Ethical Issue in Patient Care:

Ethical Issue in Patient Care: Non-Treatment

One ethical question which occasionally arises in the treatment of patients is when healthcare providers have a right to refuse to provide care to a patient. Ethically speaking, a physician is usually not viewed as having a duty to treat any patient if he or she lacks a prior relationship with that individual. Physicians can refuse to provide treatment to a patient if they are currently overbooked, if the patient is unruly and uncooperative, or if the patient asks for treatment outside the physician's realm of expertise. However, to limit the right of refusal of physicians to treat patients who cannot afford to pay for care, Congress passed the Emergency Medical Treatment and Active Labor Act. According to this Act, physicians are required to medically stabilize and screen patients when they seek emergency care, regardless of the patient's ability to pay, or the physician may be subject to monetary penalties (Katz & Paul 2002). Still, physicians are notoriously less apt to treat regularly patients who receive insurance through Medicaid, the federal health insurance program for the poor, because of the lower rates of reimbursement for that program -- far lower than bestowed by Medicare.

Physicians have been criticized for refusing to perform certain procedures because of a fear of higher risks of complications and malpractice lawsuits. Some obstetrician/gynecologists are on record as refusing to provide medical care to obese women because of the high rates of complications for these patients in a field of specialty that already has costly insurance rates for doctors. Doctors state that their examination equipment cannot accommodate persons over a certain BMI and they fear that insurance premium rates may compromise their ability to remain in practice (LaMendola 2011).

Legal issue: Birth control for teens

At present, Texas, Utah and one county in Illinois require parental consent for family planning services paid for with state funds. These policies are defended on the basis of the claim that the state has an interest in discouraging children below a certain age from engaging in sexual activity. However, critics of such laws counter that such restrictions merely discourage teens from obtaining birth control and engaging in safe sex, thus increasing the teen pregnancy rate and also the spread of STDs. This idea is supported by a Journal of the American Medical Association. The study found that 60% of the teens surveyed said that their parents knew they were using a clinic for sexual health services. These statistics act as a counterweight to the contention that parental notification laws would improve communication on the subject between teens and their parents. Additionally, 18% of teens said that if they were legally required to tell their parents about their use of the clinic, they would not seek contraceptive services at all and instead engage in unsafe sex (Jones 2005).