Dominic Pedulla, MD - April 23, 2002 Letter to the Editor of American Family Physician

Return to For Physicians & Health Care Professionals

To the Editor:

Chervenak and McCullough dispense advice to a group practice struggling to discern the morality of prescribing contraceptives: “Strictly speaking, objections to abortion or contraception by physicians do not rise to the level of objections based on professional medical ethics.” (1) Surely the authors must be aware that medical schools, residencies, and physician practices are increasingly questioning the medical wisdom of prescribing contraceptives and performing sterilizations. The advent of safe, highly effective, and reliable methods of noncontraceptive birth control has largely forced this dilemma on us, because with these it becomes necessary to admit there is a realistic choice to be made between contraceptive and noncontraceptive methods. (2) Further, it is often toxicology rather than theology which allows this choice to enter the physician’s consciousness for the first time. From a purely secular viewpoint the physician rightly asks: “While I have the right to choose the risks of modern contraceptives as my private personal choice, how can I justify making that choice for my uninformed patient?” To claim this is a partisan religious belief is to ignore the real toxicities associated with birth control pills, injectables, and IUD’s, and to correspondingly disregard the relative safety of noncontraceptive birth control.

The concept of “ethics” advanced by Cherverak and McCullough, by closing itself to the true (if uncomfortable) insights of traditional philosophy and religion, becomes merely the influence of majority opinion, something not really consensual because the medical intuition of dissenters is overpowered in a “group praxis”. But, surely then traditional medical wisdom loses its power, which if anything at all must surely mean the professional competence to protect the patient from the most unhealthy trends and fads.

Conflicts over contraception will inevitably erupt more and more frequently; they should be faced courageously, and in a spirit of honest and open dialogue, because the well-being of women and children is at stake. Trying to put out these “fires” with the smothering influence of a “consensus of tyranny” will only marginalize the brightest and most insightful among us! Let me suggest the book, “Physicians Healed” (3) which chronicles the illumination of 25 physicians who realized they should no longer prescribe contraceptives and concluded their patients benefited medically from that decision. Patients who became “angry’ in most cases had to admit that this was the first time they had ever faced choices that in truth had always existed, and had the insight required to ask themselves why this made them angry.

Finally, I would suggest that all physicians who treat women get to a course on Natural Family Planning without delay. Patients can only be informed by physicians who are likewise informed.

Dominic Pedulla, MD, FACC, CNFPMC
Associate Clinical Professor of Medicine at the University of Oklahoma Health Sciences Center, Creighton Model Natural Family Planning Medical Consultant, Board Certified in Cardiology and Internal Medicine
Phone: 1-405-947-2228
E-mail: edithstein@worldnet.att.net

References:

(1) “Curbside Consultation”, American Family Physician, Vol. 65,6; March 15, 2002
(2) Ryder, REJ. “Natural Family Planning”: effective birth control supported by the Catholic Church BMJ 1993; 307: 723-726
(3) “Physicians Healed”, One More Soul, 184 N. Main Street Dayton, OH 45405 1-800-307-7685 (www.omsoul.com)

For questions, comments, or inquiries concerning any of these topic areas, or to establish a dialogue with The Edith Stein Foundation contact us through the Q&A section found on the left panel of this page.