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.
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.
The experience of an English professor dying of ovarian cancer in Margaret Edson’s play Wit shows that both literary and medical discourse obfuscate and objectify rather than promote communication of “simple human truths” that dignify life and death.
AMA J Ethics. 2015;17(9):858-864. doi:
10.1001/journalofethics.2015.17.9.imhl1-1509.
When a seriously ill mature minor and his parent disagree about his receiving an experimental intervention, who should decide what treatment he will receive?
Elizabeth Lee Daugherty, MD, MPH and Douglas B. White, MD, MA
Opportunities to advance scientific knowledge may arise during humanitarian crises, but their presence does not justify suspension of the ethical foundations governing human subjects research.
Does a surgeon’s complication rate in a randomized controlled trial constitute a “significant new finding” that must be reported to patients during the consent process?
Physicians’ ethical obligations to disclose conflicts of interest to patients and to obtain their informed consent for treatment are particularly critical when proposed treatments are experimental.