-natal care, or does the fetus override the woman like always. *sigh*

As Liza pointed out, the logic is completely flawed with this. Just because you're getting a pap smear or requesting birth control doesn't mean you're having sex. But I guess I should have to continue to endure cramps and what not because I haven't yet found a husband.

That is the same as saying, "I'm not going to perform surgery on this youth because he was shot in a gang war, and I don't believe in that." Idiotic, and completely sexist.

Shouldn't the Hippocratic oath trump their personal feelings about marriage?

I refuse to dispense cold medicine to you! You may have breathed in the winter months and Jesus doesn't look kindly on that!!

Yes, that makes just about as much sense.

I refuse to dispense cold medicine to you! You may have breathed in the winter months and Jesus doesn't look kindly on that!!

Yes, that makes just about as much sense.

I was wondering the same thing about the hypocratic oath...and I was told you should start getting pap smears when you turn 16. You know, when you've had a few periods, since sex isn't what causes cervical cancer. I seriously can't understand how DOCTORS can be so stupid...are the going to abstinence only medical schools or something?

I wonder if these doctors would refuse to prescribe ED medication for unmarried men?

I wonder if they would stitch up wounds which one received while one was committing a burglary. That's against the law, most moralities, and the commandments. I also wonder how they would react if a Jewish doctor refused to treat a patient who had contracted food poisoning from oysters.

Some days I see the headlines at feministing and think, "no way, they are making that shit up just to rile me and spike my blood pressure."

But then you LINK to actual articles.

The insanity is just amazing.

Your body is not worth worth keeping healthy until you're married? Women cease to have medical needs prior to walking down the aisle?

Well... lesbians are fucked.

BUT!! Even with their ludicrous and totally unacceptable "reasoning," It's still illogical! You can have cancer or other problems with your cervix even if you are a virgin. There is no body part that is guaranteed to be disease free just because one is not having sex!

All these pharmacists and doctors who are not willing to do ALL PARTS of their jobs without discrimination need to be fired, fined, and heavily censured. This trend is disgusting.

This is what I don't get. These doctors are saying that unmarried women shouldn't get pap smears because unmarried women shouldn't be having sex. But then why would married women need pap smears if they've only had sex with their husbands? I mean, isn't this whole abstinence-until-marriage crap telling us that if we only have sex with our husbands, we don't have to worry about STDs? They must not think much of married men either, since they suspect that they're running around having sex with all those whorish unmarried women who shouldn't be having sex in the first place!

With mental health professionals, it is their ethical responsibility to refer to a competent counselor if they feel, for whatever reason, that they are unable to provide services to the best of their ability to their client. For example, if a pregnant woman was unsure about whether or not to get an abortion, and the counselor was pro-life and could not remain objective in the matter, the counselor has an ethical obligation to refer to someone who would be objective. And that is for the client's, not the counselor's, benefit. So why are medical doctors allowed to refuse help to someone based on their own, not the patient's, objections? Since when are doctors in the business of doing whatever they want and not what's in the best interest of their patients? I'm not saying that counselors are never going to impose their values on their clients, but at least there are serious risks for doing so. Do medical doctors have the same ethical obligation? I suppose since law trumps ethics created by professional organizations, it doesn't really make a difference.

"Um...I was instructed to start going to the gyno annually once I turned 18 whether or not I was having sex."

Me too!

I went to get one at 18 but my doctor at the time didn't finish it. I was nervous about the exam and I guess it showed because she said she was afraid I'd kick her into the wall. Maybe her being shorter and smaller than me had something to do with it?

Later I had a pap smear with a GYN and that's how she found out I have PCOS.

Oddly enough, these days my doctor tells me "you're not at risk of HPV since you're not sexually active, and I'll still give you a pelvic exam if you choose." She also prescribes my BCP instead of saying "no, that's for married women."

does the "conscience clause" apply to anything other than birth control, abortion, and pap smears? Seems it might also cover things like medical research/testing and also might include doing things one shouldn't do, such as giving non-emergency medical care above the bare minimum. Is it a wide-ranging thing or a defense specifically thought up for and narrowly applied to BC, abortions, and now pap smears?

Law may indeed trump professional ethics but doctors or lawyers or members of any member of a professional group can still be sanctioned. I hate that this is happening but at the same time, for non-emergency care, I'm trying to wrap my head around a doctor being mandated to perform any legal medical action the person in front of the doc might want, regardless of the doctors ethics. Doctors are not machines and while I think the people who refuse to prescribe BC or perform pap smears are idiotic, a person does not lose their personal ethics upon donning a white coat. Even saying that though, its hard for me to think of a reason a doc could come up with to not do something other than it medically doing more harm than good.

I have a medical condition that increases my chances of getting cancer so having my annual pap is doubly important. I think my head would explode if my doctor refused to treat me on "moral" grounds. Thank heavens I have the most feminist, liberal gyno on the planet. I really hope that the women affected by this in Canada can mobilize to get the healthcare they deserve.

I don't think it's just HPV that can cause cervical cancer, is it? It's sick either way. Doctors need to give their patients the absolute best medical treatment possible. If their personal feelings get in the way of that, they shouldn't practice medicine.

I think the idea for this story came from the essay I read at the Morgentaler decision celebrations in Ottawa (I am the Peggy Cooke mentioned in the story). Two of my friends - who go to two different doctors - have been refused pap smears. I don't know if this is something that is widespread that we have to worry about; I mentioned it in the essay only as part of a broader point about the declining standards of health care and reproductive choice in New Brunswick.

So really, I don't think there is an epidemic of doctors refusing to do pap smears (of course, I could be wrong), but there does seem to be an awful lot of anti-choice doctors (at least in my neck of the woods) and in general it is something to be concerned about.

Horrible if true, but the writer lost credibility with me when I realized her main basis for the article was the experiences of two friends of a friend and she revealed a sad lack of understanding in the difference between "conscience" and "conscious."

It would be interesting to hear more details from the friends of the friend of the writer about the experiences.

Okay so since I'm not married does that mean I can have lots of unprotected sex with lots of partners and not have to worry about getting HPV?

But honestly I understand that a doctor's personal ethics don't fly out the window when s/he becomes a doctor, and those beliefs should be respected, but refusing a service to one specific group and granting it to others is weird.

the RH reality check article is about the statements of Peggy Cooke "about her friends". Peggy Cooke is a New Brunswick choice activist and that a friend of hers said she was refused a pap is likely true, but I caution readers that it is absolutely not status quo for New Brunswick women to be refused pap tests. The province announced a cervical screening program in January to systematically assure every single woman from 18 and up is getting screened, and it is also funding HPV vaccination for every grade 7 girl from now until forever. There are whack job doctors everywhere, and NB does have a deservedly terrible rep for poor abortion access, but cervical cancer prevention is another fish entirely, and the province is doing a commendable job.

Of course that said, whack job doctors SHOULD re evaluate why on earth they got into doctoring if they'd rather be preachers.

No, you don't get to impose your religious beliefs on people in a professional setting when it affects other people's health. Why apply for a job you're not going to perform. Why pledge to do something you find objectionable. Why go into business with the intent of dicriminating. Just find something better suited to you, like judging beauty pageants or quality control.

No, you don't get to impose your religious beliefs on people in a professional setting when it affects other people's health. Why apply for a job you're not going to perform. Why pledge to do something you find objectionable. Why go into business with the intent of dicriminating. Just find something better suited to you, like judging beauty pageants or quality control.

the RH reality check article is about the statements of Peggy Cooke "about her friends". Peggy Cooke is a New Brunswick choice activist and that a friend of hers said she was refused a pap is likely true, but I caution readers that it is absolutely not status quo for New Brunswick women to be refused pap tests. The province announced a cervical screening program in January to systematically assure every single woman from 18 and up is getting screened, and it is also funding HPV vaccination for every grade 7 girl from now until forever. There are whack job doctors everywhere, and NB does have a deservedly terrible rep for poor abortion access, but cervical cancer prevention is another fish entirely, and the province is doing a commendable job.

Of course that said, whack job doctors SHOULD re evaluate why on earth they got into doctoring if they'd rather be preachers.

“whack job doctors SHOULD re evaluate why on earth they got into doctoring if they'd rather be preachers.�
My suspicion is that wingnuts get into healthcare professions just so they can refuse care to “undesirable� people and put bitches in their place.

I've been in touch with the Office of Ethics at CMA and he assures me that the Conscience Clause is NOT intended to be applied at individual doctors' discretion - it is intended for abortion-related cases only:

"Thank you for the additional information. I suspect that when people quote the CMA's "conscience clause" they are referring to our policy on induced abortion, which should not be extrapolated to any and all clincal scenarios. While there may be grey areas where the acceptibility of conscientious objection could be debated, Pap smears is in my opinion not one of these, and any physician refusing to perform this service on the basis of marital status is not following CMA policy."

So it appears that the judgmental bigots of doctors denying women paps are entirely abusing the policy and could experience severe repercussions were they to be reported to the College of Physicians.

This just fucking pisses me off. Between pharmacists refusing to fill prescriptions and these doctors, I don't even know where to begin. I'm reading a book right now, called FOR HER OWN GOOD. It's about how the medical/advice professions have gone out of their way to basically screw women over through the past few centuries, starting with the witch burnings during the Inquisition. Denying women access to medicines and procedures based on your own misconceptions is nothing new, but you'd think we'd be enlightened enough to be past this shit.

providentially,
thanks for the clarification. this is indeed fucked up.

Well, that is just stupid. Lots of people get HPV from their mothers during birth, so even if they never had sex they would still need pap smears.

This really frightens me. Are they equally allowed to refuse pregnant unmarried women access to pre-natal care, or does the fetus override the woman like always. *sigh*

Yes, doctors are "allowed" to refuse treatment. However, there may be consequences for them including censure by the medical board, removal from their post at a hospital, etc.

There are no laws requiring that doctors offer paps, or prenatal care, or anything else and thats the way it should be. This should be handled by medical boards, malpractice suits, and bad publicity driving the doctor out of business.

This may be a blessing in disguise. Afterall, who wants to go to a doctor who clearly doesn't give a shit about your health in the first place?

This may be a blessing in disguise. Afterall, who wants to go to a doctor who clearly doesn't give a shit about your health in the first place?

There are no laws requiring that doctors offer paps...

Um... that might be the case, but if you are a gynecologist, you damn well better offer pap smears. That's fucking ridiculous.

If an OB/GYN has a hangup about paps (of all things), then they probably picked the wrong field.

It's like someone who refuses to perform digital rectal exams, choosing GI as a field. Um... hello?

That said... there probably shouldn't be an actual law. Let the bad publicity drive them out of business.

Be glad they are treating them at all. There have been cases in UK of male Muslim students refusing to examine women for anything.

Conscience clauses make sense when another human life (whether or not you, as pro-choicers, happen to value that life yourselves) is on the line.

That applies to medical and surgical abortion, IUDs, and pharmaceuticals that could be disastrous for a foetus but are not medically necessary.

The line here is that no other human is involved. If the woman has HPV (and associated cervical abnormalities), she ought to know, at the very least so she can avoid infecting other people.

Furthermore, given that there are things like, oh, rape and incest in the world, it wouldn't hurt to check up on all women. If a woman had been sexually assaulted, she needs both medical and psychological care. The doctor's app't is a great place to start building a long-term relationship that can help her work through any associated issues.

Given that cervical cancer has other causes - smoking, bad luck - this makes absolutely no sense.

My final problem with this: I think that it's absolutely crucial for women to go to the gynaecologist BEFORE there is a problem. You ought to know what "normal" for her looks like, before you can tell whether a problem is attributable to a certain cause. There are always issues of how long some abnormality has been there, or whether the particular abnormality is causing a problem.

I went to the gynaecologist starting at age 17 or so. When I was 19 and had screwy periods, I was happy that she had a baseline on my body. (My one problem was that she would not lay off the idea of oral contraceptives for my abstinent self. That really sucked. I refused several times - let it be, lady.)

Oenophile, what does an IUD have to do with fetuses? Other than preventing them from existing? And if you're abstinent, why would you mind taking a medication that would fix your periods? (I'm not being snippy, I'm honestly curious.) It seems they would have a chance to contracept if you're not having sex.

KMP, let me clear that up.

My periods are usually perfect. Three to four days, relatively light flow, and I've gotten cramps (slightly achy back) maybe a half-dozen times in my life, for no more than an hour at a time.

"Fixing" my periods is sort of bullshit. (I'm not mad at you for not knowing the intimacies of my cycle - just at the theory that we need to fill our bodies with every pharmaceutical in existence to "fix" ourselves.)

The problem I sometimes have is stress-related double periods - maybe once every two years. I went to have it checked out because I wasn't sure if it was stress or something else. My MD then spent the next few years (when I went for yearly exams) trying to shove BC down my throat.

It seems they would have a chance to contracept if you're not having sex.
?

I'm a vegetarian. I really, really hate putting crap in my body. Downing the Pill to make my "everyone has sex at age 18, gets married at age 25, and then has 2.2 children" doctor isn't on the to-do list. Abstinence works for me, and, as per above, my periods really can't be improved.

---

IUDs:

They work in one of two ways. Some of them are hormonal and/or block off the Fallopian tubes, which prevent fertilisation of an egg (by preventing ovulation or by preventing the sperm from reaching the egg).

Most of them, however, work by preventing implantation of the fertilised egg, and, if the egg has implanted, causing a very early miscarriage. I know some pro-choice women who prefer to use birth control that is at least designed to work by preventing ovulation or by a barrier method, rather than one whose primary purpose is to prevent implantation of a fertilised egg.

Whether or not you believe that a fertilised egg is a human worthy of moral protection, there are some issues there. I can really understand if a doctor would not, himself or herself, want to insert IUDs. The proper thing to do then is to send the patient to a physician who will do it.

As a future Ob Gyn, I find this horrifying. These doctors do NOT have a conscience based issue with pap smears. They are valuable screening tools for women. A valuable screening that they do not seem to have a problem using with a subset of their population that is not different in ANY medical way.

They have a problem with hypothetical activity outside of the office. Sex outside of wedlock. Now, they have NO way of proving any of their married clients are "faithful". Hell, they could be going home and fucking dead donkeys for all they know.

I think that it is fine for a doctor to have a moral issue with a procedure or drug. But, that has to be based on risk and ethics of the procedure. You cannot deny care and increase risk of death from cancer based on marital status. That is not ethical.

I question why these people chose medicine, especially gynecology, if they have such a twisted and paternalistic view of women's sexuality and genitalia.

They do not own their patients' vaginas. Why is it these kinds of challenges ALWAYS seem to circle around women's genitalia. You never hear about doctors refusing to treat drug addicts, or liars, or philandering husbands. One of our rotations is a prison rotation. Should I tell a murderer that he violated a commandment, so he can have a heart attack for all I care?