Refusing to treat – is it legal? Is it justifiable? Is it ethical?

Historically, when clinicians wanted to know if certain conduct was ethical, they would consult the guidelines set out in the Hippocratic oath. While adherence to the oath may “represent an expression of the professions’ ethical obligations”, and be useful in promoting their commitment to “abide by these norms”, this assumption is open to question.1 Different practitioners may see and interpret the codes in different ways, depending on their personal ethos as well as the specific time and situation under consideration. At the same time, ethical material can and should reform, and when needed, be re written under optimal cool, calm conditions. Changes should be based on “contributions from those with a variety of perspectives who have access to as much available knowledge as possible” and not implemented as a result of immediate pressures where there may be distorting circumstances.1 Perhaps the best way to judge their value is to debate how well the code addresses the issue at hand in terms of its “comprehensiveness, clarity and consistency”.1 This paper uses an actual patient scenario as a basis on which to pose some clinically and ethically related queries and postulate possible solutions.