Physicians vote to exercise conscience in medical care


Physicians voted in favor of new policies during the 2014 AMA Interim Meeting in Dallas, focusing on physicians’ exercise of conscience and physician civil discourse.

Nearly 500 delegates voted to pass policy that supports high standards of civility and respect among physicians, stating that different beliefs, aspects of conscience and ethical views are essential to the improvement of medicine. 

Also adopted was policy outlined in a report by the AMA Council on Ethical and Judicial Affairs on physicians’ exercise of conscience. This policy supports giving physicians’ latitude to practice in accordance with their own well-considered, deeply held beliefs that are central to their self-identities. 

Physicians are expected to provide care in emergencies, honor patients’ decisions to refuse treatment, respect basic civil liberties and not discriminate against individuals. At the same time, policy also recognizes that physicians have an interest in maintaining personal integrity.

According to the new policy, to responsibly follow the dictates of conscience, physicians should:

  • Consider whether and how significantly an action will undermine the physician’s personal integrity, create emotional or moral distress for the physician, or compromise the physician’s ability to provide care for the individual and other patients.
  • Make clear that there are interventions or services the physician cannot in good conscience provide because they are contrary to the physician’s deeply held personal beliefs before entering into a patient-physician relationship. In particular, the physician should focus on interventions or services a patient might otherwise reasonably expect the practice to offer.
  • Take care that their actions do not discriminate against or unduly burden individual patients or patient populations and do not adversely affect patient or public trust.
  • Be mindful of the burden their actions may place on fellow health care professionals.
  • Uphold standards of informed consent and let the patient know about all relevant options for treatment, including options to which the physician morally objects.
  • In general, physicians should refer a patient to another physician to provide treatment the physician declines to offer. When a deeply held, well-considered personal belief leads a physician to also decline to refer, the physician should offer impartial guidance to patients about how to inform themselves regarding access to desired services.
  • Continue to provide other ongoing care for the patient or formally terminate the patient-physician relationship in keeping with ethical guidelines.