Recent discussions I had with a bioethicist and an attorney representing victims of the meningitis outbreak provided some insight. According to Gerald Schatz at the Center for Clinical Bioethics at Georgetown University Medical Center, disclosure is required when providing care beyond what one would typically consider "ordinary care" and/or when conditions are such that the provider has reason to believe there could be an adverse outcome. The recent public health disaster involving compounded injectable steroid indicates that it would be prudent to advise patients regarding the source of externally compounded preparations, to disclose that these are not FDA-approved, and to discuss the benefits and risks, including possible adverse effects.