As high-tech care decisions led to value clashes in hospital corridors, ethics committees developed to respond to diverse viewpoints, families’ concerns, and clinicians’ moral distress. They now exist in almost all US health care organizations.
AMA J Ethics. 2016;18(5):546-553. doi:
10.1001/journalofethics.2016.18.5.mhst1-1605.
A physician has an obligation to order necessary diagnostic tests for a patient on Medicaid with whom he or she has an established patient-physician relationship regardless of whether the cost of the necessary test will be reimbursed.
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.
Herman Melville's account of Bartleby the scrivener has something to teach us about the interactive nature of refusal and the empathy necessary for an exchange of values in the setting of conscientious refusal.