Code of Ethics essential to meet professional and community expectations
DR CHRIS MOY, CHAIR, AMA ETHICS AND MEDICA LEGAL COMMITTEE
Doctors are granted a high level of professional autonomy and clinical independence because of the highly specialised knowledge and skills that we possess and upon which our patients and the health care system rely. But this autonomy and clinical independence are contingent on us maintaining high standards of practice, competency and conduct through an open and accountable process of profession-led regulation that meets both professional and community expectations.
An essential component of profession-led regulation is the development and maintenance of ethical codes of behaviour and standards of conduct. By articulating and promoting a body of ethical principles to guide doctors’ conduct in their relationships with patients, colleagues and society, the AMA’s Code of Ethics makes an integral contribution to setting and promoting high standards of ethical behaviour for doctors in Australia.
Although these principles may sometimes feel almost restrictive and burdensome in our daily work, it is their very existence, and our ability to care for patients while upholding them, which leads patients and the public to trust and respect doctors.
An essential feature of any Code of Ethics is that it is responsive to, and reflective of, the changing values and expectations of the community it serves. The AMA’s Code of Ethics has grown out of other similar ethical codes stretching back into history including the Hippocratic Oath and those from other cultures.
In 1964, the (then newly independent) Australian Medical Association published its first Code of Ethics. Since then, the Code has been formally updated 12 times, the most recent iteration being the Code of Ethics 2004. Editorially Revised 2006. Revised 2016.
The Code has transformed significantly since 1964, from a 25-page ‘statement of policy, definitions and rules’ to a (currently) seven-page framework of overarching ethical principles and guidance.
There are common themes inherent to every iteration of the Code, most importantly the commitment to the primacy of our patients. As highlighted in the AMA’s first Code of Ethics:
The Medical profession occupies a position of privilege in a society because of the understanding that a doctor’s calling is to serve humanity, and because members of the profession have built up a tradition of placing the needs of the patient before all else.
Over the last 50 years, the entire tone of the Code has shifted to recognise changing societal values and expectations regarding the relationship between doctors and patients – where doctors no longer make decisions on behalf of patients but where doctors and patients work together in partnership.
The contemporary versions of the Code are patient-centred, treating the relationship as a partnership where both doctors and patients have rights as well as responsibilities. The Code serves to guide doctors in supporting patients to be active in managing their own health care and make their own informed health care decisions.
The dynamic nature of the AMA’s Code of Ethics continues with the most recent update including new guidance on:
- close personal relationships;
- patients with impaired or limited decision-making capacity;
- patients’ family members, carers and significant others including support persons;
- working with colleagues, including on bullying and harassment;
- working with other health care professionals;
- supervising/mentoring; and
- health standards, quality and safety.
Significant amendments have also been made to existing sections on consent; conscientious objection; complaints; control of patient information; fees; professional boundaries; managing interests; stewardship; medico-legal responsibilities; and protecting others from harm.
Copies of the AMA Code of Ethics 2004. Editorially Revised 2006. Revised 2016 are available on the AMA’s website in PDF and brochure format at position-statement/code-ethics-2004-editorially-revis…. Brochures and A2 posters of the Code are available in hard copy from email@example.com.
 The Medical Board of Australia says that Good Medical Practice. A Code of Conduct for Australia, complements the Australian Medical Association Code of Ethics and is aligned with its values, and is also consistent with the Declaration of Geneva and the international code of medical ethics, issued by the World Medical Association.’
 Ethical issues that require greater policy consideration, prescription or guidance are now addressed in standalone position statements or policy resolutions.