When deciding whether to offer deep brain stimulation earlier than usual for Parkinson disease, it is important to consider not only the patient’s autonomy but also the validity of the evidence and concepts of harm that are being used to form practice policies.
Michael J. O’Brien, MD and William P. Meehan III, MD
It is unclear whether the decreased risk of injury associated with prohibiting a teenage boy from playing football outweighs the benefits to his health and well-being of allowing him to participate.
Distinctions between treatment and enhancement, and between supposedly authentic and inauthentic tools, often inform judgments about what is morally acceptable in sport.
Clinical equipoise—the idea that the community of medical experts is uncertain about the relative therapeutic merits of the arms of a clinical trial at its outset—mitigates physicians’ responsibility for patients’ poor outcomes when patients are assigned to the control arm or are harmed by an investigational agent.
AMA J Ethics. 2015;17(12):1108-1115. doi:
10.1001/journalofethics.2015.17.12.ecas1-1512.
Bias toward allopathic medicine in the research funding and publication of study results makes it difficult for physicians and others to find accurate data about the efficacy of non-Western, nonallopathic treatments.