Excerpt From Medical Ethics: Real-World Application By Afshin Nasser

Reproductive Issues

An adult woman has an unrestricted right to abortion through the end of the first trimester. In the second trimester, the decision is still between a woman and her attending physician, but the ease of access is not so clear. States may place regulations on access to a second- trimester abortion.

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Abortion
An adult woman has an unrestricted right to abortion through the end of the first trimester. In the second trimester, the decision is still between a woman and her attending physician, but the ease of access is not so clear. States may place regulations on access to a second- trimester abortion.

However, second-trimester abortions are still performed at the patient’s discretion. Third-trimester abortions are not available since the fetus is viable, and are clearly restricted. The father’s consent for an abortion is not required. The fetus is considered as a part of the woman’s body and does not have the individual rights of ‘personhood’ until after birth.

It is unethical for a patient to seek an abortion for gender selection. Fundamentally, if there is a procedure that a patient wants which appears unethical, you should refer the patient to another physician. The physician must voluntarily agree to the physician-patient relationship.

Contraception
Contraception has no limitation and is entirely at the discretion of the patient. This is equally true for minors. Contraception is one of the issues for which a minor is considered partially emancipated. Parental consent is not necessary to obtain contraception.

Q30 A young couple present to your office to discuss contraception. The wife wishes to have tubal ligation. Her husband is shocked and upset stating that they have no children and storms out of the room. The wife is adamant about sterilization and wishes to move forward with the procedure.
What should be next?
A- Proceed with a psychological evaluation.
B- Proceed with tubal ligation
C- Refer only with husband’s consent
D- Schedule a follow up appointment to reevaluate the decision

Sterilization
Men and women have free access to sterilization. Consent is only necessary from the patient. Each patient has autonomy over his or her own body.

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State Medical Boards

The medical board’s duty is to protect the public, not the physician. State medical boards today focus on licensed physicians who violate professional ethics, and their mandate has significantly evolved to focus on disciplining physicians.

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Boundary Violation

Boundaries create a therapeutic distance between physician and patient and clarify their respective roles and expectations. Boundaries define limits of the therapeutic relationship.

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Medical Ethics: Real-World Application By Afshin Nasser

You may have acquired this book as a result of conflicts with peers, administrators, patients, or State Medical Boards, where the outcomes of those interactions have left you wondering, “…what if I had done things differently?”

In that case, I hope that this book answers some of your questions and guides you with regards to any future quandaries you may encounter.


If you are a healthcare worker seeking to understand the subject of medical ethics, then I hope this book helps you acquire the clarity you seek.
If you are an individual simply curious about medical ethics, then I raise my hat to you for your pursuit of knowledge.