Master the board step 3

Ethics
Reproductive Issues
Abortion
A woman’s right to an abortion varies by trimester of pregnancy:
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First trimester: A woman has an unrestricted right to an abortion.
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Second trimester: A woman has access, but her rights are less clear.
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Third trimester: There is no clear access to abortion in the third trimester.
In the third trimester, the fetus is potentially viable.
You do not need the consent of the father for the abortion.
Donation of Gametes
Patients have an unrestricted right to donate sperm and eggs. There is no ethical
problem with being a paid donor for sperm and eggs. Note that one cannot
be a paid donor for organs, such as the kidney or corneas.
HIV Issues
A patient has a right to confidentiality of his HIV status. However, this
confidentiality can be broken to protect the uninfected, such as sexual and
needle-sharing partners.
There is no obligation for HIV-positive health care workers to disclose their
HIV status. This includes surgeons. A surgeon does not have to disclose her
HIV status to patient.
Physicians have the legal right to refuse to treat any patient. It is not illegal to
refuse to take care of HIV-positive persons—it is unethical to refuse care to HIVpositive
patients simply because they are HIV-positive, but it is legal to do so.
Doctor-Patient Relationship
Accepting a Patient
A physician does not have an obligation to accept a patient. The need of a
person does not compel the physician to accept that person as a patient. For
example, if there is only 1 neurosurgeon at a hospital and a patient needs neurosurgery,
this situation does not compel the physician to accept the patient.
Once having accepted a patient, however, the physician cannot simply abandon
the patient. The physician has an obligation to inform the patient that
he must find another physician, and the physician must render care until a
substitute caregiver can be identified.
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