Direct sterilization by means of tubal ligation is morally unacceptable in Catholic bioethics but other procedures that result in indirect sterilization may be acceptable under certain conditions.
Appropriate use of the pay-for-performance system may improve quality of care by counteracting physician incentives to overtreat in fee-for-service situations or undertreat in capitation plans.
Physicians should understand and be sensitive to all of the issues that affect patients when they prescribe the tertogenic medication isotretinoin for treatment of acne vulgaris.
Professional, practical, clinical and cultural obligations should guide decision making when a funding agency restricts the types of counseling and advice it allows medical professionals to dispense.
To be a useful tool for assessing quality of physician care, pay-for-performance must be designed to include process measures and to not penalize physicians for treating patients with difficult-to-manage conditions.