I watched this the other day, and honestly, I thought they were a little hyperbolic.

"Sometimes the nearest hospital is over an hours drive away!"

er, yeah.... the USA is a big country.

Even in NZ, a country over 30 times smaller, the nearest big hospital can easily be over an hour away from a small rural town.

It seems really unreasonable to expect that someone who lives up a windy mountain road should have an emergency obstetrics dept on their doorstep.

Ahh, so you were lying. You did have time.

From your response it's clear you don't know much about medicine.

"If you don't provide all the services required of a hospital, you don't get to call yourself a fucking hospital. "

No. You do get to call yourself a hospital. Most hospitals don't offer all medical services. Even major hospitals. You don't get to choose what is and isn't a hospital.

"There's a big bloody difference between "not equipped" and "unwilling"."

Sort of. It's a chicken and egg situation that has an order to it.

Most private hospitals are unwilling to provide non-profit services and are therefore not equipped to provide them. You won't find hospitals with the skills (i.e. doctors and nurses able to perform the procedure) and equipment (which is almost always purpose specific in medicine) and not the willingness to do the procedure. Catholic hospitals won't have either of those necessary requirements for most of the disputed procedures.

"And it's a bit fucking rich to bring up false equivalencies when you just compared unavailability of potential life-saving medical treatment to someone whinging over not getting a big mac at kfc."

No, mine was an appropriate analogy in regards to asking for a service or product that a company does not provide. In this case a Big Mac at KFC.

'"Really? They "articulate the truth"... as I said before, this is self-evidently complete and utter fucking bullshit.'

I can't say it's bullshit, but it is irrelevant.

'Yes, "inconvenient" is exactly the right word for a woman who is probably in the middle of the worst day of her life.
I mean, she might end up "inconveniently" dead, but hey, we wouldn't want to stop catholics telling other people how to live, would we?'

You're wrong. It is only an inconvenience. It sucks to be transferred to a different hospital but in general it has no adverse medical outcome on the patient. If the patient is critical the hospital will do what they can (which will be limited because they don't have the skills or equipment for that service) before transferring the patient. Just like one thousand and one other non-life-threatening and life-threatening procedures that most hospitals don't treat. Leaving the patient in place at that hospital carries a higher adverse risk than transferring them to an appropriate facility.

'And here we come to strawman of all strawmen. The problem is NOT that a woman needs a "direct abortion", it's that she may a surgical procedure that kills the child inadvertently. And this isn't theoretical, women have died from this.'

Not a strawman. You've given one example in a tabloid paper of a single woman who died from septacaemia, a week after a procedure. Unless you can show a conclusive coroner's report showing that the delay in removing the foetus (i.e. waiting until it was dead) was the cause, and not the 1000% more likely cause of infection during or after the surgery, then you don't even have that one example. And this sort of sepsis is just as likely from doing the same procedure with a live foetus. The procedure is pretty much the same. And even with one example, that's not statistically relevant. Do you have a study published in a reputable medical journal?

"The fundamental point is that religion has no place in medicine. If a patient wishes to refuse certain treatments because of their beliefs, well, they're an idiot, but it's their choice to be an idiot."

These hospitals have a mission statement based on their beliefs but they are practicing state of the art medicine. Based on their beliefs they don't offer all services , but this is no different than any other small hospital who limits their services. There are no statistically relevant adverse medical outcomes for anyone from this situation.

"But a hospital doesn't get to refuse treatment based on some bronze-age belief. If the treatment is legal in its jurisdiction and they have the capability to provide it, they must provide it. Businesses should not be allowed to refuse service on religious grounds ("I am religiously opposed to treating gay people or blacks!!")"

You're confusing you're belief of "shouldn't" with "doesn't". They can and should limit their services to what they want to offer as a hospital. The same as every public hospital does. And no, if the procedure is legal they do not have to provide it. This is true for public and private hospitals.

You seem to be sorely missing this basic vital understanding that all hospitals are limited in capacity and don't offer all services. If you go to the largest hospital near me (one of two major hospitals near me) and need emergency obstetrics, you will be shipped off to the other major hospital. That's how it works. If you go to one of many dozens of smaller private hospitals and ask for a,b, or c and they only offer x, y or z, then you're going to end up going to a different hospital.

The catholic hospital is practicing conscientious objection and passively practicing this (yes, passively, they're happy for you to go elsewhere). You want to force (that's the best word) all medical personal to bend to your will and don't accept worldviews that don't coincide with yours. Bigotry at it's finest.

'("I am religiously opposed to treating gay people or blacks!!")'
FFS: Evidence of hospitals doing this please. Not an individual doctor. Hospitals.

'As you said yourself "If you don't like it, go work somewhere else".'

You're saying "if you don't like my personal rules, then go find a different industry". Democracies a bitch when you don't get what you want. You're going to have to live with the fact that your way is just your opinion and nothing else.

You're getting pretty boring pretty quickly. I doubt I'll bother anymore with you, it's readily apparent that you're not going to learn any time soon.

They mix just fine.

If one doesn't want the very small set of restrictions that go with some (not all) religiously affiliated hospitals, don't go there. One does have a choice.

If one doesn't agree with the work conditions in those hospitals, don't work there (just like any other job).

Businesses don't have to offer all services. It is the business' choice, not the customers, what services they offer. Each and every medical procedure is a different service. E.g., in Australia, most private hospitals and small public hospitals don't offer emergency care in any substantive way. So if you self present with an acute injury that they don't provide care for, they will initiate transfer to another hospital.

If the patients life is in danger, the hospital will stabilise the patient and await medical transfer to another facility. This happens in both private and public hospitals every day. E.g. in general, smaller public hospitals don't offer obstetrics. You will be transferred to a larger public hospital. In the event that the procedure must be done stat, then all hospitals will give their best effort (including religious hospitals) to save the patient. It is basically the same in the USA.

Have you seen videos of a customer in a KFC screaming that they want their BigMac, with everyone staring in disbelief because that is a product KFC doesn't sell?

This death is down to the Irish government, 6 or 7 of them, have been in power since the Supreme court ruled that a woman has the right to an abortion on medical grounds. They all did nothing and left it for the next crowd of useless fuckers to worry about.

Just a couple of months ago the "United Left Alliance" brought legislation forward that would have covered this situation but both government parties (Fine Gael and Labour) voted against together with most of the opposition. The current Taoiseach (Prime Minister) has said he wont legislate.

Medical terminations are performed in Irish hospitals (just read an interview with a Professor of Obstetrics who described how she performs it), unfortunately in a different hospital she may not have died, but theres no way of knowing which hospitals to go to because there is no clear laws, one Doctor may interpret things differently to another. Doctors differ and patients die.

Ireland has been a democracy for 90 years, the electorate (myself included) have to take responsibility for the continuing series of catastrophes and fuckups that are destroying the lives of people here.

Edit:
This is probably the best reporting on this I've encountered from non-Irish media I've heard/read in the last few days. Good for TYT.

>> ^snoozedoctor:

Exactly what is preventive medicine? It's basically don't smoke, don't drink too much, eat right, exercise, and wear your seatbelt. Oh, and don't text while you drive. So, most of it is just personal responsibility. Then there are the screening tests, mammograms, PSAs.....most of which are being cut back because of lack of evidence they improve outcomes and because they probably lead to many unnecessary tests. Immunizations are a great example of preventive medicine that works.
The Emergency treatment and active Labor Act of 1986 was an unfunded mandate that required hospitals to provide emergency services and obstetrical care to all patients presenting for emergent care, regardless of their ability to pay or citizenship. So, nobody is denied emergent care in the US health-care system. Of course, the real problem is uninsured patients that have non-emergent health-care problems.
The complexities of the current US system will make it very difficult, if not impossible, to completely convert to a single payer, National Health Care Plan. Perhaps it may evolve as a parallel public system, similar to the VA system. Regardless, the major problems with the current system are not being addressed. The heroic measures to save a few elderly people, without realistic hope for recovery, are consuming resources that could be used to provide health-care for younger citizens with some hope for a good quality of life. The threat of lawsuits are resulting in physicians ordering tests and consultations that are unnecessary and may add up to a full 10% of all health-care costs.
One often overlooked result of a "for profit" system is the investment in medical technology. The US is by far the World's largest exporter of medical devices. We invented and manufactured the MRI and CT scanners, and much of the high tech devices that other countries use in their National Health Care Systems.
>> ^criticalthud:
@snoozedoctor
personal responsibility is not really the issue. actual access to healthcare is.
yeah, americans are fat, stupid, and lazy, and eat like shit, but the "for profit" status of western medicine and the insurance and pharma scams aren't really helping matters.
one of the big problems with a "for profit" system is that preventative medicine is not nearly as profitable as medicine that bills by procedures.



well, one really lacking area is in somatic complaints, which make up, i believe, the close to the majority of complaints at hospitals. things like - bad back, bad shoulder...etc. these are all complaints that often have chronic structural issues, for which western medicine is ill-equipped to deal. they often just medicate those issues until they turn into procedural issues, which is often a very incomplete treatment.
instead structural issues are left to mostly the chiro's to muck about with, and while they get some of the theory right, their quick-fix practices are also often based on a profit motive, and rather incomplete.

Exactly what is preventive medicine? It's basically don't smoke, don't drink too much, eat right, exercise, and wear your seatbelt. Oh, and don't text while you drive. So, most of it is just personal responsibility. Then there are the screening tests, mammograms, PSAs.....most of which are being cut back because of lack of evidence they improve outcomes and because they probably lead to many unnecessary tests. Immunizations are a great example of preventive medicine that works.
The Emergency treatment and active Labor Act of 1986 was an unfunded mandate that required hospitals to provide emergency services and obstetrical care to all patients presenting for emergent care, regardless of their ability to pay or citizenship. So, nobody is denied emergent care in the US health-care system. Of course, the real problem is uninsured patients that have non-emergent health-care problems.
The complexities of the current US system will make it very difficult, if not impossible, to completely convert to a single payer, National Health Care Plan. Perhaps it may evolve as a parallel public system, similar to the VA system. Regardless, the major problems with the current system are not being addressed. The heroic measures to save a few elderly people, without realistic hope for recovery, are consuming resources that could be used to provide health-care for younger citizens with some hope for a good quality of life. The threat of lawsuits are resulting in physicians ordering tests and consultations that are unnecessary and may add up to a full 10% of all health-care costs.
One often overlooked result of a "for profit" system is the investment in medical technology. The US is by far the World's largest exporter of medical devices. We invented and manufactured the MRI and CT scanners, and much of the high tech devices that other countries use in their National Health Care Systems.
>> ^criticalthud:

@snoozedoctor
personal responsibility is not really the issue. actual access to healthcare is.
yeah, americans are fat, stupid, and lazy, and eat like shit, but the "for profit" status of western medicine and the insurance and pharma scams aren't really helping matters.
one of the big problems with a "for profit" system is that preventative medicine is not nearly as profitable as medicine that bills by procedures.

>> ^dag:
I do think they cultivate such an environment, perhaps not intentionally in all cases - but the relationship between patients and doctors, in my experience is mostly about domination and control. I'm not against medical science, I am for breaking down the walls between the medical world and consumers.

That is starting to change. The old generation of doctors, especially surgeons do have a paternalistic relationship with their patients. However, for quite a while now, medical education has shifted heavily to a patient centered, team based approach.

And as E_Nygma pointed out, it is great that your births went well. But having worked in Obstetrics and seen some of the fucking complication nightmares that can occur, it is ridiculous for me to even consider a birth without some form of OR and surgical team ready on hand. And there is such a huge shortage of OBs that it's hard to find one who is not overworked and overstressed. They do it out of a sense of duty to their communities and their profession. They sacrifice their personal lives so that in case the shit hits the fan, there's someone there to save you. And it's not that some OB's prefer C-Sections just for their patients for profit. Studies show that a significant portion of OBs prefer, and select C-sections for themselves. It's not some industry trying to screw you out of your money.

And painting epidurals as something unnecessary, and used instead to line the OB's pockets, is so ignorant. You might as well say the same thing of antibiotics, vaccines, and anesthetics in general.

> most infants dead at birth

who knows might have been safer than todays obstetrical environment...

Persephone, I don't have a lot of time to write, so apologies for being brief.

You're right about the video, I went back and listened to that part. I do believe he says that the amygdala shuts down at some point, but he didn't there.

However, even that quote is not quite right. Labor cannot be shut down so simply, especially because of the volume of adrenaline required to provide to create a reaction to the effects of oxytocin is sky-high, as in, must be artificially manufactured and injected, even for the stress of childbirth. On top of that, the evolutionary mechanism for such an interaction between fear and contractions, if it were actually true, is shoddy at best and more likely plain wrong. The oxytocin/adrenaline interaction mechanism is a complex one, and one that is not chemically antagonistic, especially since high levels of adrenaline are expected and in fact natural during and after birth, as well as during sex, and orgasms. If adrenaline and oxytocin couldn't work together, sex wouldn't be as fun as it is. In short, adrenaline does not neutralize oxytocin, nor do contractions just stop when adrenaline is released.

Since that particular argument is factual in nature, it's only fair if I quote you some sources. If you'll take a look at the three papers I have below, you'll notice that in no way do high-stress levels of adrenaline serve to interfere with contractions in a negative, non-regulatory manner, and that in fact, it has a beneficial effect at a natural (read: non-Epipen injection) level.

Contraction of the depolarized uterine muscle. Department of Normal Physiology, Sverdlovsk Medical Institute (Presented by Academician L. S. Persianinov, Academy of Medical Sciences of the USSR). Translated from Byulleten'' Éksperimental''noi Biologii i Meditsiny, Vol. 68, No. 7, pp. 8–11, July, 1969.

Obstetric Outcome Following Epidural Analgesia with Bupivacaine-Adrenaline 0.25% or Bupivacaine 0.125% with Sufentanil-A Prospective Randomized Controlled Study in 1000 Parturients.
Obstetrical & Gynecological Survey. 53(9):533-534, September 1998.
Olofsson, Ch.; Ekblom, A.; Ekman-Ordeberg, G.; Irestedt, L.

or, perhaps most ironically: Why Natural Childbirth? Judith A. Lothian. J Perinat Educ. 2000 Fall; 9(4): 44–46.

Anyways, I agree hospitals do bad things, and there should be more oversight and regulation to prevent this. I have no problem with that, I have a problem with bad science.

You can email me or go to the Coffeehouse if you want, but it's probably not the best idea to continue this discussion on profile comments, perhaps a better setting would be in order. Cheers.

Persephone, I don't have a lot of time to write, so apologies for being brief.

You're right about the video, I went back and listened to that part. I do believe he says that the amygdala shuts down at some point, but he didn't there.

However, even that quote is not quite right. Labor cannot be shut down so simply, especially because of the volume of adrenaline required to provide to create a reaction to the effects of oxytocin is sky-high, as in, must be artificially manufactured and injected, even for the stress of childbirth. On top of that, the evolutionary mechanism for such an interaction between fear and contractions, if it were actually true, is shoddy at best and more likely plain wrong. The oxytocin/adrenaline interaction mechanism is a complex one, and one that is not chemically antagonistic, especially since high levels of adrenaline are expected and in fact natural during and after birth, as well as during sex, and orgasms. If adrenaline and oxytocin couldn't work together, sex wouldn't be as fun as it is. In short, adrenaline does not neutralize oxytocin, nor do contractions just stop when adrenaline is released.

Since that particular argument is factual in nature, it's only fair if I quote you some sources. If you'll take a look at the three papers I have below, you'll notice that in no way do high-stress levels of adrenaline serve to interfere with contractions in a negative, non-regulatory manner, and that in fact, it has a beneficial effect at a natural (read: non-Epipen injection) level.

Contraction of the depolarized uterine muscle. Department of Normal Physiology, Sverdlovsk Medical Institute (Presented by Academician L. S. Persianinov, Academy of Medical Sciences of the USSR). Translated from Byulleten'' Éksperimental''noi Biologii i Meditsiny, Vol. 68, No. 7, pp. 8–11, July, 1969.

Obstetric Outcome Following Epidural Analgesia with Bupivacaine-Adrenaline 0.25% or Bupivacaine 0.125% with Sufentanil-A Prospective Randomized Controlled Study in 1000 Parturients.
Obstetrical & Gynecological Survey. 53(9):533-534, September 1998.
Olofsson, Ch.; Ekblom, A.; Ekman-Ordeberg, G.; Irestedt, L.

or, perhaps most ironically: Why Natural Childbirth? Judith A. Lothian. J Perinat Educ. 2000 Fall; 9(4): 44–46.

Anyways, I agree hospitals do bad things, and there should be more oversight and regulation to prevent this. I have no problem with that, I have a problem with bad science.

You can email me or go to the Coffeehouse if you want, but it's probably not the best idea to continue this discussion on profile comments, perhaps a better setting would be in order. Cheers.