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.
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.
Some disability advocates take issue with the “normalization” goals of the medical model of rehabilitation, but expressions of that position can be dismissive of rehabilitationists’ efforts to remediate oppressive functional deficits.
AMA J Ethics. 2015;17(6):562-567. doi:
10.1001/journalofethics.2015.17.6.msoc1-1506.
Margaret Little, PhD and Anne Drapkin Lyerly, MA, MD
Society is best served by an approach to conscience that combines a progressive understanding of patients’ needs, a nuanced determination of when those needs translate into claims, and a limited role for conscientious refusal.
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.
Julian Savulescu's writing on conscientious objection is guided by an emphasis on the principle of distributive justice that does not allow religion to have a special status as justification.