The Ethical Imperative of Equity in Oncology: Lessons Learned From 2020 and a Path Forward

Author:

Marron Jonathan M.123,Charlot Marjory45,Gaddy Jacquelyne4,Rosenberg Abby R.678

Affiliation:

1. Division of Pediatric Hematology/Oncology, Boston Children’s Hospital, Harvard Medical School, Boston, MA

2. Department of Pediatric Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA

3. Center for Bioethics, Harvard Medical School, Boston, MA

4. Division of Oncology, University of North Carolina School of Medicine, Chapel Hill, NC

5. University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC

6. Department of Pediatrics, Division of Hematology/Oncology, University of Washington School of Medicine, Seattle, WA

7. Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA

8. Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA

Abstract

The COVID-19 pandemic and the simultaneous increased focus on structural racism and racial/ethnic disparities across the United States have shed light on glaring inequities in U.S. health care, both in oncology and more generally. In this article, we describe how, through the lens of fundamental ethical principles, an ethical imperative exists for the oncology community to overcome these inequities in cancer care, research, and the oncology workforce. We first explain why this is an ethical imperative, centering the discussion on lessons learned during 2020. We continue by describing ongoing equity-focused efforts by ASCO and other related professional medical organizations. We end with a call to action—all members of the oncology community have an ethical responsibility to take steps to address inequities in their clinical and academic work—and with guidance to practicing oncologists looking to optimize equity in their research and clinical practice.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

General Medicine

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