BANDER CONTEST WINNING ESSAY Medical Ethics and Retail ClinicsThomas Heyne Scenario Dr. Bunell was surprised to see Mrs. Scott and her second-to-youngest child when the office assistant showed them into his exam room."Long time, no see, Mrs. Scott," he said. "Everyone's been well, I take it?" "Well, I'm worried about this one, " she said, looking down on her son who sat in her lap. Dr. Bunell figured he must be about 5 years old by now. "I've been taking the boys [she had four] to the SureCare Clinic at the mall for the last 2 years," Mrs. Scott said. "I can get their immunizations there, get them seen for colds and bouts of poison ivy. My oldest even got his physical to be on a pony league team last spring." She took a breath. "And it's so quick and far less expensive than coming here. With a family of six," she said, "it makes a huge difference in medical bills." Before Dr. Bunell could speak, Mrs. Scott started again."But, we've been treating this one," she looked down again, and Dr. Bunell wished she'd say the lad's name because, to tell the truth, he'd forgotten it, "with antibiotics for 3 weeks and he seems to be getting worse, not better. Just look at him." Visits like Mrs. Scott's were becoming familiar to Dr. Bunell. More and more of his patients were showing up after long periods during which he figured they had been well and had had no need for medical care. He found out, instead, that they had been going to retail clinics for the "everyday stuff," and making appointments with him only when something more serious cropped up. It would be months or years since he had seen them and he'd have no record of what had transpired at the clinics.A family practice specialist, Dr. Bunell did not know the best and most professional way to manage this situation. Some of his colleagues had told their patients that they (the physicians) had to manage all the care or none. But Dr. Bunell didn't know if that was ethical; besides, it was entirely unenforceable. How would one know if a patient had received care elsewhere between visits to the doctor's office?
Adolescence is an important yet vulnerable period of transition from childhood to adulthood. An increasing number of studies support the traditional Catholic view, which sees teens as prone to making poor decisions when influenced by emotions or peer pressure but capable of thriving when guided by parents and religion. However, newer policies of medical societies undermine the traditional supports of family and faith with a permissive approach toward sexual exploration. To counter this unhealthy trend, which seems to be based more on postmodern ideology than robust science, Catholic physicians should become experts in adolescent behavior and sexual health. Physicians should be sensitive to opposing viewpoints but participate only in treatments which are ethical and beneficial for their patients. Specifically, Catholic physicians must avoid contraceptives, abortion, and “gender-affirming” therapies. By using good science and emulating the models of service, Socratic dialogue, and accompaniment, physicians can guide adolescents toward a virtuous, healthy adulthood.
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