Thanks David, fair enough.

Hmmm- you're right JL- I didn't think of all the implications:

1- Having prior abortions would be the obvious criteria to cancel penalizing the doctor for not referring. But the hypothetical case of knowing where to find a clinic but going to the doctor for emotional support would be quite a sticky one and I can't really make a case for it. I think it is still fair that the doctor not be allowed to charge for the consultancy though, unless he/she gave any additional advice on a separate medical issue if asked.

2- Tougher- but similar story to the last one- by providing some legal/technical input into the right to access the drug probably satisfies some consultancy-fee criteria though. Although I'm a bit wary on the right to deny prescription on the grounds that it's dangerous if it's still legally accessible (particularly someone who got injured and was in a lot of pain needing higher than average doses of morphine to soothe it- but being denied and given a less efficient drug, for example- as someone I know experienced). So I'll have to get back to you on that one.

3- Hmmm- it seems you are right- so long as the doctor's permission is not needed before accessing these services, these don't seem like grounds to lose their jobs- so I retract my previous statement (although I still think refusal to assist or provide a referral and providing no further information to questions asked aught to be grounds not to charge a fee).

Nice points indeed!

Agree totally on the not charging in all three cases.

The not prescribing prescription drugs goes into a harder basket. I guess for me medicine is not an exact science. If a doctor genuinely believes that there are reasons for treating a drug with caution and have done their research, I think I'd allow them their position and seek another doctor if I'd still like that particular treatment. Not always easy of course if you are injured like your friend so it's not a perfect system.

As I previously posted, my doctor doesn't offer immunisations. If that's for reasons of convenience to him, and he has no issues with the safety of immunisations, then I don't think he is doing his job. It's a pain for me. If though he has genuine concerns about their safety, then I think he has the right to withhold and not prescribe.

For a dramatic example, I've heard a story of one of our family medicos who about 40 years ago did not prescribe his pregnant patients a drug that was supposed to control their nausea. He was uneasy about the drug. Some of his patients might have been grumpy at the time, but when he delivered their babies, they had all their fingers and toes. Yep - thalidomide. My doctor 20 years ago likewise decided only to perform relatively new ultra-sounds on his pregnant patients if medically indicated - 'just in case' they had negative side effects. Now they are proven safe and are routine but I don't think he was wrong in his approach.

My hypothetical doctors of course were of the polite variety as all doctors should be. A social worker friend told me the story of taking a 14 year old client seeking a termination to a doctor where the 14 year old copped a lecture about it being 'good enough for her mother' also pregnant at 14 and she should lump it. I don't think any doctor has a right to wave any sort of personal moral stick at patients seeking a termination and should be the subject of a complaint if they do.

In my perfect world my social worker friend would have not even thought about taking his client to a GP. There would have been a clinic where she could get a range of advice on all sorts of health issues (and it made sure there was nothing sinister happening to her at home) a termination if she wanted one, and advice on bringing up baby or other other options if she decided against it. Also in my perfect world all doctors taking on new patients let their patients know that they don't offer services such as termination or euthanasia, and not charge for that visit if the patient goes elsewhere.

I don't live in Victoria so I don't know what sort of follow up the government did when they legalised abortion. Be nice to think they sent every house hold a letter letting them know, and telling people how to access the service as well as setting up a information hotline and information being put up in public places. I bet they didn't though.

If we legalise euthanasia then all the same issues of access will come up. People if not provided with access and information even if it's legalised will suffer and any it will probably be the less educated and well off that will resort to taking drastic measures at home.

Yep- nothing more for me to say I complete agree!