Physician's ethical responsibilities when there is a discrepancy between demand and supply of medical services.
BACKGROUND
The discrepancy between the demand for and the supply of physician's services is the result of actions of multiple parties, including physicians. This situation raises ethical challenges for physicians, because it involves the profession's core values.


OBJECTIVE
To discuss physicians' ethical obligations regarding the quantity of services that they might provide.


METHODS
The obligations to accept new patients and to provide services to existing patients are deduced from the Code of Ethics of the Canadian Medical Association and The Royal College of Physicians and Surgeons of Canada. A model of physicians' ethics proposed by Pellegrino and Thomasma is examined as an example of a possible higher ethical standard.


RESULTS
According to the Code of Ethics, physicians may refuse or accept new patients provided they do not discriminate improperly, and do not deny aid when there is "urgent need." It also states that the termination of medical services is permissible after "adequate notice" is given to the patient. The code states that physicians are to be guided by principles such as justice and compassion. Motivated by these principles, overworked physicians may accept new patients or delay the justifiable termination of services. Such action is praiseworthy as long as the physician can provide to all his or her patients the quantity and quality of care that meets professional standards. More altruistic ethical standards of practice than those in the Code of Ethics have been advocated. Physicians who, in making decisions about the quantity of services they provide, are guided by altruism rather than self-interest deserve recognition and encouragement.
Kotalik
Jaro F
JF
Centre for Health Care Ethics, Lakehead University, Thunder Bay ON P7B 5E1, Canada. jkotalik@tbaytel.net.
D000533:Altruism; D026686:Beneficence; D002170:Canada; D032781:Codes of Ethics; D004992:Ethics, Medical; D006301:Health Services Needs and Demand / Q000191:economics* / Q000941:ethics*; D006801:Humans; D028681:Moral Obligations; D010817:Physician-Patient Relations; D011287:Prejudice; D016079:Refusal to Treat / Q000941:ethics*; D012935:Social Justice; D014850:Waiting Lists