title: Physicians' duties and the non-identity problem.
abstract: The non-identity problem arises when an intervention or behavior changes the identity of those affected. Delaying pregnancy is an example of such a behavior. The problem is whether and in what ways such changes in identity affect moral considerations. While a great deal has been written about the non-identity problem, relatively little has been written about the implications for physicians and how they should understand their duties. We argue that the non-identity problem can make a crucial moral difference in some circumstances, and that it has some interesting implications for when it is or is not right for a physician to refuse to accede to a patient's request. If a physician is asked to provide an intervention (identity preserving) that makes a person worse off, then such harm provides a good reason for the physician to refuse to provide the intervention. However, in cases where different (identity-altering) interventions result in different people having a better or worse life, physicians should normally respect patient choice.
authors.affiliation: University of Oxford.
authors.forename: Tony
authors.initials: T
authors.lastname: Hope
authors.forename: John
authors.initials: J
authors.lastname: McMillan
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002755:Choice Behavior / Q000941:ethics*; D016265:Conflict of Interest; D003242:Conscience; D003638:Deafness / Q000235:genetics; D004992:Ethics, Medical; D005260:Female; D005307:Fertilization in Vitro / Q000941:ethics; D006801:Humans; D008297:Male; D033262:Narration; D026684:Personal Autonomy; D019986:Persons with Hearing Disabilities; D010817:Physician-Patient Relations / Q000941:ethics*; D010820:Physicians / Q000941:ethics*; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000941:ethics*; D043762:Reproductive Behavior / Q000941:ethics*; D015974:Wrongful Life / Q000941:ethics*