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Unexpected (and Unintended) Support

Posted by MDViews on August 31, 2009

The American Journal of OB/GYN, July 2009 has a clinical opinion by Drs. Minkoff and Ecker entitled, “The California octuplets and the duties of reproductive endocrinologists,” in which they discuss the ethics and obligations of embryo transfer and those who do them.

They assert that reproductive endocrinologists need not consider the economic interests of society (patient on welfare), cannot refuse embryo transfer based on perceive parenting ability or lack thereof and can limit the number of embryos transferred both ethically and medically.

Leaving aside the moral issue of in-vitro fertilization and creating embryos for transfer, I noticed the logic used to justify limiting the number of embryos transferred parallels our arguments regarding rights of conscience.

They write, “Yet while respect for autonomy [patient autonomy–the ethic that trumps all in this day and age] is the central tenet of a principle-based approach to providing ethically appropriate medical care, there are important differences between “negative” and “positive” autonomy. Pregnant or not, a patient may decline any procedure or treatment offered her; she may not, however, demand and receive treatment that her provider feels is inappropriate or that is an undue risk to her health.”

Now why would such a statement apply to “any procedure or treatment”, as they state above, except abortion? The American College of OB/GYN in its ethics statement #385 contends any doctor refusing perform abortion or refer for abortion at the patient’s request is unethical. But here, Minkoff and Ecker make a blanket statement which would obviously contradict ACOG ethics.

Why should a pro-life OB/GYN doctor be obliged to perform a procedure (abortion) that her or she feels “is inappropriate or that is an undue risk to her health,” as our authors state above? According to the argument made by Drs. Minkoff and Ecker, such a pro-life doctor should not be obligated at all.

Now I don’t know Dr. Minkoff or Ecker, but I would guess they are not members of AAPLOG. Promotions into the higher reaches of academic medicine usually involve genuflection at the alter of “choice.” Maybe they should write a hasty addendum stating there argument does not apply to abortion lest someone use their names to argue for life in the halls of congress. How embarrassing would that be?

Once again, the lack of consistency in their arguments illustrates the true ethic ACOG uses against us pro-life doctors, the ethics of might-makes-right. (We are bigger than you, more powerful than you and so we will make you agree with us or shut you down.)

How sad! Do they not understand the battle is not ours? And the battle belongs to the LORD?

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