Letters to the Editor
To the Editor: Kwakye and colleagues recently described some benefits of reprocessing (i.e., recycling) medical equipment.1 They showed that with little or no impact on patient safety, reprocessing saves hospitals money, boosts the economy, reduces medical waste by millions of pounds annually, and mitigates climate change. Given these outcomes and the duty of the medical profession to reduce its own carbon footprint,2 it seems clear that hospitals have an ethical imperative to use reprocessed medical equipment.
Disagreeing with this view, some lobby for patients to provide written informed consent to the use of reprocessed (as opposed to new or single-use) equipment in their care.1 The standard for informed consent is to identify and disclose to patients any information about prognosis and treatment options that a reasonable person would want to know before giving or withholding consent, including issues of safety. Society presumes that nothing unsafe will be used in patient care unless there are no better options and the potential benefits outweigh the risks. In such situations, disclosure of risks is necessary, but if a reprocessed device is as safe as a single-use device—and hospitals have a duty to make sure this is the case—there is no need to disclose that it was reprocessed, and no need to obtain written informed consent.
By using safe, reprocessed equipment, there will be less need for single-use devices, which are relatively new on the scene and were adopted for convenience, not safety. To promote health and fulfill the ethical imperative discussed above, the medical profession must replace single-use devices with safe, reprocessed ones whenever possible.
Cheryl Macpherson, PhD
Professor and chair, Bioethics Department, St. George's University School of Medicine, St. George's, Grenada; firstname.lastname@example.org.
1Kwakye G, Pronovost PJ, Makary MA. Commentary: A call to go green in health care by reprocessing medical equipment. Acad Med. 2010;85:398–400.
2Macpherson CC. Time for physicians to take action on climate change. Acad Med. 2009;84:817.