The CMA Code of Ethics and Professionalism (Code) is a document produced by the Canadian Medical Association. The Code articulates the ethical and professional commitments and responsibilities of the medical profession in Canada. [1]
The CMA Code of Ethics was first published in 1868, and as recently as 2015 was considered by the CMA to be "arguably the most important document produced by the CMA. It has a long and distinguished history of providing ethical guidance to Canada's physicians. Focus areas include decision-making, consent, privacy, confidentiality, research and physician responsibilities. The code is updated every 5-6 years and has a major revision approximately every 20 years. Changes must be approved by CMA General Council." [2]
On 15 October 1996, the CMA Board of Directors approved a document entitled Code of Ethics of the Canadian Medical Association, which contained a Preface, and 43 enumerated points in sections entitled: General Responsibilities; Responsibilities to the Patient; Responsibilities to Society; Responsibilities to the Profession; and Responsibilities to Oneself. [3]
The CMA Code of Ethics was updated in 2004. This document, which was in force at least until March 2015 was composed of four double-column pages and had 54 enumerated points in the section heads identified in 1996. [4]
In November 2017, the new Code document (with a slightly amended title) was in draft form and was noticed by both the Toronto Star and the Simcoe Times in the former's article on cyber-bullying problems at the Ontario Medical Association. [5]
In October 2018, the Code was in draft form. The political position taken by the government of Justin Trudeau to legalize physician assisted suicide in Canada was in question. In the view of some doctors, the withdrawal of the CMA from the World Medical Association (WMA) was due to a conflict over each body's vision of society. Because the CMA supported the legislative change while the WMA found the practice to be repugnant, the president of the CMA, Gigi Osler, manufactured a storm in a teacup in order to withdraw from the WMA. [6]
In December 2018, the Board of Directors issued the Code. [1]
In March 2019, the CPSNL adopted the CMA Code "in accordance with the College's By-Law 5: Code of Ethics". [7]
As of December 2018, the Code document is seven pages long and organized into three alphabetically itemized sections. Section C is by far the longest, and contains 44 numerically itemized paragraphs. [8]
Section A, entitled VIRTUES EXEMPLIFIED BY THE ETHICAL PHYSICIAN, is a statement concerned with five virtues that the medical profession should strive to embody: [8]
Section B, entitled FUNDAMENTAL COMMITMENTS OF THE MEDICAL PROFESSION, documents: [8]
Section C describes in subsections, [8]
and helpfully refers the reader to inter-relationship between: the Physician and him- or herself; the Physician and his or her colleagues; and the Physician and his or her society.
The Hippocratic Oath is an oath of ethics historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific ethical standards. The oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today. These include the principles of medical confidentiality and non-maleficence. As the seminal articulation of certain principles that continue to guide and inform medical practice, the ancient text is of more than historic and symbolic value. It is enshrined in the legal statutes of various jurisdictions, such that violations of the oath may carry criminal or other liability beyond the oath's symbolic nature.
The Declaration of Geneva was adopted by the General Assembly of the World Medical Association at Geneva in 1948, amended in 1968, 1983, 1994, editorially revised in 2005 and 2006 and amended in 2017.
Patient rights consist of enforceable duties that healthcare professionals and healthcare business persons owe to patients to provide them with certain services or benefits. When such services or benefits become rights instead of simply privileges, then a patient can expect to receive them and can expect the support of people who enforce organization policies or legal codes to intervene on the patient's behalf if the patient does not receive them. A patient's bill of rights is a list of guarantees for those receiving medical care. It may take the form of a law or a non-binding declaration. Typically a patient's bill of rights guarantees patients information, fair treatment, and autonomy over medical decisions, among other rights.
Ethical codes are adopted by organizations to assist members in understanding the difference between right and wrong and in applying that understanding to their decisions. An ethical code generally implies documents at three levels: codes of business ethics, codes of conduct for employees, and codes of professional practice.
Internal medicine, also known as general internal medicine in Commonwealth nations, is a medical specialty for medical doctors focused on the prevention, diagnosis, and treatment of internal diseases in adults. Medical practitioners of internal medicine are referred to as internists, or physicians in Commonwealth nations. Internists possess specialized skills in managing patients with undifferentiated or multi-system disease processes. They provide care to both hospitalized (inpatient) and ambulatory (outpatient) patients and often contribute significantly to teaching and research. Internists are qualified physicians who have undergone postgraduate training in internal medicine, and should not be confused with "interns", a term commonly used for a medical doctor who has obtained a medical degree but does not yet have a license to practice medicine unsupervised.
Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal. These four values are not ranked in order of importance or relevance and they all encompass values pertaining to medical ethics. However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation. Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.
The Canadian Medical Association is a national, voluntary association of physicians and medical learners that advocates on national health matters. Its primary mandate is to drive positive change in health care by advocating on key health issues facing doctors and their patients.
Professional ethics encompass the personal and corporate standards of behavior expected of professionals.
Professional responsibility is a set of duties within the concept of professional ethics for those who exercise a unique set of knowledge and skill as professionals.
Athletic training is an allied health care profession recognized by the American Medical Association (AMA) that "encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of emergent, acute, or chronic injuries and medical conditions." There are five areas of athletic training listed in the seventh edition (2015) of the Athletic Training Practice Analysis: injury and illness prevention and wellness promotion; examination, assessment, diagnosis; immediate and emergency care; therapeutic intervention; and healthcare administration and professional responsibility.
The World Medical Association (WMA) is an international and independent confederation of free professional medical associations representing physicians worldwide. WMA was formally established on September 18, 1947 and has grown to 116 national medical associations, as of 2022, with 1467 Associate Members, including Junior Doctors and medical students. and more than 10 million physicians. WMA is in official relations with the World Health Organization (WHO) and seeks close collaboration with the UN Special Rapporteur on the right to physical and mental health.
The Declaration of Helsinki is a set of ethical principles regarding human experimentation developed originally in 1964 for the medical community by the World Medical Association (WMA). It is widely regarded as the cornerstone document on human research ethics.
Engineering ethics is the field of system of moral principles that apply to the practice of engineering. The field examines and sets the obligations by engineers to society, to their clients, and to the profession. As a scholarly discipline, it is closely related to subjects such as the philosophy of science, the philosophy of engineering, and the ethics of technology.
Mark Kuczewski is an American philosopher and bioethicist who has been a key contributor to the New Professionalism movement in medicine and medical education. In general, interest in professionalism has been widespread in medicine probably owing to the increasing regulatory and economic pressures on the practice of medicine. Many physicians have sought to identify the focal meaning of what it is to be a doctor in an effort to revitalize the profession. Kuczewski has been among a group that includes Richard and Sylvia Creuss, John Coulehan, and Matthew Wynia who see medical professionalism as including a commitment to social justice. That is, while professionalism entails such things as etiquette, communication skills, and basic medical ethics, professions are also expected to be leaders in educating the public and in advocating for the health of the public. Such leadership requires an understanding of the factors that lead some patient populations to be underserved and a commitment to bringing about social change to ameliorate these problems. The New Professionalism movement in medicine is a revival of communitarian bioethics that focus on the kinds of people and society we wish to be rather than on particular ethical questions of right and wrong. This focus on the relationship between the professional and the community can have important implications for medical education and professional development. While not eschewing case analysis and problem solving, the emphasis on the development of the person has created a renewed interest in narrative methods and reflection. Kuczewski has been an outspoken critic of efforts in medical education to focus on quantitative measures of professionalism education. He has argued that in an effort to make professionalism education “objective,” many medical educators are equating professionalism with trivial but easily measured behaviors. Kuczewski’s interest in professionalism and social justice has led him to pursue ethical issues in the interactions between medicine and recent immigrant populations. He has brought his work in communitarian and casuistic methods to bear on questions such as medical repatriation, insurance for undocumented immigrants, and the eligibility of DREAMers to become practicing physicians. His scholarship and advocacy was the catalyst for the Loyola University Chicago Stritch School of Medicine becoming the first medical school in the United States to explicitly welcome applications from DREAMers with Deferred Action for Childhood Arrivals (DACA) status. Under Kuczewski’s direction, the Neiswanger Institute for Bioethics and Health Policy at Loyola University Chicago has become a leader in educational programming to promote the relationship between medical professionalism and social justice. The Neiswanger Institute has contributed elements to the Stritch curriculum that explore the relationship between the business of medicine and social justice. The Institute also has online master of arts and doctoral programs that incorporating public health and leadership training in order to help health care professionals across the United States to promote service to the underserved. Kuczewski was elected president of the American Society for Bioethics and Humanities and served a two-year term from 2009 to 2011. The ASBH is the major professional association in the United States for individuals engaged in bioethics and medical humanities. During his term, the society aggressively began moving toward a process called Quality Attestation that will attest to the credentials and expected competence of clinical ethics consultants.
Fee splitting is the practice of sharing fees with professional colleagues, such as physicians or lawyers, in return for being sent referrals.
Veterinary ethics is a system of moral principles that apply values and judgments to the practice of veterinary medicine. As a scholarly discipline, veterinary ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. Veterinary ethics combines veterinary professional ethics and the subject of animal ethics. The subject of veterinary ethics can be interpreted as an extension of critical thinking skills necessary to make the decisions in veterinary care in order to support the profession's responsibilities to animal kind and mankind. Five main topics construct the physical usage of Veterinary Ethics. The first is history which describes how these ethics came to be, and how they have changed in the modernization of the veterinary industry. The second is the relation veterinary ethics has with human medical ethics, which together share many values. Third, the principles of these ethics which are updated regularly by the AVMA. Fourth are the key topics of veterinary ethics, which describe what these ethics cover. Last, how these ethics are incorporated into everyday practice and also how they affect those employed in the industry.
Various organizations of practicing chiropractors have outlined formal codes of professional ethics. Actual practice has revealed a wide range of behaviors which may or may not conform to these standards.
The American Psychological Association (APA) Ethical Principles of Psychologists and Code of Conduct includes an introduction, preamble, a list of five aspirational principles and a list of ten enforceable standards that psychologists use to guide ethical decisions in practice, research, and education. The principles and standards are written, revised, and enforced by the APA. The code of conduct is applicable to psychologists in a variety of areas across a variety of contexts. In the event of a violation of the code of conduct, the APA may take action ranging from termination of the APA membership to the loss of licensure, depending on the violation. Other professional organizations and licensing boards may adopt and enforce the code.
The College of Physicians and Surgeons of British Columbia is a regulatory college which regulates the practice of medicine in British Columbia. The primary function of the college is to ensure that physicians are qualified, competent and fit to practise medicine. The college administers processes for responding to complaints from patients and for taking action if a physician is practising in a manner that is incompetent, unethical or illegal.
Many health organizations around the world have denounced and criticized sexual orientation and gender identity change efforts. National health organizations in the United States have announced that there has been no scientific demonstration of conversion therapy's efficacy in the last forty years. They find that conversion therapy is ineffective, risky and can be harmful. Anecdotal claims of cures are counterbalanced by assertions of harm, and the American Psychiatric Association, for example, cautions ethical practitioners under the Hippocratic oath to do no harm and to refrain from attempts at conversion therapy.