When deciding whether a pregnant woman will take antidepressants that pose a slight risk to the fetus, the patient and doctor must each make value-based determinations about whether absolute protection of the fetus is more important than preventing the mother’s probable suffering.
Punishing women who use drugs during pregnancy deters them from seeking prenatal care and entering drug treatment programs, and the relevant policies may unfairly target poor or minority women.
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.
James Mills Jr., MD, a founder of emergency medicine, believed he could have greater impact on medical care for the poor in his city by giving up his practice and working in the emergency room full time.
Nancy Berlinger, PhD and Annalise Berlinger, BSN, RN
Physicians’ reliance on “culture” to explain patients’ noncompliance may serve as code for their discomfort with difference, uncertainty, and distress.
AMA J Ethics. 2017;19(6):608-616. doi:
10.1001/journalofethics.2017.19.6.msoc1-1706.