In 1997, the ACEP Board of Directors approved the Code of Ethics for Emergency Physicians, recognizing the unique nature of emergency care, the moral challenges of emergency practice, and the ethical obligations of emergency physicians. Since that time, the ACEP Ethics Committee has recommended and the Board of Directors has adopted a wide number of policy statements that describe further ethical positions that ACEP members should uphold. These statements cover a wide range of topics, including standards in personal conduct, interactions in patient care in the emergency department, and the role of emergency physicians in society. Together, the Code of Ethics and related policy compendium are a statement of the values and standards that ACEP supports, ACEP members endorse, and the organization puts forward to all stakeholders in emergency care.
To ensure that ACEP members, who agree to abide by the Code of Ethics and related policy statements when joining the organization, meet their ethical obligations, ACEP has developed a process by which members can request review of and potential action against other ACEP members for Code of Ethics violations. Over the past 15 years, all received complaints have alleged violations of ACEP’s policies on expert witness testimony. However, the ethical obligations of ACEP members also extend to other areas of personal and professional conduct. In this article, we describe the areas where ACEP members have ethical obligations and issues that may rise to the level of an alleged ethics violation resulting in review.
Ethical Obligations of Emergency Physicians in Personal and Professional Conduct
The Code of Ethics outlines ethical principles that all emergency physicians should uphold in their conduct with patients. The principle of beneficence defines a fundamental duty to serve the best interests of patients by treating disease, preventing injury, and minimizing pain and suffering. Emergency physicians also respect the principles of autonomy and beneficence by protecting the privacy of their patients and the confidentiality of their patients’ information, within constraints of the law. The principle of non-maleficence affirms an obligation to avoid doing harm to patients and directs emergency physicians to consider the potential for adverse consequences to patients when initiating diagnostic or treatment measures. The principle of autonomy most commonly manifests in emergency practice in the realm of informed consent and respect for refusal of interventions by patients after being presented information about the risks and benefits of treatment options.
Equally as important, the Code of Ethics outlines the obligation of emergency physicians to treat all patients in a just manner, with impartiality with regard to race, color, creed, gender, nationality, or other characteristics. As the primary health care providers of the ultimate health care safety net, emergency physicians regularly care for patients who lack regular access to medical care. Therefore, the ethical principle of justice and its application in emergency practice has a vital importance for emergency physicians and their care of patients.