Ethics training module helps clarify professional boundaries

Robert Nagler Miller , Contributing News Writer

A brain tumor patient is grateful to his neurosurgeon for saving his life. As a thank-you gift, he presents his physician with a rare first edition of a book he knows his physician will appreciate. Should his physician accept this gift?

At a holiday dinner with family, an elderly relative admits to his niece, an internist, that he has a persistent, debilitating cough he cannot shake off. He asks her to set aside a few minutes to examine him and prescribe some medication. What should the internist do?

A hospitalist is scrolling through social media on his down time and notices that one of his colleagues has written a blog in which she complains about her patients. Though she does not identify the patients by name, the hospitalist recognizes some of them through his colleague’s vivid descriptions and is concerned that others—including the patients themselves—may read these less-than-flattering portraits and see themselves exposed. How should he handle his concerns?

All of these questions—and more—are covered  in a new interactive educational module that spells out the ethical do’s and don’ts and covers those gray areas that can leave physicians with a sense of discomfort and lack of clarity.

The module, the most robust of its kind to be produced by the AMA’s Ethics Group, focuses on potential boundary violations in the following areas: treating yourself, colleagues and family members; relationships with patients outside of professional practice; and communicating with patients about political issues, soliciting and accepting gifts from them, and discussing patients on social media.

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The module analyzes relevant ethics guidance, presents various ethical dilemmas and then quizzes users on how best to respond. Follow-up answers are provided, along with in-depth explanations as to why, for example, a physician should not treat his 16-year-old niece for mononucleosis or ask patients for charitable donations.

The professional boundaries module, free to any AMA member, is worth one AMA PRA Category 1 Credit™. The Code of Medical Ethics is a living document, updated periodically to address the changing conditions of medicine. The new edition, adopted in June 2016, is the culmination of an eight-year project to comprehensively review, update and reorganize guidance to ensure that the Code remains timely and easy to use for physicians in teaching and in practice.