Jan 2018

AMA Policies and AMA Code of Medical Ethics’ Opinions Related to Responding to Violence

Danielle Hahn Chaet, MSB
AMA J Ethics. 2018;20(1):44-46. doi: 10.1001/journalofethics.2018.20.1.coet1-1801.

 

The American Medical Association has several policies regarding physician response to violence (“Firearms as a Public Health Problem in the United States—Injuries and Death,” H-145.997 [1]; “Firearm Safety and Research, Reduction in Firearm Violence, and Enhancing Access to Mental Health Care,” H-145.975 [2]; “Addressing Sexual Assault on College Campuses,” H-515.956 [3]; “Rape Victim Services,” H-80.998 [4]; “Family and Intimate Partner Violence,” H-515.965 [5]; and “Alcohol, Drugs, and Family Violence,” H-515.975 [6]). These policies specifically encourage awareness and prevention on local, state, and national policy levels as well as physician education in these areas. The Code of Medical Ethics also addresses violent harm to patients. The following paragraph is reprinted (with the exception of changes in citation numbers) from the January 2017 issue, 19(1), of the AMA Journal of Ethics.

Specifically, Opinion 8.10, “Preventing, Identifying and Treating Violence and Abuse,” states that “physicians have an ethical obligation to take appropriate action to avert the harms caused by violence and abuse” [7]. Outlined in this opinion is the physician’s obligation to familiarize him- or herself with strategies for violence and abuse detection, resources available to the patient, and legal requirements for reporting. The opinion further states that physicians should “obtain the patient’s informed consent when reporting is not required by law.” In the case of minors, reporting to an appropriate agency, with or without the consent of the child, is required by law in all 50 states [8]. When the patient is an adult, however, physicians should inform the patient about his or her legal requirements to report any suspected violence or abuse and should obtain the adult patient’s informed consent to do so [7]. Exceptions are appropriate when a physician believes that an adult patient’s refusal to authorize reporting is coerced. As always, physicians should protect adult patient privacy when reporting by disclosing only the minimum necessary information. This information might vary depending on what applicable laws or policies are valid where the physician is practicing. (See also Opinion 3.2.1, “Confidentiality” [9].)

References

  1. American Medical Association. Firearms as a public health problem in the United States—injuries and death H-145.997. https://policysearch.ama-assn.org/policyfinder/detail/firearms%20as%20a%20public?uri=%2FAMADoc%2FHOD.xml-0-554.xml. Updated 2013. Accessed September 29, 2017.

  2. American Medical Association. Firearm safety and research, reduction in firearm violence, and enhancing access to mental health care H-145.975. https://policysearch.ama-assn.org/policyfinder/detail/firearm%20safety?uri=%2FAMADoc%2FHOD.xml-0-532.xml. Updated 2016. Accessed September 29, 2017.

  3. American Medical Association. Addressing sexual assault on college campuses H-515.956. https://policysearch.ama-assn.org/policyfinder/detail/H-515.956?uri=%2FAMADoc%2FHOD-515.956.xml. Updated 2016. Accessed September 29, 2017.

  4. American Medical Association. Rape victim services H-80.998. https://policysearch.ama-assn.org/policyfinder/detail/H-80.998?uri=%2FAMADoc%2FHOD.xml-0-5233.xml. Updated 2015. Accessed September 29, 2017.

  5. American Medical Association. Rape victim services H-80.998. https://policysearch.ama-assn.org/policyfinder/detail/H-80.998?uri=%2FAMADoc%2FHOD.xml-0-5233.xml. Updated 2015. Accessed September 29, 2017.

  6. American Medical Association. Alcohol, drugs, and family violence H-515.975. https://policysearch.ama-assn.org/policyfinder/detail/Alcohol%2C%20drugs%2C%20and%20family%20violence%20H-515.975?uri=%2FAMADoc%2FHOD.xml-0-4674.xml. Updated 2013. Accessed September 29, 2017.

  7. American Medical Association. Opinion 8.10 Preventing, identifying and treating violence and abuse. Code of Medical Ethicshttps://www.ama-assn.org/delivering-care/preventing-identifying-treating-violence-abuse. Accessed November 16, 2017.

  8. Child Welfare Information Gateway. Mandatory reporters of child abuse and neglect. Washington, DC: US Department of Health and Human Services; Children’s Bureau; 2016. https://www.childwelfare.gov/pubPDFs/manda.pdf. Accessed November 7, 2016.

  9. American Medical Association. Opinion 3.2.1 Confidentiality. Code of Medical Ethicshttps://www.ama-assn.org/delivering-care/confidentiality. Accessed November 16, 2017.

Citation

AMA J Ethics. 2018;20(1):44-46.

DOI

10.1001/journalofethics.2018.20.1.coet1-1801.

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