When a patient challenges the use of a reusable, stainless steel speculum rather than a plastic, throw-away one, the physician should educate her on the safety and environmental benefits of reusable medical devices.
Moral distress arises not only from organizational constraints on moral action but also from the environmental impacts of health care and climate change.
AMA J Ethics. 2017;19(6):617-628. doi:
10.1001/journalofethics.2017.19.6.mhst1-1706.
Climate is a primary determinant of whether a particular location has the environmental conditions suitable for the transmission of several vector-borne diseases, including dengue fever, St. Louis encephalitis, and West Nile virus.
When the health care industry came under the environmental microscope, the daily work of treating patients was discovered to be highly wasteful of natural and financial resources.
Physicians make patients aware of those interventions that they (the patients) may then refuse. In short, informed consent is less about patient decisions than it is about restraining physicians.
The question is whether the medi-spa is a consumer-driven, profit-motivated business that happens to fall under the purview of medical practice or a legitimate and integral part of the health care system? Does it fulfill consumers’ desires or relieve suffering and promote wellness?
Is our generation of physicians somehow “weaker” because we’d rather not spend our entire lives at the office? Physicians who trained and practiced under more grueling conditions wonder how we expect to be competent physicians if we don’t work at it?
Giving undocumented immigrants and those with DACA status (DREAMers) access to health care and medical education enables them to contribute to these systems.
AMA J Ethics. 2017;19(3):221-233. doi:
10.1001/journalofethics.2017.19.3.peer1-1703.