Ethics Opinions

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.

Having contact with patients is essential for training medical students, and both patients and the public benefit from the integrated care that is provided by health care teams that include medical students. All physicians share an obligation to ensure that patients are aware that medical students may participate in their care and have the opportunity to decline care from students.

Residents and fellows have dual roles as trainees and caregivers; however, residents and fellows are physicians first and foremost and should always regard the interests of patients as paramount.

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.

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.