BackTable / VI / Podcast / Episode #80
Making Ethics Matter
with Dr. Eric J. Keller
Dr. Eric J. Keller of Stanford Medicine Department of Radiology discusses his work in applied medical ethics and his mission to help docs navigate challenging ethical situations better.
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BackTable, LLC (Producer). (2020, September 3). Ep. 80 – Making Ethics Matter [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Dr. Eric J. Keller
Dr. Eric J. Keller is an interventional radiologist at Delaney Radiology in southeastern North Carolina.
Dr. Christopher Beck
Dr. Chris Beck is a practicing interventional radiologist with Regional Radiology Group in New Orleans.
Synopsis
In this episode, Dr. Eric Keller joins Dr. Christopher Beck to discuss medical ethics within IR. He speaks about using a bottom-up approach of applied ethics, and we examine why a combination of casuistry and virtue ethics may be helpful rather than principlism.
We dig deeper into medical futility and the challenge of prospectively determining if a procedure is futile. Dr. Keller describes how to design a study that can explore medical ethics as well as methods of collecting and presenting data in an ethical way.
We discuss advanced care planning, managing bias, and the role that unbounded ethicality plays in research. We talk through some benefits and drawbacks of ethics boards as well as how using decision support aides may improve informed consent and allow patients to become advocates for themselves.
Resources
Journal of the American Geriatrics Society
https://onlinelibrary.wiley.com/action/doSearch?AllField=futility&SeriesKey=15325415
This website presents all the papers in the journal that are related to futility.
Journal of the American Geriatrics Society (Medical Futility: Where Do We Go from Here?)
https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1532-5415.1994.tb06570.x
This article discusses various perspectives on medical futility.
Decision Aids to Help People who are Facing Health Treatment of Screening Decisions
https://www.cochrane.org/CD001431/COMMUN_decision-aids-help-people-who-are-facing-health-treatment-or-screening-decisions
This article evaluates the effects of decision aids on health outcomes.
Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons
https://pubmed.ncbi.nlm.nih.gov/31882313/
American Geriatrics Society Feeding Tubes in Advanced Dementia Position Statements
https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.12924
This article discusses feeding tubes and how to handle feeding for patients with advanced dementia.
The Impact of Advance Care Planning on End of Life Care in Elderly Patients
https://www.bmj.com/content/bmj/340/bmj.c1345.full.pdf
This article describes a randomized controlled trial that examines advanced care planning.
Does Facilitated Advance Care Planning Reduce the Costs of Care Near the End of Life?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838173/
This paper discusses the ethical conflicts in advanced care planning.
Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units
https://www.atsjournals.org/doi/full/10.1164/rccm.201505-0924ST
This article describes how to handle treatment disagreements in the ICU.
Research Ethics in IR: The Intersection Between Care and Progress
https://pubmed.ncbi.nlm.nih.gov/32359529/
This paper mentions the ethical issues in collecting and presenting data. It also discusses the role IR plays in conflict of interest and bias.
Understanding Bias: A Look at Conflicts of Interest in IR
https://www.researchgate.net/publication/332750177_Understanding_Bias_A_Look_at_Conflicts_of_Interest_in_IR
This article examines conflicts of interest and how they affect the field of IR.
Reflect and Remember: The Ethics of Complications in Interventional Radiology
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531013/
This paper discusses the ethics behind the relationship between IR and complications.
Informed Consent: Beating a Dead Horse or an Opportunity for Quality Improvement?
https://www.researchgate.net/publication/338303598_Informed_Consent_Beating_a_Dead_Horse_or_an_Opportunity_for_Quality_Improvement
This paper examines the ethical implications of informed consent and its complexities.
Reconsidering Requests - Futility in IR
https://www.jvir.org/article/S1051-0443(19)30069-7/fulltext
This article discusses the ethics in challenging healthcare situations.
You’re Performing My Procedure: Teamwork and Tribalism in IR
https://www.jvir.org/article/S1051-0443(19)30826-7/fulltext
This article discusses teamwork between specialities.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.