AMA Code of Ethics

Protecting information gathered in association with the care of the patient is a core value in
health care.
Privacy
Patient privacy encompasses a number of aspects, including personal space (physical privacy),
personal data (informational privacy), personal choices including cultural and religious
affiliations (decisional privacy), and personal relationships with family members and other
intimates (associational privacy).
Physicians must seek to protect patient privacy in all settings to the greatest extent possible and
should:
1. Minimize intrusion on privacy when the patient’s privacy must be balanced against other
factors.
2. Inform the patient when there has been a significant infringement on privacy of which the
patient would otherwise not be aware.
3. Be mindful that individual patients may have special concerns about privacy in any or all
of these areas.
Audio or visual recording of patients can be a valuable tool for educating health care
professionals, but physicians must balance educational goals with patient privacy and
confidentiality. The intended audience is bound by professional standards of respect for patient
autonomy, privacy, and confidentiality, but physicians also have an obligation to ensure that
content is accurate and complete and that the process and product of recording uphold standards
of professional conduct.
To safeguard patient interests in the context of recording for purposes of educating health care
professionals, physicians should:
1. Ensure that all nonclinical personnel present during recording understand and agree to
adhere to medical standards of privacy and confidentiality.
2. Restrict participation to patients who have decision-making capacity. Recording should
not be permitted when the patient lacks decision-making capacity except in rare
circumstances and with the consent of the parent, legal guardian, or authorized decision
maker.
3. Inform the patient (or authorized decision maker, in the rare circumstances when
recording is authorized for minors or patients who lack decision-making capacity):
1. About the purpose of recording, the intended audience(s), and the expected
distribution
2. About the potential benefits and harms (such as breach of privacy or
confidentiality) of participating
3. That participation is voluntary and that a decision not to participate (or to
withdraw) will not affect the patient’s care
4. That the patient may withdraw consent at any time and if so, what will be done
with the recording
5. That use of the recording will be limited to those involved in health care
education, unless the patient specifically permits use by others
4. Ensure that the patient has had opportunity to discuss concerns before and after
recording.
5. Obtain consent from a patient (or the authorized decision maker):
1. Prior to recording whenever possible
2. Before use for educational purposes when consent could not be obtained prior to
recording
6. Respect the decision of a patient to withdraw consent.
7. Seek assent from the patient for participation in addition to consent by the patient’s
parent or guardian when participation by a minor patient is unavoidable.
8. Be aware that the act of recording may affect patient behavior during a clinical encounter
and thereby affect the film’s educational content and value.
9. Be aware that the information contained in educational recordings should be held to the
same protections as any other record of patient information. Recordings should be
securely stored and properly destroyed, in keeping with ethics guidance for managing
medical records.
10. Be aware that recording creates a permanent record of personal patient information and
may be considered part of the medical record and subject to laws governing medical
records.
Code for Medical Ethics Opinion 3.1.4

Audio and/or visual recording of patient care for public broadcast is one way to help educate the
public about health care. However, no matter what medium is used, such recording poses
challenges for protecting patient autonomy, privacy, and confidentiality. Filming cannot benefit a
patient medically and may cause harm. As advocates for their patients, physicians have an
obligation to protect patient interests and ensure that professional standards are upheld.
Physicians also have a responsibility to ensure that information conveyed to the public is
complete and accurate (including the risks, benefits, and alternatives of treatments).
Physicians involved in recording patients for public broadcast should:
1. Participate in institutional review of requests to record patient interactions.

2. Require that persons present for recording purposes who are not members of the health
care team:
1. Minimize third-party exposure to the patient’s care
2. Adhere to medical standards of privacy and confidentiality
3. Encourage recording personnel to engage medical specialty societies or other sources of
independent expert review in assessing the accuracy of the product.
4. Refuse to participate in programs that foster misperceptions or are otherwise misleading.
5. Restrict participation to patients who have decision-making capacity. Recording should
not be permitted when the patient lacks decision-making capacity except in rare
circumstances and with the consent of the parent, legal guardian, or authorized decision
maker.
6. Inform a patient (or authorized decision maker) who is to be recorded:
1. About the purpose for which patient encounters with physicians or other health
care professionals will be recorded
2. About the intended audience(s)
3. That the patient may withdraw consent at any time prior to recording and up to an
agreed on time before the completed recording is publicly broadcast, and if so,
what will be done with the recording
4. That at any time the patient has the right to have recording stopped and recording
personnel removed from the area
5. Whether the patient will be allowed to review the recording before broadcast and
the degree to which the patient may edit the final product
6. Whether the physician was compensated for his participation and the terms of that
compensation
7. Ensure that the patient has had the opportunity to address concerns before and after
recording.
8. Ensure that the patient’s consent is obtained by a disinterested third party not involved
with the production team to avoid potential conflict of interest.
9. Request that recording be stopped and recording personnel removed if the physician (or
other person involved in the patient’s care) perceives that recording may jeopardize
patient care.
10. Ensure that the care they provide and the advice they give to patients regarding
participation in recording is not influenced by potential financial gain or promotional
benefit to themselves, their patients, or the health care institution.
11. Remind patients and colleagues that recording creates a permanent record and may in
some instances be considered part of the medical record.
Code of Medical Ethics Opinion 3.1.5

Ensuring that the public is informed promptly and accurately about medical issues is a valuable
objective. However, media requests for information about patients can pose concerns about
patient privacy and confidentiality, among other issues.
Physicians who speak on health-related matters on behalf of organizations should be aware of

institutional guidelines for communicating with media, where they exist. To safeguard patient
interests when working with representative of the media, all physicians should:
1. Obtain consent from the patient or the patient’s authorized representative before releasing
information.
2. Release only information specifically authorized by the patient or patient’s representative
or that is part of the public record.
3. Ensure that no statement regarding diagnosis or prognosis is made except by or on behalf
of the attending physician.
4. Refer any questions regarding criminal activities or other police matters to the proper
authorities.
Confidentiality
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Patients need to be able to trust that physicians will protect information shared in confidence.
They should feel free to fully disclose sensitive personal information to enable their physician to
most effectively provide needed services. Physicians in turn have an ethical obligation to
preserve the confidentiality of information gathered in association with the care of the patient.
In general, patients are entitled to decide whether and to whom their personal health information
is disclosed. However, specific consent is not required in all situations.
When disclosing patients’ personal health information, physicians should:
(a) Restrict disclosure to the minimum necessary information; and
(b) Notify the patient of the disclosure, when feasible.
Physicians may disclose personal health information without the specific consent of the patient
(or authorized surrogate when the patient lacks decision-making capacity):
(c) To other health care personnel for purposes of providing care or for health care operations; or
(d) To appropriate authorities when disclosure is required by law.
(e) To other third parties situated to mitigate the threat when in the physician’s judgment there is
a reasonable probability that:
1. The patient will seriously harm him/herself.

2. The patient will inflict serious physical harm on an identifiable individual or individuals.
For any other disclosures, physicians should obtain the consent of the patient (or authorized
surrogate) before disclosing personal health information.
Confidentiality & Electronic Medical Records
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Information gathered and recorded in association with the care of a patient is confidential,
regardless of the form in which it is collected or stored.
Physicians who collect or store patient information electronically, whether on stand-alone

systems in their own practice or through contracts with service providers, must:
1. Choose a system that conforms to acceptable industry practices and standards with respect to:
1. Restriction of data entry and access to authorized personnel
2. Capacity to routinely monitor/audit access to records
3. Measures to ensure data security and integrity
4. Policies and practices to address record retrieval, data sharing, third-party access and
release of information, and disposition of records (when outdated or on termination of
the service relationship) in keeping with ethics guidance
2. Describe how the confidentiality and integrity of information is protected if the patient requests.
3. Release patient information only in keeping with ethics guidance for confidentiality.

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AMA Code of Ethics

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Protecting information gathered in association with the care of the patient is a core value in

Code for Medical Ethics Opinion 3.1.4

Physicians involved in recording patients for public broadcast should:

1. Participate in institutional review of requests to record patient interactions.

Code of Medical Ethics Opinion 3.1.5

Physicians who speak on health-related matters on behalf of organizations should be aware of

Code of Medical Ethics Opinion 3.2.1

When disclosing patients’ personal health information, physicians should:

(a) Restrict disclosure to the minimum necessary information; and

(b) Notify the patient of the disclosure, when feasible.

(d) To appropriate authorities when disclosure is required by law.

1. The patient will seriously harm him/herself.

Confidentiality & Electronic Medical Records

Physicians who collect or store patient information electronically, whether on stand-alone

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