Can I prescribe birth control?

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OBNurseRachel

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Hi all,

I am an RN who has recently completed studies to become a nurse practitioner. I work for an OBGYN who is pro-life, but not Catholic. I have carried this question in my heart for many months. Can I prescribe birth control? To be perfectly honest, there is no job for me in OBGYN if I can’t prescribe at least birth control pills and diaphragms. Most of our patients are not opposed to birth control and are not Catholic. I would not be responsible for inserting IUDs, but the OBGYN does. I also would not prescribe the “morning after” pill. I am really torn because I know I cannot force my beliefs on others (my husband and I used NFP), and I do need to work. On the other hand, I do not want to commit a grave sin.

Thanks for your (name removed by moderator)ut.

Rachel
 
How can your OBGYN be pro-life if he/she inserts IUDs. Don’t IUDs prevent a fertilized egg from implanting? You might want to bring that up.
 
Birth control is legal and people have a right to use it. In my opinion, the NP’s job is to determine that the medication would have a low chance of harming the patient if she chose to take it. The NP isn’t signing off that it would in fact be moral or good to use the medication in that way, just that it wouldn’t put the patient’s health in danger. I don’t think you are obligated to block other people from using it. I would prefer that pro-life docs and NP’s stay in business.
 
I am a nurse also and have ruled out work in areas which deal with birth control or abortion. Is your qualification specifically for obs and gynae? Could you move into another area?
 
Allegra said:
Birth control is legal and people have a right to use it. In my opinion, the NP’s job is to determine that the medication would have a low chance of harming the patient if she chose to take it. The NP isn’t signing off that it would in fact be moral or good to use the medication in that way, just that it wouldn’t put the patient’s health in danger. I don’t think you are obligated to block other people from using it. I would prefer that pro-life docs and NP’s stay in business.
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Opinions are like elbows, as the saying goes.

Doctors and nurses use their own moral and ethical judgment all the time in determining how and when to treat or not treat patients. And so do all of us. Our morality as professionals is no different to our morality as private individuals.

You couldn’t give poison or a knife to someone who has told you that they intend to use that poison or knife to kill their child. In law such makes you an accessory to the crime, and in theological terms it is called formal and/or material cooperation in evil.

Since contraception is intrinsically evil, like abortion or sterilization, such direct cooperation
as prescribing contraceptive pills or devices is very wrong.

Bearing in mind some women can and do use the pill to treat various medical conditions. That is fine. It is the use to deliberately prevent conception that is wrong.
 
Well I mean it’s not a sin for Catholics to use birth control…
it’s a sin to use birth control, it’s evil, it turns sex into something selfish.
I want to be a doctor one day so I worry about this too…but I believe we have an obligation to stand up against contraception.
 
OBNurseRachel said:
Hi all,

I am an RN who has recently completed studies to become a nurse practitioner. I work for an OBGYN who is pro-life, but not Catholic. I have carried this question in my heart for many months. Can I prescribe birth control? To be perfectly honest, there is no job for me in OBGYN if I can’t prescribe at least birth control pills and diaphragms. Most of our patients are not opposed to birth control and are not Catholic. I would not be responsible for inserting IUDs, but the OBGYN does. I also would not prescribe the “morning after” pill. I am really torn because I know I cannot force my beliefs on others (my husband and I used NFP), and I do need to work. On the other hand, I do not want to commit a grave sin.

Thanks for your (name removed by moderator)ut.

Rachel
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You may want to consult the National Catholic Bioethics Center, rather than relying on amateur opinions from a site like this.

ncbcenter.org/
 
So there are two issues here… sin and culpability.

Sin is objective. We can’t change that. When we participate in sin or facilitate sin, we sin. Artificial Birth Control is objectively sinful. That is crystal clear, and promoting or facilitating the sin of contraception is a sin. So perscribing birth control to enable people to prevent pregnancy is sinful.

What we are faced with is culpability to sin - how much blame do we bear for the sin?

Someone who works as a cashier at a WalMart where contraception is sold or a person who shops there is less culpable than the owner of a pharmacy which makes money by selling contraception. The owner of the building where the pharmacy operates is less culpable than the pharmacist, and the pharmacist is less culpable than the one who uses the contraception.

The OP is in a difficult situation here, because she is directly involved in the process, and really needs to speak to a priest or other spiritual director about this issue. The internet is not the place to resolve this issue. We cannot judge, but the OP is right to ask the question.

I would go so far as to say that the OBGYN who sells and inserts IUD’s is not pro-life no matter what he claims. Pro-life isn’t just about abortion but about contraception, the death penalty and euthanasia as well. If you administer artificial contraceptives, you are not pro-life.

-Tim-
 
This is part of your job. Seems like it’s a little late to have a qualm with the line of work. If you choose not to, you have to realize that it will limit your employment options.
 
Allegra said:
Birth control is legal and people have a right to use it. In my opinion, the NP’s job is to determine that the medication would have a low chance of harming the patient if she chose to take it. The NP isn’t signing off that it would in fact be moral or good to use the medication in that way, just that it wouldn’t put the patient’s health in danger. I don’t think you are obligated to block other people from using it. I would prefer that pro-life docs and NP’s stay in business.
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By your logic abortion is legal and people have a right to it. It is not the medical professional’s job to determine…\

Same sex marriage is legal in some places. It is not the minsiter’s job to …

Doctors killing very sick people is legal…

Why do you care if pro=life docs stay in business if they can’t be prolife in their profession?

IUDs cause aboritions and they are both perfectly legal.
 
Et_Cetera said:
This is part of your job. Seems like it’s a little late to have a qualm with the line of work. If you choose not to, you have to realize that it will limit your employment options.
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Not the way to think here…
 
You can contact too the NCBC (phone at bottom) and ask for an ethicist (number at bottom) --they can explain in detail what is gravely wrong here and why: ncbcenter.org/?aspxerrorpath=/NetCommunity/Page.aspx

You note: “To be perfectly honest, there is no job for me in OBGYN if I can’t prescribe at least birth control pills and diaphragms”

Such is not the case. I understand your very new a this but such is not the case.

There are Catholic Hospitals and here NFP only OB practices around the country where one could preform wonderful service (my wife and I go to one…well she goes I tag along…).

Contact the Paul VI institute --they will have a whole list of practices…
 
OBNurseRachel said:
Can I prescribe birth control?

No, you can’t.
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OBNurseRachel:
I do need to work. On the other hand, I do not want to commit a grave sin.
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Then I pray you will soon be able to find work in another doctor’s office or field of nursing that does not include immediate material cooperation in sin, which is itself a sin.
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Note: if you have firefox browser, it seems to have trouble opening the webpage for the link below. Internet explorer does just fine, though.

If you are not able to try and contact an expert to answer this question, I suggest you read the reply to a similar question posed by a physician. This is excerpted from a reasonable text on moral theology, and is available to read the question and the answer in full here.

… But can such cooperation be morally acceptable? I think not. In the first place, writing such prescriptions, however reluctantly, is almost certain to be understood by patients and others as approval of the pill’s use. That perception of approval-especially approval by a physician who, like you, usually tries to follow the Church’s teaching—will reinforce the self deception and rationalization involved in the dissenting opinions you described. By contrast, taking a clear stand and refusing to have anything to do with the pill’s contraceptive use offers a necessary witness and example for patients and other physicians. Second, in the ongoing physician-patient relationship, a physician’s prescribing the pill, together with his or her concern for the patient’s well-being, is all too likely to lead to intending the drug’s effective use. …
There is a lot more at the link, so I have only quoted a small portion to let you know what is there. The person who posed the questions asks other stuff besides what you ask, but your question seems to be addressed fairly well.
 
If you’re Rx’ing it for medical reasons unrelated to a contraceptive intention, then sure. Of course, there’s enough info out there to suggest the pill ain’t all its cracked up to be, and I can’t shake the fact the WHO classes it as a carniogen in the same group as asbestos.

But as a profession you have an obligation to your patients to make them aware that you will not Rx for contraceptive reasons.

I’m an RN, and I really wanted to work public health, but as a student I went with the public health nurses for clinical experience and while a lot of the job I loved, the part about Rxing the pill and MAP for teenagers, handing out condoms to 12 year old boys and organising abortions for kids without their parent’s consent, I realised with great sadness I could never do that job.

I won’t put a job ahead of my soul. There are jobs I’d like to do, but can’t because of the contraceptive/pro-abortion aspect of them.

So sadly, you can’t Rx the pill if you know its for contraceptive purposes. You’d be involving yourself in a great sin, and while for the patient, it might not be a mortal sin for them because of ignorance, it would be a mortal sin for you because you have full knowledge and full consent.

But yeah, IUDs? That ain’t pro-life, not by a long shot.
 
vera_dicere said:
If you’re Rx’ing it for medical reasons unrelated to a contraceptive intention, then sure. Of course, there’s enough info out there to suggest the pill ain’t all its cracked up to be, and I can’t shake the fact the WHO classes it as a carniogen in the same group as asbestos…
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Note: There are differing judgments among good orthodox Catholic voices on such (one the first part) due to the potential abortive nature of the pill -that is in the case of one who is sexually active.
 
Jacob18 said:
Three!

Otherwise, have you thought about changing specialties or checking out working at a Catholic hospital?
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It’s not very realistic to change specialties. I have been working toward my NP for many years, in this field. I don’t have experience with other nursing fields and I can’t just “decide” to switch to dermatology and start looking for a job. It’s a long road and that would be a huge diversion that I cannot afford.

I do not work at a hospital. I work for a private practice OBGYN who is the only one in my town who does not perform or recommend abortions. He is also the only one in town willing to do VBACs. He is a lovely man and a caring, gentle practitioner. Unless you live in a heavily orthodox area, I am not sure there is a way to carry a practice if you do not prescribe any birth control, and I do not live in a Catholic-heavy area. There are several Catholic OBGYNS, but none that have a no-contraceptive practice, in our area. It’s simply part of the job, since very few people are opposed to it (even most of our Catholic clients use contraception.) It is kind of like being a pediatrician who doesn’t give vaccines. Not a huge number of people lining up for that in most areas! Right now, about 70% of our practice uses some sort of prescription birth control that was prescribed by us. That is not counting those who use over-the-counter varieties, or who get their contraceptives from their family practice doctor or a clinic.

The hospital that the OBGYN I work for admits to at is, in fact, owned by Catholic Healthcare West. Abortions cannot be performed on the premises, of course, but there are no rules about the OBGYNs who deliver/operate there not prescribing birth control in their private practices.

Right now we are waiting on some documentation and insurance stuff to be settled before I start seeing patients as a licensed NP. I am so torn about this, since I will NOT be doing obstetrics at all, but straight gynecology and clearly Rx family planning is a huge part of that for the majority of women. I do not want to sin or offend God, but this is a hard one.
 
OBNurseRachel said:
I do not want to sin or offend God, but this is a hard one.
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It’s really not a hard one at all. We may never do evil. Period. Contraception and sterilization are evil.

It is best you walk away now and stop attempting to rationalize it. The longer you do this job and rationalize that it is ok, the more it will chip away at and dull your conscience until you have completely convinced yourself you are doing nothing wrong.

Contact the National Catholic Bioethics Center for help.
 
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