Transcript AMA’s Code of Medical Ethics: A Practical Guide to Physicians

Shaping Professionalism:
Medical Oaths and Codes of Ethics
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Presentation Outline
• History of medical oaths and codes
• Awareness and understanding of the AMA’s
Code of Medical Ethics
• Relevancy of selected Code Opinions
• Strengthening professionalism’s future
Hippocratic Oath
“I swear by Apollo the Physician…to keep
according to my ability and judgment the
following oath”
“I will prescribe regimen for the good of my
patients according to my ability and my
judgment and never do harm to anyone”
The Oath of Hippocrates of Kos, 5th Century BC
Medical Oaths
• Personal ethic of oaths
• Medicine’s moral mandate, the duty to
care for the sick, is reflected in the
conduct of physicians with good character
• Notion of binding covenant:
“If I keep this oath faithfully, may I enjoy my
life and practice my art, respected by all men and
in all times; but if I swerve from it or violate it,
may the reverse be my lot.”
Medical Codes
• Professional ethics of codes
• Developed through a process of
collaboration, consensus, and finally
codification
• Notion of professional self-regulation
AMA’s Code of Medical Ethics
1847 Edition
2001 Edition
AMA’s Code of Medical Ethics
• The Code first drafted by Drs. Bell and
Hays was based on Percival’s conceptions
of professional ethics
• A “living” compendium of ethical
guidelines for physicians that is continually
revised and updated by the Council on
Ethical and Judicial Affairs
• The Code is freely accessible at:
www.ama-assn.org/ceja
Awareness of the Code
• Routinely cited in legal cases and frequently
referenced by judges, lawyers, legal scholars,
and state licensing boards
• Ironically, physicians are generally unaware
of the ethical guidance embodied in the Code
• Illustrative examples:
- Capital punishment
- Physician-assisted suicide
Capital Punishment
Disallowed actions include:
• Starting intravenous lines for lethal
injection drug
• Determining death during execution
• Administering the lethal drug
• Supervising personnel who give the
lethal drug
Capital Punishment
Disallowed actions include:
• Ordering lethal drugs for the prison
pharmacy
• Maintaining or inspecting lethal
injection devices
• Monitoring vital signs during execution
• Selecting injection sites for lethal drugs
Physician Attitudes about
Capital Punishment
• 80% indicated that at least 1 of the
disallowed actions was acceptable
• 53% indicated that 5 or more were
acceptable
• 34% approved all 8 disallowed actions
Physician-Assisted Suicide
• Physician-assisted suicide is
fundamentally incompatible with the
role of physician as healer
• Instead, physicians must aggressively
and compassionately respond to the
needs of patients at the end of life
Physician Attitudes about
Physician-Assisted Suicide
Of 658 physicians from a national sample:
• 44% favored legalization of PAS
• 34% opposed
• 22% unsure
Of 315 physicians from AMA’s HOD:
• 23% favored legalization of PAS
• 62% opposed
• 15% unsure