Ethical Concerns in Rheumatology Require Nuance

ACR’s Code of Ethics May Be Helpful

Editor’s note:ACR on Air, the official podcast of the ACR, dives into topics important to the rheumatology community, such as the latest research, solutions for practice management issues, legislative policies, patient care and more. Twice a month, host Jonathan Hausmann, MD, a pediatric and adult rheumatologist in Boston, interviews healthcare professionals and clinicians on the rheumatology front lines. In a series for The Rheumatologist, we provide highlights from these relevant conversations. Listen to the podcast online at acronair.org, or download and subscribe to ACR on Air wherever you get your podcasts. Here we highlight episode 84, “How Should We Navigate Moral Dilemmas in Rheumatology?” which aired on Aug. 27, 2024.

The ACR on Air podcast on ethics in rheumatology touched on a whole range of issues, including patient decision making, physician conflict of interest, treatment access and more, with Kelly Weselman, MD, a rheumatologist with Arthritis and Rheumatology of Georgia in Smyrna and chair of the ACR’s Committee on Ethics and Conflict of Interest.

During the podcast discussion, Dr. Weselman reviewed with Dr. Hausmann some of the most common ethical questions that arise in the specialty and the considerations in each situation.

Dr. Weselman

Filtering Information for Patients

Here’s a common scenario: A patient sees a commercial for a rheumatology medication or talks to a friend who uses it. That patient does a little more research and concludes that is the medication they want to use for their condition. Yet the rheumatologist may not think that treatment is the best next step for the patient. What should a rheumatologist do?

Balancing a patient’s autonomy for healthcare decisions and their access to so much information on the internet along with the physician’s interpretation of that information may not be thought of as an ethical dilemma, but it actually is, Dr. Weselman explained.

“It’s [about] trying to reconcile that and give the patient time and help them interpret the information they have accessed so that they may have a better understanding of our recommendation that may differ from theirs,” she said.

Although a patient’s autonomy in making decisions about their healthcare is important, the role of informed consent is also crucial.

“I think the physician’s role is really important in spending time educating the patient beyond what they may have read or heard from others,” Dr. Weselman said.