American College of Physicians: Internal Medicine — Doctors for Adults ®

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New Ethics Manual expands focus on managed care, other issues

From the December 1997 ACP Observer, copyright 1997 by the American College of Physicians.

  • Previously published ethics case studies are available online.
  • For additional ethics resources, visit the College's Center for Ethics and Professionalism

After an extensive review process, ACP's fourth and newest edition of the Ethics Manual received final approval from the Board of Regents on Oct. 26.

The most significant changes to the Ethics Manual include new sections on genetic testing, managed care ethics, organ donation, disability certification and a new appendix. The manual also reflects the current ethical tensions faced by practitioners, whether they arise from technological developments, market forces or the public's growing involvement in health care.

In revising the manual, ACP's Ethics and Human Rights Committee recognized that physicians are called upon to develop the skills necessary for genetic testing, patient education and counseling, and to better familiarize themselves with principles of palliative care. The new manual provides physicians with guidance on how to interact with patients who turn to alternative medicine in seeking treatment, and how to fulfill their obligation towards disability certification.

A new section in the manual, "The Changing Practice Environment," emphasizes that quality care supercedes finances, and calls on all parties to be involved at various levels of policy and decision-making. The manual also reminds physicians of their collective obligation to provide care to all in need.

In addition, the manual's new appendix outlines a method that physicians can use to analyze ethical issues. Using the example of an AIDS patient, the Ethics Manual illustrates how physicians can approach ethical issues when providing care. "This is something physicians may or may not know intuitively," said Lois Snyder, JD, the College's Counsel for Ethics and Legal Affairs. "But like everything else, there is a method they can use for reaching ethical decisions."

"We effectively cover the main issues of an ethical nature that physicians will be confronting," said Lloyd W. Kitchens Jr., FACP, an ACP Regent and Chair of the Ethics and Human Rights Committee. "We have tried to address the changes that have come along in medicine with new ethics statements to guide members."

The Manual is expected to be published in the Annals of Internal Medicine in early 1998.

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