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Year |
2001 |
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Question Number |
232. |
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Category |
Select |
Question
A surgeon who is planning a total elbow arthroplasty would like to use a prosthesis that he helped to develop. A royalty payment is received each time the prosthesis is used. What is the surgeon’s ethical responsibility?
1. The prosthesis should not be used.
2. The prosthesis can be used, but the royalty payment information should not be discussed with the patient.
3. The royalty payment information should be included on the informed consent document but not discussed with patient.
4. The patient should be informed that the surgeon receives a royalty payment for using the prosthesis.
5. The surgeon should offer to split the royalty payment with the patient.
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Answer (click for answer)
Answer: 4
Ethically, it is appropriate to inform patients of any royalties that may be bestowed to you by any third parties for products that you use in practice. Orthopaedic surgery residents will be faced with a variety of ethical issues when they enter clinical practice. A previous survey suggested that they lack knowledge about how to approach several types of medical ethics dilemmas. Wenger et al developed a medical ethics curriculum for orthopaedic surgery residents and presented it over a one-year period to the residents in one training program. The effect of the educational intervention on the residents’ knowledge of medical ethics and their ability to handle hypothetical situations was measured by comparing their responses to a questionnaire, administered before and after the intervention, with those of residents in a training program in which the intervention was not provided. The twenty-five residents at the site of the educational intervention had a mean improvement of 0.10 in the overall score, from a mean score of 0.71 on the baseline survey to a mean score of 0.81 on the follow-up survey. This improvement was significantly greater than the mean improvement of 0.02 for the thirty residents at the control site, who had a mean score of 0.72 on the baseline survey and a mean score of 0.74 on the follow-up survey (p = 0.002). Six residents who participated in the medical ethics curriculum rated it as very useful; seventeen, as somewhat useful; one, as slightly useful; and one, as not at all useful. A medical ethics curriculum can increase orthopaedic residents’ knowledge of medical ethics. Whether this curriculum also will lead to behavioral changes requires additional evaluation.
Reference: Wenger NS, Liu H, Lieberman JR: Teaching medical ethics to orthopaedic surgery residents. J Bone Joint Surg Am 1998;80:1125-1131