Codes of ethics serve multiple purposes: as public declarations of the values to which members of a profession commit themselves; as codifications of the expectations about how those members will conduct themselves; and as a mechanism for holding individual professionals and their organizations accountable to stakeholders. The AMA Code of Medical Ethics articulates the values that ground the profession of medicine and sets out the expectations to which physicians should be held in their roles as healers, educators, scientists and leaders in health care organizations and institutions, without regard to specialty.
The Code provides a framework for trust between patients and their physicians, and between the profession as a whole and society. It offers practical guidance for physicians as they confront the challenges of day-to-day practice. Far more than a set of rules to be followed, the Code, through the Opinions of AMA’s Council on Ethical and Judicial Affairs, helps physicians think through what is at stake as they engage patients and work with colleagues to reach ethically sound decisions.
A living document at its inception, the Code framed its guidance as standards for ethical relationships, and corresponding reciprocal obligations, between physicians and their patients, between professional colleagues, and between the profession and society. Over time, the broad injunctions of the original Code gave way to guidance mapped to emerging dilemmas across a range of medical domains and specialties not imagined by its framers—genetics and reproductive medicine, managed care, organ transplantation, health information technologies, and others. Guidance evolved with those changes, informed as well by the charge of 20th century bioethics to recognize patients’ rights as moral agents to make health care decisions in keeping with their goals and values. Of note, a comprehensive update of the Code was completed in 2016.
Today, medicine—and the Code with it—is called to again look beyond clinical care and biomedical science to examine critically medicine’s relationships with society and to respond to the damage wrought by continuing injustice within and outside the profession. For the Code, the challenge going forward is to codify medicine’s ethical responsibility to join the work of unmaking the structures and policies that have so profoundly and adversely affected individuals and communities.