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.
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?
Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.
The picture that emerges from study of physician economic behavior is mixed, but from the intensity of responses by some professional societies to Medicare's coding modifier proposal, it appears that economic incentives matter a lot to many of their members.
Refusal of pediatric euthanasia can be considered iatrogenic insofar as it inadvertently prolongs patient suffering, but attitudes differ cross-culturally.
AMA J Ethics. 2017; 19(8):802-814. doi:
10.1001/journalofethics.2017.19.8.msoc1-1708.
The Moseley study found no significant difference between those in the arthroscopic lavage and debridement arm of the study and those in the sham surgery arm.
This process of developing EBM-based guidelines and applying them to clinical care highlights the tension between generating unbiased knowledge based on statistical aggregation and the application of this information to individual patients.