American College of Physicians Releases 7th Edition of Ethics Manual

Ethical principles are discussed in an updated Ethics Manual, issued by the American College of Physicians (ACP) and published as a supplement to the Jan. 15 issue of the Annals of Internal Medicine.

Lois Snyder Sulmasy, J.D., from the ACP, and Thomas A. Bledsoe, M.D., from Brown Physicians Inc. in East Providence, Rhode Island, for the ACP Ethics, Professionalism and Human Rights Committee discuss emerging issues in medical ethics and revisit older issues to explore how existing principles extend to emerging concerns.

The authors note that current understanding of medical ethics is based on principles such as beneficence (the duty to promote good and act in the best interest of the patient) and nonmaleficence (the duty to do no harm). In addition is the duty to protect and foster a patient's free choice. The authors provide guidance on several issues, including initiating and discontinuing the patient-physician relationship, especially in the context of telemedicine; informed decision making and consent; decisions about reproduction; precision medicine, genetic testing, privacy, and confidentiality; and medical risks to physicians and patients. They also discuss the patient-physician relationship in the context of health care system catastrophes and in terms of complementary and integrative care use.

"Medicine poses challenging ethical dilemmas for patients, clinicians, and institutions," the authors write. "We hope that this Manual will help physicians -- whether they are clinicians, educators, or researchers -- and others to address these issues."

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