Ethics Awareness Committee of the American Academy of Dermatology

eVols at University of Hawaii at Manoa

Patient-Physician CovenantMedicine is, at its center, a moral enterprise grounded in a covenant of trust. Thiscovenant obliges physicians to be competent and to use their competence in thepatient’s best interests. Physicians, therefore, are both intellectually and morallyobliged to act as advocates for the sick wherever their welfare is threatened and fortheir health at all times.Today, this covenant of trust is significantly threatened. From within, there isgrowing legitimation of the physician’s materialistic self-interest; from without, for-profit forces press the doctor into the role of commercial agent to enhance theprofitability ofhealth care organizations. Such distortions of the doctor’s responsibility degrade the doctor/patient relationship which is the central element and structureof clinical care. To capitulate to these alterations of the trust relationship is tosignificantly alter the doctor’s role as healer, carer helper and advocate for the sick,and for the health of all.By its traditions and very nature, medicine is a special kind of human activity—one which cannot be pursued effectively without the virtues of humility, honesty,intellectual integrity, compassion and effacement of excessive self-interest. Thesetraits mark doctors as members of a moral community dedicated to something otherthan its own self-interest.Our first obligation must be to serve the good of those persons who seek our helpand trust us to provide it. Physicians, as physicians, are not and must never becommercial entrepreneurs, gateclosers, or agents of fiscal policy that runs counter toour trust. Any defection from primacy of the patient’s well-being places the patientat risk by treatment which may compromise quality of or access to medical care.We believe the medical profession must reaffirm the primacy of its obligation to thepatient through national, state, and local professional societies, our academic,research and hospital organizations, and especially through personal behavior. Asadvocates for the promotion of health and support of the sick we are called upon todiscuss, defend and promulgate medical care by every ethical means available. Onlyby caring and advocating for the patient can the integrity of our profession beaffirmed. Thus we honor our covenant of trust with patients.This Covenant was produced by a group of American doctors including Dr. David Rogers (recently deceased) who was former Dean ofMedicine at Johns Hopkins and former President of the Robert Wood Johnson Foundation and also including Dr. Christine Cassel, who isnow Professor ofMedicine at the University of Chicago Dr. Edmund Pelligrino, Director for the Advanced Study of Ethics at GeorgetownUniversity, and Dr. George Lundberg, Editor of the Journal of the American Medical Association, also participated in its development. Dr.Roger Bulger, President of the Association of Academic Health Centers, and Dr. Ralph Crashaw, a practicing psychiatrist in Oregon whohas been active locally and nationally in ethical issues that pertain to physicians, were also co-authors. Finally, Dr. Lonnie Bristow, thePresident of the American Medical Association, and Dr. Jeremiah Barondess, the President of the New York Academy of Medicine, areauthors.

Patient-Physician Covenant

http://evols.library.manoa.hawaii.edu/bitstream/10524/54438/1/1997-05p129-129.pdf

Patient-Physician Covenant

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eVols at University of Hawaii at Manoa