American College of Radiology

Article XIII Code of Ethics

The Code of Ethics of the American College of Radiology is intended to aid radiologists and radiation oncologists, individually and collectively, in maintaining a high level of ethical conduct. The code is not a set of laws but rather a framework by which radiologists may determine the propriety of conduct in their relationship with patients, with the public, with colleagues, and with members of allied professions.

Section 1
Principles of Ethics

The Principles of Ethics form the first part of the Code of Ethics of the American College of Radiology. They serve as goals of exemplary professional conduct for which members of the American College of Radiology should constantly strive.

1. The principal objective of the medical profession is to render service to people with full respect for human dignity and in the best interest of the patient. Radiologists and radiation oncologists should merit the confidence of patients entrusted to their care, rendering to each a full measure of service and commitment.
2. Radiologists and radiation oncologists should strive continually to improve their medical knowledge and skill and make these improvements available to their patients and colleagues.
3. Radiologists and radiation oncologists should at all times be aware of their limitations and be willing to seek consultations in clinical situations where appropriate. These limitations should be appropriately disclosed to patients and referring physicians.
4. The medical profession should safeguard the public and itself against physicians deficient in moral character or professional competence by reporting, to the appropriate body, without hesitation, perceived illegal or unethical conduct of members of the medical profession. Radiologists and radiation oncologists should uphold all laws, uphold the dignity and honor of the medical profession and accept its self-imposed discipline and deal honestly and fairly with patients and colleagues.
5. The honored ideals of the medical profession imply that responsibilities of radiologists and radiation oncologists extend to society in general as well as their patients. These responsibilities include the interest and participation of radiologists and radiation oncologists in activities which improve the health and well-being of the individual and the community.
6. Radiologists and radiation oncologists may not reveal confidences entrusted to them in the course of medical attendance, or deficiencies they may observe in the character of patients, unless they are required to do so by law or unless it becomes necessary to protect the welfare of the individual or of the community.
7. The decision to render a service by a radiologist or radiation oncologist is a matter of individual physician and patient choice governed by the best interest of the patient.
8. The traditional bond between radiologists and between radiation oncologists, particularly in their professional relationships with each other, is a powerful aid in the service of patients and should not be used for personal advantage.

Section 2
Rules of Ethics

The Rules of Ethics form the second part of the Code of Ethics of the American College of Radiology. They are mandatory and directive of specific minimal standards of professional conduct for all members of the American College of Radiology.

1. It is proper for a diagnostic radiologist to provide a consultative opinion on radiographs and other images regardless of their origin. A radiologist who regularly interprets radiographs and other images, should reasonably participate in quality assurance, utilization review and other matters of policy which affect the quality of patient care.
2. It is proper for a radiation oncologist to provide a consultative opinion in the management of cancer and other disorders treated with radiation. A radiation oncologist should regularly treat patients only in settings where the radiation oncologist reasonably participates in the quality of patient management, utilization review and matters of policy which affect the quality of patient care.
3. Prior to practicing in a hospital or other health care entity, a radiologist or radiation oncologist shall apply, and be accepted, as a member of that entity's medical staff in accordance with the medical staff's bylaws and in the same manner as all other physicians.
4. The practice of physicians referring patients to health care facilities in which they have a financial interest is not in the best interest of patients. Self-referral may improperly influence the professional judgments of those physicians referring patients to such facilities. When such an arrangement exists, radiologists and radiation oncologists may be in violation of these Rules of Ethics and should make efforts to restructure the ownership of the facility.
5. Radiologists and radiation oncologists shall relate to other members of the health care team with mutual respect and refrain from harassment or unfair discriminatory behavior.
6. Radiologists and radiation oncologists should have the right to enter into whatever lawful contractual arrangements with health care systems they deem desirable and necessary but they should seek to ensure that the system of healthcare delivery in which they practice does not unduly influence the selection and performance of appropriate available imaging studies or therapeutic procedures.
7. Radiologists and radiation oncologists should not enter into an agreement that prohibits the provision of medically necessary care or that requires care at below acceptable standards. Notwithstanding policies of a health plan, radiologists should advocate cost-effective appropriate studies or therapies that will benefit the patient, whose welfare is paramount.
8. Radiologists and radiation oncologists should clearly and adequately respond to inquiries by patients regarding fees and/or any financial incentive. A radiologist should not participate in a billing arrangement which misleads patients or third party payers concerning the fees charged by the radiologist. Radiologists shall not divide radiological fees either directly or by any subterfuge.
9. In providing expert medical testimony, radiologists and radiation oncologists should exercise extreme caution to ensure that the testimony provided is non-partisan, scientifically correct, and clinically accurate. The radiologist or radiation oncologist shall not accept compensation that is contingent upon the outcome of litigation.
10. Radiologic research must be performed with integrity and be honestly reported.
11. Radiologists and radiation oncologists should not claim as their intellectual property that which is not theirs. Plagiarism or the use of others' work without attribution is unethical.
12. Radiologists and radiation oncologists should not publicize themselves through any medium or forum of public communication in an untruthful, misleading, or deceptive manner.

Section 3
Disciplinary procedures for violation of rules of ethics

The Board of Chancellors of the College may censure, suspend or expel any fellow or member for due cause. Disciplinary proceedings shall be considered confidential. The levels of disciplinary action shall be defined as follows:

Censure: A censure shall be a written reprimand to the fellow or member from the Secretary of the College, with no loss of benefits of fellowship or membership. Such censure shall be made a part of the membership file of the fellow or member.

Suspension: A suspension shall cause the fellow or member to lose the benefits of fellowship or membership for a specific period of time as determined by the Board of Chancellors, after which the individual may be fully reinstated upon review by the Ethics Committee. Suspension shall be for such term as the Board of Chancellors determines is necessary to ensure modification of behavior.

Expulsion: Expulsion shall cause the fellow or member to be removed from the rolls of the College. An expelled fellow or member shall not be entitled to any of the benefits of fellowship or membership. The College shall not accept a reapplication for fellowship or membership from an expelled fellow or member until a prescribed period, as the Board shall determine, has elapsed from the date the individual was notified of the Board's action.

Grounds for Disciplinary Action: A fellow or member of the American College of Radiology may be disciplined for any one or more violations of Section 2 of the Code of Ethics (the Rules of Ethics) of the American College of Radiology. Additionally, a fellow or member may be disciplined for:
Limitations or restriction of any right associated with the practice of medicine by any state or Canadian province, including the revocation, suspension, and restriction of a medical license or the voluntary surrender of a license while under investigation;
Conviction of any felony;
Conviction of scientific fraud (see Rules of Ethics, Section 2, Number 10)

Disciplinary Process: A complaint that a fellow or member of the College has violated the Rules of Ethics may be filed with the chair of the Board of Chancellors or with the person or persons authorized to receive such complaints by the bylaws, rules or regulations of the state chapter to which such fellow or member belongs. The chair of the Board of Chancellors may refer any complaint filed to the appropriate state chapter, may initiate an investigation or may dismiss, with written justification, a complaint as non-meritorious.

Complaints or requests for disciplinary action against a fellow or member of the College shall be made in writing with reasonable specificity and shall be referred by the chair of the Board of Chancellors to the Chair of the Ethics Committee. The Ethics Committee shall investigate in accordance with such procedures as the Board may from time to time determine.

Written notice shall be sent to the fellow or member in question by registered or certified mail at least thirty (30) calendar days prior to a meeting of the Ethics Committee (a) stating the time and place of the meeting, (b) informing the fellow or member of the nature of the complaint which will be considered, (c) advising that the fellow or member may then and there appear in person and/or by legal or other representative and may submit such evidence as the fellow or member deems appropriate, and (d) advising the fellow or member in question that failure to cooperate reasonably with an ethics investigation is independent grounds for disciplinary action. A majority of the Ethics Committee shall determine that either disciplinary action or no disciplinary action shall be taken. It shall in writing notify the chair of the Board of Chancellors and the fellow or member of its decision.

A fellow or member against whom disciplinary action is taken either by a state chapter or upon the recommendation of the Ethics Committee may appeal the decision to the Judiciary Committee by mailing a written notice of appeal to the chair of the Board of Chancellors within thirty (30) days of the mailing of notice of the adverse decision to the fellow or member in question.

Before the Judiciary Committee shall hear an appeal, the Judiciary Committee shall, by registered or certified mail, notify the fellow or member in question not less than thirty (30) calendar days prior to a meeting of the Judiciary Committee that the fellow or member may then and there appear in person and/or by legal or other representative to present such argument as the fellow or member deems proper to show that the disciplinary action taken should be reversed.

If a majority of the members of the Judiciary Committee determines that the disciplinary action taken against a fellow or member is supported by the evidence and is the result of fair procedures, consistent with these Bylaws and, to the extent applicable, with the bylaws of the chapter, the Judiciary Committee shall affirm the disciplinary action. If a majority of the members of the Judiciary Committee does not so determine, the Judiciary Committee shall reverse the disciplinary action and may remand the matter as a whole or in part for further proceedings or may dismiss the matter in whole or in part.

Status during Disciplinary Proceedings: The status of a fellow or member shall be unaltered during the pendency of these disciplinary proceedings.