August 20th, 2015

Judgmental attitudes towards sex can affect healthcare

doctorsBy Jolene Tan, Programmes and Communications Senior Manager

We share Dr John Hui Keem Peng’s sentiments that doctors should show respect and empathy towards patients and others (“Provide positive work culture for young doctors”; Tuesday).

The ethical code for doctors sets out important standards, including that doctors should provide “compassionate” care and “shall not allow personal beliefs… to influence (their)management of patients”.

Many doctors in Singapore strive to embody these values. However, the Association of Women for Action and Research (Aware) is concerned that some patients encounter doctors who display judgmental attitudes that affect access to sexual and reproductive healthcare.

One unmarried woman reported multiple negative experiences with doctors when seeking reproductive healthcare. One doctor lectured her on abstinence from sexual activity.

Another doctor, after being asked for emergency contraception, avoided eye contact with the patient for the rest of the session, and answered her questions in a contemptuous tone.

Another patient who needed emergency contraception also reported difficulty. Her doctor suggested that a married woman had no reason to avoid becoming pregnant, and required her to describe her finances and living situation in detail, in order to justify her request for the medication.

This effectively disrespected the patient’s stated wishes, based on the doctor’s own views about marital status and reproduction.

Yet another patient saw a doctor who concluded, initially, that the patient required a vaginal swab test for diagnosis. However, on learning that the patient had not had sex before, she refused to perform the test, although the patient made it clear that she preferred to have the test done to ensure an accurate diagnosis.

In essence, the doctor placed personal beliefs about the patient’s “virginity” above the need for treatment. These beliefs were not shared by the patient.

Doctors may have strong views about sexuality, but their duty to their patients must come first. Patients need to feel safe disclosing private, even socially controversial, aspects of their lives. They should not have to run the gauntlet of a doctor’s disapproval to receive treatment.

Hopefully, these cases do not reflect the majority of healthcare experiences. But given the especial sensitivity of sexual and reproductive healthcare, those involved in training and educating doctors may wish to pay particular attention to the question of respect, empathy and non-discrimination in this context.

This letter was first published in The Straits Times Forum on 20 August 2015.

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