Ethics And Bioethics

Laws must evolve to meet a changing environment. Hippocrates lived in ancient times and managed to write a code of ethics for physicians that is still recited today (the Hippocratic Oath). The AMA and the AAMA have codes of ethics for the modern physician and medical assistants. Both codes address human dignity, death, honesty, confidentiality, the responsibility of the physician to improve society, and the doctor-patient relationship as a sacred trust.

As you might imagine, the AMA’s Code of Medical Ethics is extremely detailed. It would be impossible to paraphrase even a small part of it; however, just because the code is lengthy, does not mean you are not responsible for being aware of its major tenets. The Council on Ethical and Judicial Affairs (CEJA) keeps this code, created in 1847, updated so that it remains relevant to current practices. A copy of the Code of Medical Ethics can be purchased online at the AMA website or you may also download a copy.

The Code of Medical Ethics is not to be confused with the Principles of Medical Ethics, which were adopted in June 2001. To summarize, the principles require that physicians:

  1. Provide quality care while upholding human rights
  2. Embody the highest level of professionalism and to expect the same of colleagues
  3. Adhere to the law
  4. Place a high importance on patients’ rights and the rights of others
  5. Continue to learn, study, and research so as to provide the best care
  6. Maintain the right to choose where and with whom to work (emergency situations excepted)
  7. Attempt to improve general public health
  8. Consider the care of the patient their most important task
  9. Promote medical care for every person

The AAMA has its own code of ethics. This, of course, relates specifically to the profession of medical assistants. In general, the medical assistants’ code of ethics requires that medical assistant pledge to:

  1. Provide quality service while preserving human dignity
  2. Adhere strictly to confidentiality laws except when it becomes legally or otherwise necessary to disseminate information
  3. Maintain honor and professionalism
  4. Continue to study and increase knowledge for the benefit of patients and coworkers
  5. Act at all times, even outside of work, to improve the health of the general public

From reading the codes of ethics, it should be obvious that ethical behavior and maintaining patient rights are of utmost importance in this field of health care. Anyone not willing or able to follow the law or to act in the best interest of the patient has no business becoming a medical assistant. As a rule, you should consider these codes carefully before entering this profession. Individuals develop personal ethics through personal experiences and influences that stimulate thoughts and opinions. Professional ethics are those that are outlined by professional organizations dictating how members should act. It is important to be able to separate personal and professional ethics and to remain objective, following the standards and codes outlined by your chosen profession.

In health care, there has been an explosion of new procedures and options. Many times, laws have not been written to cover the cutting-edge technology (bioethics). Health care providers must turn to using their own beliefs (ethics) to decide what is right or wrong. Many health care professions have written ethical codes of behavior to help their membership to decide how to handle tough decisions. Medical assistants have an ethical code on their accrediting body’s website.

Many ethical issues today are based on advances in science such as artificial insemination, transplantation, surrogacy, euthanasia, cloning, gene therapy, fetal tissue research, stem-cell research, abortion, harvesting of embryos, and in vitro fertilization. Many areas of health care have inconclusive answers to what is right or wrong. Each individual is allowed to refuse to participate in an activity that violates the individual’s values (conscience clause). The conscience clause should be documented in the employee’s record.

Recent societal changes, including the legalization of same-sex marriage and increased public conversation about transgender rights, have also raised awareness of the need to ensure equitable care to the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. Individuals in this population may experience health disparities for a multitude of reasons including but not limited to discrimination and limited access to health insurance. The medical assistant is responsible for expanding the personal knowledge to understand the challenges that these and other patients may experience and should be ready to effectively communicate about these challenges with patients and allied health professionals.