With good planning and good will, medical professionals’ right of conscience and patients’ rights to controversial services can be both protected and accommodated.
Medical stewardship is a way of describing a relatively new obligation to maximize health care resources. A professionwide conversation about its meaning and value is needed.
Specific advocate guidelines are needed for the protection of children in state custody who are potential research subjects in trials that would expose them to greater-than-minimal risk but also hold the prospect of direct benefit.
Physicians are cautioned that the two obstacles to reforming post-marketing clinical trials are the FDA's reluctance to revisit past approvals and its inability to enforce pharmaceutical companies' commitment to conduct Phase IV trials.
Two physicians give an overview of the iPledge program and discuss the problematic aspects of the program for physicians who prescribe isotretinoin and their patients.