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Why Some "Futile" Care Is "Appropriate": The Implications for Conscientious Objection to Contraceptive Services
Perspectives in Biology and Medicine
|January 30, 2018
Summary
This critique argues against unilateral clinician authority to deny treatments, even if deemed "futile." It proposes clinicians must provide treatments achieving patient goals under specific conditions, unlike refusals for contraceptive services.
Area of Science:
- Medical Ethics
- Healthcare Policy
Background:
- Professional medical organizations' policy statements use terms like "inappropriate" for treatments once called "futile."
- Schneiderman et al. (2017) criticized these new terms as ambiguous.
Purpose of the Study:
- To critique the ambiguity of "inappropriate" and "potentially inappropriate" in medical treatment discussions.
- To challenge the conclusion that clinicians or hospitals have unilateral authority to refuse treatments.
- To establish conditions under which clinicians should provide treatments that achieve patient goals.
Main Methods:
- Analysis of terminology used in medical policy statements.
- Ethical argumentation regarding clinician authority and patient autonomy.
- Comparison of "futility" objections to conscientious objection regarding contraceptive services.
Main Results:
- The terms "inappropriate" and "potentially inappropriate" are indeed ambiguous.
- Clinicians should not have unilateral authority to refuse treatments that plausibly achieve patient-defined goals.
- Five conditions are proposed for obligating clinicians to provide such treatments.
Conclusions:
- Physician authority in rejecting treatments not achieving patient goals is affirmed.
- Physicians are obligated to provide treatments that *do* achieve patient goals if five conditions are met.
- The ethical implications of conscientious objection for "futile" treatments are compared to objections regarding contraception.