Ethics Opinions

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.

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.

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.

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.

In handling patient data, individual physicians should balance supporting and respecting patient privacy with upholding their ethical obligations to the betterment of public health. The use of data for the benefit of public health should be treated as a form of public good in which the standards and values of health care should follow the data and be upheld and maintained. Those with access to datasets have a duty to uphold the ethical values of health care in which the data were produced.

Donation of nonvital organs and tissue from living donors can increase the supply of organs available for transplantation, to the benefit of patients with end-stage organ failure. Enabling individuals to donate nonvital organs is in keeping with the goals of treating illness and relieving suffering so long as the benefits to both donor and recipient outweigh the risks to both.

Physicians have a responsibility to protect the confidentiality of minor patients, within certain limits. In some jurisdictions, the law permits unemancipated minors to request and receive confidential services relating to: contraception, pregnancy testing, prenatal care, delivery services and care to prevent, diagnose, or treat sexually transmitted disease, substance use disorders, or mental illness.

Respecting patient privacy is a fundamental expression of respect for patient autonomy and a prerequisite for trust. Patient privacy includes personal space (physical privacy), personal data (informational privacy), personal choices, including cultural and religious affiliations (decisional privacy), and personal relationships with family members and other intimates (associational privacy). Physicians must seek to protect patient privacy in all settings to the greatest extent possible.

When individuals who are not involved in providing care seek to observe patient-physician encounters, physicians should safeguard patient privacy by permitting such observers to be present only when the patient has explicitly agreed to the presence of the observer(s), the presence of the observer will not compromise care, and the observer has agreed to adhere to standards of medical privacy and confidentiality.

Audio or visual recording of patients can be a valuable tool for educating health care professionals, but physicians must balance educational goals with patient privacy and confidentiality. Physicians also have an obligation to ensure that content is accurate and complete and that the process and product of recording uphold standards of professional conduct.