title: When negative rights become positive entitlements: complicity, conscience, and caregiving.
abstract: Clinicians have an obligation to ensure that patients with adequate capacity can make autonomous decisions. Thus, patients who choose to forego treatment and leave hospitals "against medical advice" are typically allowed to do so. But what happens when they require clinicians' assistance to physically leave? Is it incumbent upon clinicians to not only respect and fulfill patients' requests with which they disagree, but to physically assist in their fulfillment? We attempt to develop an ethical framework wherein clinicians can honor patients' wishes without necessarily sacrificing their own moral position.
authors.affiliation: Division of Medical Ethics, Weill Cornell Medical College, New York City, New York, USA. shumana@mskcc.org
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Shuman
authors.forename: Adam A
authors.initials: AA
authors.lastname: Khan
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Moyer
authors.forename: Mark E
authors.initials: ME
authors.lastname: Prince
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Fins
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000451:nursing; D017028:Caregivers / Q000941:ethics / Q000523:psychology; D028661:Complicity; D003242:Conscience; D003657:Decision Making / Q000941:ethics*; D004992:Ethics, Medical; D017051:Hospice Care / Q000941:ethics*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000451:nursing; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D028681:Moral Obligations; D010351:Patient Discharge; D028701:Patient Rights; D026684:Personal Autonomy; D016079:Refusal to Treat / Q000941:ethics; D013727:Terminal Care / Q000941:ethics; D016312:Treatment Refusal