肿瘤药物短缺时代临床肿瘤学家的伦理考虑
Ethical considerations for the clinical oncologist in an era of oncology drug shortages.
机构信息
Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA; American Society of Clinical Oncology, Alexandria, Virginia, USA; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; University of Pennsylvania, Philadelphia, Pennsylvania USA; Duke University, Durham, North Carolina, USA; Medical Oncology Hematology Consultants, Newark, Delaware, USA; Massachusetts General Hospital, Boston, Massachusetts, USA.
出版信息
Oncologist. 2014 Feb;19(2):186-92. doi: 10.1634/theoncologist.2013-0301. Epub 2014 Jan 21.
Shortages of injectable drugs affect many cancer patients and providers in the U.S. today. Scholars and policymakers have recently begun to devote increased attention to these issues, but only a few tangible resources exist to guide clinical oncologists in developing strategies for dealing with drug shortages on a recurring basis. This article discusses existing information from the scholarly literature, policy analyses, and other relevant sources and seeks to provide practical ethical guidance to the broad audience of oncology professionals who are increasingly confronted with such cases in their practice. We begin by providing a brief overview of the history, causes, and regulatory context of oncology drug shortages in the U.S., followed by a discussion of ethical frameworks that have been proposed in this setting. We conclude with practical recommendations for ethical professional behavior in these increasingly common and challenging situations.
在美国,注射用药物短缺影响着许多癌症患者和医务人员。学者和政策制定者最近开始更加关注这些问题,但只有少数切实可行的资源可以指导临床肿瘤学家制定应对药物短缺的策略。本文讨论了来自学术文献、政策分析和其他相关来源的现有信息,并试图为越来越多在实践中遇到此类情况的肿瘤学专业人员提供实用的伦理指导。我们首先简要介绍美国肿瘤药物短缺的历史、原因和监管背景,然后讨论在这种情况下提出的伦理框架。最后,我们提出了在这些日益常见和具有挑战性的情况下的伦理专业行为的实用建议。