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.
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.
Thomas W. LeBlanc, MD, MA and Amy P. Abernethy, MD, PhD
One strategy to promote adherence is the use of “care pathways,” effectively roadmaps that seek to standardize cancer treatment on the basis of some agreed-upon set of guidelines within a particular center or group of patients.
There are few situations in which the standard of care is so clear-cut as to preclude physician judgment. Assessing the degree of need (not just the standard of care) when asking a patient to spend money requires judgment.