Jeffrey Blustein
Abstract
Avoiding complicity in injustice is not limited to engaging in acts of noncompliance on behalf of one’s patients. The injustices from which one’s patients suffer may be rooted in morally suspect norms to which the profession of medicine, or some influential part of it, has lent its support or that it has not opposed and from which it and its practitioners have benefited. There may also be injustices that the profession has condemned but that remain. In general, avoiding complicity in wrongdoing involves, as a base- line, understanding that the norms and practices responsible for it have contributed to making noncompliance an option that at least deserves serious moral consideration, if not endorsement. A physician may then decide to engage in some form of rule breaking in order to act on this understanding and express her refusal to be complicit.. . .Complicity threatens the moral and professional integrity of the physician, and noncompliance may be warranted in part because it is the only way that a physician can meet the threat.
Blustein J. When Doctors Break the Rules: On the Ethics of Physician Noncompliance. Camb Q Healthc Ethics. 2012;21(02):249-259.