Why do 85% of GPs not provide abortion services? - mod warning in OP (01/01/20)

volchitsa

One eyed Jack wrote: »

I’m just going to address this part of your post as I’m going to adhere to the mod warning above.

Doctors refuse to treat people all the time for personal reasons. Even when doctors do treat people, how they treat them is informed by their personal beliefs and values. Your idealised scenario of a medical professional ignores the reality that medical professionals are first and foremost human beings, they aren’t mindless automatons.

Never heard of Best Medical Evidence then? No, they (should) propose treatments based strictly on their professional not personal opinions.

(To be clear, I'm not saying doctors are automatons, but that they should consciously try not to impose their personal beliefs on the advice they give and the treatments they propose to their patients. They won't always succeed, but that is a different point.)

lozenges

crossman47 wrote: »

Thats such a stupid comparison it doesn't deserve a reply. A soldier joins the army to fight. A doctor joins his profession to save lives. no comparison.

Not correct at all. Why do you think doctors who end up in palliative care joined their profession? They're not saving lives...

Hotblack Desiato

Gynoid wrote: »

And when people happily break the news at 12 weeks that they are expecting, what is it that "the people" know they are expecting?

Expecting.

Somethiing that you are hoping to have in the future but don't yet have.

So If Jane was expecting to graduate from college in two years' time, she's done one year of the work, does she have a degree already?

Hotblack Desiato

Deleted User wrote: »

GPs are up the walls as it is with all the medical card holders clogging up the system with every sniffle they have. They are probably not keen taking on an additional difficult task.

Dispensing 5 pills is not a difficult task. And they get a fee of €450 for it.

Hotblack Desiato

Dav010 wrote: »

The death of Sanita Halapenavar was a tragedy, an avoidable one, but something good did result, religious beliefs would never again play a part in medical treatments provided in an Irish Hospital.

That's a very confident claim, to say the least.

Nuns still own the new NMH site. We're waiting on a decision from the Vatican as to whether they're allowed sell it to the state, or not. :rolleyes:

Countless other hospitals still under religious control (while being entirely funded by taxpayers.)

Half of maternity units still not providing surgical abortions, as they are obliged to.

How may state-funded hospitals still refuse to provide elective female sterilisation?

But GPs are not bound by Hospital policies nor contracts, and therefore can consciously object to providing abortions.

They can yes, but patients have choice too. My GP signed up for Doctors for Yes, if she was on the other side of the debate then she'd have lost a patient, and I'm a man.

thomasdylan wrote: »

Refusal to provide abortion is protected in pretty much every health service. Refusal to provide a procedure is protected as long as the doctor has strongly held moral or ethical beliefs. The onus is on the doctor to justify that the refusal is based on personal ethics. If they refuse to give a flu vaccine they need to justify it. If they cannot justify it there's an issue. If they were to try to justify it based on incorrect medical beliefs I'd say that would be a fitness to practice issue.

Maybe you're seeing a chasm between refusal to provide a vaccine and refusal to provide abortion pills, but I'm not.

Neither has any grounds to object other than "moral". "Ethical" doesn't stand up as abortion within our law is medically ethical. So when a doctor is prepared to put their "moral" happenstance, whether it be based on internet woo or religious belief (and, really, what is the difference) ahead of the welfare of their patient then there is a problem.

Dav010

Hotblack Desiato wrote: »

Maybe you're seeing a chasm between refusal to provide a vaccine and refusal to provide abortion pills, but I'm not.

Neither has any grounds to object other than "moral". "Ethical" doesn't stand up as abortion within our law is medically ethical. So when a doctor is prepared to put their "moral" happenstance, whether it be based on internet woo or religious belief (and, really, what is the difference) ahead of the welfare of their patient then there is a problem.

You don’t see the difference between a vaccine and an abortion? How trite. Doctors aren’t objecting about the ethics, they are consciously objecting, two very different considerations. And in most cases, unless gone beyond 12 weeks, the termination is often not for the patients welfare.

You may look at this as a binary decision taking only legal and practical considerations into account, it is much more complex than that, hence why the State and the Medical Council have allowed GPs to opt in or out based on their feelings on the matter.

Dav010

Hotblack Desiato wrote: »

Dispensing 5 pills is not a difficult task. And they get a fee of €450 for it.

Are you talking about the physical act of handing over the pill, or the 11 years of training to be qualified and licensed to do so?

One eyed Jack

volchitsa wrote: »

Never heard of Best Medical Evidence then? No, they (should) propose treatments based strictly on their professional not personal opinions.

(To be clear, I'm not saying doctors are automatons, but that they should consciously try not to impose their personal beliefs on the advice they give and the treatments they propose to their patients. They won't always succeed, but that is a different point.)

I’m aware of course of concepts like evidence based clinical best practices, they’re based upon knowledge that medical professionals have at the time, and if medical professionals strictly adhered to those clinical practices then they wouldn’t be very professional physicians IMO, they would be nothing more than assembly workers - presented with a set of circumstances, apply knowledge that is based upon what they have learned from best practices, should lead to an expected outcome.

That’s great in theory, but in practice medicine simply can’t function like that, precisely because physicians cannot guarantee outcomes - their judgment is based upon their personal opinions which they hope will lead to a positive outcome for their patients. That’s why evidence based medicine isn’t just based upon providing a clinical diagnosis and treating the patient as though they are just another broken machine.

The evidence suggests that’s not the best way to treat patients - professional ethics requires that physicians regard the welfare of their patients as their priority. Physicians who adhere strictly to best practices are unlikely to care about the outcomes of their patients, and I wouldn’t regard those physicians as acting professionally. I would rather be treated by a physician whom I knew cared about the outcomes for me as their patient, than a physician who thought acting professionally meant acting according to a specific set of instructions and expecting all outcomes should be the same.

It’s the very reason why research was conducted into better ways to treat patients who refused blood transfusions, it’s the reason why professional codes of practice now emphasise caring for the patient as opposed to just treating them as another broken machine to be fixed. It’s the reason why no medical professional ethics body will compel physicians to treat patients according to a specific set of instructions with no regard for the patients welfare, because that’s not a very professional way to practice medicine.

minikin

AndrewJRenko wrote: »

Maybe GPs need to realise that eliminating part of their current client base by refusing to provide basic treatments makes no business sense?

Herein lies the issue, you consider an abortion to be merely a ‘basic treatment’.
A nice clean procedure of no serious impact or consequence?
Sure it’s like advising a patient on their hernia...
Or maybe the majority of GPs, being medically literate, have a harder time in pretending a potential life isn’t being terminated... maybe the concept of the ‘family doctor’ looking after several generations and forming close bonds with that extended family is a thing of the past now? That ethical approach made good business sense, as it ensured an understanding that the GP was also concerned with the best interests of all they dealt with.

There’s an attitude of mandatory service here among some posters... the GP MUST provide a service I want or they should quit.
Like the constant demand for anti-biotics when the GP knows it is not the right course of action and will have a detrimental effect on society by lowering its effectiveness in terms of ‘herd immunity’.
But the individual customer is always right, eh???

Let’s disregard the experts (GPS), force them into a situation they don’t wish to be in, how will that end? All for the sake of ‘convenience’ with this ‘basic treatment’.

Loafing Oaf

crossman47 wrote: »

They do not believe in ending the life of an unborn child.

And you are saying this is the position of every single GP who is not currently providing abortion services?

Hotblack Desiato

Dav010 wrote: »

You don’t see the difference between a vaccine and an abortion? How trite. Doctors aren’t objecting about the ethics, they are consciously objecting, two very different considerations. And in most cases, unless gone beyond 12 weeks, the termination is often not for the patients welfare.

That's not what I wrote, at all.
I was talking about refusal to treat based on grounds not supported by medical evidence or the best interests of the patient. They are both the same in that regard.

Are you seriously claiming that an unwanted pregnancy is in a woman's best interest? Surely that is for her, and her alone, to decide.

You may look at this as a binary decision taking only legal and practical considerations into account, it is much more complex than that, hence why the State and the Medical Council have allowed GPs to opt in or out based on their feelings on the matter.

They may be opting in or out for a variety of reasons and being "pro-life" may have little or nothing to do with it. And the state constantly panders to religion when it shouldn't, and the vast majority of objection to aboriton stems from the catholic religion.

Dav010 wrote: »

Are you talking about the physical act of handing over the pill, or the 11 years of training to be qualified and licensed to do so?

:rolleyes: So why doesn't the state pay €450 for a normal medical card consultation then? It could go on as long or longer. The doctors' union extorted the taxpayer over a politically sensistive issue and got away with it.

One eyed Jack

Hotblack Desiato wrote: »

That's not what I wrote, at all.
I was talking about refusal to treat based on grounds not supported by medical evidence or the best interests of the patient. They are both the same in that regard.

Are you seriously claiming that an unwanted pregnancy is in a woman's best interest? Surely that is for her, and her alone, to decide.

I don’t think anyone is arguing that the medical profession should have the sole authority to decide what is in a patients best interests. Of course a patient has every right to decide how they wish to be treated according to what they believe is in their best interests, but that right doesn’t extend to compelling physicians to violate their conscience if a physician doesn’t believe the course of action the patient wishes for is in their best interests. The physician who takes their directions on how to treat their patients from the patient themselves, isn’t a physician, they’re a jackass who isn’t acting in the best interests of their patients.

Hotblack Desiato wrote: »

They may be opting in or out for a variety of reasons and being "pro-life" may have little or nothing to do with it. And the state constantly panders to religion when it shouldn't, and the vast majority of objection to aboriton stems from the catholic religion.

No it doesn’t? It doesn’t even stem from religion of any particular denomination. The vast majority of objection to abortion and the reason the stigma against abortion is prevalent in most societies and cultures throughout history is simply because people generally find the idea repugnant.

Hotblack Desiato wrote: »

:rolleyes: So why doesn't the state pay €450 for a normal medical card consultation then? It could go on as long or longer. The doctors' union extorted the taxpayer over a politically sensistive issue and got away with it.

The Irish Medical Council aren’t extorting anyone. They are serving the best interests of their members in negotiations with the State. If you want some jackass handing out pills on a party bus with no responsibility or accountability for the welfare of the person who they’re handing out pills to, it’s certainly cheaper than paying a licensed medical professional for their expertise, but I would suggest that the State would not regard that as acting in people’s best interests, which is why it’s prohibited by law.

Hotblack Desiato

One eyed Jack wrote: »

I don’t think anyone is arguing that the medical profession should have the sole authority to decide what is in a patients best interests.

This is what the poster wrote:

And in most cases, unless gone beyond 12 weeks, the termination is often not for the patients welfare.

How can it be in the interests of a woman's welfare to force her to continue with a pregnancy against her will? Even on the grounds of physical health alone, abortion is safer than giving birth.

No it doesn’t? It doesn’t even stem from religion of any particular denomination. The vast majority of objection to abortion and the reason the stigma against abortion is prevalent in most societies and cultures throughout history is simply because people generally find the idea repugnant.

This is also completely untrue.
One church, and one church alone, supported the introduction of the 8th amendment to Ireland.
The movement to introduce it was entirely driven by lay Roman Catholic organisations. Read Masterminds of the Right by Emily O’Reilly - your library can get it for you.

There was no secular campaign to retain the 8th amendment in 2018.
The only non-religious organisation to oppose repeal was a tiny fringe republican organisation.
Internationally, we see religious groups everywhere opposed to abortion but very very few non-religious ones.
Even the US Evangelicals and Baptists were generally not troubled by abortion until conservative activists realised it was a wedge issue they could exploit to basically take over the Republican party.

United States anti-abortion movement

Wikipedia wrote:

In the late 1960s, in response to nationwide abortion-rights efforts, a number of organizations were formed to mobilize opinion against the legalization of abortion.[8] Most of these were led by Catholic institutions and communities; most evangelical Christian groups did not see abortion as a clear-cut or priority issue at the time. The first major U.S. organization in the modern anti-abortion movement, the National Right to Life Committee, was formed out of the United States Catholic Conference in 1967.[7]


The first organized action was initiated by U.S. Catholic bishops who recommended in 1973 that the U.S. Constitution should be amended to ban abortion.[1]

The New Front Line of the Anti-Abortion Movement

The New Yorker wrote:

Until the seventies, abortion had mostly been a Catholic issue, but following Roe v. Wade, in 1973, evangelical Christians began to join the pro-life movement. In 1978, the Southern Baptist pastor Jerry Falwell partnered with the conservative activist Paul Weyrich in an effort to register and organize religious voters, and they seized on the issue of abortion as a mobilizing cause.

The Irish Medical Council aren’t extorting anyone. They are serving the best interests of their members in negotiations with the State. If you want some jackass handing out pills on a party bus with no responsibility or accountability for the welfare of the person who they’re handing out pills to, it’s certainly cheaper than paying a licensed medical professional for their expertise, but I would suggest that the State would not regard that as acting in people’s best interests, which is why it’s prohibited by law.

Funny how their expertise is only worth a very small fraction of €450 when it's a 'normal' medical card consultation, isn't it? Even a private patient normally pays a GP €50-60.

One eyed Jack

Hotblack Desiato wrote: »

How can it be in the interests of a woman's welfare to force her to continue with a pregnancy against her will? Even on the grounds of physical health alone, abortion is safer than giving birth.

I thought we were talking about the best interests of the patient, which will be determined depending upon the circumstances in each and every particular case. That’s what physicians are bound by their professional code of ethics to do - to regard all the circumstances of each particular case and make their determinations accordingly in the best interests of their patients.

Their patients of course have every right to disagree and seek treatment that suits them elsewhere, but I don’t see how attempting to compel physicians to act in a way which they don’t believe is acting in the best interests of their patients, is in anyone’s interest? If the patient wants to be treated according to what they believe is in their best interests, then it is in their best interests to seek a physician who agrees with their self-diagnosis. The type of physician who practice medicine that way are generally best described as quacks, and shouldn’t be let near anyone.

Hotblack Desiato wrote: »

This is also completely untrue.

I misunderstood your point then. I thought you were talking about abortion itself, not the politics of reproductive rights. Advocating for, or objecting to reproductive rights is hardly the same thing. Reproductive rights are based in law, whereas attitudes to abortion are conditioned based upon prevailing social morality. It’s why a stigma around abortion exists in spite of the fact that people also aren’t too interested in what the Church has to say on the issue. It’s why people voted by somewhat of a landslide in favour of broadening reproductive rights in Irish law in spite of the fact that they would never want to have an abortion themselves.

Abortion itself is repugnant, forcing pregnant women to give birth against their will is just that much more repugnant than a pregnant woman deciding to end her own life because she is adamant that remaining pregnant is worse. That’s why there is a complex moral dilemma that presents itself that goes beyond legislating for reproductive rights. Legislating for reproductive rights really applies to persons who provide for termination of pregnancy. It’s why all the responsibility and/or liability for a termination of the pregnancy rests with the person performing the termination, and doesn’t seek to criminalise pregnant women. The majority of physicians in Ireland don’t appear to be willing to take on that sort of risk, the €450 they would get for providing the means for a termination of a pregnancy isn’t worth the potential risks involved.

Hotblack Desiato wrote: »

Funny how their expertise is only worth a very small fraction of €450 when it's a 'normal' medical card consultation, isn't it? Even a private patient normally pays a GP €50-60.

Even the fact that you had to use quotes around the word normal, suggests you know yourself that termination of a pregnancy aren’t a normal service provided by GPs. That’s precisely why they incur the extra cost, because the stakes and the risks involved are also that much greater than the normal services provided by GPs - the potential of being sentenced to 14 years in prison and being unable to practice medicine again is not a risk they are prepared to take lightly.

Hotblack Desiato

One eyed Jack wrote: »

I thought we were talking about the best interests of the patient, which will be determined depending upon the circumstances in each and every particular case.

No. I was addressing a specific point made by a poster, I quoted it for you, looks like I need to quote it for you again:

And in most cases, unless gone beyond 12 weeks, the termination is often not for the patients welfare.

^^^^^
And I said that forced pregnancy is not for the patient's welfare, either.

That’s what physicians are bound by their professional code of ethics to do - to regard all the circumstances of each particular case and make their determinations accordingly in the best interests of their patients.

It is in no way professionally ethical for a physician to obstruct a woman's legal right to have an abortion. At the very least they must refer. However I and many others regard that as letting their patient down for the sake of the doctor's own sanctimony.

Their patients of course have every right to disagree and seek treatment that suits them elsewhere, but I don’t see how attempting to compel physicians to act in a way which they don’t believe is acting in the best interests of their patients, is in anyone’s interest? If the patient wants to be treated according to what they believe is in their best interests, then it is in their best interests to seek a physician who agrees with their self-diagnosis. The type of physician who practice medicine that way are generally best described as quacks, and shouldn’t be let near anyone.

You are ignoring two things

1. It is probably not legally possible to compel doctors to prescribe, but it is possible to compel them to refer, and they have an ethical duty to refer a patient they refuse to treat.
2. A woman in Ireland less than 12 weeks pregnant has a legal right to an abortion.

I misunderstood your point then. I thought you were talking about abortion itself, not the politics of reproductive rights. Advocating for, or objecting to reproductive rights is hardly the same thing. Reproductive rights are based in law, whereas attitudes to abortion are conditioned based upon prevailing social morality. It’s why a stigma around abortion exists in spite of the fact that people also aren’t too interested in what the Church has to say on the issue. It’s why people voted by somewhat of a landslide in favour of broadening reproductive rights in Irish law in spite of the fact that they would never want to have an abortion themselves.

A lot of people say they would never have an abortion, but that's easy to say if they've never been in the position where they might need one. There are many stories from the US of abortion clinic protestors who one day bring their daughter in for one - or even have one themselves. Then are back protesting the next day.

You cannot separate abortion from the politics of reproductive rights - at least, not as long as there are people trying to take those rights away.

In a democracy it's impossible to separate politics and social attitudes, each feeds into the other, so you are making no coherent point here.

In a country where the vast majority of people went to catholic ethos schools, it's impossible to say that all of the attitudes pushed by that church are dropped the instant a teenager stops going to mass. Again and again and again during the referendum campaign we heard about people who had a sort of reflex against abortion which had been instilled in them at school and by society generally when they were growing up.They'd never really thought through the issues as an adult, but once they did, they became pro-choice.

Nobody really talked about abortion, apart from spittle-flecked rants from the pulpit, until the campaign. Women's experiences of crisis pregnancy were generally not talked about. The word was so stigmatised, some of those who set up the Abortion Rights Campaign (only 7 years ago) thought at the time that putting the "A" word in their name would be counterproductive.

Abortion itself is repugnant

Says you.
Most women who've actually had one don't regret it at all. They often regret the secrecy, stigma and shame this country pre-repeal put them through though.

It’s why all the responsibility and/or liability for a termination of the pregnancy rests with the person performing the termination, and doesn’t seek to criminalise pregnant women. The majority of physicians in Ireland don’t appear to be willing to take on that sort of risk, the €450 they would get for providing the means for a termination of a pregnancy isn’t worth the potential risks involved.

The person who performs the abortion is the woman, she takes the pills.
Your assertion that legal risk is the reason for 85% not providing abortion services is just that, an empty assertion with no facts.
If they follow the IMO guidelines on abortion then there should be no question of legal risk.
Surely treating a woman who remains pregnant brings about more risk?
Ask any obstetrician how much insurance for private obstetric practice costs.

Even the fact that you had to use quotes around the word normal, suggests you know yourself that termination of a pregnancy aren’t a normal service provided by GPs. That’s precisely why they incur the extra cost, because the stakes and the risks involved are also that much greater than the normal services provided by GPs - the potential of being sentenced to 14 years in prison and being unable to practice medicine again is not a risk they are prepared to take lightly.

It's not a normal service because of the vast fee and the fact that only 15% of GPs offer it. But eventually this will change.
Again if they follow the IMO guidlines then there is no possibility of 14 years in prison, but that law should be removed in any case.

One eyed Jack

Hotblack Desiato wrote: »

Your assertion that legal risk is the reason for 85% not providing abortion services is just that, an empty assertion with no facts.
If they follow the IMO guidelines on abortion then there should be no question of legal risk.
Surely treating a woman who remains pregnant brings about more risk?
Ask any obstetrician how much insurance for private obstetric practice costs.

Surely by that standard, the number of assertions you’re making in your own posts are just empty assertions with no facts? I’m prepared to say they’re a fair argument given your perspective, but if you’re now going to hold me to sticking to the facts, I expect both our posts will be considerably shorter :pac:

volchitsa

One eyed Jack wrote: »

Surely by that standard, the number of assertions you’re making in your own posts are just empty assertions with no facts? I’m prepared to say they’re a fair argument given your perspective, but if you’re now going to hold me to sticking to the facts, I expect both our posts will be considerably shorter :pac:

Which assertions specifically? My rule of thumb is that I expect/ask for links to claims that I don't already know to be true or that I know/suspect to be false - it would be tedious if we had to link to all claims made, including that the sun rises in the west and that Ireland has a wetter climate than central Spain.

So for instance HB's claim that even uncomplicated pregnancy is multiple times more dangerous to a woman than a (legal) abortion is one that I know to be true so I wouldn't ask for it to be backed up anyway. For someone who doesn't know it, then asking for a link is fair enough, as long as it's not done repeatedly to wear them down.

So which claims here do you find incredible? It seems about right to me. (Your claim about legal risks seems like complete speculation to me, FWIW, and I've already pointed out why I don't think it holds water.)

One eyed Jack

volchitsa wrote: »

Which assertions specifically? My rule of thumb is that I expect/ask for links to claims that I don't already know to be true or that I know/suspect to be false - it would be tedious if we had to link to all claims made, including that the sun rises in the west and that Ireland has a wetter climate than central Spain.

So for instance HB's claim that even uncomplicated pregnancy is multiple times more dangerous to a woman than a (legal) abortion is one that I know to be true so I wouldn't ask for it to be backed up anyway. For someone who doesn't know it, then asking for a link is fair enough, as long as it's not done repeatedly to wear them down.

So which claims here do you find incredible? It seems about right to me (Your claim about legal risks seems like complete speculation to me, FWIW, and I've already pointed out why I don't think it holds water.)

Well colour me shocked that yourself and HB would be of the same opinions as each other

Honestly though, it’s fine, my rule of thumb is simply that I’ll take a posters opinions as just that.

volchitsa

One eyed Jack wrote: »

Well colour me shocked that yourself and HB would be of the same opinions as each other

Honestly though, it’s fine, my rule of thumb is simply that I’ll take a posters opinions as just that.

So you can't actually say what exactly you have a doubt about in his posts? Are you suggesting the higher risk of pregnancy compared to abortion is false? Or are you just attempting a minor smear as a way of deflecting from something you know can't dismiss by factual argument?

Oh and I see you can't/won't back up your assertion about legal risk (well I know you can't because I already pointed out why it's mere speculation).

But way to go to to dismiss all posters you disagree with by association. :rolleyes:

You know, in that previous post I decided against adding something about posters' credibility, but since you've decided that attack is the best form of defence, I will just point out that someone's credibility is not about whether you agree with the poster, it's about what they've posted in the past.

Because the thing is, your claims have sometimes been seen to be based on you fitting the facts to your beliefs, and clinging to those beliefs even when your "facts" are being knocked down around you, so when I see a claim from you that I find a bit dodgy, I'm certainly going to ask for evidence. There are pro choice posters whose posts I find dodgy as well, TBF.

One eyed Jack

volchitsa wrote: »

So you can't actually say what exactly you have a doubt about in his posts?

...

But way to go to to dismiss all posters you disagree with by association. :rolleyes:

I could, but given the mod warning earlier in the thread, I wasn’t prepared to rehash the whole abortion referendum discussion again.

I wasn’t dismissing all the posters I disagree with by association either btw, I was making the point that it really doesn’t come as a shock that yourself and HD would be of the same opinion as each other in a completely hypothetical scenario where you’re both able to determine the best outcomes for a hypothetical patient on the basis of precisely nothing.

That wasn’t saying anything about any other poster I disagreed with, it was saying something about how strident you both are in your own personal opinions, that I am of the opinion would undoubtedly influence how you would treat a pregnant woman who wished to terminate her pregnancy.

I would be of the opinion that physicians have to consider a lot more factors in terms of their patients welfare than just handing over the pills because they supported her decision. I would think any physician who would do that would be highly irresponsible and their behaviour unethical, because if that’s not your personal beliefs influencing how you would practice medicine, I don’t know what is. I don’t agree that it is acting in the patients best interests, but rather would appear to be acting in your own best interests.

FishOnABike

SusieBlue wrote: »

And I would also agree that this would be the most straightforward option, only for the fact that as recently as New Years Day we had hundreds of protestors picketing our national Maternity hospital, harassing and intimidating pregnant women, with no regard for their circumstances.
Some of those women who may have just gotten some bad news about a much wanted pregnancy, or had a miscarriage or stillbirth, and absolutely no regard or respect was shown to them.

News spread that one of my local GP offices was offering abortion services and the do-gooders were parked outside for months, imposing on innocent people going about their medical business, the vast majority of whom were probably not availing of any abortion services at all.

We all have a right and should be entitled to avail of medical care without interferance or harassment. For that reason, a list of GP's who provide the service just isn't feasible. Unfortunately the No protesters just can't be trusted in that sense. They see their right to protest as superior to everyone else's right to see their doctor.
It would leave the clinic and its patients wide open to abuse and that's in no ones best interests.

Perhaps if the implemention exclusion zones come in, it would be possible. But there's also resistence on that front so you can't win.
A list of doctors who are unwilling to provide the service would be a safer option all round, particularly because there's little to no chance of anyone protesting & picketing outside their clinics.

The problem with a list of doctors who are unwilling to provide the service would be that it would be simple, by process of elimination, to identify the doctors who are willing and would then be just as likely to be picketed as if there were a list of doctors willing to provide the service.

Hotblack Desiato

One eyed Jack wrote: »

Honestly though, it’s fine, my rule of thumb is simply that I’ll take a posters opinions as just that.

While spouting opinions of your own without ever providing a reference or link to back up your assertions.

Hotblack Desiato

One eyed Jack wrote: »

Surely by that standard, the number of assertions you’re making in your own posts are just empty assertions with no facts? I’m prepared to say they’re a fair argument given your perspective, but if you’re now going to hold me to sticking to the facts, I expect both our posts will be considerably shorter :pac:

Can you be specific about what you are claiming are empty assertions on my part? I did you the courtesy of being specific, rather than rudely dismissing everything you wrote simply because I didn't like it.

One eyed Jack

Hotblack Desiato wrote: »

Can you be specific about what you are claiming are empty assertions on my part? I did you the courtesy of being specific, rather than rudely dismissing everything you wrote simply because I didn't like it.

I’ll give you just one example then, and I’ll leave it there because I don’t want to get into another rehashing of the abortion referendum discussion -

Hotblack Desiato wrote: »

It's not a normal service because of the vast fee and the fact that only 15% of GPs offer it. But eventually this will change.
Again if they follow the IMO guidlines then there is no possibility of 14 years in prison, but that law should be removed in any case.

1. You don’t know that it will change, and you have provided no evidence to support your assertion that any of the three conditions you refer to will eventually change (that it’s not a normal service provided by GPs, the fee, that only 15% of GPs offer the service).

2. Even if GPs do follow Irish Medical Council guidelines, the possibility of 14 years in prison is still there, because that’s determined in Irish law, it’s not determined by the Medical Council. It could only be determined afterwards in each and every case following an investigation, whether a GP acted in accordance with the law, or not, as the case may be -


23. (1) It shall be an offence for a person, by any means whatsoever, to intentionally end the life of a foetus otherwise than in accordance with the provisions of this Act.

(2) It shall be an offence for a person to prescribe, administer, supply or procure any drug, substance, instrument, apparatus or other thing knowing that it is intended to be used or employed with intent to end the life of a foetus, or being reckless as to whether it is intended to be so used or employed, otherwise than in accordance with the provisions of this Act.

(3) Subsections (1) and (2) shall not apply to a pregnant woman in respect of her own pregnancy.

(4) It shall be an offence for a person to aid, abet, counsel or procure a pregnant woman to intentionally end, or attempt to end, the life of the foetus of that pregnant woman otherwise than in accordance with the provisions of this Act.

(5) A person who is guilty of an offence under this section shall be liable on conviction on indictment to a fine or imprisonment for a term not exceeding 14 years, or both.

(6) A prosecution for an offence under this section may be brought only by or with the consent of the Director of Public Prosecutions.

(7) Nothing in subsection (4) shall operate to prevent or restrict access to services lawfully carried out in a place outside the State.


Health (Regulation of Termination of Pregnancy) Act 2018


I took your suggestion that the law should be removed in any case in the spirit in which I think it was intended, and assumed you meant that should a GP be found guilty of an offence, they should not face the prospect of 14 years in prison. I disagree. As you can also see from the above, when you corrected me earlier in pointing out that it wouldn’t be a GP performing an abortion, that it would be the woman taking the pills would be performing an abortion - a GP could still be found guilty of having committed an offence according to Irish law. I hadn’t accounted for the fact that you required me to be so specific, I thought it was understood that the law does not seek to criminalise a pregnant woman for prematurely terminating her pregnancy, it applies to anyone providing termination of pregnancy services - specifically GPs, in the context of this discussion.

I hope that now I’ve been specific enough for you, but in any case I wasn’t being rude or dismissive of anything you posted that I didn’t like. I was stating a fact - if we both have to stick to the facts, our posts will be considerably shorter.

Hotblack Desiato

One eyed Jack wrote: »

1. You don’t know that it will change, and you have provided no evidence to support your assertion that any of the three conditions you refer to will eventually change (that it’s not a normal service provided by GPs, the fee, that only 15% of GPs offer the service)

That's two things which go together to explain another thing, not three separate things.
Of course the 15% figure will change, it is ludicrous to claim that it will not. The number of doctors signed up has been steadily increasing for the last year and we can reasonably expect it to continue to increase.

It's hard to see a €450 fee for one service surviving a new deal with GPs (especially when other services they provide are so poorly funded.)

2. Even if GPs do follow Irish Medical Council guidelines, the possibility of 14 years in prison is still there, because that’s determined in Irish law, it’s not determined by the Medical Council. It could only be determined afterwards in each and every case following an investigation, whether a GP acted in accordance with the law, or not, as the case may be -

Pendantic well beyond the point of tediousness, as usual.

The fact remains, the guidelines represent best medical practice in this area and if followed, what basis for a prosecution could exist? The DPP is not stupid and will not take cases where such a strong case for the defence would exist.

One eyed Jack

Hotblack Desiato wrote: »

That's two things which go together to explain another thing, not three separate things.
Of course the 15% figure will change, it is ludicrous to claim that it will not. The number of doctors signed up has been steadily increasing for the last year and we can reasonably expect it to continue to increase.

It's hard to see a €450 fee for one service surviving a new deal with GPs (especially when other services they provide are so poorly funded.)

I never claimed anything one way or the other because I don’t know. You don’t know either, but I could see why you would think it was a reasonable claim to make so I figured fair enough, it wasn’t worth arguing over.

I also don’t see why more GPs would sign up if they were being offered less for their services, but I’m not going to argue that point either, I’m sure it seems perfectly reasonable to you.

Hotblack Desiato wrote: »

Pendantic well beyond the point of tediousness, as usual.

The fact remains, the guidelines represent best medical practice in this area and if followed, what basis for a prosecution could exist? The DPP is not stupid and will not take cases where such a strong case for the defence would exist.

I’m not sure what else you expected when you asked me to be specific. Yes it is tedious to have to be so specific when I figured there were some things were understood like the idea of you being familiar with the legislation and the fact that guidelines were published by the IMC and not the IMO at least.

The fact remains that if it is determined in any case that the provisions in the Act were not followed, then depending upon the circumstances of the case, the DPP may decide that it is in the public interest to pursue a prosecution. I wouldn’t be as confident as you are that they wouldn’t pursue a prosecution if they determined that the GP had failed to act in accordance with the provisions of the Act.

volchitsa

One eyed Jack wrote: »

I’m not sure what else you expected when you asked me to be specific. Yes it is tedious to have to be so specific when I figured there were some things were understood like the idea of you being familiar with the legislation and the fact that guidelines were published by the IMC and not the IMO at least.

The fact remains that if it is determined in any case that the provisions in the Act were not followed, then depending upon the circumstances of the case, the DPP may decide that it is in the public interest to pursue a prosecution. I wouldn’t be as confident as you are that they wouldn’t pursue a prosecution if they determined that the GP had failed to act in accordance with the provisions of the Act.

That was already the case before the referendum, but then it was without the massive advantage for medical staff wanting to stay on the right side of the law of having proper legislation which allows guidelines to be produced.

Anti choicers were insistent before the referendum that competent doctors would always be able to identify the situations when it was legal to carry out an abortion. I'm sure you'll be able to show us where you disagreed with them and said it was too high a risk to expect them to take?

Or are you just cutting your cloth to fit your (new) measures?

One eyed Jack

volchitsa wrote: »

That was already the case before the referendum, but then it was without the massive advantage for medical staff wanting to stay on the right side of the law of having proper legislation which allows guidelines to be produced.

Anti choicers were insistent before the referendum that competent doctors would always be able to identify the situations when it was legal to carry out an abortion. I'm sure you'll be able to show us where you disagreed with them and said it was too high a risk to expect them to take?

Or are you just cutting your cloth to fit your (new) measures?

I can’t make any sense of your post to be honest. You’re using the same sort of vague language you’ve done throughout this thread and made all sorts of personal accusations and insinuations and I just don’t know what your deal is tbh.

If I understand your post correctly, you want me to provide evidence of my disagreement with an argument I’ve never heard of? I don’t know as your post is so vague, but I do remember the case where a clinically dead pregnant woman was being maintained by the hospital because the medical team were concerned that if they made a judgment call to withdraw life support based upon best practice medicine, they may fall foul of Irish law as it was at the time -


Clinically dead pregnant woman being kept alive by hospital


I figured somewhat like HD above that it would be incredibly unlikely that anyone would face prosecution in those circumstances for ending what could only be described as an unethical and grotesque experiment that had already gone too far, but if I were in their position, I could understand why they were reluctant to pull the plug first and be asked questions later.

Leo, a former GP himself, was quite right in pointing out at the time that the existence of the 8th amendment had a “chilling effect” on doctors. Current legislation doesn’t do a whole lot to assuage doctors concerns either, and so the situation is still the same as he described before he became Taoiseach -


Mr Varadkar also said difficult decisions that should be made by women and their doctors, a couple "or the next-of-kin where there is no capacity", and on the basis of best clinical practice, are now made on foot of legal advice. "That isn't how it should be," he said.


It’s not how it should be, and the Government under his leadership haven’t actually done anything to change that.

volchitsa

Well you are right that it is turning into too much of a personal attack on you, and I didn't intend it to, so my apologies for that.

I will just say that I disagree that this government has done nothing to remove the legal ambiguity from our law on abortion and how it affected all pregnant women prior to the referendum - they were the first to enact a law, albeit a seriously flawed law (POLDP), and have also produced the legislation that currently exists.

I can't say yet whether the current law has massive flaws or not, we shall see, but it's certainly easier for medics to use than the constant "lets see what the judges say" that was the case in preceding decades.

But your claim was that the reason for the 85% not signing up was that the risk was too high - you've not shown that at all, just reasserted it. That's all.

volchitsa

Well you are right that it is turning into too much of a personal attack on you, and I didn't intend it to, so my apologies for that.

I will just say that I disagree that this government has done nothing to remove the legal ambiguity from our law on abortion and how it affected all pregnant women prior to the referendum - they were the first to enact a law, albeit a seriously flawed law (POLDP), and have also produced the legislation that currently exists.

I can't say yet whether the current law has massive flaws or not, we shall see, but it's certainly easier for medics to use than the constant "lets see what the judges say" that was the case in preceding decades.

But your claim was that the reason for the 85% not signing up was that the risk was too high - you've not shown that at all, just reasserted it. That's all.