The AMA was founded in part to establish the first national code of medical ethics. Today the Code is widely recognized as authoritative ethics guidance for physicians through its Principles of Medical Ethics interpreted in Opinions of AMA’s Council on Ethical and Judicial Affairs that address the evolving challenges of contemporary practice.
Physicians have an ethical obligation to provide care in cases of medical emergency; Physicians must also uphold ethical responsibilities not to discriminate against prospective patients on the basis of personal or social characteristics that are not clinically relevant; Physicians are nevertheless not ethically required to accept all prospective patients.
Successful medical care requires ongoing collaboration between patients and physicians. Their partnership requires both individuals to take an active role in the healing process.
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.
Genetic testing of children implicates important concerns about the minor patient’s present and future autonomy and best interests. Decisions to test must balance multiple considerations, including: likely benefits, the risks of knowing genetic status, features unique to the condition(s) being tested for (such as age of onset), and the availability of effective preventive, therapeutic, or palliative interventions.
Therapeutic donor insemination using sperm from a woman’s partner or a third-party donor can enable a woman or couple who might not otherwise be able to do so to fulfill the important life choice of becoming a parent (or parents). However, the procedure also raises ethical considerations about safety for the woman and potential offspring, donor privacy, and the disposition of frozen semen, as well as the use of screening to select the sex of a resulting embryo.
Xenotransplantation, i.e., using organs or tissues from nonhuman animal species for transplantation into human patients, is a possible novel means of addressing the shortage of transplantable organs that can pose distinctive ethical challenges with respect to patient safety and public health.
Routine universal screening of adult patients for HIV helps promote the welfare of individual patients, avoid injury to third parties, and protect public health. Nonetheless, physicians must continue to seek patients’ informed consent, including informed refusal of HIV testing.
Due to their commitment to care for the sick and injured, individual physicians have an obligation to provide urgent medical care during disasters. However, physicians also have an obligation to evaluate the risks of providing care to individual patients in the present versus the need to be available to provide care in the future.
In the context of infectious disease, physicians’ public health responsibility may include the use of quarantine and isolation to reduce the transmission of disease and protect the health of the public. They also have an obligation to protect their own health. In such situations, these obligations may conflict with patients’ rights of self-determination and with physicians’ duty to advocate for the best interests of individual patients.
Differences in treatment that are not directly related to differences in individual patients’ clinical needs or preferences constitute inappropriate variations in health care. Such variations may contribute to health outcomes that are considerably worse in marginalized populations. Physicians ethically are called on to provide the same quality of care to all patients without regard to medically irrelevant personal characteristics.
