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.

I'm thinking that instead of taking up Precious Column Inches, the Doc could've just said "You'll shoot your eye out, kid!" and conveyed exactly the same amount of respect for his patient's decisions.

I think part of the reason he comes off as such a prig is he's very dismissive of what she has to say. He sums it up as:

a patient of mine in her early 20s who was expecting her third child asked to have her tubes tied. A mother of two, with a full-time job and part-time school classes, she saw a fourth child as an impossible burden.

Which is practical and reasonable and, yeah rich-guy (or at least stably employed and educated guy), fairly impossible.

He says nothing about why she is concerned with other birth control methods. He just launches into new husbands and dead kids in house fires (which he sees as practical and reasonable arugments... not all wacky and emotional like seeing a fourth child as an impossible burden.)

Is that how it happened? Was it a dismissive lecture? Don't know, but that's how opted to portray it.

Yeah, ass.

I'm thinking that instead of taking up Precious Column Inches, the Doc could've just said "You'll shoot your eye out, kid!" and conveyed exactly the same amount of respect for his patient's decisions.

"Tubal ligation is always fun until someone loses an eye."

In other news, how the fuck is this day not over yet? I swear I've been here 100 hours. And yet? Not even 4 o'clock.

Oh, and "I hope it gives her a feeling of control in her life". Gosh, how big of him. Wonder what the odds of effective birth control giving a feeling of control are.

Ass.