Definitive birth control and the physician--ethical issues.

We analyze the ethical issues related to the physician's role in informing about, advising, rejecting, or performing a definitive birth control procedure (sterilization). We define a rational request for tubal ligation, the limited delaying (or facilitating) role that guidelines for deciding on ligation should have, the justifiable reasons for rejecting a request, and the physician's obligations and options. We also consider the need to supply adequate information, the implications of recommending a second-best treatment, and the pivotal place of the "likelihood of regret" in medical decision-making.