Internists Remind Physicians About Universal Ethical Principles

Not sure how I missed this last week, but I was in the hospital all week putting a lot of hours and things were bound to slip by. Regardless, I did miss it, and thank RCentor at db's Medical Rants for posting it for all to see.

Last week the American College of Physicians (ACP), which represents 130,000 internal medicine physicians and students, released a statement speaking to the lapse of judgement demonstrated by the FP doc's in Wisconsin. The fact that this was addressed to the members of the ACP and not to the American Board of Family Practitioners does little to take the sting out of the blow. On February 28 the ACP "reminded physicians that professional ethics does not allow for them to sign off on false "sick notes" to excuse patients to engage in political advocacy purposes." This may not seem like much, but in the world of governing medical bodies, this is blistering criticism.

The full statement is as follows:

Internists remind physicians about universal ethical principles

PHILADELPHIA, February 28, 2011 – "Honesty is a core professional obligation and lying, even for a patient, is a breach of that obligation," J. Fred Ralston Jr., MD, FACP, president of the American College of Physicians (ACP) reminded all physicians, including the organization's 130,000 internal medicine physician and medical student members today.

ACP's statement was issued amid reported confusion surrounding "sick notes" issued without a medical evaluation to some protesters absent from work to attend rallies at the state capitol in Madison, Wis.

"This has most recently been discussed in Wisconsin, but it's not a state-based issue, like a state law," said Steven B. Pearson, MD, FACP, governor of the Wisconsin Chapter of ACP. "Rather it is a universal ethics principle on which ethics policy is based."

"Society empowers and trusts physicians to serve the interests of individual patients," Ralston said. "But physician authority and privileges also come with responsibilities to the community, even when individual patients want otherwise."

The 'sick note' situation is only one example of an array of ethical issues addressed by ACP in its Ethics Manual. The organization also develops policies and case studies providing ethical guidance and recommendations to help internists and their patients with many situations.

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The American College of Physicians (www.acponline.org) is the largest medical specialty organization and the second-largest physician group in the United States. ACP members include 130,000 internal medicine physicians (internists), related subspecialists, and medical students. Internists specialize in the prevention, detection, and treatment of illness in adults. Follow ACP on Twitter (www.twitter.com/acpinternists) and Facebook (www.facebook.com/acpinternists).

For more commentary along the same lines I refer you to Dr. Rich's Covert Rationing Blog where he discusses at some length his unique observations on lying physicians.

Instead, these doctors were, in a professional capacity, lying. They did not lie in any truly malicious way, however. They lied because they have been trained to believe in a higher cause than mere professional ethics, namely, the cause of social justice. They lied in full confidence that telling lies to advance such a noble cause is a natural duty of the medical profession. They never expected to be criticized for it (except perhaps by Rush Limbaugh and sundry teabaggers and the like), and they almost certainly will be stunned into indignant incoherence if they end up actually receiving the full punishments their actions allow.

But what really interests DrRich is the near-perfect silence we have seen from the mainstream news media regarding this sad episode. While it’s easy to find stories about the phony sick excuses all over Fox News and conservative websites, major outlets like the New York Times, Washington Post, CNN, CBS and NBC – sources one might expect to express at least some sympathy for these doctors and their work to advance a just cause – have reported next to nothing about it. When a left-leaning mainstream outlet does report on the episode (for instance, this article appearing in the Atlantic), rather than expressing any support for the Wisconsin doctors, they express at least mild dismay. It seems plain to DrRich that the mainstream media wish the whole thing hadn’t happened, and that perhaps their silence might help it go away as soon as possible.

So here we’ve got a small cadre of youthful and idealistic physicians, behaving in a manner entirely consistent with what they’ve just learned during their medical training, and not only are they facing formal investigations and potential punishment, but also the very people and organizations whom they were surely counting on for support have retreated into an embarrassed silence, or worse, criticism.

What gives?

Indeed!

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