An undercurrent in all debates about allocation of health care resources to the poor is the matter of access to and coverage of health care for immigrants, particularly low-income and undocumented ones.
Patients seeking IVF are highly motivated to become parents and may wish to preserve financial resources for surrogacy or adoption should IVF not succeed, so risk sharing appeals to them, which makes its high cost especially problematic.
With the U.S. Supreme Court likely to decide on the constitutionality of the Affordable Care Act, it is instructive to understand the relevant policy positions of the largest physician organization in the country.
You are not just the rural patient’s doctor, you are the doctor for the football team, a friend, and perhaps a relative; you speak on health at local schools and are expected to attend fundraisers.
The social-justice question we must pose to physicians is: Are you willing to advocate for changes to the medical system that creates the need for you to take on charity care in the first place?
If a patient’s feelings become sources of resistance to treatment, clinicians need to know how to address these feelings’ influence on the therapeutic capacity of patient-clinician relationships.
AMA J Ethics. 2017;19(5):436-443. doi:
10.1001/journalofethics.2017.19.5.ecas3-1705.