Serious Ethical Violations in Medicine: A Statistical and Ethical Analysis of 280 Cases in the United States From 2008–2016

James M. DuBois, Emily E. Anderson, John T. Chibnall, Jessica Mozersky, Heidi A. Walsh

Research output: Contribution to journalArticlepeer-review

38 Scopus citations

Abstract

Serious ethical violations in medicine, such as sexual abuse, criminal prescribing of opioids, and unnecessary surgeries, directly harm patients and undermine trust in the profession of medicine. We review the literature on violations in medicine and present an analysis of 280 cases. Nearly all cases involved repeated instances (97%) of intentional wrongdoing (99%), by males (95%) in nonacademic medical settings (95%), with oversight problems (89%) and a selfish motive such as financial gain or sex (90%). More than half of cases involved a wrongdoer with a suspected personality disorder or substance use disorder (51%). Despite clear patterns, no factors provide readily observable red flags, making prevention difficult. Early identification and intervention in cases requires significant policy shifts that prioritize the safety of patients over physician interests in privacy, fair processes, and proportionate disciplinary actions. We explore a series of 10 questions regarding policy, oversight, discipline, and education options. Satisfactory answers to these questions will require input from diverse stakeholders to help society negotiate effective and ethically balanced solutions.

Original languageEnglish
Pages (from-to)16-34
Number of pages19
JournalAmerican Journal of Bioethics
Volume19
Issue number1
DOIs
StatePublished - Jan 2 2019

Keywords

  • ethical violations
  • medical ethics
  • medical malpractice
  • medical regulation
  • patient safety
  • sexual abuse

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