Abstract

Your patient's first trimester exposure to a drug associated with a fourfold increase in the incidence of cleft palate leads her to request an abortion, although the actual risk is very small and the condition can be corrected. Another patient has just announced her engagement to a man you have certified as homosexual for draft exemption purposes, and you are quite sure she isn't aware of his sexual preference. A premed student preparing for the MCAT approaches you with some persuasive arguments that the small doses of amphetamines he is asking for, to enhance his examination performance, won't hurt him or you. There is the patient whose motor vehicle accident, you are almost certain, was self-inflicted. Now he needs lifesaving surgery but calmly and apparently rationally refuses to consent. Or, as a resident you may be torn by your awareness that your program's unusually tough work schedule is hurting both

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