Table 1.

Ethical Requirements of the Physician Depending on Their Assessment of the Scientific Evidence Supporting or Dissuading Medical Marijuana for a Particular Condition and if They Have a Personal Moral Commitment Opposed to Attest or Recommend Medical Marijuana Use

A Four-Box Approach to a Physician's Ethical Obligations
Willingness to attest/recommendScience
BenefitNo Benefit
Box ABox B
YesAnalogous to the physician's evidence-based decision to prescribe any other medicationAnalogous to requests for experimental treatments or homeopathic remedies
Same ethical obligations: obtain informed consent by educating the patient about potential risks, benefits, and burdens ofIf science is ambiguous, the physician has additional ethical obligations beyond educating the patient on same topics required for informed consent
• The prescribed treatment• Educate the patient about why there is a lack of evidence which may create increased risk
• Other treatment options
• Declining treatmentIf the harms seem to clearly outweigh the potential benefit, physician may decline to assist the patient
• Assistance would be medically inappropriate
Box CBox D
NoEthical obligation to be transparent with the patientEthical obligation to be transparent with the patient
May have an obligation to refer the patient to a provider who does not have a moral objection to assistingInform the patient of both reasons for decision to decline assistance
• Institutional/personal objections to assisting
• Lack of scientific evidence supporting potential benefit