Delaware County Medicine & Health Spring 2017 - 15

AMA Code of Medical Ethics
First of Its Kind

n 1847, physicians representing 22 states and the District of Columbia came together to establish America's
first national professional association for physicians, the
American Medical Association (AMA).

meant the underlying value motivating the guidance was not
readily apparent; and were not always consistent in the guidance they offered or language they used." (Brotherton et al.,
JAMA, 2016)

As one of its first acts, the AMA created the first national
codification of ethics for any profession anywhere in the
world. Authored by a committee chaired by Drs. John Bell
and Issac Hays, the 1847 AMA Code of Medical Ethics was
"unlike any ethics subscribed to by any earlier group of medical practitioners. No national assemblage had ever proposed
to bind all of its members by a uniform code of ethics, and
no previous code of ethics had ever been formulated as an
explicit social contract between the profession, its patients,
and the public." (Baker et al., JAMA, 1997)

To address these issues, the AMA embarked on a multi-year
"modernization" project to comprehensively review and
update the AMA Code. To make guidance easier to locate,
Opinions were reorganized into 11 more intuitive topical
chapters. Opinions that addressed overlapping topics were
consolidated, reducing the number of Opinions from 220 to
161. In addition, a consistent format was "constructed to ensure that each Opinion succinctly articulates the core ethical
values on which guidance is based, defines the broad context
in which guidance is relevant, and sets out specific ethical
responsibilities in the form of practical actions for individual
physicians or the profession as a whole to take." (Brotherton
et al.) Over the course of the modernization project, input
and feedback was solicited from physicians representing the
diversity of medicine. After much deliberation and debate,
the AMA House of Delegates adopted the modernized AMA
Code last June.

As the first of its kind, the 1847 AMA Code was reprinted by
medical societies in Berlin, London, Paris, Vienna, and around
the world. Throughout the rest of the 19th century, it was
the most commonly printed medical document in the English
language. (Baker et al., eds. The American Medical Ethics
Revolution, Johns Hopkins University Press, 1999) Today,
the AMA Code remains the only codification of professional conduct for all US physicians regardless of their medical
specialty, practice type or location.
Ethics guidance is regularly added or amended in the AMA
Code to reflect changes in medical science and societal
expectations. As with any "living" document that is authored
by different individuals over many decades, the AMA Code
became fragmented and unwieldy. Ethics guidance on individual topics (referred to as Opinions in the AMA Code) were
"difficult to find; lacked a common narrative structure, which

"The modernization project ensures that the Code of Medical Ethics will remain a useful and effective resource that
physicians can continue to rely on, while remaining faithful to
the virtues of fidelity, humanity, loyalty, tenderness, confidentiality and integrity enshrined in the original Code," AMA
Immediate Past President, Steven J. Stack, MD, said.
A commemorative, leather-bound edition of the modernized
AMA Code is available.

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DELAWARE COUNTY MEDICINE & HEALTH

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Table of Contents for the Digital Edition of Delaware County Medicine & Health Spring 2017