SGO Ethics Committee Quarterly Bulletin | Zachary Schwartz, MD, and Joshua Kesterson, MD

Joshua Kesterson, MD

Zachary Schwartz, MD

Gynecologic Oncology is a unique specialty, focused on the optimization of a multitude of outcomes, of quality and quantity, for women over the continuum of care. We pride ourselves on our ability to provide and coordinate multimodal, multidisciplinary care, from diagnosis to death, being ever mindful of each woman’s unique goals, hopes and dreams, while navigating through complex and dynamic socioeconomic and cultural factors.  

On any given day, we as clinicians may be tasked with providing informed consent, detailing the risks, benefits, and alternatives to a major surgery to a medically complex patient with a suspected cancer diagnosis, enrolling a patient with an aggressive, recurrent cancer to a clinical trial with potential randomization to an experimental therapy or placebo, and counselling a patient and her family regarding transition to hospice care. These conversations and decisions involve foundational ethical issues such as autonomy, beneficence, and end of life care, to name a few.  

These issues and the moral conundrums they generate are endemic to the care of women with gynecologic malignancies and, considering evolving issues related to access to care, gender equity, the expanding role of genetics in clinical decision making, the influence of industry and insurance in defining patient care, as well as the contemporary turbulent medico-legal climate, these issues will only become more complex, necessitating a nuanced approach, based on a foundational understanding of oft encountered moral and ethical issues. This is essential to ensure optimal physical, mental, emotional and spiritual well-being for the patient and we the caregivers. 

The Society of Gynecologic Oncology (SGO) strives to “develop and promote high ethical and practice standards for cancer clinicians and scientists” [1]. This entails not only keeping its members abreast of current standards of care and latest developments in clinical and surgical care, but also empowering its members with the knowledgebase, language and framework, to facilitate and engage in conversations regarding the intersection and intimate and intertwined relationship between medical, ethical, moral, social, cultural, economic, gender, and legal issues. Toward this end, the SGO Ethics Committee will address clinically relevant ethical quandaries in a quarterly series, entitled, “SGO Ethics Committee Bulletin.” We welcome your input regarding clinical scenarios, moral dilemmas, and ethical quandaries that you believe would benefit from a structured, formulaic analysis and/or community-based forum approach.  

Want to start a conversation with other members? Present an interesting ethics case? Suggest topics for the quarterly bulletin? Join the Ethics Committee Community Group on the SGO Portal. 

References

1. Society of Gynecologic Oncology. SGO Bylaws. https://www.sgo.org/members-only/bylaws/. Accessed July 18, 2022. 

Zachary Schwartz, MD, is a gynecologic oncologist at Loma Linda University Medical Center in Loma Linda, CA. 

Joshua Kesterson, MD, is a gynecologic oncologist at UPMC Magee-Womens in Williamsport, PA.