Ethical Issues in Gynecological Oncology

Ethical concerns in the subspecialty of gynecologic oncology are worth singling out for several reasons: the malignancies treated in this field are often aggressive, recurrent, and incurable; they frequently occur in young women; and their prevention and treatment entail radical surgeries and side effects that can alter the remainder of a woman’s life. Contributors to the September issue of the AMA Journal of Ethics extol breakthroughs in the prevention and treatment of gynecologic cancers, while grappling with such ethical dilemmas as preserving fertility in adolescent girls undergoing chemotherapy, disclosing increased disease risk to a patient’s family members, and overcoming public resistance to a cancer-preventing vaccine.

Volume 17, Number 9: 815-883 Full Issue PDF
  • From the Editor
    Sep 2015

    Advances in Gynecologic Oncology

    W. Miller Johnstone III, MD, PhD
    We now have a vaccine that prevents cervical cancer and newfound evidence about the cause of ovarian cancer.
    AMA J Ethics. 2015;17(9):817-818. doi: 10.1001/journalofethics.2015.17.9.fred1-1509.
  • Case and Commentary
    Sep 2015

    Disclosing Information about the Risk of Inherited Disease

    Clint Parker, MD, PhD
    When confidential medical information can prevent a serious harm to a third party, the patient’s prima facie right to confidentiality must be balanced against the physician’s prima facie obligation to prevent serious harm to that third party.
    AMA J Ethics. 2015;17(9):819-825. doi: 10.1001/journalofethics.2015.17.9.ecas1-1509.
  • Case and Commentary
    Sep 2015

    Oncofertility for Adolescents: When Parents and Physicians Disagree about Egg Cryopreservation for a Mature Minor

    Annekathryn Goodman, MD
    This month, AMA Journal of Ethics editor-in-chief Audiey Kao, MD, PhD, interviewed Peter A. Ubel, MD, about factors contributing to the high cost of health care, how to bend the cost curve, and the compatibility of cost containment and profit seeking.
    AMA J Ethics. 2015;17(9):826-833. doi: 10.1001/journalofethics.2015.17.9.ecas2-1509.
  • Medical Education
    Sep 2015

    Designing an Ethics Curriculum in Obstetrics and Gynecology

    Matthew Schlumbrecht, MD, MPH
    A gynecologic oncology ethics education program intended to engage students and foster open exchange was designed after review of ethics consults at a tertiary cancer center over a 15-year period.
    AMA J Ethics. 2015;17(9):834-838. doi: 10.1001/journalofethics.2015.17.9.medu1-1509.
  • In the Literature
    Sep 2015

    After Equipoise: Continuing Research to Gain FDA Approval

    Allison Kerianne Crockett, MD
    This month, AMA Journal of Ethics editor-in-chief Audiey Kao, MD, PhD, interviewed Peter A. Ubel, MD, about factors contributing to the high cost of health care, how to bend the cost curve, and the compatibility of cost containment and profit seeking.
    AMA J Ethics. 2015;17(9):839-842. doi: 10.1001/journalofethics.2015.17.9.nlit1-1509.
  • State of the Art and Science
    Sep 2015

    Fallopian Tube Ligation or Salpingectomy as Means for Reducing Risk of Ovarian Cancer

    J. Brian Szender, MD, MS and Shashikant B. Lele, MD
    The estimated reduction in risk of ovarian cancer for any woman undergoing opportunistic removal of the Fallopian tubes is up to 50 percent, but whether removal is more beneficial than ligation has not been established.
    AMA J Ethics. 2015;17(9):843-848. doi: 10.1001/journalofethics.2015.17.9.stas1-1509.
  • Medicine and Society
    Sep 2015

    The HPV Vaccine: Overcoming Barriers to Acceptance of a Medical Triumph

    Jennifer Emberger, MD, MPH
    Vaccination rates among adolescents and young adults, for whom the risk of infection is greatest, remain lower than was true for other vaccines in their first years. And vaccination rates among males is extremely low.
    AMA J Ethics. 2015;17(9):854-857. doi: 10.1001/journalofethics.2015.17.9.msoc1-1509.
  • Art of Medicine
    Sep 2015

    The Patient as Text: Literary Scholarship and Medical Practice in Margaret Edson’s Wit

    Ann Henley, PhD
    The experience of an English professor dying of ovarian cancer in Margaret Edson’s play Wit shows that both literary and medical discourse obfuscate and objectify rather than promote communication of “simple human truths” that dignify life and death.
    AMA J Ethics. 2015;17(9):858-864. doi: 10.1001/journalofethics.2015.17.9.imhl1-1509.
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    Podcast
    Sep 2015

    Ethics Talk: Facilitating End-of-Life Care Discussions through the Conversation Project

    This month, AMA Journal of Ethics theme editor W. Miller Johnstone III, MD, PhD, a resident in obstetrics and gynecology at the University of Buffalo, interviewed Kate M. Lally, MD, about patient-centered management of end-of-life care, the unique care needs of women with advanced gynecologic cancers, and how to prepare medical students and residents to hold difficult conversations with patients.