Two Doctors. Opposite Beliefs. Should Doctors Let Personal Beliefs Influence Patient Care? – Transcript

00:00So, supportive or against? Evidence-based medicine, >> supportive. >> Supportive. Uh, patient centered care, >> supportive, depending on how you define it. >> Supportive. Yeah. Medical assistance and dying. >> Against.

00:14>> Against. Okay. Supportive. Contraception like condoms and birth control. >> Supportive in the right context. >> Okay. Yeah. We'll dive into that. I'm supportive. Um, elective abortion >> against.

00:26>> Against. Okay. Supportive. uh gender affirming care for adults, whether that's medical or surgical transgenderism. [snorts] I can't give a one-word answer on that.

00:40I I really care about the people that are caught in that, but I have a hard time supporting something that I don't think is addressing the underlying issue. >> I will say in general, supportive. Okay. >> Okay. Do you think that a doctor's religion affects their medical decisions for the patients that they are treating?

00:58Yes or no? >> I think a doctor's core beliefs affect that. So, yes. >> Yeah, I agree. Yes, I do believe that. Do you think that it's okay if it does?

01:09>> I don't see how it can't. >> Okay. But I guess the question is whether um you think it is okay for someone to impose their own I guess uh religious beliefs and the moral compass that they have derived from it onto patients that don't necessarily share the same religion as them. Thanks so much for joining me on the podcast. Um,

01:35I've been wanting to do a podcast talking about faith, religion, and personal beliefs and how that shapes doctors uh care for patients. And one thing that I want to say before we even start the podcast is that the point of this podcast and discussion is not to debate whether or not God is real or really to kind of argue whether um the way that you practice or I practice is

02:01correct or not. Um but really it's really to explore how these personal beliefs shape uh patient care when you're face tof face with a patient. I personally feel that so many topics around healthcare have become so polarized in the recent years and this forces people to separate into separate silos and um leads to things like identity politics and group think and I think that this is one of the biggest

02:29modern tragedies. So, you know, like I know that you and I are coming from different perspectives and I really do appreciate that you were willing to sit down with me cuz you honestly when I was searching for people and reaching out to people to speak with me on some of these things, a lot of people are either not brave enough or not stupid enough as you and me to actually talk about this in a public forum, you know. So, thank you.

02:54Um, and one thing that I'll say to anyone that's watching or listening to this is, um, you know, please watch and listen with an open mind. Um, you know, if what we say does not totally align with your personal beliefs, please don't demonize us. This is really supposed to be an open conversation and a constructive one for that matter.

03:14>> I I totally agree. I think the world is a better place if we listen to each other and understand where the other person is coming from. understand some of the wounds that they may have from the past. But one of the things that is the top of the list for marriage counseling is always to put the best spin on things. So always expect the best interpretation of what's been said.

03:39So I think we did that when we had a telephone conversation and I hope that we can do that and I hope that your listeners or your watchers will be able to have that same idea that maybe either of us doesn't express things in the way that they can hear the best but that we are not intending to be inflammatory or to disrespectful in any way.

04:05>> Absolutely. So on that note, Dr. Dr. Margaret Cotto, please introduce yourself, maybe um talk about what you uh have done in your medical career and how what your involvement is in the Christian faith.

04:20>> I graduated from the University of BC in 1978 before most of your watchers were probably born. So, I've been involved in medicine for over 50 years. And I was drawn to medicine partly because of my Christian faith and through lots of experiences that came through that. But because I really like most of us who are in medicine really wanted to help people and I felt that there was a very

04:47holistic part of medicine where we were able to help physical needs as well as spiritual and emotional needs as well. And when I was in medical school, there was no such thing as paliative care. The the the big textbook of pain didn't even excuse me, the big textbook of cancer that's about this thick didn't have a single entry in the index for pain. So it was a new concept. When I was about

05:1410 years out of medical school, I attended a a morning conference in Halifax when my husband was doing his residency that was included four of the original bright light people from pal the paliotative care world. And I came home just stunned because I felt that this was an area of medicine that took

05:39into consideration all those things that I had loved about medicine for so many years when I would start to talk to my preceptors about wow this person had been in a concentration camp in World War II and they'd roll their eyes and they'd say what's the blood pressure and I finally found a discipline within medicine that was interested in people's stories interested in who they were and understood the power of that narrative

06:05in their life. And so I I never looked back. I ended up doing what was available then, which was four weeks of training in Montreal with Dr. Balfur Mount and his team. I came back to Nova Scotia. I had little kids. My dad, who had lost his wife to cancer a few years before, came to Nova Scotia and was the mom for for our children.

06:29Well, uh, my husband was in residency and I came home from my four weeks of training and was on call the first weekend. >> So, it was trial by fire, but there was so much about it that really just fed something important in me as well that there were people who were fearful and I was able to come into their lives and say, "I'm here. I'm I'm I can come alongside you." There were people who

06:56were in pain and I knew how to help that. uh there were families who were in kind of disarray and I knew how uh how to help them come together and that was a really beautiful thing in my life and we moved back to BC after my husband's residency and I've been involved in all aspects of paliotative care um home care

07:22on the paliative care unit care on the consult team um all those sorts of things and and teaching and I um um really have enjoyed the home care the most. >> I think partly because I'm kind of a nosy person and I love going into people's homes and and seeing a picture.

07:42Oh, this is when I met the Aakhan like whoa, this is interesting or pictures of where where they came from and stories that they can tell me. And I'm I still I think cause some of the home care nurses to roll their eyes because when I I do a home visit, it usually takes longer than somebody else because I'm so interested in their lives and in what's going on.

08:03But I I have found in my practice that that time is never wasted. You know, you make those connections with people and they come back to you and they they feel like they can trust you and that you understand them and then you can determine a >> [snorts] >> a a course of where to go from here together. And anytime that you can do

08:28that collaboratively, it's always it's always going to be better. >> Yeah. I mean, so much of what you just said resonates so deeply with me. uh just taking the time to hear someone's life story, hear their values, um and just like yeah, develop a basic connection on a humanto human level just goes such a long way in terms of patient physician trust and uh I think just even the overall fulfillment that you get

08:54from your job as a physician, right? Uh we're not there to treat patient with chest pain or girl with gastroenterteritis. we're there to treat the human that's in front of us, not only the biological portion but the biocschosocial portion of them, right?

09:08So that's uh that's wonderful. >> Well, I also think that in paliative care doc um Dr. Sisley Saunders who's the founder of modern paliative care um she was from the UK and she talked about total pain and how there's uh it's sort of an overlapping ven diagram. There's there's physical pain, there's spiritual pain, there's psychological pain, and there's social pain or familial pain.

09:36And one of my colleagues actually says there's such a thing as bureaucratic pain, too, which >> I believe it >> which, you know, people we laugh and say in the US, well, they have all these different um insurance and all these things to deal with, but here in Canada, we have bad bureaucratic pain, too. If somebody is has a cancer biopsy that's positive and they wait six weeks before they can get an MRI and then they wait another three

10:03weeks before they get the results of that that's bureaucratic pain. So I think we have that we have that everywhere. >> But that that sense of >> people being whole people is is so important and that has a real overlap uh or congruence with my Christian faith >> when from my understanding of of the

10:29Bible, my understanding of who Jesus was as a person and how he treated people around him. Every person is made in the image of God. Every person is worthwhile. Every person deserves my respect, deserves all the expertise that I can bring to them. Have I always done that? Well, no, I haven't. My mentor Dr. Mount always loved the the uh

10:54Martin Booers thing with the I thou relationship, that idea of of really connecting with people. And if you look at the person of Jesus, he did that. you know, he he met the woman at the well who he should never even have been talking to and he connected with her. He knew all about her and he invited her to serve him. So there were there were things there are things like that that