Ethics Opinions

Physicians individually and collectively share the obligation to ensure that the care patients receive is safe, effective, patient centered, timely, efficient, and equitable.

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.

When physicians participate in developing and disseminating innovative practices, they act in accord with professional responsibilities to advance medical knowledge, improve quality of care, and promote the well-being of individual patients and the larger community.

Telehealth and telemedicine span a continuum of technologies; As in any mode of care, patients need to be able to trust that physicians will place patient welfare above other interests, provide competent care, provide the information patients need to make well-considered decisions about care, respect patient privacy and confidentiality, and take steps to ensure continuity of care.

Medical tourists may receive excellent care, but issues of safety and quality can arise: substandard surgical care, poor infection control, inadequate screening of blood products, and falsified or outdated medications can pose greater risks than patients would face at home; Medical tourism can leave home country physicians in problematic positions since patients may need follow-up when they return and records may be unavailable.

Surgical co-management refers to the practice of allotting specific responsibilities of patient care to designated clinicians. Such arrangements should be made only to ensure the highest quality of care.

Although often thought of primarily for terminally ill patients or those with chronic medical conditions, advance care planning is valuable for everyone, in order to ensure that their own values, goals, and preferences will inform care decisions when they cannot speak for themselves. Physicians should routinely engage their patients in advance care planning but should be sensitive to each patient’s individual situation and preferences when broaching this topic.

Physicians are not required to offer or to provide interventions that, in their best medical judgment, cannot reasonably be expected to yield the intended clinical benefit or achieve agreed-on goals for care. Respecting patient autonomy does not mean that patients should receive specific interventions simply because they (or their surrogates) request them.

Differences in treatment that are not directly related to differences in individual patients’ clinical needs or preferences constitute inappropriate variations in health care. Such variations may contribute to health outcomes that are considerably worse in marginalized populations. Physicians ethically are called on to provide the same quality of care to all patients without regard to medically irrelevant personal characteristics.

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.