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Shaping Professionalism:

Medical Oaths and Codes of Ethics I


Prepared and presented by Marc Imhotep Cray, M.D.
Basic Medical Sciences and Clinical Knowledge (CK) Teacher

Marc Imhotep Cray, M.D.

Presentation Outline

History of medical oaths and codes Awareness and understanding of the AMAs Code of Medical Ethics
Relevancy of selected Code Opinions Strengthening professionalisms future

Marc Imhotep Cray, M.D.

Hippocratic Oath
I swear by Apollo the Physicianto keep according to my ability and judgment the following oath I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone
The Oath of Hippocrates of Kos, 5th Century BC

Marc Imhotep Cray, M.D.

Medical Oaths

Personal ethic of oaths Medicines moral mandate, the duty to care for the sick, is reflected in the conduct of physicians with good character Notion of binding covenant: If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

Marc Imhotep Cray, M.D.

Medical Codes

Professional ethics of codes Developed through a process of collaboration, consensus, and finally codification Notion of professional self-regulation

Marc Imhotep Cray, M.D.

AMAs Code of Medical Ethics


The Code is freely accessible

1847 Edition
Marc Imhotep Cray, M.D.

2001 Edition

AMAs Code of Medical Ethics

The Code first drafted by Drs. Bell and Hays was based on Percivals conceptions of professional ethics A living compendium of ethical guidelines for physicians that is continually revised and updated by the Council on Ethical and Judicial Affairs The Code is freely accessible

Marc Imhotep Cray, M.D.

Awareness of the Code

Routinely cited in legal cases and frequently referenced by judges, lawyers, legal scholars, and state licensing boards Ironically, physicians are generally unaware of the ethical guidance embodied in the Code Illustrative examples: - Capital punishment - Physician-assisted suicide

Marc Imhotep Cray, M.D.

Capital Punishment
Disallowed actions include (8) 1. Starting intravenous lines for lethal injection drug 2. Determining death during execution 3. Administering the lethal drug 4. Supervising personnel who give the lethal drug

Marc Imhotep Cray, M.D.

Capital Punishment (2)


Disallowed actions include: 5. Ordering lethal drugs for the prison pharmacy 6. Maintaining or inspecting lethal injection devices 7. Monitoring vital signs during execution 8. Selecting injection sites for lethal drugs
Marc Imhotep Cray, M.D.

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Physician Attitudes about Capital Punishment

80% indicated that at least 1 of the disallowed actions was acceptable


53% indicated that 5 or more were acceptable 34% approved all 8 disallowed actions

Marc Imhotep Cray, M.D.

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Physician-Assisted Suicide

Physician-assisted suicide is fundamentally incompatible with the role of physician as healer Instead, physicians must aggressively and compassionately respond to the needs of patients at the end of life

Marc Imhotep Cray, M.D.

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Physician Attitudes about Physician-Assisted Suicide


Of 658 physicians from a national sample: 44% favored legalization of PAS 34% opposed 22% unsure Of 315 physicians from AMAs HOD: 23% favored legalization of PAS 62% opposed 15% unsure
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Marc Imhotep Cray, M.D.

Reference Resources and Further Study


Bioethics Online Study Recourses NIH - Bioethics Resources University of Toronto - Joint Center for Bioethics World Medical Association - Medical Ethics Manual Virtual Mentor Video Education (drimhoteptv)

IVMS-MEDICAL ETHICS & PROFESSIONALISM 12 videos, 3 hrs. and 16 min. http://www.youtube.com/playlist?list=PL08E700EA3F8313EB

E-Textbook Medical Ethics Today: The BMAs handbook of ethics and law Books; 3 edition (January 30, 2012) Updates http://bma.org.uk/practical-support-at-work/ethics/medical-ethics-today Best Price $148.33 or Buy New $181.49

Marc Imhotep Cray, M.D.