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 should prescribe drugs, devices, and other treatments based solely on medical considerations, patient need, and reasonable expectations of effectiveness for the particular patient.
Direct-to-consumer advertising may raise awareness about diseases and treatment and may help inform patients about the availability of new diagnostic tests, drugs, treatments, and devices. However, direct-to-consumer advertising also carries the risk of creating unrealistic expectations for patients and conflicts of interest for physicians.
Diagnostic imaging tests are sometimes marketed directly to consumers before they have been scientifically validated. Physicians should advocate for the conduct of appropriate trials aimed at determining the predictive power of diagnostic imaging tests and their sensitivity and specificity for target populations.
Physicians should not refer patients to a health care facility that is outside their office practice and at which they do not directly provide care or services when they have a financial interest in that facility.
Physicians have an obligation to assist in the administration of justice. Physicians who testify as fact witnesses in legal claims involving a patient they have treated must hold the patient’s medical interests paramount.
Physicians have civic duties, but medical ethics do not require a physician to carry out civic duties that contradict fundamental principles of medical ethics, such as the duty to avoid doing harm. In limited circumstances, physicians can ethically participate in court-initiated medical treatments.
As a member of a profession dedicated to preserving life when there is hope of doing so, a physician must not participate in a legally authorized execution.
Questions about the propriety of physician participation in interrogations and in the development of interrogation strategies may be addressed by balancing obligations to individuals with obligations to protect third parties and the public. The further removed the physician is from direct involvement with a detainee, the more justifiable is a role serving the public interest. When physicians have reason to believe that interrogations are coercive, they must report their observations to the appropriate authorities.
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.
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.