Thursday, August 16, 2007

Basic Principles of Good Dieting

Instructors who are looking for a readable recent article on diets and dieting for their students should take a look at the article entitled "Eating Made Simple" in the September issue of Scientific American (pp. 60-69). The article cuts through the confusing mountain of good and bad dietary advice out there by pointing out that the principles of good dieting are not in dispute – eat fewer calories, get more exercise, eat more fruits, vegetables and whole grains, and reduce our intake of junk foods.

When we get too deep into the details, however, (Is this food better than that food? And better for what?), we are likely to confront conflicting advice. That’s because nutrition research is difficult do and often produces ambiguous results. To complicate matters, a lot of nutrition advice comes from sources that are trying to sell us something. (See the comments by the Scientific American editors on pages 38-39, entitled “Take Nutrition Claims with a Grain of Salt”.)

If we really could get students to focus on the basic principles – reduce their overall caloric intake, get more exercise, and try to become a bit more knowledgeable about which are the “good” food categories - the details probably wouldn’t matter all that much.

Saturday, August 4, 2007

Can a Physician Refuse to Treat a Patient?

Yesterday I wrote about two Washington pharmacists who are suing for the right to refuse to sell the morning-after pill because of their religious and moral beliefs. What rights do physicians have when it comes to offering certain services or choosing to treat certain patients?

According to the Guttmacher Institute, 46 states specifically allow doctors to refuse to provide abortion services if they wish. Sixteen states allow doctors to refuse to provide sterilization services, and at least 8 states allow doctors to refuse to provide contraception. These policies have stood up to challenge as long as the doctor does not offer the service to any of his/her patients.

Well, okay, doctors certainly should have rights, too. The problem arises when a doctor provides the service to some patients but then refuses it to others. Patients’ advocates say that such doctors are hiding behind religion while violating anti-discrimination laws. For example, if a physician prescribes Viagra for a straight guy, should he/she be allowed to refuse it to a gay patient? What about a doctor who refuses artificial insemination to lesbian couples and single women, but offers it to married couples?

The California Supreme Court is about to hear a case in which a lesbian woman is suing two doctors for refusing to provide artificial insemination to her on religious grounds. The case is generating a lot of interest, with over 40 groups asking to be heard. Doctors’ attorneys are likely to argue that if physicians are forced to violate their religious or moral beliefs they may be driven out of certain specialties. But is it right that they should be able to force their beliefs on others instead?

What do you think? Whose rights should take precedence here?

Friday, August 3, 2007

Pharmacists Sue over 'Morning-After' Pill

Last year the federal Food and Drug Administration made the ‘morning-after’ contraceptive pill known as Plan B available without a prescription. So can a pharmacist who sees the pill as tantamount to abortion and who objects on moral or religious grounds refuse to sell it? In Washington State, the answer is no. The State of Washington passed a regulation recently that requires pharmacies to sell the pill, arguing that individual pharmacists cannot stand in the way of patients’ rights to a perfectly legal drug. Last month two Washington pharmacists sued in federal court over the issue, arguing that the regulation forces them to choose between their jobs and their “deeply held religious and moral beliefs”. The case is pending.

In fact, a compromise of sorts had already been worked out between the governor and the state Board of Pharmacy even before the lawsuit. In the compromise, a pharmacist with personal objections to selling the drug is free to get a co-worker to fill an order. But that only works if a co-worker is available - the patient must not be inconvenienced by having to make a second visit. And not all pharmacies have at least two staff members on duty at all times.

Apparently this is becoming an issue in many states. Four states (Arkansas, Georgia, Mississippi and South Dakota) have specific policies that allow pharmacists to refuse to sell contraceptives if they wish. On the other hand, pharmacists in California can only refuse to sell contraceptives when their employer approves and when the woman can still get her prescription filled in a timely manner. That sounds a lot like the new Washington law. It’ll be interesting to see how the legal challenge in Washington comes out.

What do YOU think?