Aaron Wightman, MD, MA and Douglas Diekema, MD, MPH
In making decisions about allocating scarce organs, undocumented immigrant status should not be used as a proxy for the legitimate criterion of likelihood of success because uncertainty about future ability to pay or insurance coverage applies to almost everyone listed for transplant.
AMA J Ethics. 2015;17(10):909-913. doi:
10.1001/journalofethics.2015.17.10.peer1-1510.
To prevent patients from avoiding care when they cannot afford it, providers should collaborate with them to eliminate unnecessary testing, reduce the frequency of follow-up visits where possible, and make manageable payment plans.
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.
The guidelines for patients’ eligibility for bariatric surgery have not changed since 1991, although recent data suggest there may be indications for broadening application of the surgery.