Dr. Walters' refusal to insert an intrauterine device (IUD) for Rebecca is an example of:

• A. Autonomy
• B. Nonmaleficence
• C. Conflict between provider's beliefs and patient's autonomy
• D. Beneficence

Answer: (C)

This centers on patient autonomy versus the physician’s conscience. Rebecca’s right to decide about her own reproductive health is autonomy. When the physician refuses to perform an IUD because of personal beliefs, that stance creates a clash between what the patient asks for and the clinician’s moral or religious values. The situation illustrates a conflict between provider beliefs and patient autonomy. While beneficence and nonmaleficence relate to doing good and avoiding harm, the defining issue here is respecting the patient’s autonomous choice in the face of a provider’s objection. In practice, conscientious objection is balanced by referring the patient to another clinician so she can access the desired care while the physician’s conscience is respected.