Code of Ethics

The ethics of the physician do not begin, nor do they end at the bedside. The pursuit of an ethical professional life is aspirational. That life is grounded in the behaviors and ideals that are present at home and in the community. While ethical behaviors are most on display when caring for patients, that behavior is required in all facets of the physician’s being.

The reputation of the American Academy of Emergency Medicine and its ability to act beneficially for its members, and society as a whole, is dependent upon each individual member acting in an ethical manner in public, private, and at the bedside.

To that end, the American Academy of Emergency Medicine affirms these principles (duties) of ethical behavior.

1. Emergency physicians shall always function as a patient advocate and place the interest of patients and the vulnerable as their primary duty.
2. Emergency physicians shall evaluate and treat all patients to the best of their ability regardless of a patient’s ability to pay. 
3. Emergency physicians will not use race, color, national origin, ethnicity, gender, religion, sexual orientation, or age to be a determining factor in providing the best care given available resources.
4. All patients will be treated with dignity and respect. Patient privacy, autonomy, and confidentiality shall be respected and maintained.
5. All emergency physicians shall obtain informed consent prior to performing non-routine procedures or treatments unless emergency conditions exist where delay would cause harm. 
6. Emergency physicians shall treat all colleagues and coworkers with honesty, dignity, and respect.
7. Emergency physicians shall respect professional boundaries and shall not let them influence any relationships outside the medical setting.
8. Emergency physicians shall act as stewards of medical resources in the best interests of their patients.
9. Emergency physicians have the duty to continually educate themselves to provide the best care for their patients.
10. Emergency physicians have a duty to intervene on behalf of patients in the event a colleague or co-worker is suspected of being unable to practice with reasonable skill and safety.

1. All members will comply with:
   1. General principles of medical ethics as enumerated by the American Medical Association (AMA Code of Medical Ethics Overview) as of November 1, 2008.
   2. Applicable rules:
      1. The AAEM Constitution and bylaws.
      2. Applicable requirements under federal and state laws as well as regulations relating to members’ status as a physician, scientist, allied health professional, or other healthcare worker.
      3. Applicable rules and requirements of each and every of the following bodies to whom such member is subject (a “Governing Body”):
         1. Healthcare entities and governing bodies and committees thereof which conduct professional review activities;
         2. Boards of medical examiners and comparable bodies with responsibility for the licensing of physicians or allied health professionals;
         3. Other self-regulatory organizations and professional societies; and,
         4. Any other body which is a “board of professional examiners” or a “professional review body” under the Healthcare Quality Improvement Act of 1986.
   3. AAEM Ethical Business Practices in Emergency Medicine Policy
   4. AAEM Position Statement on Ethical Expert Conduct and Testimony
   5. AAEM Conflict of Interest and Disclosure Policy (for officers, board of directors, and task force and committee chairs).
      
2. The following actions may constitute a violation of this policy:
   1. Failure to comply with the AAEM constitution, bylaws, and policies listed above.
   2. Discipline by licensing boards, other professional societies or hospitals for violations of applicable rules and requirements described in section 1.b.
   3. Conviction of felony related to medical activities:
      1. Treatment of patients;
      2. Billing activities; or,
      3. Illegal prescribing of controlled substances.
   4. False certification of eligibility for AAEM membership, or any office or position in AAEM.
      
3. Procedures for handling submissions regarding the Ethics Policy are described in AAEM Ethics Policy Administrative Procedures.

1. Financial conflicts of interest exist in the following scenarios:
   1. An official or extended family member owns a significant financial interest in any entity that
      • provides goods or services to the Academy or its subsidiaries;
      • seeks to provide goods or services to the Academy or its subsidiaries; or
      • engages in business negotiations with the Academy or its subsidiaries.
   2. An official or extended family member holds a leadership position (such as a medical directorship in a medical services company) that does not comply with relevant corporate practice of medicine laws.
   3. An official earns $10,000 or more annually for personal activities (such as legal consulting), sales, or other non-clinical services related to medicine that may overlap with Academy interests.
      
2. Legal conflicts of interest exist when an official or immediate family member has a significant financial interest in any entity involved in a lawsuit, legal complaint, personal claim for damages, or formal grievance involving the Academy.
   
3. Conflicts arising from current or prior service to another organization exist when officials serve other organizations with goals and objectives that are not aligned with the Academy. Examples of such service include:
   1. Serving on a board of directors for another organization;
   2. Chairing a committee or task force for another organization.
      
4. Personal conflicts of interest exist when officials are unable to separate personal interests from their obligation to objectively serve the interests of the membership.
   
5. Academy officials will disclose in writing all conflicts or potential conflicts of interest.
   1. Candidates must complete their conflict of interest form prior to the nomination deadline and this information will be included in the candidate statement publications.
   2. Disclosures will be made at the commencement of a position;
   3. Updated disclosures will be made when changes occur to alter conflicts of interest;
   4. Updated disclosures will also be made every year following the annual scientific assembly;
   5. Written disclosures are to be made using the “Conflict of Interest Disclosure Form” attached to this policy.
      
6. The Academy’s president shall make the final determination of situations representing actual conflicts of interest.
   
7. Officials with conflicts of interest will recuse themselves from the following activities:
   1. Discussing or voting on issues related to the conflicts of interest;
   2. Participation on committees, subcommittees, or task forces charged with addressing issues involved in the conflicts of interest.
      
8. Academy officials shall not offer, solicit, or accept gifts (including money, benefits, loans, or other payments) from any entity with which the Academy does or seeks to do business, or from any entity seeking to do business with the Academy. However, the following gifts are acceptable:
   • nominal gifts, social amenities, and entertainment which are given in normal business practice and which would not create the appearance of undue influence
   • gifts for a non-business reason, which are motivated by a family relationship or personal friendship;
   • books, journals, media, software, and other informational material provided to assist the officials in performing their duties for the Academy.
     
9. Disclosure of confidential or proprietary information:
   1. When in the course of performing services to the Academy, officials have access to information that is confidential or proprietary to the Academy, officials shall
      • maintain the confidentiality of such information;
      • use their best efforts to prevent unauthorized disclosure of confidential or proprietary information.

Principles and practices of the American Academy of Emergency Medicine (AAEM) board of directors, executive committee, committee and section chairs, and division leadership are to provide guidance and direction for effective governance.

Members of the board of directors, executive committee, committee and section chairs, and division leadership are committed to observing and promoting the highest standards of ethical conduct in the performance of their responsibilities to AAEM. Members of these groups pledge to accept this code as a minimum guideline for ethical conduct and shall:

• Faithfully abide by the articles of incorporation, bylaws and policies of the Academy.
• Exercise reasonable care, good faith and due diligence in governing and managing affairs.
• Fully disclose, at the earliest opportunity, information that may result in a perceived or actual conflict of interest.
• Fully disclose, at the earliest opportunity, information of fact that would have significance in board of directors, executive committee section and division decision-making.
• Remain accountable for prudent fiscal management to AAEM members, the nonprofit sector, and, where applicable, to government and funding bodies.
• Maintain a professional level of courtesy, respect, and objectivity in all matters and activities.
• Strive to uphold those practices and assist other members of the board of directors, executive committee, committee chairs, section chairs and division leadership in upholding the highest standards of conduct.
• Exercise the powers invested for the good of all members of the AAEM and the emergency medicine community rather than for personal benefit.
• Ensure the right of all members to access benefits and services without discrimination on the basis of culture, gender, sexual orientation, geography, political, religious or socioeconomic aspects.
• Ensure the right of all members to access benefits and services without discrimination on the basis of the Academy’s volunteer or staff make-up in respect to gender, sexual orientation, national origin, race, religion, age, political affiliation or disability, in accordance with all applicable legal and regulatory requirements.
• Respect the confidentiality of sensitive information and member contact information known to board and committee members and used for the purposes of governance and management. Understand and support the concept that what is learned or heard as a representative of AAEM will remain the intellectual property of AAEM.
• Respect the diversity of opinions as expressed or acted upon by the committees and membership, and formally register dissent as appropriate.

Violations of the Code of Conduct & Ethics Policy may result in disciplinary action in accordance with AAEM’s governing documents. Discipline may include removal of a board member, executive committee member or committee chair from his or her position.

• The AAEM Ethics Committee shall receive and be responsible for the administration of all Complaints, which must be in writing and signed by the Complainant. The committee shall be appointed by the president unless the Ethics is against the president.  In that instance, the committee shall be appointed by the immediate past president.  The Ethics Committee shall initially review each Complaint to ascertain whether it (1) contains insufficient information upon which to base an investigation and/or corresponding determination; (2) would be better suited for consideration by another body (i.e., a health care entity or governing body or committee thereof, a governmental or quasi-governmental administrative body, a board of medical examiners or comparable body, or another self-regulatory organization) which conducts peer review activities and has jurisdiction over such matter; or (3) is patently frivolous or inconsequential.
  
• In the event of the Ethics Committee ascertains that the Complaint falls within any of the above three standards, the Complaint shall be dismissed by written notice from the Ethics Committee to the Complainant. The Ethics Committee shall also report such dismissal to the AAEM board of directors.
  
• If the Ethics Committee ascertains that the Complaint is not within any of the three standards described in above, the Ethics Committee shall then investigate the facts and/or circumstances to whatever extent it deems necessary or appropriate in order to evaluate the information provided by the Complainant and the allegation(s) of the Complaint. Respondent shall be notified in writing at the beginning of such investigation of the following: (i) the allegation(s); (ii) those provisions of the Code of Member Conduct which, if true, would be violated thereby; (iii) the sanctions to be imposed in the event of a violation; and (iv) the opportunity to request a hearing on the Complaint before the Ethics Committee prior to the time a determination is made with respect to the Complaint. An investigation may consist of such actions as the Ethics Committee shall determine are necessary or appropriate in order to determine the veracity of the allegation(s) in the complaint and may, include, among other things, one or more informal interviews with the Respondent, the Complainant and any witnesses or others relevant or potentially relevant to the allegations in the Complaint.
  
• Upon completion of the investigation and hearing (if one is conducted) with respect to the Complaint, the Ethics Committee shall recommend to the AAEM board of directors a determination with respect to the Complaint, and, as applicable, any recommended sanctions.  Such recommendation shall be in writing and shall include a statement setting forth the basis for, and the rationale supporting, such recommendation.
  
• The AAEM board shall make a determination with respect to the Complaint by accepting, rejecting or modifying such recommendation based solely on the record provided by the Ethics Committee.