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.
Romantic or sexual interactions between physicians and patients that occur concurrently with the patient-physician relationship are unethical. A physician must terminate the patient-physician relationship before initiating a dating, romantic, or sexual relationship with a patient. Sexual or romantic relationships with former patients are unethical if the physician uses or exploits trust, knowledge, emotions, or influence derived from the previous professional relationship, or if a romantic relationship would foreseeably harm the individual.
Gifts to physicians from industry create conditions that carry the risk of subtly biasing—or being perceived to bias—professional judgment in the care of patients. To preserve the trust that is fundamental to the patient-physician relationship and public confidence in the profession, physicians should decline any gifts for which reciprocity is expected or implied.
To be ethically appropriate, word-of-mouth referrals must be voluntary on the part of current patients and should reflect honestly on the practice. Physicians must not offer financial incentives or other valuable incentives to current patients in exchange for recruitment of other patients.
Diagnostic imaging tests are sometimes marketed directly to consumers before they have been scientifically validated. Physicians should advocate for the conduct of appropriate trials aimed at determining the predictive power of diagnostic imaging tests and their sensitivity and specificity for target populations.
Health disparities across patient populations reflect deeply embedded, historically rooted socioeconomic and political dynamics. Physicians and health care institutions have a duty to serve as agents of change to address these structural barriers to optimal health for all.
Financial obstacles to medical care can directly affect patients’ well-being and may diminish physicians’ ability to use their knowledge and skills on patients’ behalf. Physicians should not be expected to risk the viability of their practices or compromise quality of care by routinely providing care without compensation. Patients should make reasonable efforts to meet their financial responsibilities or to discuss financial hardships with their physicians.
