Osteoporosis
NOFSA 2024 Masterclass: Ethical decision-making when assessing for osteoporosis in the older patient
During the routine practice of medicine, the healthcare provider will encounter circumstances in which potential conflicts arise between obligations/duties and the potential outcome, wherein a doctor owes a duty to both the patient and society. Deontology and utilitarianism are two philosophies underpinning a systematic approach to ethical decision-making in healthcare and each perspective has its own importance. Ethical principles common to both deontology and utilitarianism are autonomy, beneficence, non-maleficence and justice (Table 1).1-3
Since medical teaching practices inculcate the perspective that harm is unacceptable, the doctor-patient interaction or relationship is deontological, being patient-centred with inclinations toward empathy and perspective-taking. When this deontological practice is breached, leading to poorer service delivery to patients, the possibility of medical negligence arises.1-3
In this fifth National Osteoporosis Foundation of South Africa (NOFSA) 2024 masterclass, Dr Lipschitz considers an ethical decision-making framework for the assessment and management of osteoporosis in older patients.
You will learn:
- A deontological framework for considering therapeutic interventions to prevent major osteoporotic fracture in older patients
- The ethical implications of placebo-controlled trials in vulnerable populations and the consequences of not treating osteoporosis in older patients
- Evidence supporting the efficacy of antiresorptive and anabolic therapies for fracture prevention and the possible harms associated with treating osteoporosis in older patients
- Approaches to clinical evaluation of benefits and risks of osteoporosis therapy in older patients.
Dr Stanley Lipschitz
Private practice as a specialist physician and geriatrician in Rosebank, Johannesburg.
Dr Lipschitz is currently in private practice as a specialist physician and geriatrician in Rosebank, Johannesburg. He graduated MBBCH in 1980 from University of the Witwatersrand medical school. From 1984 to 1986 he worked as a registrar in general medicine at baragwanath hospital, Johannesburg. From 1986 to 1999 he was a trainee in internal medicine and subsequently an advanced trainee in geriatric medicine in New Zealand. In 1989 he graduated as a fellow of the Royal Australasian College of physicians in internal medicine and geriatric medicine. He was awarded his face (n.z) in 1990.
From 1989 to 1992 he worked as a consultant specialist physician and geriatrician at Tauranga Hospital, New Zealand. Between 1992 and 1997 he worked at the Netcare rehabilitation hospital and the Milpark Hospital as a specialist physician and geriatrician in general acute medicine, rehabilitation, assessment for the elderly, osteoporosis, and memory disorders. Since 1997 he has been a specialist in private practice in Rosebank, Johannesburg. His current special interests include the assessment and management of osteoporosis and metabolic bone disease and the assessment and management of memory disorders.
Dr Lipschitz has published widely in his fields of interest. He has participated as a principal investigator in more than 80 randomized clinical trials. He regularly participates as a keynote speaker at local and international conferences. Dr Lipschitz is an executive committee member and current vice-chairman of the National Osteoporosis Foundation of South Africa. He is also an executive committee member and current president of the South African Geriatrics Society.
Dr Lipschitz has published widely in his field of interest and has been a presenter at numerous conferences locally and internationally including keynote addresses. He regularly presents at postgraduate continuing medical education conferences. Dr Lipschitz has served as the principal investigator in over 90 clinical studies.
