Here's a brief, but important article from a Dr. regarding a request to sign a disability placard for a patient who has some medical needs, but are not significant enough to warrant a disability parking pass.
I found that the dilemma that the Dr. faces very similar to the decisions a VR counselor has to make every day. As a VR counselor the questions that the doctor asks are those that we each ask ourselves.
"This woman convinced herself that society owed her a recognition of her perceived disability. My duty to the patient is to a degree constrained by my own values toward honesty and justice. I also have a social duty to protect valuable resources, and this can sometimes create a conflict with doing what is in any one patient's best interest."
I don't understand how, in this instance, his duty to "protect valuable resources" was in conflict with the patient's best interest.
I would argue that his denial to sign this was both being fiscally responsible, as well as in the patient's best interest. It not only encourages her to get the exercise he states she needs, but more importantly does not collude with her perception of her disability.
As a VR counselor it is important to keep both of these in mind, even if it means (as it did for Dr. Wilkes) that we need to accept some scolding for doing the right thing.