Nonmaleficence must not be sacrificed in the name of the patient’s autonomy, but there is no need to undertake needlessly invasive treatments for a small boost in protection against cancer recurrence if the patient does not wish to do so.
Although not everything on the Choosing Wisely lists is likely to reduce low-value care, it is a good starting point for a conversation about curtailing low-value interventions.
The Geisel School of Medicine at Dartmouth College has integrated health care delivery science, which includes quality improvement and leadership training, into its medical school curriculum.
The case of Johnson v Kokemoor illuminates the conflict between patients’ right to informed consent and clinicians’ need to learn through practice, a conflict that possibly could be resolved through greater transparency about clinicians’ experience or experience-dependent medical fees.
Medical specialty boards improve the quality and safety of health care, but they can overreach, and their board members express disapproval of board action by petition and through legal action.
AMA J Ethics. 2015; 17(3):193-198. doi:
10.1001/journalofethics.2015.17.3.spec1-1503.
The American Society of Transplant Surgeons offers web-based educational modules and public discussions to promote exploration of ethical issues in the field.