Pathologists should work cooperatively with clinicians and provide guidance about appropriate testing to uphold the medical ethics principle of justice.
AMA J Ethics. 2016;18(8):793-799. doi:
10.1001/journalofethics.2016.18.8.ecas5-1608.
Clinicians can support shared decision making by assessing patients’ knowledge, eligibility for screening, and preferences for engagement—active, collaborative, or passive—in the decision making process.
AMA J Ethics. 2015;17(7):601-607. doi:
10.1001/journalofethics.2015.17.7.ecas1-1507.
Patients seeking IVF are highly motivated to become parents and may wish to preserve financial resources for surrogacy or adoption should IVF not succeed, so risk sharing appeals to them, which makes its high cost especially problematic.
Measuring outcomes alone is not the answer. There should be a way to reward the doctor for educating a patient about lifestyle modifications and then documenting that the care provided followed patient preferences.