AMA meeting: Delegates see boosting quality of care as duty

Meeting notes: Medical ethics

Issue: Breaches of electronic medical records security can compromise privacy and harm patients physically and emotionally. When such breaches occur, what responsibilities do physicians have toward their patients?
Proposed action: An ethical policy recommending that physicians promptly inform patients of any breach and the potential for harm, describe how the breach happened and what steps patients can take to minimize any adverse results. [Adopted]

Issue: Physician assistants and nurse practitioners are increasingly taking on ownership roles in practices such as retail health clinics. This gives rise to the ethically problematic situation where a doctor is hired to supervise the work of a midlevel practitioner who also owns the practice and is the physician's employer.
Proposed action: An ethical policy that acknowledges the conflicts inherent in such an arrangement. The opinion says physicians have a duty to always exercise their independent professional judgment in patients' best interest, even if it puts them at odds with their employers. [Adopted]

Issue: Some hospital patients with racial or other prejudices are hostile to the physicians assigned to care for them or refuse their treatment, but hospitals do not have uniform guidelines to address these situations.
Proposed action: Direct the AMA to work with other organizations to encourage hospitals and health systems to adopt policies allowing patients to change doctors and have mechanisms to address abusive patient behavior and ensure continuity of care for a patient who declines care from the attending physician. [Adopted]

Issue: So-called chimeric embryos -- created when human genetic material is introduced into a nonhuman embryo or transferred into an enucleated nonhuman egg, creating a hybrid -- are being explored as an alternative to stem cell research techniques that destroy human embryos.
Proposed action: The Council on Ethical and Judicial Affairs said there is a lack of policy or scientific and ethical consensus on chimeras, and the issue affects few physicians. The council proposed examining the issue as part of its review of opinions relating to medical genetics in the AMA Code of Medical Ethics. [Adopted]

Issue: Working with patients to plan in advance for end-of-life care situations is a legally complicated and ethically fraught area for doctors.
Proposed action: Direct the AMA to develop an educational session on advance care planning at an upcoming Annual or Interim Meeting and ask CEJA to update its ethical guidance on end-of-life issues. [Adopted]

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