Abstract
Recommendations for treating males: An ethical reasoning for the inclusion of testicular self-examination (TSE) in a standard of care
Michael J. Rovito, PhD, CHES, FMHI1, Janna Manjelievskaia, MPH2, James Leone, PhD, MPH, MS, CHES3, Michael Lutz, MD4, Chase Cavayero, OSMIV5 and David Perlman, PhD6
(1)University of Central Florida, Orlando, FL, (2)University of the Sciences, (3)Bridgewater State University, Bridgewater, MA, (4)Michigan Institute of Urology, West Bloomfield, MI, (5)LECOM, Orlando, FL, (6)University of the Sciences, Philadelphia, PA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Considering the benefits testicular self-examination (TSE) has beyond cancer detection, and the historical support it has received among health practitioners, it is paramount to consider the ethical implications of its official ‘exclusion’ from preventive health and clinical care recommendations (i.e., standard of care). However, the USPSTF, among others, discourage its promotion.
Since good ethics should lead practitioner patient care guidelines, not fear of increased malpractice risks, we recommend the development of a standard of care for counseling males to perform TSE. In addressing this issue further, we conducted a comprehensive review on current practice guidelines and the standard of care for testicular health abnormalities across a multitude of health practices. Further, the USPSTF rubric for recommendation decree served as a foundation for an ethical analysis of creating a standard of care and clinical care endorsements.
Regarding testicular health, standards are historically well-established but prevention/screening standards remain ambiguous. The need for TSE advocacy and education as an integral part of this new standard of care is demonstrated by the current inconsistencies surrounding testicular health at the point of care. Considering the support for the behavior, coupled with the lack of robust evidence demonstrating that TSE harms more than benefits, it is unethical for health practitioners to not recommend the procedure.
This presentation discusses our position that practice guidelines should not be perceived as the definite standard of care for decisions at the point of care, but rather fluid, documents that aid providers in patient care and are subject to regular updates as new evidence becomes available.
Advocacy for health and health education Ethics, professional and legal requirements Implementation of health education strategies, interventions and programs Other professions or practice related to public health Planning of health education strategies, interventions, and programs Systems thinking models (conceptual and theoretical models), applications related to public health