US physicians consider access to health care for all

Abstract

Physicians in the United States could be required to support access to health care for everyone, if proposals currently before the American Medical Association are passed next June. The association's council of ethical and judicial affairs has proposed that 2 new statements be included in the association's “principles of medical ethics.” If passed, the changes will mark the first change in the association's principles since 1980. The first new principle reads: “A physician shall, while caring for a patient, regard responsibility to that patient as paramount.” The purpose of this new principle is to indicate that financial incentives in health care may be unethical and to reduce the effect of finances and beside health care rationing as motivating factors in patient care. The second new principle states: “A physician shall support access to health care for all.” The proposals were endorsed by the association's house of delegates at a meeting in Florida earlier this month. In accordance with the association's rules, which require affirmative votes at 2 consecutive meetings for such a change to be made, final approval awaits a vote by the association's house of delegates at the annual meeting next June. A two-thirds majority is required. At the Florida meeting, several delegates questioned the inclusion of the second statement as a principle and were worried that it might be misinterpreted as a call for socialized medicine or as support for a single-payer system. The Texas delegation tried to stall an interim vote on the universal-access principle because of worries that the word “all” could mean support for universal coverage. In response to these concerns, Frank Riddick Jr, vice chair of the association's council of ethical and judicial affairs, remarked that the association was not advocating any particular health care delivery system. It was merely stating an ethical principle that physicians were morally obliged to seek medical care for all sick people, regardless of means. This concept was supported by delegate William Golden, an internist from Little Rock, Arkansas, and a representative of the American College of Physicians and American College of Internal Medicine. Golden sought to remind the house of delegates that the votes were on “principles” and “not policies” and cautioned against the association getting involved in the implementation of these principles. Currently the association's code of medical ethics comprises 7 principles. Prospective members are asked to agree to these principles as a condition of membership, and a physician found in violation of such principles may be subject to loss of license. The current principles are on the association's Web site at www.ama-assn.org/ama/pub/category/2512.html.