Professional Rights and Responsibilities

Physicians may choose whom to serve, but may not refuse a patient on the basis of race, color, religion, national origin, or any other illegal discrimination. It is unethical for physicians to deny treatment to HIV-infected individuals on that basis alone if they are qualified to treat the patient's condition. Once a physician takes a case, the patient cannot be neglected nor refused treatment unless official notice is given from the physician to withdraw from the case. Patients have the right to know their diagnoses, the nature and purpose of their treatment, and to have enough information to be able to make an informed choice about their treatment protocol. Physicians should inform families of a patient's death and not delegate that responsibility to others. Physicians should expose incompetent, corrupt, dishonest, and unethical conduct by other physicians to the disciplinary board. It is unethical for any physician to treat patients while under the influence of alcohol, controlled substances, or any other chemical that impairs the physician's ability.

Physicians who know they are HIV positive should refrain from any activity that would risk the transmission of the virus to others. Any activity that might be regarded as a "conflict of interest" (for example, a physician holding stock in a pharmaceutical company and prescribing medications only from that company) should be avoided. Financial interests are not to influence physicians in prescribing medications, devices, or appliances.

It is the responsibility of physicians and their employees to report all cases of suspected child abuse, to protect and care for the abused, and to treat the abuser (if known) as a victim also. This is not an easy task. Abuse is not easy to witness. While there are very specific laws regarding suspected child abuse, and in most states medical assistants are mandated to report abuse, the laws are vague or nonexistent in elderly and spousal abuse. However, whatever form the abuse takes, it is best to treat all forms of abuse in the same manner by providing a safe environment for those abused and seeking treatment for the abuser and the abused.    

Bioethical Dilemmas
Guidelines for bioethical issues are even harder to define than are guidelines for ethics, because each of the bioethical issues calls upon us to make decisions that directly affect a person's life. In some instances, the bioethical issue requires a choice about who lives and requires a definition of the quality of life. Such dilemmas are difficult, if not impossible, to approach from a neutral point of view even though medical assistants should strive not to place their moral values upon patients or coworkers.    

Allocation of Scarce Medical Resources
 The issue faced daily by health care workers is the allocation of scarce medical resources. Even with the government's attempts at health care reform, medical resources still will not be available to everyone. When the receptionist determines who receives the only available appointment in a day, when patients are turned away because they have no insurance or financial resources to pay for services, when Medicare/Medicaid patients are denied services because of low return from state and federal insurance programs, scarce medical resources are being allocated.