Chapters

Building relationships of trust with patients is fundamental to ethical practice in medicine.

To enable patients to participate meaningfully in decisions about health care, physicians have a responsibility to provide information and help patients understand their medical condition and options for treatment.

Protecting information gathered in association with the care of the patient is a core value in health care.

Ongoing progress in genetic technologies opens new prospects for understanding and treating disease, while advances in reproductive technologies offer opportunities to create families in novel ways — posing challenges for patients, families, physicians and society.

Caring for patients at the end of life is a privilege that draws deeply on physicians’ commitment to alleviate suffering. Physicians must help patients identify what matters most to them when cure is no longer possible and to negotiate difficult decisions about what trade-off to accept between quality and quantity of life, what interventions to accept, and when to refuse efforts to sustain life.

Transplantation offers a last hope for patients whose organs are failing. But the promise of transplantation is tempered by chronic shortage of suitable organs and ongoing challenges of fairly distributing these severely limited resources, ensuring informed consent on the part of both organ donors and organ recipients, and avoiding conflicts of interest.

Physicians who are involved in clinical research have special responsibilities as investigators to protect the rights, safety and welfare of research participants that include matters of study design, informed consent and selection of participants.

Although physicians' primary ethical obligation is to individual patients, they also have a responsibility to protect and promote public health.

Society permits medicine to set standards of ethical and professional conduct for physicians. In return, medicine is expected to hold physicians accountable for meeting those standards and to address lapses in professional conduct when they occur.

Physicians are expected to uphold professional standards of conduct not only in their relationships with patients, but also in their relationships with other health care professionals.

In today's health care, patient-physician relationships are influenced by changing payment systems and models for delivering care and thus physicians must find new ways to balance responsibilities to multiple stakeholders.