Preserving opportunity for physicians to act (or to refrain from acting) in accordance with the dictates of conscience is important for preserving the integrity of the medical profession as well as the integrity of the individual physician; Physicians’ freedom to act according to conscience is not unlimited; They are expected to provide care in emergencies, honor patients’ informed decisions to refuse life-sustaining treatment, respect basic civil liberties and not discriminate against patients on the basis of arbitrary characteristics.
Disrespectful, derogatory, or prejudiced language or conduct, or prejudiced requests for accommodation of personal preferences on the part of either patients or physicians can undermine trust and compromise the integrity of the patient-physician relationship.
In keeping with the professional responsibility to safeguard the confidentiality of patients’ personal information, physicians have an ethical obligation to manage medical records appropriately. This obligation encompasses managing the records of current patients, retaining old records against possible future need, and providing copies or transferring records to a third party when requested by the patient or the patient’s authorized representative.
Differences in treatment that are not directly related to differences in individual patients’ clinical needs or preferences constitute inappropriate variations in health care. Such variations may contribute to health outcomes that are considerably worse in marginalized populations. Physicians ethically are called on to provide the same quality of care to all patients without regard to medically irrelevant personal characteristics.