Virtual Mentor

Virtual Mentor. August 2013, Volume 15, Number 8: 633-739.

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August 2013 Contents

Ethics in Cancer Prevention and Care

Ethics Poll

The celebration of cancer survivors as "heroes":
Is an inspiration to all those who have cancer.
Contributes to feelings of failure for those who are not "beating" their cancer.
Neither.
Both.

Some terminally ill people for whom all FDA-approved treatments have failed want access to drugs that are not yet approved for general use by the FDA. Which of the following best expresses your opinion on access to unapproved drugs?
The terminally ill should have access to such drugs upon request; they have the right to take the risk since it is their only chance to live.
The FDA should decide who has access to non-approved drugs; it is the FDA's duty to protect all people--including the terminally ill--from undue risk.
No one should have access to non-approved drugs; it is not fair for some to have access and not others.

Jill is a 9-year-old whose acute lymphocytic leukemia is not responding to treatment. Jill keeps asking members of the medical team why she feels so sick. Jill's parents think that telling Jill her diagnosis would be bad for her mental health, which, they say, is crucial to her physical health. The care team disagrees, saying that most children know when they are seriously ill and when they are being lied to. And children who know their diagnosis are no more depressed than those who do not. Which of the following is the more ethical way to proceed?
Jill's parents should have the final decision on what their daughter is told. They can forbid the medical care team to tell Jill she is severely ill and to tell her the name of her disease.
Jill's parents cannot force the medical team to lie to Jill about why she feels so sick or, if she asks specifically, about the name of her disease. (To learn what ethics experts think about this question, see case 1 in the August 2013 issue of VM.)

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From the Editor

Clinical Cures, Ethical Questions
Dhruv Khullar
Full Text | PDF
Virtual Mentor. 2013; 15:635-637.

Educating for Professionalism

Ethics Cases

Minors' Right to Know and Therapeutic Privilege
Commentary by Cristie M. Cole and Eric Kodish
Full Text | PDF
Virtual Mentor. 2013; 15:638-644.

Allocation of Drugs in Short Supply
Commentary by Liza-Marie Johnson and Deena Levine
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Virtual Mentor. 2013; 15:645-648.

End-of-Life Decisions and Off-Label Drug Use
Commentary by Laura L. Tenner and Paul R. Helft
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Virtual Mentor. 2013; 15:649-652.

Conley Essay Contest

2012 Winning Essay
Joey Knows Best? Balancing Conflicts and Defending a Child's Best Interest in Difficult Clinical Decisions

Mariam O. Fofana
Full Text | PDF
Virtual Mentor. 2013; 15:653-659.

2012 Runner-Up Essay
Pediatric Assent in Clinical Research: A Patient-Centered Perspective Using Motivational Interviewing

William Sveen
Full Text | PDF
Virtual Mentor. 2013; 15:660-665.

2012 Runner-Up Essay
Keeping Joey at the Center of the Conversation: Ethical Considerations in a Challenging Pediatric Case

B. Corbett Walsh
Full Text | PDF
Virtual Mentor. 2013; 15:666-671.

Medical Education

The Medical Student and Care at the End of Life
Thomas P. Duffy
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Virtual Mentor. 2013; 15:672-676.

Journal Discussion

Why Clinical Oncologists Should Talk about the Price of Cancer Drugs
Nancy Berlinger
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Virtual Mentor. 2013; 15:677-680.

State of the Art and Science

The Promise and Pitfalls of Genomics-Driven Cancer Medicine
Erin W. Hofstatter and Allen E. Bale
Full Text | PDF
Virtual Mentor. 2013; 15:681-686.

Law, Policy, and Society

Health Law

The Terminally Ill, Access to Investigational Drugs, and FDA Rules
Valarie Blake
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Virtual Mentor. 2013; 15:687-691.

Policy Forum

Overcoming Inequalities: The Affordable Care Act and Cancer Treatment
Michael K. Gusmano
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Virtual Mentor. 2013; 15:692-696.

Medicine and Society

What Cancer Survivorship Means
Gayle Sulik
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Virtual Mentor. 2013; 15:697-703.

History, Art, and Narrative

Images of Healing and Learning

Images in Cigarette Warning Labels: How Should They Warn?
James F. Thrasher, Amira Osman, and Dien Anshari
Full Text | PDF
Virtual Mentor. 2013; 15:704-712.

Op-Ed and Correspondence

Op-Ed

Defining Quality, Disseminating Evidence, and Enforcing Guidelines for Cancer Treatment
Thomas W. LeBlanc and Amy P. Abernethy
Full Text | PDF
Virtual Mentor. 2013; 15:713-717.

Resources

Suggested Readings and Resources
PDF
Virtual Mentor. 2013; 15:718-736.

About the Contributors
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Virtual Mentor. 2013; 15:737-739.