Shaping Professionalism Medical Oaths and Codes of Ethics

Shaping Professionalism: Medical Oaths and Codes of Ethics [Insert Name of Presenter]

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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, 5 th 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