AMA Code of Ethics

The AMA Code of Ethics articulates and promotes a body of ethical principles
to guide doctors’ conduct in their relationships with patients, colleagues and society.

This Code has grown out of other similar ethical codes stretching back into
history with origins in the Hippocratic Oath.

Because of their special knowledge and expertise, doctors have a responsibility
to improve and maintain the health of their patients who, either in a vulnerable
state of illness or for the maintenance of their health, entrust themselves to
medical care.

The doctor-patient relationship is a partnership based on mutual respect and
collaboration. Within the partnership, both the doctor and the patient have
rights as well as responsibilities.

Changes in society, science and the law constantly raise new ethical
issues and may challenge existing ethical perspectives.

The AMA accepts the responsibility for setting the standards of ethical
behaviour expected of doctors.

1. The Doctor and the Patient

1.1 Patient Care

a. Consider first the well-being of your patient.

b. Treat your patient with compassion and respect.

c. Approach health care as a collaboration between doctor and patient

d. Practise the science and art of medicine to the best of your ability.

e. Continue lifelong self-education to improve your standard of medical care.

f. Maintain accurate contemporaneous clinical records.

g. Ensure that doctors and other health professionals upon whom you call to
assist in the care of your patients are appropriately qualified.

h. Make sure that you do not exploit your patient for any reason.

i. Avoid engaging in sexual activity with your patient.

j. Refrain from denying treatment to your patient because of a judgement
based on discrimination.

k. Respect your patient’s right to choose their doctor freely, to accept or
reject advice and to make their own decisions about treatment or procedures.

l. Maintain your patient’s confidentiality. Exceptions to this must be taken
very seriously. They may include where there is a serious risk to the patient
or another person, where required by law, where part of approved research,
or where there are overwhelming societal interests.

m. Upon request by your patient, make available to another doctor a report
of your findings and treatment.

n. Recognise that an established therapeutic relationship between doctor
 and patient must be respected.

o. Having initiated care in an emergency setting, continue to provide that
care until your services are no longer required.

p. When a personal moral judgement or religious belief alone prevents you
from recommending some form of therapy, inform your patient so that they
may seek care elsewhere.

q. Recognise that you may decline to enter into a therapeutic relationship
where an alternative health care provider is available, and the situation is
not an emergency one.

r. Recognise that you may decline to continue a therapeutic relationship.
Under such circumstances, you can discontinue the relationship only if an
alternative health care provider is available and the situation is not an
emergency one. You must inform your patient so that they may seek care
elsewhere.

s. Recognise your professional limitations and be prepared to refer as appropriate.

t. Place an appropriate value on your services when determining any fee.
Consider the time, skill, and experience involved in the performance of those
services together with any special circumstances.

u. Ensure that your patient is aware of your fees where possible. Encourage
open discussion of health care costs.

v. When referring your patient to institutions or services in which you have a
direct financial interest, provide full disclosure of such interest.

w. If you work in a practice or institution, place your professional duties and
responsibilities to your patients above the commercial interests of the owners
or others who work within these practices.

x. Ensure security of storage, access and utilisation of patient information.

y. Protect the right of doctors to prescribe, and any patient to receive, any new
treatment, the demonstrated safety and efficacy of which offer hope of saving
life, re-establishing health or alleviating suffering. In all such cases, fully inform
the patient about the treatment, including the new or unorthodox nature of the
treatment, where applicable.

1.2 Clinical Research

a. Accept responsibility to advance medical progress by participating in properly
developed research involving human participants.

b. Ensure that responsible human research committees appraise the scientific
merit and the ethical implications of the research.

c. Recognise that considerations relating to the well-being of individual participants
in research take precedence over the interests of science or society.

d. Make sure that all research participants or their agents are fully informed
and have consented to participate in the study. Refrain from using coercion
or unconscionable inducements as a means of obtaining consent.

e. Inform treating doctors of the involvement of their patients in any research
project, the nature of the project and its ethical basis.

f. Respect the participant's right to withdraw from a study at any time without
prejudice to medical treatment.

g. Make sure that the patient's decision not to participate in a study does not
compromise the doctor-patient relationship or appropriate treatment and care.

h. Ensure that research results are reviewed by an appropriate peer group
before public release.

1.3 Clinical Teaching

a. Honour your obligation to pass on your professional knowledge and skills to
colleagues and students.

b. Before embarking on any clinical teaching involving patients, ensure that patients
 are fully informed and have consented to participate.

c. Respect the patient’s right to refuse or withdraw from participating in clinical
teaching at any time without compromising the doctor-patient relationship or
appropriate treatment and care.

d. Avoid compromising patient care in any teaching exercise. Ensure that your
patient is managed according to the best-proven diagnostic and therapeutic
methods and that your patient’s comfort and dignity are maintained at all times.

e. Where relevant to clinical care, ensure that it is the treating doctor who imparts
feedback to the patient.

f. Refrain from exploiting students or colleagues under your supervision in any way.

1.4 The Dying Patient

a. Remember the obligation to preserve life, but, where death is deemed to be
imminent and where curative or life-prolonging treatment appears to be futile,
try to ensure that death occurs with dignity and comfort.

b. Respect the patient’s autonomy regarding the management of their medical
condition including the refusal of treatment.

c. Respect the right of a severely and terminally ill patient to receive treatment
for pain and suffering, even when such therapy may shorten a patient’s life.

d. Recognise the need for physical, psychological, emotional, and spiritual
support for the patient, the family and other carers not only during the life of
the patient, but also after their death.

1.5 Transplantation

a. Recognise that a potential donor is entitled to the same standard of care as
any other patient.

b. Inform the donor and family fully of the proposal to transplant organs, the
purpose and the risks of the procedure.

c. Exercise sensitivity and compassion when discussing the option to donate
organs with the potential donor and family.

d. Refrain from using coercion when obtaining consent to all organ donations.

e. Explain brain death to potential donor families. Similarly explain that continued
artificial organ support is necessary to enable subsequent organ transplantation.

f. Ensure that the determination of the death of any donor is made by doctors
who are neither involved with the transplant procedure nor caring for the
proposed recipient.

g. Recognise the important contribution donor families make in difficult
circumstances. Ensure that they are given the opportunity to receive
counselling and support.

2. The Doctor and the Profession

2.1 Professional Conduct

a. Build a professional reputation based on integrity and ability.

b. Recognise that your personal conduct may affect your reputation and that
of your profession.

c. Refrain from making comments which may needlessly damage the
reputation of a colleague.

d. Report suspected unethical or unprofessional conduct by a colleague
to the appropriate peer review body.

e. Where a patient alleges unethical or unprofessional conduct by another
doctor, respect the patient’s right to complain and assist them in resolving the issue.

f. Accept responsibility for your psychological and physical well-being as it
may affect your professional ability.

g. Keep yourself up to date on relevant medical knowledge, codes of practice
and legal responsibilities.

2.2 Advertising

a. Confine advertising of professional services to the presentation of information
reasonably needed by patients or colleagues to make an informed decision
about the availability and appropriateness of your medical services.

b. Make sure that any announcement or advertisement directed towards patients
or colleagues is demonstrably true in all respects. Advertising should not
bring the profession into disrepute.

c. Do not endorse therapeutic goods in public advertising.

d. Exercise caution in publicly endorsing non-therapeutic goods in public advertising.

e. Do not have any public association with products that clearly affect health adversely.

f. Ensure that any therapeutic or diagnostic advance is described and examined
through professional channels, and, if proven beneficial, is made available to
the profession at large.

2.3 Referral to Colleagues

a. Obtain the opinion of an appropriate colleague acceptable to your patient if
diagnosis or treatment is difficult or obscure, or in response to a reasonable
request by your patient.

b. When referring a patient, make available to your colleague, with the patient’s
knowledge and consent, all relevant information and indicate whether or not
they are to assume the continuing care of your patient during their illness.

c. When an opinion has been requested by a colleague, report in detail your
findings and recommendations to that doctor.

d. Should a consultant or specialist find a condition which requires referral of
the patient to a consultant in another field, only make the referral following
discussion with the patient’s general practitioner – except in an emergency
situation.

3. Professional Independence

a. In order to provide high quality healthcare, you must safeguard clinical
independence and professional integrity from increased demands from
society, third parties, individual patients and governments.

b. Protect clinical independence as it is essential when choosing the best
treatment for patients and defending their health needs against all who
would deny or restrict necessary care.

c. Refrain from entering into any contract with a colleague or organisation
which may conflict with professional integrity, clinical independence or
your primary obligation to the patient.

d. Recognise your right to refuse to carry out services which you consider
to be professionally unethical, against your moral convictions, imposed
on you for either administrative reasons or for financial gain or which
you consider are not in the best interest of the patient.

4. The Doctor and Society

a. Endeavour to improve the standards and quality of, and access to,
medical services in the community.

b. Accept a share of the profession’s responsibility to society in matters
relating to the health and safety of the public, health education and
legislation affecting the health of the community.

c. Use your special knowledge and skills to minimise wastage of resources,
but remember that your primary duty is to provide your patient with the
best available care.

d. Make available your special knowledge and skills to assist those
responsible for allocating healthcare resources.

e. Recognise your responsibility to give expert evidence to assist the
courts or tribunals.

f. When providing scientific information to the public, recognise a
responsibility to give the generally held opinions of the profession in
a form that is readily understood. When presenting any personal
opinion which is contrary to the generally held opinion of the profession,
indicate that this is the case.

g. Regardless of society’s attitudes, ensure that you do not countenance,
condone or participate in the practice of torture or other forms of cruel,
inhuman, or degrading procedures, whatever the offence of which the
victim of such procedures is suspected, accused or convicted.