AMA & Professional Responsibility
What it says, and 2025 suggestions
The first thing I saw on social media this morning was an image of the Earth with a hand holding a pin from the AMA.1 My immediate reaction was to groan—what on earth…—but I clicked, and to my surprise, I was actually impressed.2 So, I’ve pasted ‘The AMA Declaration of Professional Responsilibity’ below, and with some ‘audacity’ suggest some minors changes. However, as a first suggestion, could we not show the Earth with a pin in a hand as if it’s a bubble?
Medicine’s social contract with humanity
Adopted by the AMA House of Delegates on Dec. 4, 2001, the Declaration of Professional Responsibility is an oath by which 21st century physicians can publicly uphold and celebrate the ideals that have inspired individuals to enter medicine and earn society's trust in the healing profession.
The duties the Declaration imposes transcend physician roles and specialties, professional associations, geographic boundaries and political divides.
The Declaration's nine duties and obligations speak to physicians in their roles as clinicians, researchers, educators and members of a civil society.
Preamble
Never in the history of human civilization has the well being of each individual been so inextricably linked to that of every other. Plagues and pandemics respect no national borders in a world of global commerce and travel. Wars and acts of terrorism enlist innocents as combatants and mark civilians as targets. Advances in medical science and genetics, while promising great good, may also be harnessed as agents of evil. The unprecedented scope and immediacy of these universal challenges demand concerted action and response by all.
As physicians, we are bound in our response by a common heritage of caring for the sick and the suffering. Through the centuries, individual physicians have fulfilled this obligation by applying their skills and knowledge competently, selflessly and at times heroically. Today, our profession must reaffirm its historical commitment to combat natural and man-made assaults on the health and well being of humankind. Only by acting together across geographic and ideological divides can we overcome such powerful threats. Humanity is our patient.
Declaration
We, the members of the world community of physicians, solemnly commit ourselves to:
Respect human life and the dignity of every individual.
Refrain from supporting or committing crimes against humanity and condemn all such acts.
Treat the sick and injured with competence and compassion and without prejudice.
Apply our knowledge and skills when needed, though doing so may put us at risk.
Protect the privacy and confidentiality of those for whom we care and breach that confidence only when keeping it would seriously threaten their health and safety or that of others.
Work freely with colleagues to discover, develop, and promote advances in medicine and public health that ameliorate suffering and contribute to human well-being.
Educate the public and polity about present and future threats to the health of humanity.
Advocate for social, economic, educational, and political changes that ameliorate suffering and contribute to human well-being.
Teach and mentor those who follow us for they are the future of our caring profession.
We make these promises solemnly, freely, and upon our personal and professional honor.
No Substaintal Changes Needed
It’s great as it is, but could it be made even better? Maybe it is time for some wordsmithing in 2025, freshening up language that has been in place since 2001. The world has changed (e.g., laws, context, expectations) so the words should evolve as well? I think so.
We, as members of the global community of physicians, solemnly commit ourselves to:
Honor and protect human life and the inherent dignity of every individual.
Changing to ‘Honor and protect inherent dignity’, as opposed to ‘respect’
Refuse to participate in, support, or remain silent about crimes against humanity, and to condemn such acts wherever they occur.
More active, refrain from supporting or committing crimes against humanity, refuse to participate, support, or remain silent.
Care for the sick and injured with competence, compassion, and impartiality.
Treat the sick and injured with competence? Wouldn’t ‘care’ be more optimal, not only ‘treat’ but actually ‘care’. This resonates with ‘duty to care’, and ‘duty to warn’.
Place our knowledge and skills at the service of those in need, even when doing so may endanger us.
Not a big change, but knowledge and skills at the service of those in need.
Safeguard the privacy and confidentiality of those entrusted to our care, disclosing information only when silence would gravely endanger their health or that of others.
Safeguard as an operationaly better word here might improve
Collaborate with colleagues to advance medicine and public health in ways that reduce suffering and promote human health.
Collaborate, rather than ‘work freely’
Inform and educate society about present and emerging threats to human health.
‘Inform’ first as a method of education - thinking Churchill learning, not ‘being taught’
Advocate for social, economic, educational, and political conditions that foster health, equity, and human well-being.
Not much, but thought ‘change’ as in the sake of change, might be better as ‘conditions that foster’ - note that being an advocate for political conditions that foster health, equity, is a little more ‘politically correct?’
Teach and mentor those who follow us, ensuring the continuity and integrity of our profession.
for they are the future of our caring profession was good. Maybe add continuity, integrity, and future of our profession even better.
We make these commitments solemnly, freely, and upon our personal and professional honor.
Honor Code
Commitment, personal and professional honor are excellent touchstones, but maybe today they have to mean something deeper. Honor used to be about reputation and respect and now might also also need to be more about about responsibility. How we protect truth and human dignity even when it costs us something. Honor Codes, perhaps historically, were once written to cultivate character and integrity in leaders.
I found myself reflecting again this morning on RFK Jr’s post and the responses from the AAP and countless physicians.3 What stands out are two unmistakable intentions: (1) to undermine and discredit vaccines, arguably among the greatest medical interventions in human history, and (2) to pry open avenues for opportunistic litigation against the very companies that safeguard public health by providing them. This is not principled dissent. This is calculated harm. To peddle fear, endanger lives, and posture for profit is the work of a dishonorable man, one who has forfeited any claim to integrity.
How sad is it the today, we may need more than codes of conduct to guide us in a world where misinformation spreads faster than truth, where it even flows from heads of government, and where our agencies are hijacked by men of diminished integrity and ideologies that harm us all. The easy path too often conflicts with the right one. Ethical leadership now demands more than words on paper. It requires courage, the courage to defend science and truth even when it is costly, the courage to call out dishonor when it threatens public health, and the courage to admit our own mkstakes and still press forward. If honor is to mean anything in this century, it must be lived, spoken, and defended, not only when convenient, but especially when it is hard. Wow, did I just write that and where might I have heard similar words ‘when it was hard’ before?
I’ll stop with that thought…
