Many pregnant undocumented immigrants are ineligible for public insurance covering prenatal care. National and state policies can either help or hinder patients’ access to health care that is universally recommended by professional guidelines.
AMA J Ethics. 2019;21(1):E93-99. doi:
10.1001/amajethics.2019.93.
Principles of respect for autonomy, beneficence, and nonmaleficence guide trauma-informed care. Care ethics should also support this framework for responding to the health needs of trafficked patients.
AMA J Ethics. 2017;19(1):80-90. doi:
10.1001/journalofethics.2017.19.1.msoc2-1701.
Preventing bad outcomes for teens and their offspring was the impetus behind confidential care for reproductive health. Requiring parental involvement created an obstacle to the provision of necessary care.
When patient autonomy became a closely held value in medical ethics in the 1960s and '70s, the physician’s conscience-based right to refuse to deliver a given service began to be contested.
Qualifying conscience protections for institutions with requirements that they minimize hardship caused to the patient would prevent religious institutions from acting as a choke point on the path to services.
If employees of religious institutions whose consciences conflict with those of their employers were to be granted legal protection for positive claims of conscience, the religious freedom of institutions within which they work would be gravely compromised.
With good planning and good will, medical professionals’ right of conscience and patients’ rights to controversial services can be both protected and accommodated.
Melissa Weddle, MD, MPH and Patricia K. Kokotailo, MD, MPH
Physicians should honor confidentiality whenever possible when screening and treating adolescents for sensitive health conditions such as substance abuse.