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.
Physicians’ fiduciary obligation to promote patients’ best interests and welfare can include consulting other physicians for advice in the care of the patient or referring patients to other professionals to provide care.
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.
Physicians should strive to distinguish conditions that are permanently incompatible with the safe practice of medicine from those that are not and respond accordingly. Physicians should intervene with respect and compassion when a colleague is not able to practice safely. Physicians should also encourage the development of inclusive training standards that enable individuals with disabilities to enter the profession and have safe, successful careers as well as work to eliminate stigma within the profession regarding illness and disability.
Peer review is recognized and accepted as a means of promoting professionalism and maintaining trust. The peer review process is intended to balance physicians’ right to exercise medical judgment freely with the obligation to do so wisely and temperately.
The obligation to report incompetent or unethical conduct that may put patients at risk is recognized in both the ethical standards of the profession and in law, and physicians should be able to report such conduct without fear or loss of favor. Reporting a colleague who is incompetent or who engages in unethical behavior is intended not only to protect patients, but also to help ensure that colleagues receive appropriate assistance. Physicians must not submit false or malicious reports.
The obligation to address misconduct falls on both individual physicians and the profession as a whole. The goal of disciplinary review is both to protect patients and to help ensure that colleagues receive appropriate assistance from a physician health program or other service to enable them to practice safely and ethically. Disciplinary review must not be undertaken falsely or maliciously.
Physicians have a responsibility to address situations in which individual physicians behave disruptively, i.e., speak or act in ways that may negatively affect patient care, including conduct that interferes with the individual’s ability to work with other members of the health care team, or that of others to work with the physician.
Physicians who are simultaneously employees and clinical supervisors of nonphysician practitioners must give precedence to their ethical obligation to act in the patient’s best interest and exercise independent professional judgment, even if that puts the physician at odds with the employer or supervisee.
Nurses hold a primary ethical obligation to promote patients’ well-being; while physicians have overall responsibility for the quality of care that patients receive, good nursing practice requires that nurses voice their concerns when, in the nurse’s professional judgment, a physician order is in error or is contrary to good medical practice. Physicians’ relationships with nurses should be based on mutual respect and trust.
Although physicians have overall responsibility for the quality of care that patients receive, allied health professionals have training and expertise that complements physicians’. Allied health professionals share a common commitment to patient well-being. Physicians’ relationships with allied health professionals should be based on mutual respect and trust.