AMAV VICDOC SUMMER 2023 - Magazine - Page 22
FEATURE
There is a general expectation
within the community that
doctors will accept a certain
amount of personal risk when
responding to a disaster, but
this risk is not unconditional
or without reasonable limit.
The AMA will continue to
advocate that governments and
the wider community have an
obligation to protect doctors
and reciprocate and support
doctors who suffer harm when
caring for patients.
While the American Medical Association’s Code of
Medical Ethics, Opinion 8.3 Physicians’ Responsibilities
in Disaster Response & Preparedness, advises that:
Whether at the national, regional, or local level,
responses to disasters require extensive involvement
from physicians individually and collectively.
Because of their commitment to care for the sick
and injured, individual physicians have an
obligation to provide urgent medical care during
disasters. This obligation holds even in the face of
greater than usual risks to physicians’ own safety,
health, or life. However, the physician workforce
is not an unlimited resource. Therefore, when
providing care in a disaster with its inherent
dangers, physicians also have an obligation to
evaluate the risks of providing care to individual
patients versus the need to be available to provide
care in the future.
While the expected standard of doctors’ risk
of personal harm may be addressed differently
in these examples, at least they are all consistent
that it is unreasonable for doctors to be placed at
risk of significant harm because of inadequate or
inappropriate safety and protection, and advocacy
to improve that protection is an important duty for
medical professionals and those who control any
aspect of workplace safety. Doctors with apparent
less agency or power, such as doctors-in-training or
those in temporary employment, must be protected
from any implied or overt obligation to practice in
conditions that are not as safe as it is reasonably
practicable for them to be. Employers, managers
and workplace safety regulators have a duty to
ensure that corners are not cut and peer group
or management pressure is not acting to
decrease safety for any doctor.
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Doctors’ willingness to risk significant personal
harm when treating patients in disasters has also
experienced a temporal shift. Doctors once entered
the profession seemingly willing to sacrifice their
own lives to care for patients, as exemplified in the
American Medical Association’s Code of Medical Ethics
in 1847, which directed:
When pestilence prevails, it is their duty to face
the danger and to continue their labours for the
alleviation of the suffering, even at the jeopardy
of their own lives.
Many of today’s doctors are not so willing to lay
their lives on the line and will need to consider their
own personal morals and values when deciding how
much risk is reasonable to them.
As the EMLC examines this issue during our
policy review, we will identify a range of factors that
doctors should consider when determining what
constitutes a reasonable risk of personal harm and
what they can do to mitigate their personal risk.
While it is not unreasonable for doctors to accept a
certain amount of personal risk when responding to
disasters, that risk is not unconditional and we will
continue to advocate that governments and the wider
community have an obligation to protect doctors
and reciprocate and support doctors (and their family
members) who suffer harm when caring for patients.