There is not system or set of rules that substitutes for a moral and spiritual commitment to putting the interest of your patients first in choosing what treatment to recommend. It is that very necessity which makes necessary the right, so disturbing to some, of physicians to have autonomy in choosing whom to accept as patients. Only with the exercise of that right, can the physician restrict her services to those patients in those situations in which she knows that she can and will make that commitment. It is an obligation that can’t effectively be legislated except in the most flagrant violations, and only the doctor can see into her own heart and examine the purity of her motives.