This month theme issue editor, Trahern Jones, a fourth-year student at Mayo Medical School in Rochester, Minnesota, spoke with Dr. Edward Laskowski about the use of performance-enhancing drugs and substances among athletes today.
Physicians are not obligated to offer testing or treatments that are not medically indicated—even if patients demand them. This does not mean, however, that a physician should be dismissive of the patient’s concerns.
Karen E. Hoffman, MD, MHSc, MPH and Paul L. Nguyen, MD
Guidelines require interpretation and should not be mindlessly applied as a template of care for all patients, particularly when there are inconsistencies between clinical practice guidelines developed by medical groups.
Is it ethical to create and advertise, either publicly or during office visits, package deals that offer patients an incentive to have procedures they are not already seeking and might not have considered?
Within the patient-physician relationship, the request for neuroenhancement becomes a chief concern, and the physician has a duty to take a history and perform a physical exam to determine whether the patient’s current level of function represents significant change.
Some question whether plastic surgeons bear responsibility for promoting suspect norms of beauty, given that certain types of cosmetic enhancements reinforce common conceptions of normality that are harmful to society.
Our ability to infer mental states from fMRI scans is still rudimentary, but the time may be approaching when neuroimaging can be used to indicate witnesses’ reliability in court proceedings.
Because regulatory approval of cognitive enhancement drugs is likely, physicians may want to consider whether they would condone the practice for restoration of function only or for enhancement purposes as well.
State medical boards, tend to follow social policy as expressed in U.S. law, which designates moral turpitude outside the clinic as a cause for restricting professional licenses.