Hospital Codes of Ethics: AMA Standards and Comparisons
This paper examines codes of ethics in the healthcare industry, focusing on the specific requirements any code should meet and identifying three critical elements of the American Medical Association's Code of Medical Ethics. It then compares the AMA's framework with the codes maintained by Greenville Memorial Hospital, the Mayo Clinic, and TriHealth, highlighting structural similarities and notable differences. The paper concludes with a discussion of why clinicians, nurses, and allied healthcare professionals should follow hospital codes of ethics, acknowledging both their value and the criticism that their guidelines can be too vague for complex real-world dilemmas.
- Introduction: Healthcare ethics context and paper overview
- Requirements of a Code of Ethics: Core legal and professional requirements for ethics codes
- Three Critical Elements of the AMA's Code: Most important AMA code sections identified
- Comparing the AMA Code with Three Hospital Codes: GMH, Mayo Clinic, and TriHealth code comparisons
- Why Individuals and Groups Should Follow a Hospital's Code of Ethics: Rationale and critiques for clinician compliance
- Conclusion: Synthesis of findings on healthcare ethics codes
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What makes this paper effective
- The paper moves logically from broad requirements to specific institutional examples, giving readers a clear analytical framework before introducing comparative detail.
- Direct quotations from hospital codes and scholarly sources ground abstract ethical concepts in concrete, documented language.
- The three-hospital comparison is well-structured, treating each institution consistently so that differences and similarities emerge naturally rather than through forced contrast.
Key academic technique demonstrated
The paper demonstrates effective comparative analysis: it first establishes a common standard (the AMA code and general legal requirements), then measures each hospital code against that standard. This approach ensures that comparisons are principled and organized rather than ad hoc, a useful model for any policy or institutional analysis assignment.
Structure breakdown
The paper opens with an industry-context introduction, then defines code-of-ethics requirements using scholarly and legal sources. A focused section identifies the three most important AMA code elements. The longest section compares three hospital codes in turn. A separate section addresses the rationale for compliance, including a critical counterpoint about guideline ambiguity. The conclusion synthesizes findings and reinforces the paper's central argument.
Introduction
Today, the healthcare industry faces rising costs, increasing regulation, and growing numbers of patients with age-related conditions as the Baby Boomer segment of the U.S. population enters retirement age. Combined with innovations in medical technology, these trends have created the need for codes of ethics that can provide clinicians and employees with the general guidelines they need to resolve the wide range of day-to-day ethical dilemmas endemic to the healthcare profession. For this purpose, the American Medical Association (AMA) publishes a code of medical ethics, and many public and private sector hospitals likewise maintain codes of ethics for their clinicians and employees.
To gain fresh insights into these issues, this paper reviews the literature to provide an analysis of the specific requirements of a code of ethics, three critical elements of the AMA's code that are deemed most important, and an assessment of the differences and similarities between the AMA's Code of Medical Ethics and the code requirements of three hospitals. Finally, an explanation of why certain individuals and/or groups should follow a hospital's code of ethics is followed by a summary of the research and important findings in the conclusion.
Requirements of a Code of Ethics
Any code of ethics should contain the general guidelines that clinicians need to resolve ethical dilemmas in their practice. For instance, Doran and Fleming (2015) note that "clinicians have traditionally dealt with ethical issues by keeping their own counsel, turning to trusted colleagues or professional codes of ethics, or seeking guidance from religious authorities" (p. 45). Likewise, a requirement for codes of ethics is to standardize what is regarded as ethical practice at the local, regional, and national levels (Zahedi & Sanjari, 2013). Another requirement is to ensure that clinicians take appropriate actions to ensure that patient safety is not jeopardized by the "incompetent, unethical or illegal acts of others — including the system" (Johnstone, 2004).
Other requirements for a code of ethics include the following:
It is also important to note that codes of medical ethics should describe the healthcare facility's mission and provide relevant interpretations of ethical principles. In this regard, Verschoor (2009) points out that "a code emphasizing proper values deals with setting examples [and] interpreting ethical principles" (p. 22). One code that serves as a standard by which others are measured in the healthcare profession is the AMA's Code of Medical Ethics, discussed further below.
Three Critical Elements of the AMA's Code
One of the first acts taken by the AMA was to adopt a code of ethics, and the original has been revised numerous times over the years (Baker & Emanuel, 2000). The current AMA code of ethics is published online as well as in e-book form and is comprised of ten sections as follows:
As can be seen from the list above, the AMA code of medical ethics is comprehensive and includes guidelines on the major issues that confront healthcare providers today. Three critical elements of the AMA's code that can be regarded as most important are as follows. In section 1.02, "The Relation of Law and Ethics," the AMA code emphasizes the need for clinicians to advocate for changes in any law that mandates unethical conduct, but when controlling legislation and ethical conduct conflict, the patient's best interests should prevail and supersede unjust laws. Likewise, section 5.05, "Confidentiality," stresses the need for clinicians and employees to safeguard all personal patient data maintained by a healthcare provider. Finally, section 10.01, "Fundamental Elements of the Patient-Physician Relationship," outlines the rights of all patients and the responsibilities that clinicians have to protect these fundamental rights.
Conclusion
Codes of ethics can be as brief as the Mayo Clinic's or as elaborate as the American Medical Association's, depending on the healthcare facility's mission and structure. In every case, however, codes of medical ethics provide clinicians and employees with general guidelines concerning what steps should be taken when confronted with an ethical situation that defies easy resolution, including reporting the incident to higher authorities. Some of the legal requirements for codes of medical ethics include being provided in written form, describing the importance of compliance, establishing methods for internal reporting of code violations, and defining what types of accountability are mandated.
An interesting point made in the AMA's code of medical ethics is that patient welfare should supersede unjust laws — a point that was not reiterated in the three other codes reviewed. All of the reviewed codes of ethics did indicate, however, that while it is not possible to foresee every type of ethical dilemma that may be encountered in the healthcare workplace, it is possible to apply the concepts contained in these codes to resolve even the most complex ethical dilemma.
References
AMA code of medical ethics. (2013). American Medical Association. Retrieved from
Baker, R. & Emanuel, L. (2000, July). The efficacy of professional ethics. The Hastings Center Report, 30(4), 13.
Doran, E. & Fleming, J. (2015, January 1). Managing ethical issues in patient care and the need for clinical ethics support. Australian Health Review, 39(1), 44–47.
Greenville Memorial Hospital code of ethics. (n.d.). Greenville Health Systems. Retrieved from http://cloudfront.greenvillehealthsystem.net/docs/greenville-health-system-code-of-excellence-employee.pdf.
Johnstone, M. J. (2004, September 3). Ethics and whistleblowing: A nursing response to the events at the Campbelltown and Camden Hospitals. Australian Health Review, 28(1), 13–16.
Legal requirements for ethics codes. (2016). Fisher & Phillips, LLP. Retrieved from http://www.inspiredelearning.com/ethics/ethics_training_legal_requirements.htm.
Mayo Clinic integrity and compliance program. (2015). Mayo Clinic. Retrieved from http://www.mayoclinic.org/documents/corporate-integrity-plan-pdf/doc-20079615.
TriHealth code of ethics. (2012). TriHealth.
Wilson, R. C. & Carraher, S. M. (2008, January). When entrepreneurship and ethics collide: The case of physician-owned specialty hospitals. Journal of Applied Management and Entrepreneurship, 13(1), 68–73.
Zahedi, F. & Sanjari, M. (2013, January). The code of ethics for nurses. Iranian Journal of Public Health, 42(1), 1–4.
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