MODERN physicians make great efforts to enter and maintain relationships with patients through the adversities of treating the illness that brings them together. This action reflects an ethical view articulated in historical and modern medical writings, that the beneficial effects of their special learning confers on physicians a duty to use this knowledge in the service of humanity. But the controversy surrounding the issue of whether physicians should decline to accept patients insured by Medicare has caused this historical perspective on the duty to use medical knowledge to be challenged. This article examines the conflicting values and arguments pervading this controversy, and seeks to sort out and balance them.
JUSTIFICATIONS FOR NOT BEGINNING A MEDICAL RELATIONSHIP
There are circumstances when physicians can override the ideal of service to humanity and not accept persons wanting to be their patients. One situation concerns harm to the patient seeking help. For example, a
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