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.
If I am unwilling to pay more taxes so an 85-year-old stranger can have a left-ventricular assist device, then I am morally obligated to say the same holds true for a future version of me in those same circumstances.
Although patients’ medical gender transition can be facilitated by counseling, as a matter of medical ethics, informed consent must be obtained for treatment.
AMA J Ethics. 2016;18(11):1079-1085. doi:
10.1001/journalofethics.2016.18.11.ecas2-1611.