Bioethics. 2017 Aug 29. doi: 10.1111/bioe.12373.

When doctors deny drugs: sexism and contraception access in the medical field

Delston JB

Abstract Politicians, employers, courts, and health insurance companies are often discussed as problematically preventing access to birth control. However, doctors have more direct control over women's health and quietly have been much more effective at preventing patients' access to contraception. Obstetrician/gynecologists routinely deny their patients access to contraception ostensibly in the name of health by withholding birth control until patients undergo yearly pap smears. I argue that those in the medical field are motivated by similarly sexist concerns as those in other major institutions in the United States, but that they are often overlooked in discussions of biomedical ethics. After providing background, I argue that using birth control as a bargaining chip to control patients is morally impermissible, is paternalistic, and is contrary to consent. I next argue that sexism explains, though does not justify, this practice. I discuss the medical harms of routine pap smears and withholding birth control. These claims make medical malpractice likely. Withholding birth control to coerce individuals seeking medical care is medical malpractice, paternalistic, violates autonomy, and is contrary to consent

Comment: This is a somewhat unusual abstract for this part of GLOWM: not technical, but ethical. Still very important and relevant: if a woman asks a healthcare worker for contraception, she should receive a medically sound advice. Furthermore, if the healthcare professional is not willing to give it, for whatever reason, he/she must refer the woman to someone who will. (HMV)