Physician's ethical responsibilities when there is a discrepancy between demand and supply of medical services.
Bibliographic record
Abstract
BACKGROUND: The discrepancy between the demand for and the supply of physician's services is the result of actions of multiple parties, including physicians. This situation raises ethical challenges for physicians, because it involves the profession's core values. OBJECTIVE: To discuss physicians' ethical obligations regarding the quantity of services that they might provide. METHOD: The obligations to accept new patients and to provide services to existing patients are deduced from the Code of Ethics of the Canadian Medical Association and The Royal College of Physicians and Surgeons of Canada. A model of physicians' ethics proposed by Pellegrino and Thomasma is examined as an example of a possible higher ethical standard. RESULTS: According to the Code of Ethics, physicians may refuse or accept new patients provided they do not discriminate improperly, and do not deny aid when there is "urgent need." It also states that the termination of medical services is permissible after "adequate notice" is given to the patient. The code states that physicians are to be guided by principles such as justice and compassion. Motivated by these principles, overworked physicians may accept new patients or delay the justifiable termination of services. Such action is praiseworthy as long as the physician can provide to all his or her patients the quantity and quality of care that meets professional standards. More altruistic ethical standards of practice than those in the Code of Ethics have been advocated. Physicians who, in making decisions about the quantity of services they provide, are guided by altruism rather than self-interest deserve recognition and encouragement.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.075 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.005 | 0.014 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.010 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".