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.
Because health care is a fundamental human good, society has an obligation to make access to an adequate level of care available to all its members, regardless of ability to pay.
Physicians have a responsibility to contribute their expertise to developing resource allocation policies that are fair and that safeguard the welfare of patients.
Physicians individually and collectively have an ethical responsibility to ensure that all persons have access to needed care regardless of their economic means.
Physicians should hold leaders accountable to meeting conditions for professionalism in health care systems. This includes advocating for changes in health care payment and delivery models to promote access to high quality care for all patients, recognizing that over-reliance on financial incentives may undermine physician professionalism.
Under no circumstances may physicians place their own financial interests above the welfare of their patients. Treatment or hospitalization that is willfully excessive or inadequate constitutes unethical practice.
Physicians have an ethical obligation to put the welfare of patients ahead of other considerations, including personal financial interests. This obligation requires them to consider carefully the terms and conditions of contracts to deliver health care services before entering into such contracts, to ensure that those contracts do not create untenable conflicts of interest.
Competition among physicians is ethically justifiable when it is based on such factors as quality of services, skill, experience, conveniences offered to patients, fees, or credit terms.
Physicians have an obligation to inform patients about all appropriate treatment options, the risks and benefits of alternatives, and other information that may be pertinent, including the existence of payment models, financial incentives, formularies, guidelines, or other tools that influence treatment recommendations and care.
Physicians are free to enter into retainer contracts to provide special non-medical services and amenities with individual patients who are willing and able to pay for them. However, physicians must always uphold their primary professional obligation of fidelity and their responsibility to treat all patients with courtesy, to respect patients’ rights and dignity, and to ensure that all patients in their practice receive the same quality of medical care.
