Ethics Vignette XIV: Refusal to Care for Patients discusses reasons (acceptable and unacceptable) a physician might refuse care to patients, the legal definition of the patient-physician relationship, distinguishing risks vs. direct threats, and how to respond to and identify occupational risks. The intended audience is physicians, residents and fellows, and is also relevant to technologists.

AANEM ethical vignettes utilize true clinical scenarios to highlight common ethical situations confronted by neuromuscular physicians and technologists. Specific application of AANEM's Ethical Guidelines are discussed throughout each vignette. This vignette references Ethical Guidelines' section The Patient-Physician Relationship in Neuromuscular and Electrodiagnostic Medicine and subsection Medical Risk to the Physician.

OBJECTIVES
Upon completion of this educational activity, participants will be able to (1) Discuss the variety of reasons (acceptable and unacceptable) a physician might refuse to care for patients; (2) Recognize reasons a physician should not refuse to care for patients—patients they personally dislike, patients whose actions (such as smoking, not adhering to medications, and alcohol or substance abuse) make treatment more difficult, or based on the patient’s race, sex, religion, or national origin; (3) Understand the legal definition of the patient-physician relationship; (4) Distinguish a "direct threat" from a "slightly increased risk" or a "speculative or remote risk", understanding that physicians and hospitals should consider a "direct threat" to refuse care "a significant risk of substantial harm"; (5) and identify that responding to occupational risk involves acknowledging that physicians have their own human fears and limitations, that fears about safety need to be acknowledged as an understandable human reaction rather than condemned as hysteria, that risk is based on objective clinical evidence, and that it is ethical to worry about personal safety.  


ACCREDITATION STATEMENT
The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CREDIT DESIGNATION
The AANEM designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits ^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

DISCLOSURE INFORMATION
No one involved in the planning of this CME activity had any relevant financial relationships to disclose. Authors/Faculty had nothing to disclose.

FORMAT: PDF

David A. Simpson, DO, MS