Document Detail


Commercial pressures and professional ethics: troubling revisions to the recent ACOG Practice Bulletins on surgery for pelvic organ prolapse.
MedLine Citation:
PMID:  19495536     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Commercial interests are reshaping the practice of gynecological surgery by promoting the use of trochar-and-mesh surgical "kits" for the treatment of stress incontinence and pelvic organ prolapse. In this article, we discuss the ethical implications of changes in surgical practice that are driven by commercial interests. We point out the dangers inherent in the adoption of new procedures without adequate and documented evidence to support their safety and efficacy. We discuss the most recent American College of Obstetricians and Gynecologists (ACOG) Practice Bulletins on pelvic organ prolapse (numbers 79 and 85) which were altered without explanation to downplay the experimental nature of these commercial products. We suggest that in so doing, ACOG is not meeting its fiduciary responsibilities to patients and is undermining important professional values.
Authors:
L Lewis Wall; Douglas Brown
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Publication Detail:
Type:  Journal Article     Date:  2009-03-28
Journal Detail:
Title:  International urogynecology journal and pelvic floor dysfunction     Volume:  20     ISSN:  -     ISO Abbreviation:  Int Urogynecol J Pelvic Floor Dysfunct     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-04     Completed Date:  2009-09-03     Revised Date:  2011-08-18    
Medline Journal Info:
Nlm Unique ID:  9514583     Medline TA:  Int Urogynecol J Pelvic Floor Dysfunct     Country:  England    
Other Details:
Languages:  eng     Pagination:  765-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Campus Box 8064, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA. WALLL@wudosis.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Commerce / economics,  ethics*
Ethics, Professional*
Female
Gynecologic Surgical Procedures / economics,  ethics*,  methods
Health Care Sector / ethics*
Humans
Practice Guidelines as Topic / standards*
Suburethral Slings / adverse effects,  economics,  ethics
United States
Urinary Incontinence, Stress / surgery
Uterine Prolapse / surgery*
Comments/Corrections
Comment In:
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Dec;20(12):1523; author reply 1525   [PMID:  19779657 ]
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Dec;20(12):1519-20; author reply 1521-2   [PMID:  19779659 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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