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Modernizing our Code of Ethics: physicians and public helping to shape a new code​

The Code of Ethics is a foundational document for the Canadian Medical Association. First published in 1868, it has a long and distinguished history of providing ethical guidance to Canada’s physicians, and over the years has been updated many times to reflect the current medical landscape.

In 2017, the CMA began a major renewal of the Code  the first in more than a decade. Medical innovation, technological advances, and new patient expectations have led to major transformations in health care, and how medicine is practised. The CMA is revising the Code of Ethics to address these new realities, and affirm the core commitments to which the medical profession aspires.

“One thing the Code of Ethics is not is the Ten Commandments, fixed for all time,” explained Dr. Ross Upshur, a physician and professor at the University of Toronto, and a member of the CMA Code of Ethics Revision Task Force. Upshur says a quick review shows how the Code has evolved with the times.

“Right before World War II, it [the code] started to talk about how physicians were in service to the state,” said Upshur. “When radio came in as a technology…there were explicit guidance statements about who should speak on the radio about medical issues.”

Upshur says technology continues to be a disruptor for medicine; gene drive technology, artificial intelligence, big data and social media are all factors that had to be considered when reviewing the Code of Ethics.

“I think the test of whether the new Code is relevant to the contemporary age will be how well it prepares physicians to manage the ethical issues that emerge from engagement with these new technologies and other challenges to a physician’s work life.”

The current revision of the CMA Code of Ethics was based on extensive conceptual and empirical research, and preliminary consultation with hundreds of physicians and medical learners. This work informed the development of an expanded Code that articulates both the ethical and professional commitments of the medical profession. 

In the new Code of Ethics and Professionalism, ethics concerns the virtues, values, and principles that ought to guide the medical profession. Professionalism is the enactment of the responsibilities of physicians arising from those norms, through behaviours, standards, and competencies.  

By expanding the Code to include professionalism, the CMA is breaking new ground. Dr. Upshur says it is a timely change.

“Ethics is about what we ought to do, and professionalism is how we go out and do that. There is a very close relationship between the Code of Ethics and the life of our profession,” said Upshur. “You can’t have professionalism without medical ethics, and you can’t have medical ethics without a profession.”

Now that a draft version of the new Code has been written, the CMA is seeking more input on this important document through a broad consultation with members, stakeholders, patients, and the public. On March 7, 2018, all CMA members received an email, with a link to a survey to collect their feedback.

Dr. Julie Richer, a member of the CMA Code of Ethics Revision Task Force, says hearing from a wide range of physicians will help ensure the Code provides a platform for the medical professions’ shared purpose and identity.

“Ultimately, this is the document that defines the medical profession, that guides the standards,” said Richer. “This should be a conversation that engages the whole membership; each physician has a slightly different practice and patient population and we all need to have the opportunity to best represent our patients and ensure their needs are met.”

Feedback gathered during the consultation will inform the final Code of Ethics and Professionalism; please take the time to share your views on this important document. If you did not receive an email with a link to the survey, please contact yourvoice@cma.ca

Forward any comments about this article to: cmanews@cma.ca.