TY - JOUR
T1 - Serious Ethical Violations in Medicine
T2 - A Statistical and Ethical Analysis of 280 Cases in the United States From 2008–2016
AU - DuBois, James M.
AU - Anderson, Emily E.
AU - Chibnall, John T.
AU - Mozersky, Jessica
AU - Walsh, Heidi A.
N1 - Publisher Copyright:
© 2019, © 2019 Taylor & Francis Group, LLC.
PY - 2019/1/2
Y1 - 2019/1/2
N2 - 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.
AB - 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.
KW - ethical violations
KW - medical ethics
KW - medical malpractice
KW - medical regulation
KW - patient safety
KW - sexual abuse
UR - http://www.scopus.com/inward/record.url?scp=85060530886&partnerID=8YFLogxK
U2 - 10.1080/15265161.2018.1544305
DO - 10.1080/15265161.2018.1544305
M3 - Article
C2 - 30676904
AN - SCOPUS:85060530886
SN - 1526-5161
VL - 19
SP - 16
EP - 34
JO - American Journal of Bioethics
JF - American Journal of Bioethics
IS - 1
ER -