Preventing Ethical Disasters in the Practice of Medicine

The goal of this project is to examine individual and environmental factors that predict serious breaches of medical ethics with the aim of developing prevention programs. The research team analyzed 280 cases in three areas of clinical wrongdoing: improper prescribing of controlled substances, sexual abuse of patients, and fraudulent, unnecessary invasive procedures. While these behaviors are relatively rare among physicians, they are very damaging to patients and harm public trust in medicine. A working group of experts convened in St. Louis to discuss the data and develop recommendations for action related to education, remediation, policy, and oversight. Now in the final year of the project, the team is developing a series of toolkits to disseminate to stakeholder groups to guide efforts to prevent and appropriately respond to serious breaches of medical ethics.

Dineen, K.K., & DuBois, J.M. (2016). “Between a rock and a hard place: Can physicians prescribe opioids to treat pain adequately while avoiding legal sanction?” American Journal of Law and Medicine. 42(1), 7-52. doi:10.1177/0098858816644712

DuBois, J. M., Chibnall, J. T., Anderson, E. E., Eggers, M., Baldwin, K., & Vasher, M. (2016). A mixed-method analysis of reports on 100 cases of improper prescribing of controlled substances. Journal of Drug Issues, 46(4), 457-472. doi:10.1177/0022042616661836

DuBois, J.M., Walsh, H.A., Chibnall, J.T., Anderson, E.E., Eggers, M.R., Fowose, M., et al. (2017). Sexual violation of patients by physicians: A mixed-methods, exploratory analysis of 101 cases. Sexual Abuse: A Journal of Research and Treatment. doi: 10.1177/1079063217712217.

DuBois, J.M., Chibnall, J.T., Anderson, E.E., Walsh, H.A., Eggers, M.R., Baldwin, K., & Dineen, K.K. (2017). Exploring unnecessary invasive procedures in the United States: a retrospective mixed-methods analysis of cases from 2008-2016. Patient Safety in Surgery, 11(30).

DuBois, J. M., Anderson, E. E., Chibnall, J. T., Diakov, L., Doukas, D. J., Holmboe, E. S., . . . Whelan, A. J. (2018). Preventing Egregious Ethical Violations in Medical Practice: Evidence-Informed Recommendations from a Multidisciplinary Working Group. Journal of Medical Regulation, 104(4), 23-31.

DuBois, J. M., Anderson, E. E., Chibnall, J. T., Mozersky, J., & Walsh, H. A. (2019). Serious Ethical Violations in Medicine: A Statistical and Ethical Analysis of 280 Cases in the United States from 2008-2016. American Journal of Bioethics, 19(1), 16-34.

Solomon, E. D., Walsh, H., Parsons, M., McIntosh, T., Mozersky, J., & DuBois, J. M. (2021). Development of a resource guide to help patients receive appropriate care. Journal of Health Care for the Poor and Underserved, 32(4), 2249-2257. https://pubmed.ncbi.nlm.nih.gov/34803074/

McIntosh, T., Walsh, H., Parsons, M., Solomon, E. D., Mozersky, J., & DuBois, J. M. (2022). Responding to sexual abuse in health care: Development of a guide for patients. Journal of patient-centered research and reviews, 9(2), 117. https://pubmed.ncbi.nlm.nih.gov/35600235/