The physician must consider the potential benefits of the new procedure and then determine, through discussion with the patient, what value the patient places on those specific benefits.
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.
To be best able to respond if third parties in assisted reproduction contracts break their terms, physicians should familiarize themselves with the contracts, encourage all parties to self-disclose, and, failing that, disclose material information to the other party.