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Re: AmenorrheaFrom: Robert J Woolley (wooll005@gold.tc.umn.edu)Wed Sep 4 09:54:21 1996
On Wed, 4 Sep 1996 DoctorJoe@aol.com wrote:
> <<I don't understand this attitude. If this patient also has psoriasis, I'm sorry, but that's simply *not* waht was said. The person to whom I was responding said that we shouldn't have any concern for any of this patient's gynecological problems, excepting cancer, as long as she smokes. And that, I repeat, is perverse. But I dieagree with even your more specific point. If, for whatever reasons, no other form of contraception is acceptable to the patient, and she is sexually active and at risk for pregnancy, it seems to me that you can together legitimately decide that the risks and costs (costs of all types) of an unwanted pregnancy outweigh the thrombotic risks. (With full discussion, documentation, etc., of course.) In such a case, *not* prescirbing the OCs may have worse consequences that *prescribing* them. Either way, it is a shared responsibility which cannot be avoided. You do not evade consequences to yourself or to her by failing to write the prescription; you merely change which negative consequences they will be.
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