Code of medical ethics of the American Medical Association: current opinions with annotations

Preface

History

Guide to Use of Annotations

Principles of Medical Ethics

Preamble

Principles of Medical Ethics, with annotations

Principles of Medical Ethics I

Principles of Medical Ethics II

Principles of Medical Ethics III

Principles of Medical Ethics IV

Principles of Medical Ethics V

Principles of Medical Ethics VI

Principles of Medical Ethics VII

Principles of Medical Ethics VIII

Principles of Medical Ethics IX

1.0. Introduction

1.1. Terminology

1.2. The Relation of Law and Ethics

2.00. Opinions on Social Policy Issues

2.01. Abortion

2.015. Mandatory Parental Consent to Abortion

2.02. Physicians' Obligations in Preventing, Identifying, and Treating Violence and Abuse

2.03. Allocation of Limited Medical Resources

2.035. Futile Care

2.037. Medical Futility in End-of-Life Care

2.04. Artificial Insemination by Known Donor

2.05. Artificial Insemination by Anonymous Donor

2.055. Ethical Conduct in Assisted Reproductive Technology

2.06. Capital Punishment

2.065. Court-Initiated Medical Treatments in Criminal Cases

2.067. Torture

2.068. Physician Participation in Interrogation

2.07. Clinical Investigation

2.071. Subject Selection for Clinical Trials

2.075. The Use of Placebo Controls in Clinical Trials

2.076. Surgical "Placebo" Controls

2.077. Ethical Considerations in International Research

2.078. Guidelines to Prevent Malevolent Use of Biomedical Research

2.079. Safeguards in the Use of DNA Databanks in Genomic Research

2.08. Commercial Use of Human Tissue

2.09. Costs

2.095. The Provision of Adequate Health Care

2.10. Fetal Research Guidelines

2.105. Patenting Human Genes

2.11. Gene Therapy

2.12. Genetic Counseling

2.13. Genetic Engineering

2.131. Disclosure of Familial Risk in Genetic Testing

2.132. Genetic Testing by Employers

2.135. Insurance Companies and Genetic Information

2.136. Genetic Information and the Criminal Justice System

2.137. Ethical Issues in Carrier Screening of Genetic Disorders

2.138. Genetic Testing of Children

2.139. Multiplex Genetic Testing

2.14. In Vitro Fertilization

2.141. Frozen Pre-embryos

2.145. Pre-embryo Splitting

2.146. Research With Stem Cells

2.147. Cloning to Produce Children

2.15. Transplantation of Organs From Living Donors

2.151. Cadaveric Organ Donation: Encouraging the Study of Motivation

2.152. Solicitation of the Public for Directed Donation of Organs for Transplantation

2.155. Presumed Consent and Mandated Choice for Organs From Deceased Donors

2.157. Organ Donation After Cardiac Death

2.16. Organ Transplantation Guidelines

2.161. Medical Applications of Fetal Tissue Transplantation

2.162. Anencephalic Neonates as Organ Donors

2.165. Umbilical Cord Blood Banking

2.169. The Ethical Implications of Xenotransplantation

2.17. Quality of Life

2.18. Surrogate Mothers

2.19. Unnecessary Medical Services

2.191. Advance Care Planning

2.20. Withholding or Withdrawing Life-Sustaining Medical Treatment

2.201. Sedation to Unconsciousness in End-of-Life Care

2.21. Euthanasia

2.211. Physician-Assisted Suicide

2.215. Treatment Decisions for Seriously Ill Newborns

2.22. Do-Not-Resuscitate Orders I29

2.225. Optimal Use of Orders Not-to-Intervene and Advance Directives

2.23. HIV Testing

2.24. Impaired Drivers and Their Physicians

2.25. The Use of Quarantine and Isolation as Public Health Interventions

2.30. Information From Unethical Experiments

2.40. Radio-Frequency ID Devices in Humans

3.00. Opinions on Interprofessional Relations

3.01. Nonscientific Practitioners

3.02. Nurses

3.03. Allied Health Professionals

3.04. Referral of Patients

3.041. Chiropractic

3.05. Physician Employment by a Nonphysician Supervisee

3.06. Sports Medicine

3.08. Sexual Harassment and Exploitation Between Medical Supervisors and Trainees

3.09. Medical Students Performing Procedures on Fellow Students

4.00. Opinions on Hospital Relations

4.01. Admission Fee

4.02. Assessments, Compulsory

4.03. Billing for Housestaff and Student Services

4.04. Economic Incentives and Levels of Care

4.05. Organized Medical Staff

4.06. Physician-Hospital Contractual Relations

4.07. Staff Privileges

5.00. Opinions on Confidentiality, Advertising, and Communications Media Relations

5.01. Advertising and Managed Care Organizations

5.015. Direct-to-Consumer Advertisements of Prescription Drugs

5.02. Advertising and Publicity

5.025. Physician Advisory or Referral Services by Telecommunication

5.026. The Use of Electronic Mail

5.027. Use of Health-Related Online Sites

5.04. Communications Media: Standards of Professional Responsibility

5.045. Filming Patients in Health Care Settings

5.046. Filming Patients for .the Education of Health Professionals

5.05. Confidentiality

5.051. Confidentiality of Medical Information Postmortem

5.055. Confidential Care for Minors

5.059. Privacy in the Context of Health Care

5.0591. Patient Privacy and Outside Observers to the Clinical Encounter

5.06. Confidentiality: Attorney-Physician Relation

5.07. Confidentiality: Computers

5.075. Confidentiality: Disclosure of Records to Data Collection Companies

5.08. Confidentiality: Insurance Company Representative

5.09. Confidentiality: Industry-Employed Physicians and Independent Medical Examiners

5.10. A Physician's Role Following a Breach of Electronic Health Information

6.00. Opinions on Fees and Charges

6.01. Contingent Physician Fees

6.02. Fee Splitting

6.021. Financial Incentives to Patients for Referrals

6.03. Fee Splitting: Referrals to Health. Care Facilities

6.05. Fees for Medical Services

6.07. Insurance Form Completion Charges

6.08. Interest Charges and Finance Charges

6.09. Laboratory Bill

6.10. Services Provided by Multiple Physicians

6.11. Competition

6.12. Forgiveness or Waiver of Insurance Copayments

6.13. Professional Courtesy

7.00. Opinions on Physician Records

7.01. Records of Physicians: Availability of Information to Other Physicians

7.02. Records of Physicians: Information and Patients

7.025. Records of Physicians: Access by Nontreating Medical Staff

7.03. Records of Physicians Upon Retirement or Departure From a Group

7.04. Sale of a Medical Practice

7.05. Retention of Medical Records

8.00. Opinions on Practice Matters

8.01. Appointment Charges

8.02. Ethical Guidelines for Physicians in Administrative or Other Nonclinical Roles

8.021. Ethical Obligations of Medical Directots

8.03. Conflicts of Interest: Guidelines

8.031. Conflicts of Interest: Biomedical Research

8.0315. Managing Conflicts of Interest in the Conduct of Clinical Trials

8.0321. Physicians' Self-referral

8.04. Consultation

8.041. Second Opinions

8.043. Ethical Implications of Surgical Comanagement

8.045. Direct-to-Consumer Diagnostic Imaging Tests

8.047. Industry Representatives in Clinical Settings

8.05. Contractual Relationships

8.0501. Professionalism and Contractual Relations

8.051. Conflicts of Interest Under Capitation

8.052. Negotiating Discounts for Specialty Cate

8.053. Restrictions on Disclosure in Health Care Plan Contracts

8.054. Financial Incentives and the Practice of Medicine

8.055. Retainer Practices

8.056. Physician Pay-for-Performance Programs

8.06. Prescribing and Dispensing Drugs and Devices

8.061. Gifts to Physicians From Industry

8.062. Sale of Non-Health-Related Goods From Physicians' Offices

8.063. Sale of Health-Related Products From Physicians' Offices

8.07. Expedited Partner Therapy

8.08. Informed Consent

8.081. Surrogate Decision Making

8.082. Withholding Information From Patients

8.083. Placebo Use in Clinical Practice

8.085. Waiver of Informed Consent for Research in Emergency Situations

8.087. Medical Student Involvement in Patient Care

8.088. Resident Physicians' Involvement in Patient Care

8.09. Laboratory Services

8.095. Reporting Clinical Test Results: General Guidelines

8.10. Lien Laws

8.11. Neglect of Patient

8.115. Termination of the Physician-Patient Relationship

8.12. Patient Information

8.121. Ethical Responsibility to Study and Prevent Error and Harm

8.13. Managed Care

8.132. Referral of Patients: Disclosure of Limitations

8.135. Cost Containment Involving Prescription Drugs in Health Care Plans

8.14. Sexual Misconduct in the Practice of Medicine

8.145. Sexual or Romantic Relations Between Physicians and Key Third-Parties

8.15. Substance Abuse

8.16. Substitution of Surgeon Without Patient's Knowledge or Consent

8.17. Use of Restraints

8.18. Informing Families of a Patient's Death

8.181. Performing Procedures on the Newly Deceased for Training Purposes

8.19. Self-treatment or Treatment of Immediate Family Members

8.191. Peers as Patients

8.20. Invalid Medical Treatment

8.21. Use of Chaperones During Physical Exams

9.00. Opinions on Professional Rights and Responsibilities

9.1. Accreditation

9.011. Continuing Medical Education

9.0115. Financial Relationships With Industry in Continuing Medical Education

9.012. Physicians' Political Communications With Patients and Their Families

9.02. Restrictive Covenants and the Practice of Medicine

9.021. Covenants Not-to-Compete for Physicians-in-Training

9.025. Advocacy for Change in Law and Policy

9.03. Civil Rights and Professional Responsibility

9.0305. Physician Health and Wellness

9.031. Reporting Impaired, Incompetent, or Unethical Colleagues

9.032. Reporting Adverse Drug or Device Events

9.035. Gender Discrimination in the Medical Profession

9.037. Signing Bonuses to Attract Graduates of US Medical Schools

9.04. Discipline and Medicine

9.045. Physicians With Disruptive Behavior

9.05. Due Process

9.055. Disputes Between Medical Supervisors and Trainees

9.06. Free Choice

9.065. Caring for the Poor

9.0651. Financial Barriers to Health Care Access

9.0652. Physician Stewardship of Health Care Resources

9.067. Physician Obligation in Disaster Preparedness and Response

9.7. Medical Testimony

9.8. New Medical Procedures

9.9. Patent for Surgical or Diagnostic Instrument

9.095. The Use of Patents and Other Means to Limit Availability of Medical Procedures

9.10. Peer Review

9.11. Ethics Committees in Health Care Institutions

9.115. Ethics Consultations

9.12. Patient-Physician Relationship: Respect for Law and Human Rights

9.121. Racial and Ethnic Health Care Disparities

9.122. Gender Disparities in Health Care

9.123. Disrespect and Derogatory Conduct in the Patient-Physician Relationship

9.124. Professionalism in the Use of Social Media

9.13. Physicians and Infectious Diseases

9.131. HIV-infected Patients and Physicians

9.132. Health Care Fraud and Abuse

9.133. Routine Universal Immunization of Physicians for Vaccine-Preventable Diseases

9.14. Quality

9.141. Physician Responsibilities for Safe Patient Discharge from Health Care Facilities

10.00. Opinions on the Patient-Physician Relationship

10.1. Fundamental Elements of the Patient-Physician Relationship

10.15. The Patient-Physician Relationship

10.16. Pediatric Decision Making

10.17. Gifts From Patients

10.18. Physician Participation in Soliciting Contributions From Patients

10.2. Patient Responsibilities

10.3. Patient-Physician Relationship in the Context of Work-Related and Independent Medical Examinations

10.05. Potential Patients

Appendix

American Medical Association: Relevant Bylaws

Preface to the Rules of the Council on Ethical and Judicial Affairs

General Rules of the Council on Ethical and Judicial Affairs

Rules for Review of Membership

Rules of the Council on Ethical and Judicial Affairs in Original jurisdiction Cases

Table of Cases

Table of Articles

Index to Opinions