Case and Commentary
Jan 2005
A. Choosing to provide emergency care on a day when fewer doctors will be available is an acceptable option for Dr. Nelson. Emergency situations make demands on the profession that override individual physicians' rights and freedoms.
B. Agreeing to participate in the rally as a way of showing solidarity with his colleagues though he thinks the action they are taking is unethical should be avoided.
C. Maintaining his regular schedule in spite of the decision of his colleagues, even if it means handling the office himself, is the preferred course of action. Opinion 9.025, "Collective Action and Patient Advocacy" of the Code states, "Strikes and other collective action may reduce access to care, eliminate or delay necessary care, and interfere with continuity of care. Each of these consequences raises ethical concerns. Physicians should refrain from the use of the strike as a bargaining tactic. In rare circumstances, individual or grassroots actions, such as brief limitations of personal availability, may be appropriate as a means of calling attention to needed changes in patient care."
D. Further discussions with his partners about the possible gains and potential consequences of a work stoppage are acceptable. Opinion 9.025, "Collective Action and Patient Advocacy" recognizes that "physicians may participate in individual acts, grass roots activities, or legally permissible collective action to advocate for change, as provided for in the AMA's Principles of Medical Ethics." Opinion 9.025 goes on to admonish physicians that "whenever engaging in advocacy efforts, physicians must ensure that the health of patients is not jeopardized and that patient care is not compromised." In addition, it warns that "some actions may put them or their organizations at risk of violating antitrust laws. Consultation with legal counsel is advised."
