CODE OF ETHICS
OF THE
MASSACHUSETTS SOCIETY OF
EYE PHYSICIANS AND SURGEONS
Preamble
The Code of Ethics of the Massachusetts
Society of Eye Physicians and Surgeons is composed of two parts, the Principles
of Ethics and the Rules of Ethics. The
Principles of Ethics form the first part of this Code of Ethics. They are
aspirational and inspirational model standards of exemplary professional
conduct. The Rules of Ethics form the
second part of the Code of Ethics. The
Rules of Ethics are more specific descriptive standards of professional conduct
based upon the Principles which the Society believes constitute the minimally
acceptable standards with which all members of the Society are expected to
comply as an initial and continued condition of membership.
A. Principles Of
Ethics
1. Ethics in Ophthalmology.
Ethics address conduct and relate to what behavior is appropriate or
inappropriate, as reasonably determined by the entity setting the ethical
standards. An issue of ethics in ophthalmology is resolved by the determination
that the best interests of patients are served.
2. Providing Ophthalmological
Services.
Ophthalmological services must be provided with compassion, respect for
human dignity, honesty and integrity.
3. Competence of the
Ophthalmologist.
An
ophthalmologist must maintain competence. Competence can never be totally
comprehensive, and therefore must be supplemented by other colleagues when
indicated. Competence involves technical ability, cognitive knowledge, and
ethical concerns for the patient. Competence includes having adequate and proper
knowledge to make a professionally appropriate and acceptable decision regarding
the patient's management.
4. Communication with the
Patient.
Open
communication with the patient is essential. Patient confidences must be
safeguarded within the constraints of the law.
5. Fees for Ophthalmological
Services.
Fees for ophthalmological services must not exploit patients or others
who pay for the services.
6. Corrective
Action.
If a
member has a reasonable basis for believing that another person has deviated
from professionally-accepted standards in a manner that adversely affects
patient care or that a fellow member has deviated from the Rules of Ethics, the
member should attempt to prevent the continuation of this conduct. This is best
done by communicating directly with the other person. When that action is
ineffective or is not feasible, the member has a responsibility to evaluate
whether legal duties or professional ethics require further action.
7. An Ophthalmologist's
Responsibility.
It is the responsibility of an ophthalmologist to act in the best
interest of the patient.
B.
Rules of Ethics
1.
Competence. An
ophthalmologist is a physician who is educated and trained to provide medical
and surgical care of the eyes and related structures. An ophthalmologist should perform only those
procedures in which the ophthalmologist is competent by virtue of specific
training or experience or
is assisted
by one who is. An ophthalmologist must
not misrepresent credentials, training, experience, ability, or
results.
2.
Informed Consent.
The performance of medical or surgical procedures shall be preceded by
appropriate informed consent.
3.
Clinical Experiments and Investigative Procedures. Use of clinical experiments or investigative
procedures shall be approved by adequate review mechanisms. Clinical experiments and investigative
procedures are those conducted to develop adequate information on which to base
prognostic
or
therapeutic decisions or to determine etiology or pathogenesis, in circumstances
in which insufficient information exists.
Appropriate informed consent for these procedures must recognize their
special nature and ramifications.
4.
Other Opinions.
Additional opinion(s) shall be obtained if requested by the patient. Consultation(s) shall be obtained if required
by the condition.
5.
The Impaired Ophthalmologist. A physically, mentally or emotionally
impaired ophthalmologist should withdraw from those aspects of practice affected
by the impairment. If the
ophthalmologist does not withdraw, it is the duty of other ophthalmologists who
know of the impairment to take
action to assure
withdrawal of the impaired ophthalmologist.
6.
Preoperative Assessment. Surgery shall be recommended only after a
careful consideration of the patient’s physical, social, emotional and
occupational needs. The preoperative
work-up must document the indications for surgery. Performance of unnecessary surgery is an
extremely serious ethical violation.
7.
Delegation of Services.
Delegation is the use of auxiliary health care personnel to provide eye
care services for which the ophthalmologist is responsible. An ophthalmologist must not delegate to an
auxiliary those aspects of eye care within the unique competence of the
ophthalmologist. When other aspects of
eye care for which the ophthalmologist is responsible are delegated to an
auxiliary, the auxiliary must be qualified and adequately supervised. An
ophthalmologist may make different arrangements for the delegation of eye care
in special circumstances, such as emergencies,
if the patient’s welfare
and rights are placed above all other considerations.
8.
Postoperative Care. The providing of postoperative eye
care until the patient has recovered is integral to patient management. The operating ophthalmologist should provide
those aspects of postoperative eye care within the unique competence of the
ophthalmologist (which do not include those permitted by law to be performed by
auxiliaries). Otherwise, the operating
ophthalmologist must make arrangements before surgery for referral of the
patient to another ophthalmologist, with the patient’s approval and that of the
other ophthalmologist. The operating
ophthalmologist may make different
arrangements for the provision of those aspects of postoperative eye care within
the unique competence of the ophthalmologist in special circumstances, such as
emergencies or when no ophthalmologist is available, if the patient’s welfare
and rights are placed above all other considerations.
9.
Medical and Surgical Procedures.
An ophthalmologist must no misrepresent the service that is
performed or the charges made for that service.
10.
Procedures and Materials.
Ophthalmologists should order only those laboratory procedures,
optical devices or pharmacological agents that are in the best interest of the
patient. Ordering unnecessary procedures
or material for pecuniary gain is unethical.
11.
Commercial Relationships. An ophthalmologists clinical judgment and
practice must not be affected by economic interest in, commitment to, or benefit
from professionally-related commercial enterprises.
12.
Communication to Colleagues. Communication to colleagues on research
including clinical investigations must be accurate and truthful. Appropriate disclosure of commercial interest
is required.
13.
Communication to the Public. Communications to the public must be
accurate,. They must not convey false, untrue, deceptive, or misleading
information through statements, testimonials, photographs, graphics or other
means. They must not omit material
information without which the communications would be deceptive. Communications must not appeal to an
individual’s anxiety in an excessive or unfair way: and they must not create
unjustified expectations of results. If
communications refer to benefits or other attributes of ophthalmic procedures
that involve significant risks, realistic assessments of their safety and
efficacy must also be included, as well
as the
availability of alternatives and, where necessary to avoid deceptions,
descriptions and/or assessments of the benefits or other attributes of those
alternatives. Communications must not
misrepresent an ophthalmologist’s credentials, training, experience or ability,
and must not contain material claims of superiority that cannot be
substantiated. If a communication
results from payment by an ophthalmologist, this must be disclosed unless the
nature, format or medium makes it apparent.
14.
Interrelations Between Ophthalmologists. Interrelations between ophthalmologists must
be conducted in a manner that advances the best interests of the patient,
including the sharing of relevant information.
15.
Conflict of Interest.
A conflict of interest exists when professional judgment concerning the
well-being of the patient has a reasonable chance of being influenced by other
interests of the provider. Disclosure of
a conflict of interest is required in communications to patients, the public,
and colleagues.
16. Expert Testimony. Expert testimony should be provided in an
objective manner using medical knowledge to form expert medical opinions. Nonmedical factors (such as solicitation of
business from attorneys, competition with other physicians, and personal bias
unrelated to professional expertise) should not bias testimony. It is unethical for a physician to accept
compensation that is contingent upon the outcome of litigation. False, deceptive or misleading expert
testimony is unethical.
