Ethical challenges in rheumatology

A survey of the American College of Rheumatology membership

C. Ronald Mackenzie, Michele Meltzer, Elizabeth A. Kitsis, Carol A. Mancuso

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective Despite the frequency of ethical issues arising in patient care, ethical discourse in the rheumatology literature is negligible. To better understand the scope of ethical problems occurring in our specialty, the American College of Rheumatology (ACR) Committee on Ethics and Conflict of Interest surveyed ACR members. Specific objectives of the survey were 1) to learn the perceived frequency of ethical issues in rheumatology, 2) to identify activities that pose ethical problems in rheumatologic practice, 3) to determine the extent of education on, and self-perceived knowledge about, ethics among ACR members, and 4) to determine member interest in, and suggest content for, future ACR-sponsored educational activities related to bioethics. Methods The survey included 12 non-open-ended questions addressing 5 core areas: 1) ethical dilemmas in daily practice, 2) ethical concerns in basic and clinical research, 3) influence of industry, 4) ethics of regulatory policies, potential conflicts, and disclosure, and 5) personal education on and interest in ethics. Two open-ended questions were also included, asking respondents to list the ethical issues most relevant to rheumatology and to provide any comments. Data analysis was descriptive. Results Seven hundred seventy-one responses were received. Respondents believed that ethical issues arise most frequently in practice and in clinical research. The most common ethical issues cited were the high cost of treatment for patients (51% of respondents) and for society (48%), and the practice of defensive medicine (45%). Conclusion The survey results suggest that ethical problems in rheumatology are of concern to the ACR membership. Further, there is a perceived need for educational programs targeted at helping members address such professional challenges.

Original languageEnglish (US)
Pages (from-to)2524-2532
Number of pages9
JournalArthritis and Rheumatism
Volume65
Issue number10
DOIs
StatePublished - Oct 2013

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Rheumatology
Ethics
Education
Defensive Medicine
Conflict of Interest
Ethics Committees
Bioethics
Surveys and Questionnaires
Disclosure
Research
Health Care Costs
Patient Care
Industry

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy
  • Rheumatology
  • Pharmacology (medical)

Cite this

Ethical challenges in rheumatology : A survey of the American College of Rheumatology membership. / Mackenzie, C. Ronald; Meltzer, Michele; Kitsis, Elizabeth A.; Mancuso, Carol A.

In: Arthritis and Rheumatism, Vol. 65, No. 10, 10.2013, p. 2524-2532.

Research output: Contribution to journalArticle

Mackenzie, C. Ronald ; Meltzer, Michele ; Kitsis, Elizabeth A. ; Mancuso, Carol A. / Ethical challenges in rheumatology : A survey of the American College of Rheumatology membership. In: Arthritis and Rheumatism. 2013 ; Vol. 65, No. 10. pp. 2524-2532.
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abstract = "Objective Despite the frequency of ethical issues arising in patient care, ethical discourse in the rheumatology literature is negligible. To better understand the scope of ethical problems occurring in our specialty, the American College of Rheumatology (ACR) Committee on Ethics and Conflict of Interest surveyed ACR members. Specific objectives of the survey were 1) to learn the perceived frequency of ethical issues in rheumatology, 2) to identify activities that pose ethical problems in rheumatologic practice, 3) to determine the extent of education on, and self-perceived knowledge about, ethics among ACR members, and 4) to determine member interest in, and suggest content for, future ACR-sponsored educational activities related to bioethics. Methods The survey included 12 non-open-ended questions addressing 5 core areas: 1) ethical dilemmas in daily practice, 2) ethical concerns in basic and clinical research, 3) influence of industry, 4) ethics of regulatory policies, potential conflicts, and disclosure, and 5) personal education on and interest in ethics. Two open-ended questions were also included, asking respondents to list the ethical issues most relevant to rheumatology and to provide any comments. Data analysis was descriptive. Results Seven hundred seventy-one responses were received. Respondents believed that ethical issues arise most frequently in practice and in clinical research. The most common ethical issues cited were the high cost of treatment for patients (51{\%} of respondents) and for society (48{\%}), and the practice of defensive medicine (45{\%}). Conclusion The survey results suggest that ethical problems in rheumatology are of concern to the ACR membership. Further, there is a perceived need for educational programs targeted at helping members address such professional challenges.",
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