Ethics Opinions

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.

The organized medical staff performs essential hospital functions even though it may often consist primarily of independent practicing physicians who are not hospital employees. The core responsibilities of the organized medical staff are the promotion of patient safety and the quality of care.

The purpose of medical staff privileging is to improve the quality and efficiency of patient care in the hospital. Physicians who are involved in granting, denying, or terminating hospital privileges have an ethical responsibility to be guided by concern for the welfare and best interests of patients.

Physicians who engage in activities that involve the accreditation, approval, or certification of institutions, facilities, and programs that provide patient care or medical education or certify the attainment of specialized professional competence have the ethical responsibility to develop and apply standards that are relevant, fair, reasonable, nondiscriminatory, and patient-centered.

Opportunities must not be denied to any physician or medical trainee because of race, color, religion, creed, ethnic affiliation, national origin, gender or gender identity, sexual orientation, age, family status, or disability or for any other reason unrelated to character, competence, ethics, professional status, or professional activities.

Inequality of professional status in medicine among individuals based on gender can compromise patient care, undermine trust, and damage the working environment. Physician leaders in medical schools and medical institutions should advocate for increased leadership in medicine among individuals of underrepresented genders and equitable compensation for all physicians.