The social institutions of medicine and the state have a complex history of interaction in which doctors have been the originators of political ideals, goals, and social change but equally often have found themselves to be instruments of political authority.
Fifty-seven percent of women in a recent large study did not want to view their ultrasounds before their abortions, suggesting that mandated viewing interferes with uncoerced consent to care, a hallmark of medical ethics.
Restrictions on employer-based health insurance coverage of medical services or treatments, whether motivated by religious prohibitions, political objections, or concerns about cost, degrade quality of care and undermine the patient-clinician relationship.
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.
Physicians who have adequately informed a competent patient of his or her diagnosis, its meaning, and medically appropriate options should then accept the patient’s informed consent or refusal of treatment.
Frank A. Chervenak, MD and Laurence B. McCullough, PhD
Clinical facts and physicians’ ethical obligations are critical in resolving disagreements between parents and physicians about resuscitation of an extremely premature infant.