Resident Physician Conscientious Objection/Opt-Out Requests: Balancing Physician Conscience with Patient-Centered Care

Course Overview

Graduate medical education prepares residents for independent practice. At the completion of internal medicine residency, learners must have the knowledge, skills, and attitudes to practice general internal medicine. Care must be respectful and responsive to all patients, independent of gender, age, culture, race, religion, or sexual orientation. The American College of Physicians states internists should have "respect for the principle of patient autonomy on matters affecting patients' individual health and reproductive decision-making rights." At the same time, the AMA Code of Medical Ethics states that "preserving opportunity for physicians to act (or to refrain from acting) in accordance with the dictates of conscience in their professional practice is important for preserving the integrity of the medical profession as well as the integrity of the individual physician.

How should residency programs navigate situations when patient-centered care to our diverse patient populations comes into conflict with a resident's personal belief system? How do programs support residents with conscientious objections without placing undue burden on more marginalized patient populations? How are these issues addressed in the context of ensuring competency in general internal medicine?

With the interests of preserving both patient autonomy and physician conscience, we have developed a policy for our residency program that attempts to balance both parties' interests. With the ever-changing landscape of medical care that is offered within the wide scope of Internal Medicine, and the increasing attention to have a diverse group of trainees, we believe this topic is timely for our community.

Learning Objectives

Understand the concept of physician conscience and how it relates to the scope of practice of a resident physician.
Brainstorm how to balance both the tenets of patient and physician autonomy, especially in the setting of a residency training program.
Understand how to create a workflow and/or policy to be able to balance both physician autonomy and patient-centered care for diverse patient populations.

Speakers

Kristin M. Collier MD
University of Michigan Medical School

Sarah Hartley MD
University of Michigan Medical School

Jennifer Lukela MD
University of Michigan Medical School

Rebecca Northway MD
University of Michigan Medical School

Additional Information

Year Published: 2022 - AIMW