Ethics Opinions

Physicians who conduct research using stem cells obtained from any source must, at a minimum, adhere to institutional review board requirements, ensure that the research is carried out with appropriate oversight and monitoring, and ensure that the research is carried out with appropriate informed consent.

Physicians involved in research with human biological materials should disclose potential commercial applications to the tissue donor, obtain informed consent to use biological materials in research from the tissue donor, and share profits from the commercial use of human biological materials with the tissue donor.

Physicians who care for patients with serious, life-threatening illness for whom standard therapies have failed, are unlikely to be effective, or do not exist, should familiarize themselves with access to investigational therapies through the U.S. Food and Drug Administration’s “expanded access” program to be better able to engage in shared decision making with patients.

Routine universal screening of adult patients for HIV helps promote the welfare of individual patients, avoid injury to third parties, and protect public health. Nonetheless, physicians must continue to seek patients’ informed consent, including informed refusal of HIV testing.

Those who operate a vehicle when impaired by a medical condition pose threats to both public safety and their own well-being. In deciding whether or how to intervene when a patient’s medical condition may impair driving, physicians must balance dual responsibilities to promote the welfare and confidentiality of the individual patient and to protect public safety.

Due to their commitment to care for the sick and injured, individual physicians have an obligation to provide urgent medical care during disasters. However, physicians also have an obligation to evaluate the risks of providing care to individual patients in the present versus the need to be available to provide care in the future.

In the context of infectious disease, physicians’ public health responsibility may include the use of quarantine and isolation to reduce the transmission of disease and protect the health of the public. They also have an obligation to protect their own health. In such situations, these obligations may conflict with patients’ rights of self-determination and with physicians’ duty to advocate for the best interests of individual patients.

Differences in treatment that are not directly related to differences in individual patients’ clinical needs or preferences constitute inappropriate variations in health care. Such variations may contribute to health outcomes that are considerably worse in marginalized populations. Physicians ethically are called on to provide the same quality of care to all patients without regard to medically irrelevant personal characteristics.

Patients have a right to know their past and present medical status, including conditions that may have resulted from medical error. Open communication is fundamental to the trust that underlies the patient-physician relationship, and physicians have an obligation to deal honestly with patients at all times.

In the context of a highly transmissible disease that poses significant medical risk for vulnerable patients or colleagues, or threatens the availability of the health care workforce, and for which there is an available, safe, and effective vaccine, physicians have a responsibility to accept immunization absent a recognized medical contraindication or when a specific vaccine would pose a significant risk to the physician’s patients.