Today’s modern trauma system is a relatively new phenomenon, and trauma surgeons are constantly responding to the changing needs of the populations they serve.
The greatest pressure to resuscitate the extremely low-birth-weight infant often results from successful marketing efforts that lead families to expect that their premature infants will be cute and healthy.
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.
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.
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?
The importance of the Oregon experiment is that the state developed a public process for prioritizing medical services rather than relying on undisclosed private decisions by individuals or insurers.