Virtual Mentor. April 2014

This month in Virtual Mentor

Third Parties in the Clinical Encounter

Medical licensure laws and legal informed consent requirements protect patient safety, promote shared decision making, and foster public trust in the profession. In the view of Virtual Mentor’s April contributors, however, other types of regulation are more troubling. These include mandated actions—e.g., making a woman view an ultrasound before an abortion and reporting possible child neglect—and prohibited actions—e.g., the “gag” on discussing gun safety with parents. Third-party activities that restrict access to certain drugs or function to maintain high drug prices also interfere with ideal standards of clinical patient care.

Outside Influences on Medical Practice Kimberly Swartz, MA Physicians operate within a system of regulations, laws, and third-party activities that impose numerous clinical restraints.

Mandated Ultrasound Prior to Abortion Commentary by Jen Russo, MD, MPH Fifty-seven percent of women in a recent large study did not want to view their ultrasounds before their abortions, suggesting that mandated viewing interferes with uncoerced consent to care, a hallmark of medical ethics.

Consent and Rights in Comparative Effectiveness Trials Collin O’Neil, PhD Some commentators say comparative trials of FDA-approved drugs are overburdened by current Common Rule regulations and that researchers should not be required to obtain explicit consent for participation in the most innocuous of these trials.

Inappropriate Obstructions to Access: The FDA’s Handling of Plan B Susan F. Wood, PhD The FDA’s approval for over-the-counter sales of emergency contraception marked a departure from its standard approval process and obstructed access to a safe and effective drug. That departure could set a dangerous precedent for future decisions.

Upcoming Issues

• May Ethical Issues in Geriatric Care
• June Intersections of Race, Ethnicity, and Medicine
• July Ethical Issues in the Physician-Athlete Relationship
• August The Humanities in Medical Education