Equating conscience with clinical judgment challenges the way that ethics is marginalized in medical education. Ethics is simply an account of what good medical practice looks like in particular situations.

Protecting one’s moral integrity may require a conscience clause that protects positive conscience claims by permitting individuals to perform actions that are otherwise prohibited by legal or institutional rules.

Julian Savulescu's writing on conscientious objection is guided by an emphasis on the principle of distributive justice that does not allow religion to have a special status as justification.

Health care reform and the national focus on reducing medical costs are forcing hospitals to reevaluate their business practices.

As physicians we decide which tests or treatments go on the bill but have little idea how our decisions impact what patients pay. Now patients, payers, and policymakers are demanding that we consider the cost of our recommendations.

To succeed in accountable care organizations, physicians will need to learn to emphasize collaboration rather than authority, keep costs in mind, and encourage patients to plan in advance for palliative care and death.

What impact will a concentrated effort to reduce the cost of inpatient hospital care have on the training of the next generations of clinicians?

Many innovations to improve transitions of care across settings are being implemented at national, regional, and local levels, and many questions remain about which promote affordable, high-quality, patient-centered care.

While critics of section 6001 of the ACA warn that it will debilitate an important competitive force in the marketplace, it does not categorically eliminate further development of the physician-owned hospital industry.

Some behavioral economists caution that, as ACOs proliferate, their focus on financial incentives could compromise hospitals’ mission and organizational behaviors.