Medical codes of ethics have traditionally listed standards of behavior for physicians in their care of patients. The American Medical Association lists nine principles, all of which begin with, “A physician shall…”1 These are formal professional standards and obligations, all related to the agency of the physician.
In their book, “What Patients Teach, The Everyday Ethics of Health Care,” Churchill, Fanning and Schenk take a refreshing, contemporary look at the ethics of health care.2 They feel that all health care professionals, whether they are physicians, physician assistants, nurses or hospital chaplains, need to be more serious about being patient-centered. In this concept, the patient is center stage, with authority to shape an ethical code that is truly centered on the care of the patient. The patient’s moral authority is not just to refuse care or have the right to be treated with what is in his/her best interests. The real authority of the patient is having their framework of experience taken seriously. It is the healing interaction — the relationship — between patients and health care professionals that should frame the ethics of patient care.
How should we rethink the medical code of ethics?
Churchill et al are not suggesting that medical codes of ethics be completely taken apart. There is no question that we should do no harm and be dedicated to providing competent medical care. However, just as importantly, they argue that an ethical code needs to “incorporate the need for compassion, the reality of patients’ vulnerabilities, and the obligations to acquire relational skills and those traits of character that are most conducive to healing.”3
Consider the following as a pledge in a reconsidered code of ethics:
“I will see my patients as equal to myself in value and dignity, whose injuries and anxieties have made them supplicants for care. Understanding and responding to them is what gives my work meaning and makes me a professional.”4
What do you think?
1. American Medical Association. Code of Medical Ethics of the American Medical Association. Council on Ethical and Judicial Affairs. Current Opinions and Annotations. 2008-2009 Edition.
2. Churchill LR, Fanning JB, and Schenck D. What Patients Teach. The Everyday Ethics of Health Care. Oxford University Press. New York. 2013.
3. Ibid p. 153.
4. Ibid p. 152