Identifying and managing ethical conflict in the gynecologist-patient relationship.

This paper applies the methods of ethics to the problem of differences between the gynecologist and patient about what is in the patient's interest. We develop a framework for clinical judgment and decision making about the ethical dimensions of the gynecologist-patient relationship. To achieve this goal we first define the fundamental principles of beneficence and respect for autonomy. We then show how these two principles interact in clinical judgment and decision making using common examples from gynecologic practice. We examine factors that influence the relative weight of these principles, including subject matter, probability of net medical benefit, availability of reasonable alternatives and ability of the patient to participate in the informed consent process.