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AMIA, as other professional societies, has a long-standing interest in promoting a strong ethical framework for its membership. This white paper presents the latest AMIA Code of Professional and Ethical Conduct. It was approved in November of 2011 by the AMIA Board of Directors. This document constitutes a revision of, and update to, the first code, approved and published in J Am Med Inform Assoc 1 in 2007. In an effort to keep pace with the field's vitality, the code presented here is intended to be a dynamic document, and will continue to evolve as AMIA and the field itself evolve. AMIA will publish on its web site this version of the code as part of a process that seeks ongoing response from, and involvement by, AMIA members.
The code is meant to be practical and easily understood, so it is compact and uses general language. Unlike the ethics codes of some professional societies, the AMIA code is not intended to be prescriptive or legislative; it is aspirational, and as such, provides the broad strokes of a set of important ethical principles especially pertinent to the field of biomedical and health informatics. The code is organized around the common roles of AMIA members and the constituents they serve—including patients, students, and others—and with whom they interact. The AMIA Board and the AMIA Ethics Committee encourage members to offer suggestions for improvements and other changes. In this way, the code will continue to progress and best serve AMIA and the larger informatics community.
Codes of ethics for professionals present special challenges in conception and execution. The goal of this code is to lay out the core values of this profession in a way that inspires AMIA members to acknowledge and embrace these values. While the crafting of the code involved many hours of debate about content and scope, the intent is to produce a document which itself does not engender controversy.
The code's authors are aware that all professionals will, from time to time, find themselves in situations shaped by what has been called “dual agency” or “multiple agency.” In these circumstances, a professional encounters conflicting duties or loyalties. An informatics professional may have conflicting duties to patients, to colleagues, to society, and to an employer. Few, if any, codes of ethics are nimble enough to provide guidance in such situations. AMIA members have an Ethics Committee which can provide guidance in some circumstances.
AMIA members are professionally diverse,2 and include those who are, or are in training to be, nurses, physicians, computer scientists, and others. In many cases, these professions have ethics codes.3–10 The International Medical Informatics Association, an international federation for which AMIA serves as the US representative organization, also has a “Code of Ethics for Health Information Professionals.”11
This document does not address—but explicitly incorporates—issues covered by other documents and laws bearing on ethics and professional conduct:
Members of the Ethics Committee are unanimous in the view that those who work in informatics—much as in other health professions—are duty-bound to embrace a patient-centered approach to their work, even if that work does not involve direct patient care or human subjects research. As elsewhere in the health professions, vulnerable populations or those with special needs may be entitled to additional considerations.
The importance of professionalism and ethics has been recognized for millennia by health professionals and organizations, now including information technology professionals. This code of ethics makes clear AMIA's commitment.
As a member of AMIA, I acknowledge my professional duty to uphold the following principles of, and guidelines for, ethical conduct.
As a matter of personal and professional integrity, adherence to the principles laid out here is expected of all who have the privilege of serving in the field of biomedical and health informatics. While the cornerstone values of professional integrity do not vary among the professions, those whose skills allow them to contribute in one way or another to the health of individuals and populations may be said to have additional responsibilities, and perhaps higher duties.
The authors and the AMIA Ethics Committee would like to thank the AMIA Board of Directors for its continuing interest in refining and publishing these guidelines. Kristin Schelin, AMIA's Director of Operations and Programs, provided invaluable support to the Ethics Committee in its work. Comments on the first version of the code were provided by Dan Stein and Kristina Thomas. Members of the AMIA Ethics Committee who contributed to the first version of the code in 2007 include Mureen Allen, MSBS, MS, MA, Joseph Catapano, MD, Oscar Gyde, MD, Carol Hope, PharmD, and Helga Rippen, MD, PhD, MPH. Also, Jane Brokel, PhD, RN, and Betty Chang, DNSc, RN, were authors of the 2007 version and are not otherwise listed here. This version of the code also owes much to members of AMIA's Ethical, Legal and Social Issues (ELSI) Working Group, chaired during the code revision process by Bonnie Kaplan, PhD.
Competing interests: None.
Provenance and peer review: Not commissioned; internally peer reviewed.