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Chapter 10
Chapter 10

Interprofessional Relationships

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.

Professional working relationships

Even when they fulfill roles that do not involve directly providing care for patients in clinical settings, physicians are seen by patients and the public, as well as their colleagues and coworkers as professionals who have committed themselves to the values and norms of medicine.
Opinion 10.1

Ethics Guidance for Physicians in Nonclinical Roles

Whatever roles physicians may play in the system of health care delivery, when they use the knowledge and values they gained through medical training and practice in roles that affect the care and well-being of individual patients or groups of patients, they are functioning within the sphere of their profession.
Opinion 10.1.1

Ethical Obligations of Medical Directors

When physicians take on roles that require them to use their medical knowledge on behalf of third parties, physicians must uphold their core obligation to promote patients’ best interests.
Opinion 10.2

Physician Employment by a Nonphysician Supervisee

Physicians who are simultaneously employees and clinical supervisors of nonphysician practitioners must give precedence to their ethical obligation to act in the patient’s best interest and exercise independent professional judgment, even if that puts the physician at odds with the employer or supervisee.
Opinion 10.3

Peers as Patients

Physicians must recognize that providing medical care for a fellow professional can pose special challenges for objectivity, open exchange of information, privacy and confidentiality, and informed consent. Physicians have the same fundamental ethical obligations when treating peers as when treating any other patient.
Opinion 10.4

Nurses

Nurses hold a primary ethical obligation to promote patients’ well-being; while physicians have overall responsibility for the quality of care that patients receive, good nursing practice requires that nurses voice their concerns when, in the nurse’s professional judgment, a physician order is in error or is contrary to good medical practice. Physicians’ relationships with nurses should be based on mutual respect and trust.
Opinion 10.5

Allied Health Professionals

Although physicians have overall responsibility for the quality of care that patients receive, allied health professionals have training and expertise that complements physicians’. Allied health professionals share a common commitment to patient well-being. Physicians’ relationships with allied health professionals should be based on mutual respect and trust.
Opinion 10.6

Industry Representatives in Clinical Settings

Physicians have a responsibility to protect patient interests and thus have a corresponding obligation to exercise good professional judgment in inviting industry representatives into the clinical setting. Physicians should recognize that in this setting appropriately trained industry representatives function as consultants.
Opinion 10.7

Ethics Committees in Health Care Institutions

Ethics committees offer assistance in addressing ethical issues that arise in patient care and facilitate sound decision making that respects participants’ values, concerns, and interests. Ethics committees may also assist in ethics-related educational programming and policy development within their institutions.
Opinion 10.7.1

Ethics Consultations

The goal of ethics consultation is to support informed, deliberative decision making on the part of patients, families, physicians, and the health care team. By helping to clarify ethical issues and values, facilitating discussion, and providing expertise and educational resources, ethics consultants promote respect for the values, needs, and interests of all participants, especially when there is disagreement or uncertainty about treatment decisions.
Opinion 10.8

Collaborative Care

In health care, teams that collaborate effectively can enhance the quality of care for individual patients. Physicians are uniquely situated to serve as clinical team leaders to synthesize the diverse professional perspectives and recommendations of the team into an appropriate, coherent plan of care for the patients.