Policy manual excerpt: Ethics
140.99 Advertising by Physicians: The LSMS opposes false, fraudulent, misleading, or deceptive statements or claims by physicians. Advertising or other publicity by physicians, medical group practices, or professional medical corporations, including participation in public functions, should not contain self-laudatory statements of claims regarding the quality of the services which cannot be readily measured or defined. A physician, medical group practice, or professional medical corporation should not compensate or give anything of value to representatives of the press, radio, television, or other communication medium in anticipation of or in return for professional publicity in a news item. A paid advertisement must be identified as such unless it is apparent from the context that it is a paid advertisement. (R9-84)
140.98 Conflicts of Interest—Physician Ownership of Medical Facilities: The LSMS adopts the following statement: Financial rewards to physicians for the referral of patients or for failing to refer patients for necessary medical services can have, at least, the appearance of impropriety and can undermine the public's confidence in the medical profession. Medical decisions made solely on the basis of financially benefiting the physician are improper. The overriding principle is that conflicts between the physician's financial interest and the patient's medical interest must always be resolved to the benefit of the patient. Where the conflict is so great that the patient's interest is not served, the physician must cede the care of the patient to another qualified physician. (R18-88, amended R101-98)
140.97 Physician Fee-Splitting: The LSMS affirms its ethical stand in opposition to fee splitting. (R8-85)
140.96 Patient Self-Determination Legislation: The LSMS supports the amendment of Act 832 of the 1984 Louisiana Legislature. The LSMS believes that the documentation of right-to-die information should be voluntary and used at the discretion of the physician. (R23-85)
140.95 Guidelines for Rendering a Second Opinion: The LSMS guidelines for physician conduct during the rendering of a second opinion are as follows:
(1) When a physician refers a patient for a second opinion, it is the ethical responsibility of the physician rendering the second opinion to refer the patient back to the primary physician.
(2) The physician selected by a patient for the purpose of obtaining a second opinion is not obligated to advise the patient's regular physician of the finding or recommendations.
(3) It is considered unethical for the physician rendering a second opinion to undermine the relationship between the regular physician for self-serving purposes. (R15-88, reaffirmed 1998)
140.94 Unethical Patient Solicitation: The LSMS opposes any financial payment by its members to any organization that procures, advertises, markets, or solicits medical or surgical consultations on a direct fee per patient basis. (R65-90)
140.93 Issues Concerning Terminally Ill Patients: The LSMS adopts the following guidelines as its policy in caring for the terminally ill.
(l) Patient autonomy requires that physicians must respect the decision of a patient who possesses decision-making capability to forego life-sustaining treatment. Physicians should encourage their patients to document their wishes regarding the use of life-prolonging medical treatment.
(2) Physicians have an obligation to relieve pain and suffering in the terminally ill patient.
(3) Physicians should never participate in the active administration of any agent for the purpose of terminating a patient's life, nor provide any medication, technique, or advice necessary for a patient to pursue a course of suicide, nor refer a patient to a physician who would. (R43-92)
140.92 Physician Self-Referral Policy: The LSMS endorses the recommendations of Conflicts of Interest: Physician Ownership of Medical Facilities, contained in Report C, December 1991, of the AMA Council on Ethical and Judicial Affairs. (R509-93)
140.91 AMA Commercial Endorsements: The LSMS opposes the practice of commercial product endorsement by the AMA. (R402-97)
PRINCIPLES OF MEDICAL ETHICS
The conduct of all members shall be governed by the following principles of medical ethics, as interpreted and applied by the Louisiana State Medical Society:
Preamble
These principles are intended to aid physicians individually and collectively in maintaining a high level of ethical conduct. They are not law but standards by which a physician may determine the propriety of his conduct in his relationship with patients, with colleagues, with members of allied professions, and with the public.
Principle I
The primary objective of the medical profession is to render service to humanity with full respect for the dignity of man. Physicians should merit the confidence of patients entrusted to their care, rendering to each a full measure of service and devotion.
Principle 2
Physicians should strive continually to improve their medical knowledge and skill, and should make available to their patients and colleagues the benefits of their professional attainments.
Principle 3
A physician should practice a method of healing founded on scientific basis, and he should not voluntarily associate professionally with anyone who violates this principle.
Principle 4
The medical profession should safeguard the public and itself against physicians deficient in moral character or professional competence. Physicians should observe all laws, uphold the dignity and honor of the profession, and accept its self-imposed disciplines. They should expose, without hesitation, illegal or unethical conduct of fellow members of the profession.
Principle 5
A physician may choose whom he will serve. In an emergency, however, he should render service to the best of his ability. Having undertaken the care of a patient, he may not neglect him; and unless he has been discharged he may discontinue his services only after giving adequate notice.
Principle 6
A physician should not dispose of his services under terms or conditions which tend to interfere with or impair the free and complete exercise of his medical judgment and skill or tend to cause deterioration of the quality of medical care.
Principle 7
In the practice of medicine a physician should limit the source of his professional income to medical services rendered by him, or under his supervision, to his patients. His fee should be commensurate with the services rendered and the patient's ability to pay. He should neither pay nor receive a commission for referral of patients. Drugs, remedies, or appliances may be dispensed or supplied by the physician provided it is in the best interest of the patient.
Principle 8
A physician should seek consultation upon request, in doubtful or difficult cases, or whenever it appears that the quality of medical service may be enhanced thereby.
Principle 9
A physician may not reveal the confidences entrusted to him in the course of medical attendance or the deficiencies he may observe in the character of patients, unless he is required to do so by law or unless it becomes necessary in order to protect the welfare of the individual or of the community.
Principle 10
The honored ideals of the medical profession imply that the responsibilities of the physician extend not only to the individual but also to society, where these responsibilities deserve his interest and participation in activities which have the purpose of improving both the health and well-being of the individual and the community.
Adopted by the House of Delegates on March 13, 1983
Content provided by: Ethics Standards