There is a severe lack of instruction during residency and fellowship regarding how to approach everyday ethical issues that arise in the allergists practice. In addition, there is a paucity of literature concerning the ethical issues that arise in caring for patients with allergy, especially food allergy. A review of the published literature was performed to demonstrate this issue.
A search was conducted using the following keywords: “ethics,” “bioethics,” “ethical,” “moral,” and “unethical;” and then paired with “food allergy,” “food intolerance,” and “food hypersensitivity.”
PubMed resulted 40 articles from 1972-2015. Of these, only 11 were manuscripts that focused on a discussion of ethical issues. This result reveals that ethical concerns regarding food allergy are not of paramount importance to the allergy community. Ethical concerns that do arise and that need to be addressed in the diagnosis and management of food allergy include: the appropriate use of testing for food allergy, the practicality and cost of oral food challenges, the uncertainty and lack of high quality evidence in food allergy, the cost of elimination or specialized diets, the prescribing of epinephrine for mild to moderate allergic reactions, health-related quality of life issues, the use of complementary medicine or unconventional methods for treating food allergy, access to food allergy research studies, and the promise of a “cure” for food allergy with OIT.
Certainly, a review that defines these ethical issues and how to address them can provide physicians who care for patients with food allergy tools to bring ethics to practice.