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Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care

Burgeoning evidence over the last 25 years has identified myriad synthetic chemicals with the capacity to alter various aspects of hormone synthesis and action. These endocrine-disrupting chemicals (EDCs) have been linked to various diseases, including reproductive disorders, metabolic diseases, and...

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Autores principales: Genco, Matthew, Anderson-Shaw, Lisa, Sargis, Robert M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442273/
https://www.ncbi.nlm.nih.gov/pubmed/32614432
http://dx.doi.org/10.1210/clinem/dgaa358
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author Genco, Matthew
Anderson-Shaw, Lisa
Sargis, Robert M
author_facet Genco, Matthew
Anderson-Shaw, Lisa
Sargis, Robert M
author_sort Genco, Matthew
collection PubMed
description Burgeoning evidence over the last 25 years has identified myriad synthetic chemicals with the capacity to alter various aspects of hormone synthesis and action. These endocrine-disrupting chemicals (EDCs) have been linked to various diseases, including reproductive disorders, metabolic diseases, and developmental abnormalities, among others. Exposure to EDCs arises from industrial activity, use of personal and home care products, and consumption of contaminated food and water; however, the role of healthcare in exposing individuals to EDCs is grossly underappreciated. Indeed, through the use of medications as well as medical equipment and devices, healthcare providers are unknowing mediators of exposure to EDCs, chemicals that might not only promote disease but that may also antagonize the efficacy of treatments. The ethical implications of provider-dependent exposure are profound. A failure to disclose the endocrine-disrupting properties of medical interventions violates core principles of nonmaleficence, patient autonomy, and justice as well as the practice of informed consent. Furthermore, physicians’ lack of knowledge regarding EDCs in medical practice artificially skews risk–benefit calculations that are fundamental to informed medical decision-making. To combat this underappreciated ethical challenge, urgent action is required. Healthcare providers must be educated about endocrine disruption. Known EDCs, defined by endocrinologists, should be clearly labeled on all medical products, and all medication components and devices should be screened for endocrine-disrupting properties. Finally, communication strategies must be devised to empower patients with knowledge about these risks. Providing ethically competent care requires an open acknowledgment of endocrine risks imposed by the medical community that have heretofore been ignored.
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spelling pubmed-74422732020-08-26 Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care Genco, Matthew Anderson-Shaw, Lisa Sargis, Robert M J Clin Endocrinol Metab Online Only Articles Burgeoning evidence over the last 25 years has identified myriad synthetic chemicals with the capacity to alter various aspects of hormone synthesis and action. These endocrine-disrupting chemicals (EDCs) have been linked to various diseases, including reproductive disorders, metabolic diseases, and developmental abnormalities, among others. Exposure to EDCs arises from industrial activity, use of personal and home care products, and consumption of contaminated food and water; however, the role of healthcare in exposing individuals to EDCs is grossly underappreciated. Indeed, through the use of medications as well as medical equipment and devices, healthcare providers are unknowing mediators of exposure to EDCs, chemicals that might not only promote disease but that may also antagonize the efficacy of treatments. The ethical implications of provider-dependent exposure are profound. A failure to disclose the endocrine-disrupting properties of medical interventions violates core principles of nonmaleficence, patient autonomy, and justice as well as the practice of informed consent. Furthermore, physicians’ lack of knowledge regarding EDCs in medical practice artificially skews risk–benefit calculations that are fundamental to informed medical decision-making. To combat this underappreciated ethical challenge, urgent action is required. Healthcare providers must be educated about endocrine disruption. Known EDCs, defined by endocrinologists, should be clearly labeled on all medical products, and all medication components and devices should be screened for endocrine-disrupting properties. Finally, communication strategies must be devised to empower patients with knowledge about these risks. Providing ethically competent care requires an open acknowledgment of endocrine risks imposed by the medical community that have heretofore been ignored. Oxford University Press 2020-07-02 /pmc/articles/PMC7442273/ /pubmed/32614432 http://dx.doi.org/10.1210/clinem/dgaa358 Text en © Endocrine Society 2020. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Online Only Articles
Genco, Matthew
Anderson-Shaw, Lisa
Sargis, Robert M
Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care
title Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care
title_full Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care
title_fullStr Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care
title_full_unstemmed Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care
title_short Unwitting Accomplices: Endocrine Disruptors Confounding Clinical Care
title_sort unwitting accomplices: endocrine disruptors confounding clinical care
topic Online Only Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442273/
https://www.ncbi.nlm.nih.gov/pubmed/32614432
http://dx.doi.org/10.1210/clinem/dgaa358
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