Ethics Opinions

At times health conditions may result in behavior that puts patients at risk of harming themselves. In such situations, it may be ethically justifiable for physicians to order the use of chemical or physical restraint to protect the patient.

Devices that transmit patient information wirelessly to remote receiving stations can offer convenience for both patients and physicians, enhance the efficiency and quality of care, and promote increased access to care, but also raise concerns about safety and the confidentiality of patient information.

Routine universal screening of adult patients for HIV helps promote the welfare of individual patients, avoid injury to third parties, and protect public health. Nonetheless, physicians must continue to seek patients’ informed consent, including informed refusal of HIV testing.

Expedited partner therapy seeks to increase the rate of treatment for partners of patients with sexually transmitted infections through patient-delivered therapy without the partner receiving a medical evaluation or professional prevention counseling. However, expedited partner therapy potentially abrogates the standard informed consent process, compromises continuity of care for patients’ partners, encroaches upon the privacy of patients and their partners, increases the possibility of harm by a medical or allergic reaction, leaves other diseases or complications undiagnosed, and may violate state practice laws.

In light of their obligation to promote the well-being of patients, physicians have an ethical obligation to take appropriate action to avert the harms caused by violence and abuse.

Short-term global health clinical encounters provide needed care to individual patients in under-resourced settings and address global health inequities. Physicians engaging in short-term global health clinical encounters have an ethical obligation to prioritize benefits for the host community and ensure quality care while maintaining awareness for cultural differences. Sponsors of short-term global health clinical encounters should ensure the provision of resources, that team members practice within the limits of their skills, and that a mechanism for meaningful data collection is in place.

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.

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 must recognize that providing medical care for a fellow professional can pose special challenges for objectivity, open exchange of information, privacy and confidentiality, and informed consent. Physicians have the same fundamental ethical obligations when treating peers as when treating any other patient.

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.