Kyle B. Brothers, MD, PhD and Esther E. Knapp, MD, MBE
Direct-to-consumer genetic testing requires that physicians share decision making with patients, not order unnecessary tests or interventions, and refer to genetic specialists when necessary.
AMA J Ethics. 2018;20(9):E812-818. doi:
10.1001/amajethics.2018.812.
Cytopathologists frequently interact directly with patients at their bedsides to perform fine needle aspiration procedures. When, if ever, should cytopathologists share preliminary diagnostic impressions directly with patients?
AMA J Ethics. 2016;18(8):779-785. doi:
10.1001/journalofethics.2016.18.8.ecas3-1608.
Requirements for informed consent are relatively vague and the exceptions are few, so it is in the physician’s best interest to inform patients about proposed treatment options, ascertain that they understand their choices, and secure their consent.
Chromosomal microarray analysis reveals many gene variants of unknown significance. The uncertainty about these variants—might they be deleterious or are they benign?—complicates genetic counseling.
The gross negligence of the physicians who cared for Steve Biko, an apartheid-era South African political activist who died of injuries inflicted while in police custody, illustrates how dual loyalty—toward patients and, in this case, the state—makes performance of professional duties difficult.
AMA J Ethics. 2015;17(10):966-972. doi:
10.1001/journalofethics.2015.17.10.mhst1-1510.
The ambiguity about and lack of uniformity in informed consent practices does not lend itself to the kind of shield from malpractice liability that exists in some more concrete, standardizable aspects of medical practice.