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.
Successful medical care requires ongoing collaboration between patients and physicians. Their partnership requires both individuals to take an active role in the healing process.
Health promotion should be a collaborative, patient-centered process that promotes trust and recognizes patients’ self-directed roles and responsibilities in maintaining health. Effective elements of this process may include educating and motivating patients regarding healthy lifestyle, helping patients by assessing their needs, preferences, and readiness for change, and recommending appropriate preventive care measures.
As an ethical responsibility, competence encompasses more than medical knowledge and skill. It requires physicians to understand that as a practical matter in the care of actual patients, competence is fluid and dependent on context. Physicians at all stages of their professional lives need to be able to recognize when they are and when they are not able to provide appropriate care for patients.
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.
Medical training sometimes involves practicing procedures on newly deceased patients, including critical medical skills for which adequate educational alternatives are not available. Such training must balance protecting the interests of newly deceased patients, their families, society, and the profession with the need to educate health care providers.
When conflicts arise between medical students, resident physicians or fellows, and/or their supervisors, it is essential to ensure that disputes are resolved fairly. Retaliatory or punitive actions against those who raise complaints are unethical and are a legitimate cause for filing a grievance with the appropriate institutional committee.
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 should strive to further their medical education throughout their careers, to ensure that they serve patients to the best of their abilities and live up to professional standards of excellence. Participating in certified continuing medical education (CME) activities is critical to fulfilling this professional commitment to lifelong learning.
Financial or in-kind support from pharmaceutical, biotechnology, or medical device companies that have a direct interest in physicians’ recommendations creates conditions in which external interests could influence the availability or content of continuing medical education (CME). When possible, CME should be provided without such support or the participation of individuals who have financial interests in the educational subject matter.