Evidence map›Paper›PMID 40494621›Full record

ArticleAnnals of family medicine2025

Advance Notification for Conscientious Refusal in Rural Health Care.

Abram Brummett, Nick Petrykowski, Forrest Bohler

Abstract read
In one paragraph

Article in Annals of family medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Abram BrummettCorewell Health William Beaumont University Hospital, Royal Oak, Michigan abrummett@oakland.edu.
Nick PetrykowskiDepartment of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan.
Forrest BohlerDepartment of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Clinicians have a federally protected right to conscientiously refuse to provide treatment that conflicts with their core moral or religious values. The American Medical Association affirms that, among other obligations, a physician should give advance notification "before entering into a patient-physician relationship" by making "clear any specific interventions or services the physician cannot in good conscience provide" (Opinion 1.1.7). We apply this guidance to the rural health care context by considering whether giving notification of conscientious refusals is best done in advance of, or during, the clinical encounter. We conclude that giving advance notice should be the moral default in rural contexts, but giving notice during the clinical encounter can be justified where patients are especially dependent upon their primary care physician for their overall medical care.

Indexed as

Conscientious Refusal to TreatPhysician-Patient RelationsRural Health ServicesHumansUnited Statesadvance notificationconscientious objectionconscientious refusalrural health carerural providers

Identifiers

PMID40494621
PMCPMC12307001

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.