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.
Advance directives, substituted judgment, and the best-interest standard all have limitations that constrain their usefulness in making medical decisions for patients who cannot choose for themselves.
The profession of medicine is duty-bound to further the best interests of the public. If evidence suggests that discrimination based on sexual orientation or denial of civil marriage to GLBT couples has adverse effects on their health, physicians must oppose such practices, regardless of their personal biases.