Ethics Opinions

Physicians have an ethical responsibility to learn from and contribute to the total store of scientific knowledge. When they engage in biomedical or health research, physicians have obligations as scientists, which include disseminating research findings.

Data obtained from cruel and inhumane experiments should virtually never be published. In the rare instances when ethically tainted data have been validated by rigorous scientific analysis and are the only data of such nature available, and human lives would certainly be lost without the knowledge obtained from the data, it may be permissible to use or publish findings from unethical experiments.

Physicians who develop medical innovations may ethically patent their discoveries or products but should not allow patents to languish or use patents to limit the availability of medical innovations.

Physicians have a responsibility to protect the confidentiality of minor patients, within certain limits. In some jurisdictions, the law permits unemancipated minors to request and receive confidential services relating to: contraception, pregnancy testing, prenatal care, delivery services and care to prevent, diagnose, or treat sexually transmitted disease, substance use disorders, or mental illness.

In many jurisdictions, unemancipated minors are not permitted to request or receive abortion services without their parents’ (or guardian’s) knowledge and consent. As such, when minors seek abortion care, this may create a conflict between the value of confidentiality and the legal obligation to obtain parental consent.

Decisions not to initiate care or to discontinue an intervention can be emotionally wrenching for the parents of a seriously ill newborn. Physicians should help parents, families, and fellow professionals understand that there is no ethical difference between withholding and withdrawing treatment, when an intervention no longer helps to achieve the goals of care or promote the quality of life.

Genetic testing of children implicates important concerns about the minor patient’s present and future autonomy and best interests. Decisions to test must balance multiple considerations, including: likely benefits, the risks of knowing genetic status, features unique to the condition(s) being tested for (such as age of onset), and the availability of effective preventive, therapeutic, or palliative interventions.

Electronic communication can raise special concerns about privacy and confidentiality, particularly when sensitive information is being conveyed. Physicians using electronic communication hold the same ethical responsibilities to patients as they do during other clinical encounters.

Use of placebo in the control arm of a study deprives these patients of the accepted therapy for a period of time. As such, the use of a placebo control will more easily be justified as the severity and number of negative side effects of standard therapy increase.

Physicians who care for patients with serious, life-threatening illness for whom standard therapies have failed, are unlikely to be effective, or do not exist, should familiarize themselves with access to investigational therapies through the U.S. Food and Drug Administration’s “expanded access” program to be better able to engage in shared decision making with patients.