If you intend to run the test regardless, why do you even ask in the first place?

Just say "we legally have to run a pregnancy test". But specifically asking, and after hearing a no running it anyway IS insulting.

Have you considered the damage insulting patients does to everyone's health and wellbeing?

A patient who thinks you are dumb (or who thinks you consider them dumb) will lose trust.

That means they may keep some embarrassing info to themselves, because doc already thinks I'm dumb, if I now tell them I forgot to mention XY, they will think I'm a complete idiot.

They may refrain from asking questions.

They may even refrain from seeking help: I remember a thread about doctors defending invasive questions about the number of sexual contacts, arguing that it helps them gauge the risk level of an STI, but completely ignoring the fact that a significant number of people would not come back to a doctor they felt slut-shamed by, especially if they develop STI symptoms after being slut-shamed.

Now you may roll your eyes and think those patients should get over themselves, but this is not how human beings work. So if you really want to provide the best care, your best bet is to protect your patients' dignity, not shrug and explain it with "standard procedure" and "protect themselves from lawsuits". To be clear: Sure you can ask in two different ways about some things like pregnancy, or explain that you are legally obliged to do a pregnancy test, but you have to do it in a way that does not get taken as insult by a significant portion of people.

Your attempt to boil down my message is kinda your exact problem in a nutshell: Your communication is bad and you don't care. There is no dichotomy here. You don't have to be insulting in order to adhere to safety, how do you even get the idea that there is a dichotomy?

And yes I am in medicine, it's just that I treat my patients with respect. Yes, including the uneducated ones. That may include follow-up questions if I am not sure we are on the same page, but somehow I manage those without insulting people. Which is very very possible, provided you give a damn about human interaction.

OK first you say it's more like a pilot doing basic checks, so you need the routine of asking in order to get it right, no matter if it sounds dumb.

To which I said: OK, but then put some brain into answering the question, like with the hysterectomy, so that you don't insult the patient.

To which you said: But some patients provide incorrect info.

And then you clarified that it's not a blanket assumption but you rather put some brain into processing the answers, if not in asking the questions (because you ask in the routine, pilot thingy way).

Thanks for explaining, but please consider: If you ask in a way that is being read as insulting by a lot of people (like all those pregnancy questions in this thread), then maybe you catch on the minority who is mistaken or lies, but you also lower the trust of everybody else. They think that either you are dumb and thus not to be trusted with delicate decisions, or that you think they are dumb and thus also not to be trusted with delicate decisions.

If you assume one way or another, then why do you ask in the first place?

But why ask the question in the first place if you are not going to believe the answer one way or another?