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. Whatever roles they may play in the system of health care delivery, when physicians 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.
When physicians take on obligations that compete with their fiduciary obligations to patients, those fiduciary obligations may ethically be tempered by the following considerations:
- The impact of the nonclinical role on the health of individuals and communities.
- The degree to which they are perceived to be acting as representatives of the medical profession.
- The extent to which they rely on their medical training or expertise to fulfill the nonclinical role.