Ethics Opinions

Some gifts are offered to physicians as an expression of gratitude or a reflection of the patient’s cultural tradition. Accepting these gifts can enhance the patient-physician relationship; Some patients offer gifts or cash to secure or influence care or to secure preferential treatment. Such gifts can undermine physicians’ obligation to provide services fairly to all patients.

Telehealth and telemedicine span a continuum of technologies; As in any mode of care, patients need to be able to trust that physicians will place patient welfare above other interests, provide competent care, provide the information patients need to make well-considered decisions about care, respect patient privacy and confidentiality, and take steps to ensure continuity of care.

Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.

A placebo is a substance provided to a patient that the physician believes has no specific pharmacological effect on the condition being treated. In the clinical setting, the use of a placebo without the patient’s knowledge may undermine trust, compromise the patient-physician relationship, and result in medical harm to the patient.

Electronic communication can raise special concerns about privacy and confidentiality, particularly when sensitive information is being conveyed. Physicians using electronic communication hold the same ethical responsibilities to patients as they do during other clinical encounters.

Social networks, and other forms of communication online create new challenges to the patient-physician relationship. Physicians and trainees have an ethical responsibility to weigh a number of considerations when maintaining a presence online: abiding by standards of patient privacy and confidentiality, maintaining appropriate professional boundaries and recognizing that actions online and content posted may negatively affect their reputations.

Informing a patient’s family that the patient has died, is a duty that is fundamental to the patient-physician relationship; In this process, physicians should give foremost attention to the family’s emotional needs and the integrity of the patient-physician relationship.

When physicians wish to express their personal political views to a patient or a patient’s family, the physician must be sensitive to the imbalance of power in the patient-physician relationship, as well as to the patient’s vulnerability and desire for privacy.

To sustain the trust that is the foundation of the patient-physician relationship and to reassure patients that their welfare is the physician’s primary priority, physicians who participate in fundraising should: refrain from directly soliciting contributions from their own patients, Protect patient privacy and confidentiality and be sensitive to the likelihood that they may be perceived to be acting in their professional role when participating in fundraising activities.

Physician-assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks. Instead of engaging in assisted suicide, physicians must respond to the needs of patients at the end of life.