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.
When conflicts arise between medical students, resident physicians or fellows, and/or their supervisors, it is essential to ensure that disputes are resolved fairly. Retaliatory or punitive actions against those who raise complaints are unethical and are a legitimate cause for filing a grievance with the appropriate institutional committee.
Medical students who volunteer to act as “patients” are not seeking to benefit medically from the procedures being performed on them; their goal is to benefit from educational instruction, yet their right to make decisions about their own bodies remains. In the context of practicing clinical skills on fellow students, instructors should ensure that medical students’ privacy, autonomy, and sense of propriety are protected.
Physicians should strive to further their medical education throughout their careers, to ensure that they serve patients to the best of their abilities and live up to professional standards of excellence. Participating in certified continuing medical education (CME) activities is critical to fulfilling this professional commitment to lifelong learning.
Financial or in-kind support from pharmaceutical, biotechnology, or medical device companies that have a direct interest in physicians’ recommendations creates conditions in which external interests could influence the availability or content of continuing medical education (CME). When possible, CME should be provided without such support or the participation of individuals who have financial interests in the educational subject matter.
When physician health or wellness is compromised, so may be the safety and effectiveness of the medical care provided. To preserve the quality of their performance, physicians have a responsibility to maintain their health and wellness, broadly construed as preventing or treating acute or chronic diseases, including mental illness, disabilities, and occupational stress.
Physicians should strive to distinguish conditions that are permanently incompatible with the safe practice of medicine from those that are not and respond accordingly. Physicians should intervene with respect and compassion when a colleague is not able to practice safely. Physicians should also encourage the development of inclusive training standards that enable individuals with disabilities to enter the profession and have safe, successful careers as well as work to eliminate stigma within the profession regarding illness and disability.
Peer review is recognized and accepted as a means of promoting professionalism and maintaining trust. The peer review process is intended to balance physicians’ right to exercise medical judgment freely with the obligation to do so wisely and temperately.
The obligation to report incompetent or unethical conduct that may put patients at risk is recognized in both the ethical standards of the profession and in law, and physicians should be able to report such conduct without fear or loss of favor. Reporting a colleague who is incompetent or who engages in unethical behavior is intended not only to protect patients, but also to help ensure that colleagues receive appropriate assistance. Physicians must not submit false or malicious reports.
The obligation to address misconduct falls on both individual physicians and the profession as a whole. The goal of disciplinary review is both to protect patients and to help ensure that colleagues receive appropriate assistance from a physician health program or other service to enable them to practice safely and ethically. Disciplinary review must not be undertaken falsely or maliciously.
Physicians have a responsibility to address situations in which individual physicians behave disruptively, i.e., speak or act in ways that may negatively affect patient care, including conduct that interferes with the individual’s ability to work with other members of the health care team, or that of others to work with the physician.