The AMA Journal of Ethics invites original submissions for peer review consideration on the following themes that will be explored in 2019 and 2020:
December 2019: Governing Human Genome Editing
Gene editing is inexpensive, simple, and becoming more widely used in clinical applications, as well as “gene hacking” techniques employed by anyone who can purchase equipment and chemical agents. The first gene-edited babies have already been born, reminding scientific and medical community members that gene editing is no longer deployed only to treat somatic disease. Germline editing promises efficiency in eradicating many diseases, but globally relevant ethical questions persist about unknown transgenerational consequences and potential for harm. Central questions explored in the December 2019 issue of the AMA Journal of Ethics are these: What should be the nature and scope of human genome editing oversight and by whose authority should such oversight be done? What should be the roles of health professionals in regulation and governance? Related issues include safety and efficacy monitoring, access equity, criteria for what count as “enhancements” for individuals and entire species, evidence generation and verification, methods of scrutinizing germline events, experimental genome editing “treatments,” and n-of-1 (single subject) clinical trials.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow all Instructions for Authors and be submitted by 15 April 2019.
January 2020: Culture, Context and Epidemic Containment
Hesitancy on the part of some actors in the Global North to actively support epidemic responses in the Global South could reflect current social and political tendencies toward isolationism. This issue of the January 2020 AMA Journal of Ethics considers how medicine should respond to global public health emergencies and engage governments, non-governmental organizations, or individuals who might feel reluctant to help. Some heroism, and also significant stigma, are associated with modern international Ebola responses, for example. Related themes include whether health professionals have rights to refuse treating patients with highly pathogenic diseases, how cultural brokering plays critical roles in contagion containment, and how treating long-lasting mental illness should be integrated into epidemic response strategies.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 April 2019.
February 2020: Global Burden of Cancer Inequality
In the 21st century, cancer is projected to be the single greatest disease killer in the world and 70% of this disease burden is concentrated in low- and middle-income countries (LMICs). Due to high costs of cancer treatment, governments in these countries will not be able to treat their way out of cancer, so prevention is critical. Thirty to fifty percent of cancers are preventable, but prioritizing prevention can be challenging in LMICs. Cancer prevention often lacks the social visibility and market appeal of treatments. Prevention is also held to a different standard than treatment: treatment’s benefits need only equal costs of care, but prevention is expected to produce a net positive return.The February 2020 issue of the AMA Journal of Ethics explores the ethical complexities of cancer prevention as a global public health imperative.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 31 May 2019.
March 2020: Wielding Organizational Influence in Health Care
Not long ago, most physicians were solo practitioners, but today, large and complex organizations dominate the health care sector. Organizational cultures shape policies, policies shape practices, and practices express the reasons clinicians have for acting in relationships with patients. Distributing authority and responsibility in health care environments is not only a function of a clinician’s professional background and training, but also how organizations situate encounters and relationships among clinicians, patients, and other stakeholders. The March 2020 issue of the AMA Journal of Ethics considers intersections of clinical ethics and organizational policy framing in health care settings.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 28 June 2019.
April 2020: Sharing Health Decisions
Ideally, shared decision making happens within patient-clinician relationships and gives shape to critical health decision point collaboration. Shared decision making is not solely definitive of a patient-clinician relationship, but it is typically conceived as broader than an informed consent process, as a model of deciding that informs a treatment plan trajectory over the long- or short-term of a patient’s illness, injury, and recovery experiences. Patients do not always comprehend their diagnoses or treatments, physicians can define successful outcomes differently than patients, and sometimes neither has enough information to confidently set priorities, choose among several high stakes options, and avoid regret. The April 2020 issue of the AMA Journal of Ethics considers what exactly should be shared—authority, risk, knowledge, for example—in shared decision making and investigates what else clinicians, patients, or their proxies need when making health care decisions.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 August 2019.