Advertisement
Should Docs Prescribe Day-After Pill in Advance?

Should Docs Prescribe Day-After Pill in Advance?

Although the teenage birth rate in the US has declined substantially over the past 20 years, it still surpasses those in other industrialized nations. In a continuing effort to reduce the number of unintended pregnancies, the American Academy of Pediatrics (AAP) released a policy statement, published in the December issue of Pediatrics, urging pediatricians to prescribe the emergency oral contraceptive – “the morning-after pill” – for girls under 16 before they actually need it. The American College of Obstetricians and Gynecologists released a similar recommendation. Emergency contraceptive formulations of levonorgestrel marketed as Plan B, Plan B One-Step (Teva Women’s Health), and Next Choice (Watson Pharma) can be purchased over the counter by women 17 and older and men 18 and older. However, adolescent girls younger than 17 must have a prescription (the drugs are unavailable entirely for boys under 18). A common misconception is that emergency contraception causes an abortion. Inhibition or delay of ovulation is the principal mechanism of action. Review of evidence suggests that emergency contraception cannot prevent implantation of a fertilized egg. Emergency contraception is not effective after implantation; therefore, it is not an abortifacient. The AAP made their recommendation based on several studies that found having a prescription for emergency contraception before actually needing to use it did not increase sexual activity. Do you...
Docs Divided on Ethical Dilemmas

Docs Divided on Ethical Dilemmas

Medscape’s 2012 Ethics Report surveyed over 24,000 US physicians across 25 specialties about their top ethical dilemmas. While there were more obvious dilemmas that physicians generally agreed on how to handle – for example, 78% of physicians would report a physician, friend, or colleague who occasionally seemed impaired by alcohol or illness – there were a considerable number of situations that physicians were split on. Here are some survey questions that divided the survey group: Would you ever give life sustaining therapy if you believed it to be futile? (Yes: 35%, No: 24%, It depends: 41%) Would you ever devote scarce or costly resources to a younger patient rather than to one who was older but not facing imminent death? (Yes: 27%, No: 39%, It depends: 25%) Should physician-assisted suicides be allowed in some situations? (Yes: 47%, No: 40%, It depends: 13%) Would you ever dismiss a patient who is ‘non-adherent’ or who ‘overuses’ resources on their capitation plans? (Yes: 32%, No: 33%, It depends: 35%) Is it right to provide intensive care to a newborn who will either die soon or survive but have an objectively terrible quality of life? (Yes: 34%, No: 27%, It depends: 39%) Would you ever continue treating a patient-despite a family’s wishes to end treatment-if you felt the patient had a chance to recover? (Yes: 23%, No: 32%, It depends: 45%) Would you perform an abortion in certain situations, even if it were against your own beliefs? (Yes: 51%, No: 36%, It depends: 13%) Click here to view Medscape’s 2012 Ethics Report. Which side of the fence do you fall on with these...
[ HIDE/SHOW ]