AUSTRALIAN MEDICAL ASSOCIATION

CODE OF ETHICS

JULY 1992

Standards of Care

1. Practise the science and art of medicine to the best of your ability and within the limits of your expertise.
   
2. Continue self education to improve your personal standards of medical care.
   
3. Evaluate your patient completely and thoroughly.
   
4. Maintain accurate contemporaneous clinical records.
   
5. Ensure that doctors and other health professionals who assist in the care of your patient are properly qualified and fully competent to carry out the care.
   

Respect for Patients

1. Ensure that your professional conduct is above reproach.
   
2. Do not exploit your patient for sexual, emotional or financial reasons.
   
3. Treat your patient with compassion and respect for human dignity.
   

Responsibilities to Patients

1. Do not deny treatment to any patient on the basis of colour, race, religion, political beliefs or nature of illness.
   
2. Respect your patient's right to choose their doctor freely, to accept or reject advice and to make their own educated decisions about treatment or procedures.
   
3. To enable them to make decisions, educate your patient about the nature of any illness from which they are known to suffer, the probable causes and the available treatments, together with their likely benefits and risks.
   
4. In general, keep in confidence information derived from your patient, or from a colleague regarding your patient, and divulge it only with the patient's permission, except when a court demands.
   
5. Recommend only those diagnostic procedures which seem necessary to assist in the care of your patient and only that therapy which seems necessary for their well being.
   
6. Recommend to your patient that additional opinions and services be obtained when treatment is not within your expertise.
   
7. Upon request by your patient, make available to another doctor a report of your findings and treatment.
   
8. Continue to provide services for an acutely ill patient until your services are no longer required, or until the services of another suitable doctor have been obtained.
   
9. When a personal moral judgment or religious conscience alone prevents the recommendation of some form of therapy, inform your patient so that they may seek alternative care.
   
10. Recognise that an established relationship between doctor and patient has a value, which dictates that it should not be disturbed without compelling reasons.
    
11. Recognise that you may refuse to treat a patient only in non-emergency situations, where the patient is given adequate notice of this intention and alternative care is reasonably available. However, the first rule under "Responsibilities to Patients" cannot be overridden.
    
12. Be responsible in setting an appropriate value on your services, and consider the personal service rendered when determining any fee.
    
13. Where possible, ensure that your patient is aware of your fees. Be prepared to discuss fees with your patient.
    
14. Do not refer patients to institutions or services in which you have a financial interest without full disclosure of such interest.
    

Clinical Research

1. Where possible, accept a responsibility to further medical progress by participating in properly developed clinical research studies involving human subjects.
   
2. Before participating in such studies, ensure that a responsible independent committee appraises the scientific merit of the clinical research, and that an institutional ethics committee evaluates its ethical implications.
   
3. Recognise that the well being of subjects always takes precedence over the interests of science or society.
   
4. Obtain prior consent of all research subjects or their agents, but only after explaining the purpose of the clinical research and any reasonably foreseen health hazards.
   
5. Inform treating doctors of the involvement of their patients in any research project, the nature of the project and its ethical basis.
   
6. Recognise that subjects should be allowed to withdraw from a study at any time.
   
7. Do not allow a refusal to participate at any stage in a study to interfere with the doctor-patient relationship or to compromise appropriate treatment and care.
   
8. Protect the right of doctors to trial, and subjects to receive, any new drug or treatment which may offer reasonable hope of saving life, re-establishing health or alleviating suffering. In all such cases, fully inform subjects about the drug or treatment including the new or unorthodox nature of the treatment, where applicable.
   
9. Ensure that research results are communicated first through recognised scientific channels to enable an informed group within the profession to establish an opinion on the merits of the results and their balanced presentation to the public.
   

Clinical Teaching

1. Pass on your professional knowledge and skills to junior colleagues.
   
2. Before embarking on any clinical teaching involving patients, explain the nature of the teaching methods and obtain the patient's agreement.
   
3. Do not allow a refusal to participate in teaching to interfere with the doctor-patient relationship.
   
4. In any teaching exercise, ensure that your patient is treated by the best proven diagnostic and therapeutic methods and that your patient's comfort and dignity are maintained.
   

The Dying Patient

1. Always bear in mind the obligation of preserving life, but allow death to occur with dignity and comfort, where death is deemed to be inevitable and where curative treatment appears to be futile.
   

Transplantation

1. Accept that when brain death has occurred (defined as the irreversible cessation of all functioning of the entire brain, including brain stem, unless otherwise defined by statute), cellular life in the body may be supported if some parts of the body may be used to prolong life or to improve the health of other people.
   
2. Recognise the responsibility to provide to the donor or their relatives a full disclosure of the intent to transplant organs, the purpose of the procedure and, in the case of a living donor, the risks of the procedure.
   
3. Ensure that the determination of the time of death of any donor patient is made by doctors who are in no way concerned with the transplant procedure or associated with the proposed recipient in a way that may exert any influence upon decisions made.
   

THE DOCTOR AND THE PROFESSION

Professional Conduct

1. Build a professional reputation based on integrity and ability. Be aware that your personal conduct may affect your reputation and that of your profession.
   
2. Refrain from making comments which may needlessly damage the reputation of a colleague or cause anxiety to a patient.
   
3. Report to the appropriate body of peers any conduct by a colleague which may be considered unethical or unprofessional.
   
4. When interpreting scientific knowledge to the public, recognise a responsibility to give the generally held opinions of the profession.
   
5. When presenting any personal opinion which is contrary to the generally held opinion of the profession, indicate that this is the case.
   
6. Protect the right of doctors to prescribe, and any patient to receive, any new drug or treatment whose demonstrated safety and efficacy offer hope of saving life, re-establishing health or alleviating suffering. In all such cases, fully inform the patient about the drug or treatment including the new or unorthodox nature of the treatment, where applicable.
   
7. Accept a responsibility for your personal health, both mental and physical, as it affects your professional conduct and patient care.
   

Contracts

1. Do not offer a contract to a colleague or organisation unless it has terms and conditions equitable to both parties.
   
2. Do not enter into a contract with a colleague or organisation which may diminish the maintenance of professional integrity and independence.
   

Advertising

1. Do not advertise professional services or make professional announcements unless the chief purpose of the notice is to present information reasonably needed by any patient or colleague to make an informed decision about the appropriateness and availability of medical services.
   
2. Ensure that any announcement or advertisement directed towards patients or colleagues is demonstrably true in all respects, does not contain any testimonial or endorsement of clinical skills and is not likely to bring the profession into disrepute.
   
3. Avoid public endorsement of any particular non-medical commercial product.
   
4. Ensure that any new therapeutic or diagnostic method is described and examined through professional channels and the benefits, if proved, are made available to the profession at large.
   

Consultation

1. Obtain the opinion of an appropriate colleague acceptable to your patient if diagnosis or treatment is difficult or obscure, or if requested by your patient or their agent.
   
2. When requesting a consultation, make available to your colleague all relevant information and indicate whether they are to assume the continuing care of your patient during this illness.
   
3. When an opinion has been requested by a colleague, report in detail your findings and recommendations to the referring doctor.
   
4. Should a consultant or specialist find a condition which they believe requires referral of the patient to a specialist or consultant in another field, the referral should be performed by the patient's general practitioner, where possible.
   

THE DOCTOR AND SOCIETY

1. Strive to improve the standards of quality of medical services in the community.
   
2. Accept a share of the profession's responsibility to society in matters relating to the health and safety of the public, health education and legislation affecting the health or well being of the community.
   
3. As a member of society, use your special knowledge and skills to consider issues of resource allocation, but remember that your primary duty is to provide your patient with the best available care.
   
4. When a witness, recognise the responsibility to assist a court in arriving at a just decision. In all circumstance certify only that which has been personally verified.
   
5. Regardless of society's attitudes, do not countenance, condone or participate in the practice of torture or other forms of cruel, inhuman, or degrading procedures whatever the offence of which the victim of such procedures is suspected, accused, or convicted.