Patient misconceptions and ethical challenges in radioactive iodine scanning and therapy.
The use and nature of radioactive iodine (RAI) are complex topics for patients with thyroid conditions to understand. Fear and anxiety over its use, misinformation in patient advocacy books and on the Internet, medical jargon, confusion regarding postscanning and posttreatment procedures, patient literacy, thyroid health status, and several other socioeconomic factors can create serious barriers to genuine informed consent in RAI scanning and treatment. The following discussion will review the origins of patient misconceptions and misinterpretations, including international differences in physician attitudes regarding RAI usage. Next, this article will present the core ethical duties, problems, and moral dilemmas that can arise in the RAI setting. Upon completion of this article, the reader should be able to describe the core ethical principles of respect for persons (patient autonomy), beneficence, nonmaleficence, and justice; describe the 3 components of informed consent; identify common barriers to informed consent and describe how such barriers can lead to misconceptions, misinformation, and refusal of treatment with RAI; and summarize where RAI candidates and patients first look for information and identify the common ways in which misinformation surfaces.
Rosenthal
M Sara
MS
Program for Bioethics and Patients' Rights, University of Kentucky College of Medicine, Lexington, Kentucky 40536-0086, USA. msrose2@uky.edu
D001294:Attitude to Health; D007258:Informed Consent / Q000941:ethics*; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D010353:Patient Education as Topic / Q000941:ethics*; D010817:Physician-Patient Relations / Q000941:ethics*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D011878:Radiotherapy / Q000941:ethics*; D014055:Tomography, Emission-Computed / Q000941:ethics; D014481:United States
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals