Code of Medical Ethics Opinion 2.1.6
Patients are entitled to choose their own physicians, which includes being permitted to accept or refuse having an intervention performed by a substitute. A surgeon who allows a substitute to conduct a medical procedure on his or her patient without the patient’s knowledge or consent risks compromising the trust-based relationship of patient and physician.
When one or more other appropriately trained health care professionals will participate in performing a surgical intervention, the surgeon has an ethical responsibility to:
(a) Notify the patient (or surrogate if the patient lacks decision-making capacity) that others will participate, including whether they will do so under the physician’s personal supervision or not.
(b) Obtain the patient’s or surrogate’s informed consent for the intervention, in keeping with ethical and legal guidelines.
AMA Principles of Medical Ethics: I, II, IV, V