AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

AMA Journal of Ethics. August 2017


Our American Family in the Wake of Charlottesville

America is a big and diverse country, and this diversity is reflected in millions of her families. Members of my family celebrate Christmas, Passover, and Chinese New Year. Some are lifelong fans of the San Francisco Giants, and some cheer for their hated rivals, the Los Angeles Dodgers. Many voted for Hillary Clinton, while others chose Donald Trump for president.

When my family immigrated here in the early 1970s, we only knew a handful of people and spoke no English. Despite these challenges, my parents were confident that this place was where our family should plant its roots. My father instilled in my five siblings and me a core belief that if we studied and worked hard, we could succeed in this country regardless of our personal backgrounds. My mother impressed upon us the importance of pursuing a meaningful and purposeful life through service to others. These values contributed to my reasons for becoming a physician.

As editor of the AMA Journal of Ethics, I have a responsibility to remind and educate current and future physicians of their ethical obligations in the care of patients and the public. These ethical obligations are reflected in the American Medical Association’s Principles of Medical Ethics, the first of which reads as follows: “a physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights” [1]. Treating patients who need our expertise with respect and dignity is fundamental to what it means to be a good doctor. Fulfilling this fundamental obligation is expected in everyday practice as physicians must not discriminate against a patient on the “basis of race, gender, sexual orientation or gender identity, or other personal or social characteristics that are not clinically relevant to the individual’s care” [2]. This obligation also manifests in less frequent situations, such as on the battlefield, where physicians are expected to care for all (including enemy combatants) who are wounded and sick without regard to politics, race, religion, or the like [3].

In the wake of the hateful violence in Charlottesville, Virginia, on August 12, millions of Americans are struggling to make sense out of such senselessness. I don’t know why racists and bigots are present in certain families, but what I am sure about is that “no one is born hating another person because of the color of his skin, or his background, or his religion” [4]. Some people say that there are certain topics that families just shouldn’t talk about, but given what has transpired this week, we don’t have the luxury of ignoring individuals, inside and outside our families, whose words or actions perpetuate hatred or ill-intentions towards people of a certain background. These conversations will not be easy, and one reason why confronting such individuals will be difficult is that they force us to reflect on biases and prejudices we can hold towards others who are not like us. As physicians are among those respected in our communities, I call on my colleagues to engage and facilitate such conversations because doing so is wholly in keeping with the ethics of our caring profession.

As always, I welcome your comments at


  1. American Medical Association. Principles of Medical Ethics. Code of Medical Ethics. Accessed August 16, 2017.
  2. American Medical Association. Opinion 1.1.2 Prospective patients. Code of Medical Ethics. Accessed August 16, 2017.
  3. Physicians for Human Rights. Introduction to medical neutrality. Accessed August 16, 2017.
  4. Mandela N. Long Walk to Freedom: The Autobiography of Nelson Mandela. New York, NY: Little, Brown; 1995:622.

Audiey Kao, MD, PhD Editor in Chief, AMA Journal of Ethics

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.