Karen E. Hoffman, MD, MHSc, MPH and Paul L. Nguyen, MD
Guidelines require interpretation and should not be mindlessly applied as a template of care for all patients, particularly when there are inconsistencies between clinical practice guidelines developed by medical groups.
The revisions balance a growing understanding of gender identity disorders and societal views with the need to retain conditions that benefit from intervention and the removal of which would hamper patients’ ability to receive medical treatment.
Patricia D. Quigley, MD and Megan A. Moreno, MD, MSEd, MPH
Maintaining an adolescent’s confidentiality while answering his or her parents’ questions about their child’s change in mood and behavior can be challenging.
Loss of personal integrity, the emotional and psychological costs of “pronoun switching,” and actively managing one’s presentation can be time-consuming and exhausting.
Nancy Berlinger, PhD and Annalise Berlinger, BSN, RN
Physicians’ reliance on “culture” to explain patients’ noncompliance may serve as code for their discomfort with difference, uncertainty, and distress.
AMA J Ethics. 2017; 19(6):608-616. doi:
10.1001/journalofethics.2017.19.6.msoc1-1706.
The profession of medicine is duty-bound to further the best interests of the public. If evidence suggests that discrimination based on sexual orientation or denial of civil marriage to GLBT couples has adverse effects on their health, physicians must oppose such practices, regardless of their personal biases.
Immigrant patients are often bewildered when they need to seek health care in the U.S., and that care usually comes from physicians who are unsympathetic to their plight.
An argument that the concept of judicious dissent can resolve the debate over a physician’s conscience-based right to refuse to provide lawful services.