Educators discussing ethically challenging topics with students should try to cultivate open mindedness while illuminating potential negative consequences that their health practice beliefs—such as refusing to provide abortion care—can have for patients, particularly those with limited options.
AMA J Ethics. 2018;20(7):E637-642. doi:
10.1001/amajethics.2018.637.
Physicians new to a case might object to an established care plan. Practice variation, clinical momentum, and how value is assigned by different parties to acute care and comfort measures can each contribute to conflict in these cases.
AMA J Ethics. 2018;20(8):E699-707. doi:
10.1001/amajethics.2018.699.
Refusal of pediatric euthanasia can be considered iatrogenic insofar as it inadvertently prolongs patient suffering, but attitudes differ cross-culturally.
AMA J Ethics. 2017;19(8):802-814. doi:
10.1001/journalofethics.2017.19.8.msoc1-1708.
Margaret Little, PhD and Anne Drapkin Lyerly, MA, MD
Society is best served by an approach to conscience that combines a progressive understanding of patients’ needs, a nuanced determination of when those needs translate into claims, and a limited role for conscientious refusal.
Jody Steinauer, MD, MAS and Carolyn Sufrin, MD, MA
Legislative policies that require a physician to misrepresent the risks of abortion to patients and to show the patient an ultrasound and those that allow physicians not to provide referral for abortion create a conflict between the physician's obligations to the patient and to the law.
Fifty-seven percent of women in a recent large study did not want to view their ultrasounds before their abortions, suggesting that mandated viewing interferes with uncoerced consent to care, a hallmark of medical ethics.
The AMA Code of Medical Ethics' opinions on confidential care for sexually active minors and physicians' exercise of conscience in refusal of services.
When patient autonomy became a closely held value in medical ethics in the 1960s and '70s, the physician’s conscience-based right to refuse to deliver a given service began to be contested.