Case Four: Mr. Chen, a 40 year-old patient originally from China, has had lumbar problems for one year. The condition includes dull pain in his right leg and the inability to sit still for long periods. X-ray examination reveals a prolapsed lumbar disc. He has been treated with conventional pain medication with minimal effect. His physician recommends back surgery, but Mr. Chen is reluctant to take this option. Instead, he asks the doctor to refer him to an acupuncturist because his insurance coverage requires physician's approval for "alternative" therapy. He mentions to the physician that he has tried acupuncture before, and it has helped him.
But the doctor is skeptical about any kind of alternative therapy. He has had extensive positive experience with surgical treatment for Mr. Chen’s condition. In his view, other forms of medicine are at best placebos, and he does not see it as his duty to recommend them. He refuses to order the acupuncture. Is the doctor making an ethical decision?