Should hospitals have to disclose cancer treatment outcome disparities?

The journal PLoS Medicine offers an interesting online debate, "Should Informed Consent for Cancer Treatment Include a Discussion about Hospital Outcome Disparities?"

Studies have shown disparities in outcomes for cancer treatment from hospital to hospital. Research suggests it's another case of "the more you do, the better you are at it." Hospitals that treat more of a certain condition have better outcomes.

The journal debate tackles the important question of whether physicians have an ethical obligation to inform patients of hospital outcome disparities for cancer treatment.

One published opinion is that such disclosure "is essential to maintain trust and honesty in the physician–patient relationship. More importantly, it will protect the cancer patient's autonomy and sense of control, a value of paramount importance for a patient battling a potentially lethal disease."

But another author writes that these "arguments do support a responsibility on the part of surgeons and hospitals to track their own complication rates and disclose these data accurately and understandably in the consent process for procedures. Competent adult patients may then decide whether the benefits and risks are compatible with pursuing the procedure. However, the ethical responsibility of hospitals to discuss other institutions' outcomes is still indeterminate. Selection of treatment site is, at this point, best done as part of a dynamic decision-making process in which all aspects of treatment can be evaluated in the context of the patient's preferences, including the importance of local treatment, differences in outcomes, existing relationships with surgeons, and other intangible considerations."

In the background, I just keep thinking about the marketing of "consumer-driven health care" and I think, "Yeah, right, like this is ever going to happen - 'surgeons and hospitals tracking their own complication rates and disclosing these data accurately and understandably in the consent process for procedures.' "