Term Paper: Goal of Their Ethical Calling

Pages: 8 (2350 words)  ·  Bibliography Sources: 1+  ·  Level: College Senior  ·  Topic: Healthcare  ·  Buy This Paper

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[. . .] Quite often, the courts declined to apply this law to a physician's refusal to treat, such as in Bragdon v Abbott in 1998 when the Supreme Court decided that asymptomatic HIV was a disability. In the case, the dentist refused to fill a cavity because the patient has HIV but without symptoms. The patient sued the dentist under the ADA and the Supreme Court ruled that health care providers had the legal obligation to treat (even) HIV infected patients because HIV was considered a disability (Katz and Paul). The American Medical Association issued a similar position.

Both ethical and legal opinions and inclinations went against a physician's intentionally and unilaterally discontinuing or refusing a patient relationship, unless the physician could provide the patient reasonable notice in writing and enough time to look for another physician (Katz and Paul). The refusal or inability to meet these conditions constituted abandonment or dereliction of duty if injury resulted. The physician could be subjected to disciplinary action and civil liability

Many physicians believed that they could "fire" a patient when the latter became unable to pay for the physician's fees under non-emergency situations. But the courts were not unanimous on the matter. Some courts determined that the relationship could be terminated if the physician gave the patient a written statement of the intention to severe the relationship and enough time to look for another physician. Other courts decided that a physician could end the relationship if the patient became uncooperative with the health plan and after informing the latter and giving him or her a list of other participating providers or upon the patient's agreement to pay from his or her own pocket for the medical services.

Likewise, a physician was not obliged to prescribe or extend medical treatment that he or she deemed ethically or religiously objectionable or medically ineffective (Katz and Paul). The physician should discuss his or her objection to the kind of treatment sought by the patient, offer non-objectionable alternatives, which could be as effective or more effective and document the discussion (Katz and Paul) for records purposes. The physician might also deny treatment or care when requested outside the physician's clinic or office hours or in inappropriate places. The physician could also choose to close their windows and refuse to accept more patients when they felt that they had no more capability to do so at that moment (Katz and Paul).

The physician was also justified in refusing to treat disorderly and uncooperative patients under non-emergency situations. Patients who refused to follow the physician's health care plan or a specific regimen could be dismissed by the physician after serving a written notice of the intent and the reasons and the patients did not modify their behavior. Just the same, the physician must wait until the uncooperative patients could find a replacement (Katz and Paul).

A physician who got employed for a specific function would not be under an obligation or duty to treat beyond the duration of that function. Surgeons on one-time basis would fall below this category. Even then, surgeons must make it clear to the patient that repeat visits or continued treatments could not be expected (Katz and Paul), as the surgeon's service was limited to a certain illness or injury or to a particular time and place and that another health care practitioner would provide follow-up care (Katz and Paul). Denial of care could never be given as a pretext of discrimination. Policies and procedures must be observed and complied with uniformly and in a non-discriminatory way in order to avoid this. The physician must give not only enough time for the patient to locate another physician but also actually help in looking for this substitute and include reasons for the termination of the relationship in the patient's medical records (Katz and Paul).

The physician-patient relationship assumed certain obligations: the physician was not allowed to say "no" without exposing himself or herself to civil liability and malpractice. Moreover, this could not be done or resorted to when the patient needed medical care. All the reasons must be made clearly and sufficiently known to the patient and adequately documented. In summary, the same utmost regard taken in treating a patient would be demanded of the physician in discontinuing their relationship.

Bibliography

Katz, Laura L. And Marshall B. Paul. When a Physician May Refuse to Treat a Patient. Physician's News Digest, 2000. http://www.physiciansnews.com/law.202.html

Levin, Aaron. Doctors Willing But Not Ready to Treat Deadly Bio-terror Agents. Health Behavior News Service: Center for the Advancement of Health, 2003. http://www.cfah.org/ubns/news/bioterror09-17-03.cfm

Murray, Terry. Health Care Staff Have a Duty to Treat. The Medical Post: Rogers Media, 2003. http://www.medicalpost.com/mpcontent/article.jsp.jsessionid=NJCJNDCEAGHH?content=20020515_09

Schulman, David I. The Dentist, HIV and the Law: Duty to Treat, Need to Understand. Dental Treatment Consideration, 2000. http://www.hivdent.org/dtcblaa082001.htm

Stavis, Paul F. And Amy Petragnani. Suicide: to Treat or Not to Treat. Quality of Care Newsletter, issue 65, November-December 1995. http://www.cqc.state.ny.us/counsels_corner/cc65.htm [END OF PREVIEW]

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