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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Ethics

Many Drug Companies Fail to Conduct Timely Safety Checks on Medicines after FDA Approval

Gene Emery  |  

(Reuters Health)—In the rush to approve new medicines, the U.S. Food and Drug Administration often requires drug companies to study possible side effects and alternative doses for medicines once they hit the broader market. A September 20 online analysis in the New England Journal of Medicine concludes that, in many cases, that’s not being done….

Ohio Sues Five Drug Companies Over Opioid Crisis

Chris Kenning  |  

CHICAGO (Reuters)—Ohio Attorney General Mike DeWine said on Wednesday his office sued five major drug manufacturers, accusing them of misrepresenting the risks of prescription opioid painkillers and so helping fuel a sky-rocketing drug addiction epidemic. A growing number of state and local governments are suing drugmakers and distributors, seeking to hold them accountable for the…

Ethics Forum: Teach Rheumatology Fellows to Use Good Judgment in Pharmaceutical Company Interactions

Arundathi Jayatilleke, MD, MS  |  

We teach medical students, residents and fellows evidence-based medicine to lay the groundwork for rational prescribing and good clinical judgment. But should we stop our rheumatology fellows from interacting with pharmaceutical companies as part of this foundation? It is not surprising that pharma­ceutical companies can influence physician pre­scribing through gifts. At least, it should not…

Ethics Forum: Ethical Challenges Arise for Rheumatologists Pressed to See Patients of High Social, Professional Standing Before Others

Karen Stellpflug, MD  |  

The Case You’re working in a busy rheumatology practice with wait times of two to three months for new outpatient consultations. A hospital administrator requests that his daughter see you right away. All but one of your urgent appointment slots for the week is already filled, and there are several patients on a waitlist; these…

AMA Updates Code of Medical Ethics

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Eight years ago, the American Medical Association’s (AMA) Council on Ethical and Judicial Affairs embarked on a comprehensive review of the AMA Code of Medical Ethics. What emerged after years of hard effort, intensive feedback and thoughtful revisions was a modernized version of the guide, which the AMA House of Delegates voted to adopt in…

Physicians Asked to Join AMA Efforts to Reduce Opioid Abuse

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In 2014, the American College of Rheumatology (ACR) was one of 25 healthcare associations invited to participate in an initiative by the American Medical Association (AMA) to reduce the public health epidemic posed by the abuse of prescription opioids.1 The AMA initiative is based on the belief that physicians are professionally obligated to participate in…

Ethics Forum: Prescribing Teratogenic Medications to Adolescents Can Raise Confidentiality, Ethical Concerns

Karen B. Onel, MD, & Melissa Tesher, MD  |  

Case A 17-year-old girl returns to the rheumatology clinic for scheduled follow-up for systemic lupus erythematosus (SLE). She is accompanied by her mother and father. She has a history of autoimmune cytopenias and Class III lupus nephritis. She has responded well to treatment with mycophenolate mofetil and hydroxychloroquine and was successfully weaned off of prednisone…

Ethics Forum: Unexpected Ethical Issues in Private Practice, Clinical Research

Donah Zack Crawford, MA, Jill Johnson, MD, Neal K. Moskowitz, MD, PhD, & James Udell, MD  |  

Ethical issues that arise in the average rheumatology practice and in clinical research are often straightforward. The AMA Code of Medical Ethics and the Office Practice and Procedures Manual offer useful information.1 In research, the Protocol and Investigators Agreement spells out who you can enroll and how the trial must be conducted. But still—even when…

Ethics Forum: Pediatric Vaccination Refusals Raise Challenges for Physicians

Emily von Scheven, MD, MAS  |  

The boy who could not walk: S.L. is a previously healthy 10-year-old boy who has not walked for three months. Physical examination reveals swollen wrists, knees, ankles and several toes. There is reduced hip range of motion and flexion contractures of both knees. He can stand with assistance, but is unable to take a single…

Authors Should Share Clinical Trial Data

Will Boggs, MD  |  

NEW YORK (Reuters Health)—Authors should agree to share deidentified patient data as a condition for publication of a clinical trial report, according to a proposal from the International Committee of Medical Journal Editors (ICMJE). “Our patients generously and selflessly volunteer to participate in clinical trials on the promise that the knowledge gained will be used…