AMA Attacks Physicians Caring for Their Families

1 The most important people in the lives of most Physicians aretheir spouses, children, parents, and siblings Their immediatefamilies. These are the very people who have every reason tobenefit from the medical knowledge and expertise of theirphysician family position of the American Medical Association (AMA)clearly means: Thou shalt NOT care for thy family member. Inactuality, the AMA does not state it so forcefully, but ratherdisguises its injunction as an ethical position. The AMA s Code of Medical Ethics Opinion , SelfTreatment or Treatment of Immediate Family Members, says: Physicians generally should not treat themselves or members oftheir immediate Let us examine each of theobjections in this is highly doubtful.

2 Physicians are rigorously trained in thescientific method, which is indeed highly objective. Althoughphysicians may not like the clinical picture they might see in theirloved ones, Their desire for the very best outcome is theoverarching concern. Often, such care is best rendered by thephysician family member, especially in circumstances requiringspecialized care, andshould arbitrarily prevent thephysician s and the family s freedom to choose Their own medicalcare. However, if the physician feels his objectivity might beclouded, or for any reason might feel uncomfortable, thatphysician may easily seek another experienced physician sassistance. The AMA s position of clouded objectivity is simplynot consistent with the vast majority of Physicians I know, andthe AMA s position amounts to imposing a limitation on eachphysician s medical degree and essentially dictates that yourlicense to practice medicine is valid for virtually everybodyfor those most important to you.

3 Of course there can be intimate parts of medical care withwhich Physicians and/or family members might beuncomfortable. If so, it is a simple matter to explain to the familymembers, as I once did, You need this service or procedure thatI m not comfortable performing, and assist in arranging for that1 Professional objectivity may be [and] thephysician s personal feelings may unduly influence Physicians may fail to probe sensitive areas when taking themedical history or may fail to perform intimate parts of thephysical examination. nothingexceptAMA Attacks Physicians Caringfor Their FamiliesKenneth D. Christman, The vast majority of medical care, however, does not requiresuch intimacy. Who is to say that a radiologist should beprohibited from interpreting an imaging study on any memberof his family?

4 Why should a pathologist be prevented fromdiagnosing a surgical pathology specimen belonging to a familymember? How does the AMA leap to the conclusion that such aradiologist or pathologist is somehow going to suffer fromclouded objectivity simply because his family member s name ison the image or specimen? Such Physicians , if viewing anythingmildly questionable, would likely engage the assistance ofanother colleague, just as they would for any other course! If such is the case, each patient s concerns andwishes should be followed. Simply seek out the care of anothertrusted physician . Why shouldn t the AMA allow Physicians andtheir Families to make this determination? While the AMA notesthat [t]his discomfort is particularly the case when the patient isa minor child.

5 Who is responsible for this minor child? Is it theAMA? The state? Some other benevolent entity? Or, is the childthe responsibility of the parents? If so, would it be reasonable toallow the parents and Their children to sort this out? Thephysicians I know would uniformly take Their children s wishesinto consideration. As a matter of fact, more often than not,children will be much more comfortable with the physicianfamily member. Is it not unethical for any organization, even theAMA, to indelicately intrude into family matters?I do not know of any physician who would compromise thewell being of a loved one by rendering care outside his area ofexpertise. It is a very simple matter to explain to the familymember that the care needed is outside one s competence, andpromptly arrange for appropriate care.

6 Is it not unthinkable thatthe AMA would level this sort of blanket accusation at membersof the medical profession? As for treating themselves, underwhat authority does the AMA mandate what Physicians can dowith Their own bodies? I must confess to being guilty of suturingmyself on two separate occasions. Does this constitute anethical lapse? [P]atients may feel uncomfortable disclosing sensitiveinformation or undergoing an intimate examination whenthe physician is an immediate family member. When treating themselves or immediate family members, Physicians may be inclined to treat problems that arebeyond Their expertise or training. Journal of American Physicians and Surgeons Volume 16 Number 3 Fall 201185 Tensions possibly related to a negative medical outcome.

7 May be carried over into the family member s personalrelationship with the physician . Concerns regarding patient autonomy and informedconsent are also Family members may be reluctant to state Their preferencefor another physician or decline a recommendation for fearof offending the physician . [P]hysicians may feel obligated to provide care toimmediate family members even if they feel uncomfortableproviding care. In emergency settings or isolated settings where there is noother qualified physician available, Physicians should nothesitate to treat themselves or family members untilanother physician becomes available. [P]hysicians should not serve as a primary or regular careprovider for immediate family Yes, negative outcomes can occur, even with unrelatedpatients.

8 Will negative outcomes be avoided if an unrelatedphysician renders care? Most definitely not. physician familymembers have in fact often been able to avoid negativeoutcomes for Their Families . What is the role of the AMA ethicspolicy in personal relationships in a physician s family?Obviously, any lack of consent, whether in a related orunrelated patient, should preclude seems doubtful, but if it is a problem, Physicians andtheir Families are quite capable of sorting it out without theAMA s Physicians feel it is a right and privilege to provide theirfamilies with the medical care they need, the ethical injunctionagainst treating patients when not qualified to do so applies toall patients.

9 How utterly demeaning is this assumption thatphysicians will provide care to the most important people in theirlives if they are uncomfortable doing so, or not properly trained,to provide such care! Obviously, the AMA does not holdphysicians in high should be obvious that Physicians should treat themselvesand Their family members in an emergency situation. Why,however, should the AMA stipulate that post-emergency caremust be provided by another physician ? Should this decision notbe made by the physician and/or family member? Should thetraining and expertise of this second physician be a factor?Why not? By making this blanket determination, the AMAblatantly limits the physician s license and unrestricted privilegeto practice medicine.

10 Furthermore, the AMA completely voidsthe wishes of the physician s family members as being of noconsequence. Physicians with years of medical school andresidency training are not considered by the AMA to becompetent in determining what is in the best interests of theirloved ones. While the AMA concedes that there are situations inwhich routine care is acceptable for short term, minor problems, these terms are not again, the AMA makes the universal assumption thatphysicians either don t know better, or will purposely abusethemselves and/or Their Families by prescribing potentiallyharmful drugs that they can prescribe for everybody else butthemselves. According to the AMA, Physicians are never to betrusted with using medications for themselves that they are freeto offer the charge of loss of professional objectivity beingcompromised is a common one, some claim that the influenceof a physician -family member may result in increased diagnostictesting and costs, though this is not part of the AMA ethicalpolicy.