title: A legal-ethical analysis of reproductive endocrinologists' right to refuse ovulation induction to patients with diminished ovarian reserve.
abstract: OBJECTIVE
  Review of the legal and ethical basis for reproductive endocrinologists to refuse ovulation induction to patients with diminished ovarian reserve.
  
  
  METHODS
  The Lexis-Nexis search engine was used to perform a legal review pertaining to refusal of treatment. Ethical opinions of medical organizations were also reviewed.
  
  
  RESULTS
  Federal antidiscrimination laws provide legal recourse for patients with diminished ovarian reserve who are denied ovulation induction. However, the same laws also permit refusal of care when there is bona fide medical justification to decline services. In addition, the codes of ethics for relevant professional organizations support physicians' decisions to refuse treatment when treatment is futile.
  
  
  CONCLUSIONS
  Although it is ethically and legally permissible to deny ovulation induction to patients with diminished ovarian reserve when medically justified, refusal may invite retaliatory litigation. Counseling remains a cornerstone in directing these patients to options with more potential for success, such as donor eggs and adoption.
authors.affiliation: Department of Obstetrics & Gynecology, The University of Texas Medical Branch, Galveston, TX 77555-0587, USA. fskaripc@utmb.edu
authors.forename: Fethiye Sinem
authors.initials: FS
authors.lastname: Karipcin
authors.forename: Amjad
authors.initials: A
authors.lastname: Hossain
authors.forename: John Y
authors.initials: JY
authors.lastname: Phelps
mesh_terms: D000300:Adoption / Q000331:legislation & jurisprudence; D004704:Endocrinology / Q000941:ethics / Q000331:legislation & jurisprudence; D026689:Ethical Analysis; D005260:Female; D006801:Humans; D010062:Ovulation Induction / Q000941:ethics*; D046269:Reproductive Rights / Q000941:ethics* / Q000331:legislation & jurisprudence*; D014019:Tissue Donors / Q000331:legislation & jurisprudence; D000078329:Workforce