Finally, on a personal level, the Code of Ethics states emergency physicians, as respected members of society, hold a responsibility to not commit crimes of moral turpitude, perhaps best defined as crimes that shock the public conscience as being inherently base, vile, or depraved, or contrary to the rules of morality and the duties owed to individuals or society in general.

The potential for ethical violations in personal and professional conduct in these areas is easily envisioned. Among these are violations of patient confidentiality, egregious clinical practices that put patients’ well-being at risk, discrimination in patient care, or felonious personal conduct. Fortunately, the quality of our ACEP members and the care that they provide has made such conduct exceedingly rare.

Ethical Obligations Surrounding Clinical Care

The Code of Ethics and related policy statements outline additional standards that emergency physicians should uphold when providing clinical care. Among these duties is maintaining patient confidentiality. In a world of smartphones, social media, immediate internet access, and recording devices in every pocket, the threats to confidentiality are significant. Physicians are still morally bound by the standards of the profession and legally bound by the Health Insurance Portability and Accountability Act (HIPAA) and other confidentiality statutes to maintain patient confidentiality. There are many circumstances where the recording (ie, images) of patient care may occur. Physicians may wish to record images from clinical encounters for later patient care, and electronic medical records have the capability to include images, from rashes to colonoscopies. In every circumstance, the patient or surrogate should give consent for the acquisition of images even where the benefits to the patient are clear. Physicians or hospitals may also wish to acquire such images for research, quality review, or education. Similar to a research protocol, patients or surrogates should consent after understanding how the images may be used and that such participation will not necessarily provide a direct personal benefit to the patient.

With the recent popularity of reality television, medical interactions may be recorded (ie, video) for entertainment or for-profit purposes. These recordings do not provide medical benefit to the patient. On the contrary, patients are often recorded in extremely vulnerable or private moments. Commercial recording of patients should only occur when the patient has the capacity to consent to the creation of the recording and, to avoid undue influence, should also require that the patient later consent to the use or dissemination of the recording.