What Cindy said.

And the doctor most certainly did not select the headline. But I got my eye on him anyway.

I just thank the goddess that he didn't suggest that the husband should have veto power.

acknowledging their humanity

Acknowledging her humanity would include recognizing that when a person asks for birth control, it's generally because they think that preventing pregnancy will make them happy. His disagreement with this premise seems entirely based in his own issues -- he's not taking her into account at all.

why is it harmful to make sure the patient has thought it all through, particularly when it's an elective procedure

I said he was a condescending twat, I didn't say his treatment was harmful. There's a world of leeway between being a jackass and causing harm to your patients. Personally, I think doctors should strive to avoid both.

Acknowledging her humanity would include recognizing that when a person asks for birth control, it's generally because they think that preventing pregnancy will make them happy. His disagreement with this premise seems entirely based in his own issues -- he's not taking her into account at all.

And ESPECIALLY when a person is living in the US in 2006 and already has (or is about to have) three kids. I can more easily imagine someone being conflicted about sterilizing a woman with no children (although of course I think a grownup can know her own mind about that), but unless the patient was exceptionally rich, I think it's fair to assume that having a fourth child would lower her (and her family's) quality of life. "What if they die in a fire" and "What if you re-marry" are bullshit questions, IMO.

which is all about treating the whole person, and acknowledging their humanity, rather than seeing them as parts and diseases.

The perspective I'm reading from the doctor though, is that she is making a poor decision based on hypothetical situations.

Like I said, this is the doctor projecting his/her own feelings onto the patient. S/he starts out by saying s/he believes it's a poor decision...but doesn't really give any details as to why s/he thinks that it is such for this particular patient.

The concern here is about the doctor's sense of regret, not the patient's. It seems to be a scattered piece. I'd be cool with it all if the piece were stronger, I think.

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.

I just don't think that questioning a patient's decision in the manner in which this doctor did so is acknowledging their humanity. To me, it comes off as questioning their maturity, their intelligence, and their knowledge of their own life and own desires.

And here's why: the doctor didn't simply offer a statement or two about the difficulty that reversing a tubal ligation could entail. If he had done that, I would consider it due diligence.

But instead he kept asking the patient questions -- "What about this? Well, what about THIS? But WHAT ABOUT THIS?!?" as if the patient hadn't fully considered her decision in an adult fashion, and needed to be reminded of all the ways her decision could destroy her life. That, in my opinion, is overbearing and paternalistic and condescending.

To me, it comes off as questioning their maturity

Ima just let Steph speak for me.

My GP is the sort that asks when it's even possibly relevant: "Are you still doing that...self injury thing?"

Our context is now underscored with an understanding that he's to start with the solutions that don't involve me quitting krav. And that he's not supposed to try and talk me into quitting krav, but just to explain how krav might affect the situation in hand.

That's whole person enough for me.

Kids? Pregnancy? Sterilisation? Should start from the same sort of place--what I want out of my life, and how this medical procedure fits into that. Not for him to suggest really predictable "side effects" of the process. He's to bring up the stuff that I don't know, that's his specialty, and put it into the context of my stated goals.

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?

Providing the information isn't harmful, but I got the distinct impression he tried his best to talk her out of a perfectly reasonable procedure and was disappointed that she stuck to her guns. Or what Steph said more effectively:

But instead he kept asking the patient questions -- "What about this? Well, what about THIS? But WHAT ABOUT THIS?!?" as if the patient hadn't fully considered her decision in an adult fashion, and needed to be reminded of all the ways her decision could destroy her life. That, in my opinion, is overbearing and paternalistic and condescending.