I think anytime someone is considering elective surgeries they need to know all the ramifications - and I don't think the doctor should do the elctive surgery if they have doubts about the suitability for the paitent. But the doctor's arguements were based on " women before 30/women after 30", not on the individual . Not on the fact that she had three children and felt that she could not reasonable care/raise/afford a 4th. it sounds like the final decsion was based on the individual, but the doctor wanted to be led by statistics. That's where it felt like bad care.

If House were a GYN everyone could always get birth control, so idiots don't breed.

I'd be pissed at the doctor if he knew a significant number of patients regretted the surgery after the fact, and didn't talk to me about it.

I'd be pissed at the doctor if he refused me the surgery.

I don't think that doctor did anything worth getting pissed off about. I think a surgeon needs to get into the pros and cons of any procedure (whether or not it involves the reproductive system), but particularly elective procedures.

That NYT article prompted me to write a short, ascerbic letter to the editor. (I realize, of course, that the odds that it will even be *read,* let alone printed, are infinitessimal, but it made me feel marginally better.)

Yeah, I think I'm going to go with "obnoxious paternalistic bastard", myself.

That about sums it up.

Personally, my experience is that men are always assumed to know what they want.

t loves erika

Thanks. But I totally think that's about our not knowing our changeable girly minds.(Although, yes, I support conversations about "Do you know what permanent is?" and "No take-backs")

This statement:

I acknowledged to my patient that the surgery was effective in preventing pregnancy. In terms of making her life better and her happier, though, the prognosis was poorer.

makes me think that the doctor is a condescending twat, no matter what their age/gender in relation to the patient. If I go to a doctor requesting a procedure, it is not their job to decide whether the results of that procedure will make me happy. It is their job to decide whether or not the procedure is a good idea medically. PERIOD.

And this:

Despite free will on her part, I would feel culpable if my actions made her life worse.

just cements it. He's not asking because he feels it's medically necessary, he's asking to make himself feel better. Which, also, not so much in the job description unless there is a medical reason to feel badly about it.

::considers how House would be as a gynecologist::

There was an episode involving a girl having a problem with the jelly she and her boyfriend were using. She brought the jar that jelly had come it. It was grape, I believe.

Good moment.

I think the headline (which may not have been at the doctor's choosing) was more paternalistic than his discussion. He's a human, he's not going not have opinions and feelings about his patients and their treatment. He's giving honest insight into his thought process.

Again, if he refused to perform the procedure, I'd think he was wrong, but why is it harmful to make sure the patient has thought it all through, particularly when it's an elective procedure? He's performing a procedure that produces not on medical results, but life results.

makes me think that the doctor is a condescending twat, no matter what their age/gender in relation to the patient. If I go to a doctor requesting a procedure, it is not their job to decide whether the results of that procedure will make me happy. It is their job to decide whether or not the procedure is a good idea medically. PERIOD.

I think what you're talking about pretty much goes against a the grain of movement in medicine (and patients' rights) -- which is all about treating the whole person, and acknowledging their humanity, rather than seeing them as parts and diseases.