Some doctors in the U.S. feel no obligation to tell patients about legal but morally controversial treatments such as abortion or birth control for teens, according to a new study.

In Thursday's New England Journal of Medicine, researchers report the results from 1,144 physicians in the U.S. who responded to a 12-page questionnaire.

The randomly chosen physicians from all specialties were asked about ethical rights and obligations when patients request a legal medical procedure that the doctor objects to on religious or moral grounds.

"If physicians' ideas translate into their practices, then 14 per cent of patients — more than 40 million Americans — may be cared for by physicians who do not believe they are obligated to disclose information about medically available treatments they consider objectionable," Dr. Farr Curlin of the University of Chicago and colleagues wrote.

Of those doctors who responded:

• About 17 per cent said they objected to sedating dying patients to the point of unconsciousness.
• 42 per cent objected to prescribing birth control to teens without parental consent.
• 52 per cent objected to abortions when contraception failed.

Most doctors, 86 per cent, believed in presenting all options.

Ask doctor about options

Of the physicians who objected to providing contraception to teenagers without parental consent, 22 per cent said they felt they were not obligated to disclose all options to the young patient. Most, 71 per cent, also said they would refer the patient to another clinician who does not object to the procedure.

"Patients who want information about and access to such procedures may need to inquire proactively to determine whether their physicians would accommodate such requests," the researchers concluded.

Doctors who were male, religious or had personal objections to morally controversial practice were less likely to report that doctors must disclose information or refer the patients, the researchers found.

Contraception and privacy

Meanwhile, given privacy concerns in small towns in Canada, some women's groups are lobbying for emergency contraception to be sold in pharmacies alongside condoms, rather than at the pharmacist's counter.

This week in Timmins, Ont., Dr. Chris Lorento said five or six women have come to emergency seeking simple pregnancy tests, although the kits are widely available at pharmacies in the town.

A national group called Women and Health Protection said that's because teens don't want to be seen buying pregnancy test kits. Similarly, they don't want to answer personal questions in front of other customers when buying morning-after pills, the group said.

The morning-after pill, also called levonorgestrel or Plan B, prevents pregnancy by preventing embryos from attaching to the wall of the uterus.

"Women and girls are finding that quite awkward in areas where they might know the pharmacist or the pharmacist might have a connection to their family," said Anne Rochon Ford of Women and Health Protection. "It's not surprising that you're hearing in your region that they're avoiding going altogether."

Planned Parenthood and the Society of Obstetricians and Gynecologists of Canada support the group's call for emergency contraception to be more accessible.