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NAVIGATING THE URBAN BIOETHICAL LANDSCAPE OF INCIDENTAL FINDINGS WITHIN RADIOLOGY: A LOOK AT DISPARITIES
Martinez, Carlos Martin
Martinez, Carlos Martin
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2025-05
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Urban Bioethics
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https://doi.org/10.34944/24ss-t953
Abstract
Within Diagnostic Radiology, incidental findings are those that are unexpectedly captured from imaging that are not part of the intended clinical question. They pose a significant ethical dilemma to both patients and healthcare providers in whether or not the finding should be disclosed and how to approach management. In reviewing the literature, the increasing prevalence of incidental findings can be attributed to a combination of increased low-value imaging, defensive medicine, and financial incentives. Guidelines and recommendations for imaging exist but are not clear or comprehensive. Differences in how physicians disproportionately image and communicate with patients from different backgrounds along with negative social determinants of health have created striking health inequities in how incidental findings are handled, with indeterminate pulmonary nodules as an example. In addressing these concerns, Diagnostic Radiology is attempting to provide more patient-centered care by working with communities through initiatives like mobile imaging services, subsidizing imaging, embracing diversity, and advocacy. Artificial intelligence and open notes at face value have the potential to complicate matters but can be leveraged to provide more equitable care if steered in that direction. Currently, incidental findings are a multifaceted issue stemming from the lack of clarity in management and patients being unable to access or afford the care they deserve. Research into incidental finding outcomes and cost-benefit analysis in management will benefit refining guidelines and recommendations. Steps are being taken in the right direction to reduce disparities but there is much left to do in ensuring patients can afford and access imaging services.
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