Doctors Affect Moral Climate

Daily Observer

January 5, 1976

 

S. Q. Laprius was clearly perturbed.

 

“He’s done it again,” he said somberly.

 

“Who has done what again?”  I asked.  “And to whom?”

 

“Hugo Swischenbeine, the gynecologist.  He prescribed birth control pills for a patient of mine.”

 

“So?  It’s done everyday,” I said.

 

“But my patient is only fifteen years old.”

 

“She probably told him she was eighteen,” I noted.

 

“Probably she did, but she looks about twelve, and Swischenbeine purposely ignored her apparent age.”

 

“There is something wrong, Harry.  No minor is allowed to be treated without the express consent of her guardians.  Certainly all doctors know that.  Yet, for some reason, there is a continuing invasion of the home by certain gynecologists and planned parenthood clinics.”

 

“I don’t know whether or not a patient at a planned parenthood clinic must prove that she is no longer a minor, but I have the uncomfortable feeling that it is harder for a minor to buy liquor than to have an intrauterine device installed or to have birth control pills prescribed.”

 

“I think I’ll call him.  Do you want to listen in on the extension?”

 

Why not, I thought?  It ought to be quite a conversation.  I went to the den and waited for Lapius to dial and then picked up the phone.

 

“Hugo, Lapius here.”

 

“Hello, Simon.  How are you?”  Hugo said.

 

“Mad as hell, Hugo.  You prescribed birth control pills to a patient of mine.”

 

“Simon,” the gynecologist purred.  “You know I would never interfere in your practice.  She came to me and said that you had refused, that you wanted to get permission from her parents first.”

 

“You’re damn right, Hugo.  She’s a minor, and you have imposed a medical risk on her without her parent’s permission.  If anything happens to her, if she develops a thrombosis or some such, the parents might be able to win a malpractice judgment.”

 

“Ridiculous, Simon.  She stated that she was eighteen years old.  But what difference does it make?  Nothing will happen.”

 

“I’m not sure,” said Lapius.  For one thing, you have invaded the privacy of her home and entered into a collusion with this child to deceive her parents.”

 

“You wouldn’t coax her to learn to smoke, but you supply the physical means and indirectly the moral approbation to have sex relations.”

 

“I do this only to protect her, Lapius.  Suppose I didn’t.  Then she would have dex relations anyway and end up pregnant.”

 

“But you did this behind the backs of her parents.”

 

“She’s my patient.  I have to protect the patient-doctor confidentiality,” Hugo said acerbically.  “And besides, what business is this of yours?”

 

“I stated at the start, Hugo, that she is my patient and that whatever happens to her is my business.”

 

“Suppose she went out and became pregnant, Lapius.  Would that be better?”

 

“Perhaps, The statistics on the subject are interesting, Hugo.  Birth control pills for a nine month term are safer than a pregnancy.”

 

“Birth control pills for three years are not safer than a single pregnancy.  The use of a diaphragm is safest of all.  If the diaphragm fails, early abortion is statistically safer than birth control pills.  You should know that, Hugo.”

 

“But that is not my complaint.  I resent your intrusion into the ethical and moral atmosphere of her home.  If physicians cannot be depended upon to uphold and encourage a moral climate, then who can?”

 

“You sound like an old lady, Simon,” Hugo rasped.  “Wake up man, we are in a new age.  The old homilies are falling by the wayside.  If she didn’t get it from me, she would get from some planned parenthood clinic.”

 

“There wouldn’t be any planned parenthood clinics if you fellows didn’t man them.”

 

“But they are subsidized by the state.  Are you going to fight the government now, Simon?  Are you against planned parenthood?”

 

“No.  But I think an age limit ought to be carefully guarded.  There is an ethical question here, Hugo, that you are losing sight of.”

 

“Look, Simon, mind your business and I’ll mind mine.  What I do is none of your affair.  I have to go now.  Goodbye.”  He hung up noisily.

 

Afterwards, Lapius said.  “I guess he is right.  What he does is not my affair.  But it is the business of the parents of the community.”