Ethical Challenges in the Practice of Echocardiography: What Is Right and How Do We Do It?

At the 2018 Scientific Sessions, the American Society of Echocardiography inaugurated the Richard E. Kerber Ethics/Humanitarian Lecture, continuing its tradition of providing ethics education and exploring the use of echocardiography to improve cardiovascular care in medically underserved settings. Echocardiography is one of the most widely applicable, safe, and cost-effective diagnostic tools available in cardiovascular medicine. The American Society of Echocardiography Foundation is well known for harnessing the power of echocardiography in its many successful humanitarian outreaches all over the world. Some practitioners might conclude that because of its important advantages, echocardiography involves few ethical complexities; however, several historical and recent scandals involving conflicts of interest and lapses in quality suggest otherwise. Every day, sonographers and echocardiographers grapple with ethical issues: integrity, truth telling, doing good and avoiding harm, altruism, and humanism. In the near future, population aging and technological advances, among other issues, will ensure that a steady stream of ethical issues will confront the practitioners of echocardiography. Medical science and engineering have given us many things that can be done, but central to the art of medical practice and research are decisions about what should be done. In this article, based in part on the first Richard E. Kerber Ethics/Humanitarian Lecture, the authors discuss ethical challenges in the practice of echocardiography, illustrated by accompanying online videos, and offer a general principle for meeting these challenges.