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Academic Medicine:
doi: 10.1097/ACM.0b013e3181eb4b9b
Letters to the Editor

An Ethical Imperative to Use Reprocessed Medical Equipment

Ibrahim, Andrew M.; Makary, Martin A. MD, MPH

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Doris Duke Research Fellow, Johns Hopkins University, Department of Surgery, Johns Hopkins University, School of Medicine, Baltimore, Maryland. (Ibrahim)

Associate professor of surgery and health policy & management, Department of Surgery, Bloomberg School of Public Health, Johns Hopkins University, School of Medicine, Baltimore, Maryland; mmakary1@jhmi.edu. (Makary)

In Reply: We appreciate the perspective of Dr. Macpherson and the bioethics community from which she hails. We agree there are multiple benefits to reprocessing medical equipment and, given these significant advantages, every hospital has an ethical imperative to adopt them. The medical profession remains the second largest contributor of landfills,1 and much needs to be done to address the carbon footprint of the health care community.

On the basis of the guidelines in place by the Food and Drug Administration and our review of the best available data, we found that there is no increased risk associated with reprocessed medical supplies and equipment.2 Patient safety has been our paramount concern, and we considered cost and environmental benefits secondary in our review. The U.S. reprocessing experience has an impeccable track record of outstanding patient safety, and this should be considered to be the leading benefit.

Since the publication of our Academic Medicine commentary, “A call to go green in health care,”3 we have received hundreds of encouraging and supportive communications from readers. To our amazement, there appears to be a strong thirst for commonsense strategies like reprocessing among health care providers and hospital workers. We hope that our commentary will continue to spark conversations about the benefits of reprocessing and a transparent reprocessing industry. Indeed, it is this transparency that allows hospitals to believe in the process while maintaining their commitment to patients.

Andrew M. Ibrahim

Doris Duke Research Fellow, Johns Hopkins University, Department of Surgery, Johns Hopkins University, School of Medicine, Baltimore, Maryland.

Martin A. Makary, MD, MPH

Associate professor of surgery and health policy & management, Department of Surgery, Bloomberg School of Public Health, Johns Hopkins University, School of Medicine, Baltimore, Maryland; mmakary1@jhmi.edu.

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References

1Diconsiglio J. Reprocessing SUDs reduces waste, costs. Mater Manag Health Care. 2008;17:40–42.

2United States Government Accountability Office. Report to the Committee on Oversight and Government Reform, House of Representatives. Reprocessed Single-Use Medical Devices: FDA Oversight Has Increased, and Available Information Does Not Indicate That Use Presents an Elevated Health Risk. Washington, DC: United States Government Accountability Office; January 31, 2008.

3Kwakye G, Pronovost PJ, Makary MA. A call to go green in health care by reprocessing medical equipment. Acad Med. 2010;85:398–400.

© 2010 Association of American Medical Colleges

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