Building on the American College of Physicians Ethics Manual
Authors: J.S. Blumenthal-Barby, Bernard Lo
Journal: Annals of Internal Medicine (2019)

Editorials15 January 2019Building on the American College of Physicians Ethics ManualJ.S. Blumenthal-Barby, PhD, MA and Bernard Lo, MDJ.S. Blumenthal-Barby, PhD, MACenter for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas (J.B.)Search for more papers by this author and Bernard Lo, MDThe Greenwall Foundation, New York, New York (B.L.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3120 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Physicians face ethical issues in their daily clinical practice. Consider a 67-year-old man newly diagnosed with low-risk localized prostate cancer after prostate-specific antigen screening. Radical prostatectomy does not decrease long-term mortality in randomized trials involving such patients, but increases patient-reported adverse effects of incontinence and sexual dysfunction (1). How should physicians present complex information during informed consent discussions? Should the physician give a recommendation? How should the physician take into account uncertainty in evidence and the weight the patient places on the benefits and adverse effects of various options?The American College of Physicians and the authors of the Ethics ...References1. Wilt TJ, Jones KM, Barry MJ, Andriole GL, Culkin D, Wheeler T, et al. Follow-up of prostatectomy versus observation for early prostate cancer. N Engl J Med. 2017;377:132-142. [PMID: 28700844] doi:10.1056/NEJMoa1615869 CrossrefMedlineGoogle Scholar2. Sulmasy LS, Bledsoe TA; American College of Physicians Ethics, Professionalism and Human Rights Committee. American College of Physicians ethics manual. Seventh edition. Ann Intern Med. 2019;170:S1-32. doi:10.7326/M18-2160 LinkGoogle Scholar3. Blumenthal-Barby JS, Lee D, Volk RJ. Toward ethically responsible choice architecture in prostate cancer treatment decision-making. CA Cancer J Clin. 2015;65:257-60. [PMID: 25998159] doi:10.3322/caac.21283 CrossrefMedlineGoogle Scholar4. Thaler R, Sunstein C. Nudge: Improving Decisions About Health, Wealth, and Happiness. New York: Penguin Books; 2008. Google Scholar5. Blumenthal-Barby JS, Krieger H. Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy. Med Decis Making. 2015;35:539-57. [PMID: 25145577] doi:10.1177/0272989X14547740 CrossrefMedlineGoogle Scholar6. Sah S. Policy solutions to conflicts of interest: the value of professional norms. Behav Pub Pol. 2017;1:177-189. CrossrefGoogle Scholar7. Bosslet GT, Pope TM, Rubenfeld GD, Lo B, Truog RD, Rushton CH, et al; American Thoracic Society ad hoc Committee on Futile and Potentially Inappropriate Treatment. An official ATS/AACN/ACCP/ESICM/SCCM policy statement: responding to requests for potentially inappropriate treatments in intensive care units. Am J Respir Crit Care Med. 2015;191:1318-30. [PMID: 25978438] doi:10.1164/rccm.201505-0924ST CrossrefMedlineGoogle Scholar8. Truog RD. Defining death—making sense of the case of jahi McMath. JAMA. 2018;319:1859-1860. [PMID: 29630700] doi:10.1001/jama.2018.3441 CrossrefMedlineGoogle Scholar9. Lo B. Beyond legalization—dilemmas physicians confront regarding aid in dying. N Engl J Med. 2018;378:2060-2062. [PMID: 29847753] doi:10.1056/NEJMp1802218 CrossrefMedlineGoogle Scholar10. Saadi A, Ahmed S, Katz MH. Making a case for sanctuary hospitals. JAMA. 2017;318:2079-2080. [PMID: 29049516] doi:10.1001/jama.2017.15714 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas (J.B.)The Greenwall Foundation, New York, New York (B.L.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3120.Corresponding Author: J.S. Blumenthal-Barby, PhD, MA, Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, MS 420, Houston, TX 77030; e-mail, [email protected]edu.Current Author Addresses: Dr. Blumenthal-Barby: Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, MS 420, Houston, TX 77030.Dr. Lo: The Greenwall Foundation, One Penn Plaza, Suite 4726, New York, NY 10119. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAmerican College of Physicians Ethics Manual Lois Snyder Sulmasy , Thomas A. Bledsoe , and American College of Physicians Ethics Manual Lois Snyder Sulmasy , Thomas A. Bledsoe , and Metrics Cited byThe Place of Philosophy in Bioethics Today 15 January 2019Volume 170, Issue 2Page: 133-134KeywordsBioethicsCancer treatmentConflicts of interestDecision makingDisclosureErectile dysfunctionIncontinenceMedical ethicsMortalityProstate cancer ePublished: 15 January 2019 Issue Published: 15 January 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...