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.
Educators discussing ethically challenging topics with students should try to cultivate open mindedness while illuminating potential negative consequences that their health practice beliefs—such as refusing to provide abortion care—can have for patients, particularly those with limited options.
AMA J Ethics. 2018;20(7):E637-642. doi:
10.1001/amajethics.2018.637.
Global health training offered through UCSF’s EMPOWUR program prepares ob/gyn residents to work in under-resourced communities locally as well as globally.
AMA J Ethics. 2018;20(3):253-260. doi:
10.1001/journalofethics.2018.20.3.medu1-1803.
Protecting one’s moral integrity may require a conscience clause that protects positive conscience claims by permitting individuals to perform actions that are otherwise prohibited by legal or institutional rules.
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.
Instead of succumbing to the urge to portray cultural differences as a dichotomy between clashing opposites, we should endeavor to note our common humanity, acknowledge the plurality of viewpoints within a given culture, and appreciate that cultures can evolve without being untrue to themselves.
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.