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Code of Medical Ethics modernized for first time in 50 years


Physicians have just affirmed a comprehensive update of the nearly 170-year-old AMA Code of Medical Ethics, the conclusion of a meticulous project started eight years ago to ensure that this ethical guidance keeps pace with the demands of the changing world of medical practice.

The modernized Code, approved Monday during the 2016 AMA Annual Meeting, is the first comprehensive review of this foundational document in more than half a century. For this undertaking, the AMA Council on Ethical and Judicial Affairs reviewed each individual ethical opinion for clarity, timeliness, ongoing relevance in today’s health care environment and consistency across the Code.

“Contemporary medicine must remain moral medicine during the current rapid pace of change in health care delivery system, and just as it did during its founding, the AMA has responded to this challenge by again putting ethics on center stage,” AMA President Steven J. Stack, MD, said in a news release. “The comprehensive update to the Code’s ethics guidance keeps pace with emerging demands physicians face with new technologies, changing patient expectations and shifting health care priorities.”

One of the goals of the modernization was to make the Code simpler to navigate and related opinions easier to find so that physicians could more readily apply it in their daily practice of medicine. Changes made include:

  • Created a more intuitive chapter structure so that guidance is easy to find
  • Implemented a uniform format for opinions so that guidance is easy to read and apply
  • Consolidated guidance into a single, comprehensive statement on each topic
  • Harmonized guidance on related issues
  • Identified, updated and retired guidance that had become significantly outdated over time

The updated Code also includes a new preface to clarify the different levels of ethical obligation in the various ethical opinions.

For the past five years, the council has opened the review process to physicians across the medical profession, soliciting their feedback and making modifications accordingly. A key part of this process has been the council’s online discussion forum, where AMA members have provided feedback on incremental updates.

The council also held special open forums, reference committee hearings and other informal discussions to collect extensive feedback from physicians in various practice settings, locations and specialties.

The Code was one of the two principal orders of business at the first AMA meeting in 1847. Even as much has changed in medicine over the last 169 years, this founding document still is the basis of an explicit social contract between physicians and their patients. The first uniform code of ethics of its kind, the Code is regularly cited as the medical profession’s authoritative voice in legal opinions and in scholarly journals.

“The modernization project ensures that the Code of Medical Ethics will remain a useful and effective resource that physicians can continue to rely on, while remaining faithful to the virtues of fidelity, humanity, loyalty, tenderness, confidentiality and integrity enshrined in the original Code,” Dr. Stack said.

The updated Code will be available online shortly.