INTRODUCTION

Each member of the Saint James School of Medicine is expected to read, understand and comply with the following Code of Ethics. A member of the Saint James School of Medicine is defined as anybody who either possesses a faculty or staff appointment to the school or is a registered student of the school.

Saint James School of Medicine is committed to achieving excellence in:

  1. education and training of medical students;
  2. continuing education of faculty members;
  3. research, and;
  4. community service.

To further the goal of excellence, all members of the medical school and its students are expected to adhere to this Code of Ethics in their interactions with patients, colleagues, other health professionals, students, other trainees, other staff and the public. The Code consists of two complementary sections: obligations and ideals. Obligations refer to necessary behaviors that are required by the ethical foundation of medical practice, teaching, learning and research. Ideals refer to desirable behaviors that healthcare providers and healthcare educators at all levels should attempt to acquire because they enhance excellence.

The Code applies to all members of the medical school involved in the clinical, teaching, research and/or administrative activities of the school. Because of its broad reach, certain portions of the Code will be more directly applicable to some disciplines than to others.  For example, the clinical portions apply mainly to physicians and medical students. Similarly, those portions pertaining to teaching and research apply to all professionals engaged in teaching and research regardless of discipline or level of training. The portions pertaining to students apply to trainees at all levels. The general portions of the Code that discuss confidentiality, conflicts of interest, interpersonal relations, and the professional ideals apply to all members. When ethics and law appear to be in conflict, one should seek counsel through the medical school, one’s own professional organizations, or individually. This Code does not replace or supersede the Policies and Procedures of Saint James School of Medicine.

PROFESSIONAL OBLIGATIONS

  1. Responsibility for Patient Care
  • Maintain the best interest of the patient as the foremost concern in all circumstances.
  • Obtain the patient’s informed consent for all diagnostic tests or therapies.
  • Follow up on ordered laboratory tests.
  • Complete patient record documentation promptly and conscientiously.
  • Coordinate with your team the timing of information sharing with patients and their families to present a coherent and consistent treatment plan.
  • Do not abuse alcohol or drugs that could diminish the quality of patient care or academic performance.
  • Do not allow to develop or engage in romantic or sexual relationships with patients. If such a relationship seems to be developing, seek guidance and terminate the professional relationship.
  • Do not abandon a patient. If you are unable or unwilling to continue care, you must assist in referring the patient to another competent practitioner willing to care for the patient.
  1. Respect for Persons
  • Treat patients, colleagues, other health professionals, other staff, students and teachers with the same degree of respect you would wish them to show you.
  • Treat patients with kindness, gentleness, dignity, compassion and honesty.
  • Respect the privacy and modesty of patients, students, faculty and other members of SJSM.
  • Do not use offensive language, either verbally or in writing, when referring to patients or their illnesses, or when communicating with peers or educators or the public.
  • Do not harass others physically, verbally, psychologically, or sexually.
  • Do not discriminate on the basis of sex, religion, race, disability, age, or sexual orientation.
  1. Respect for Patient Confidentiality
  • Do not share the medical or personal details of a patient’s history, diagnostic or therapeutic regimen, or prognosis with anyone, except those health care professionals integral to the well-being of the patient or within the context of an educational endeavor and the patient’s identity must not be disclosed.
  • Do not discuss patients or their illnesses in public places where the conversation may be overheard.
  • Do not publicly identify individual patients, in words or in writing, without adequate justification and the patients’ authorization
  • Do not invite or permit unauthorized persons into patient care areas of the institution.
  • Do not share your confidential clinic passwords with unauthorized persons.
  • Do not look up confidential data on patients without a professional “need to know”.
  • Do not photograph, audiorecord or videotape a patient without the patient’s written authorization. Every member of the institution will be responsible for observing the HIPAA rules (where applicable) in respect to patient records and confidentiality. (http://www.hhs.gov/ocr/privacy/hipaa/administrative/privacyrule/)
  1. Honesty, Integrity
  • Be truthful in verbal and in written communications.
  • Acknowledge your errors of omission and/or commission to colleagues and/or patients.
  • Clinical decision-making must not be influenced by personal, institutional, or financial considerations, at the expense of the delivery of medical care of the highest feasible quality.
  • Do not knowingly mislead others.
  • Do not cheat, plagiarize, or otherwise act dishonestly.
  • Do not abuse privileges, e.g. charge personal expenses to the medical school.
  1. Awareness of Limitations, Professional Growth
  • Be aware of your personal limitations and deficiencies in knowledge and abilities.
  • Know when and whom to ask for supervision, assistance, or consultation.
  • Know when and for whom to provide appropriate supervision.
  • Students and other trainees should have all patient workups and orders countersigned by the appropriate supervision.
  • Avoid patient involvement when you are ill, distraught, or overcome with personal problems.
  • Do not engage in unsupervised involvement in areas or situations where you are not adequately trained.
  1. Deportment as a Professional
  • Avoid the use of first names without permission when addressing adult patients.
  • Do not criticize the medical decisions of colleagues in the presence of patients or in inappropriate places.
  • Do not write offensive or judgmental comments in patients’ charts.
  • Do not introduce medical students as “Doctor” or allow yourself as a medical student to be introduced as “Doctor”.
  • Maintain a professional composure despite the stresses of fatigue, professional pressures, or personal problems.
  • Dress in a neat, clean, professionally appropriate manner.
  • Clearly identify yourself and your professional level to patients and staff. Wear your nametag when in patient areas.
  1. Avoiding Conflicts of Interest
  • Do not accept any reward in any form for any patient referral.
  • Do not refer patients to laboratories or other agencies in which you have a direct personal financial stake.
  • Do not participate in individual incentive programs sponsored by pharmaceutical and/or instrument supply companies.
  • Do not accept non-educational gifts of value from pharmaceutical companies or medical equipment vendors or suppliers.
  • Maintain the best interests of the patient when making all clinical decisions.
  1. Responsibility for Peer Behavior
  • Take the initiative to identify and help rehabilitate students, physicians, nurses, and other employees who act in an inappropriate manner, with the assistance of all of the appropriate resources made available by the school.
  • Report serious breaches of the Code of Ethics to the appropriate person.
  • Indicate disapproval or seek appropriate intervention if you observe less serious breaches.
  1. Respect for Personal Ethics
  • You are not required to perform procedures (e.g., elective abortions, termination of medical treatment) that you, personally, believe are unethical, illegal, or may be detrimental to patients.
  • You have an obligation, however, to inform patients and their families of all available treatment options that are consistent with acceptable standards of medical care.
  1. Respect for Property and Laws
  • Adhere to the regulations and policies of Saint James School of Medicine and its component institutions.
  • Adhere to all applicable local, state, and federal laws and regulations.
  • Do not misappropriate, destroy, damage, or misuse school’s property or attempt to do so.
  1. Integrity in Research and Teaching
  • Adhere to the institutional and national regulations that govern research using human subjects and/or animals.
  • Adhere to the research-specific Conflict of Interest policy.
  • Ensure all teaching practices conform with those of the school and the profession.
PROFESSIONAL IDEALS
  1. Clinical Virtues
  • Attempt to cultivate and practice accepted clinical virtues, such as caring, empathy, compassion, fidelity, fortitude, justice, integrity and self-effacement.
  1. Conscientiousness
  • Fulfill your responsibilities thoroughly.
  • Notify the responsible supervisor if something interferes with your ability to perform clinical tasks effectively.
  • Learn from experience and grow from the knowledge gained from making errors and recognizing them to avoid repeating them.
  • Dedicate yourself to lifelong learning and self-improvement by implementing a personal program of continuing education and continuous quality improvement.
  • Students and trainees should complete all assignments accurately, thoroughly, legibly and in a timely manner.
  • Students and trainees should attend scheduled classes, laboratories, seminars and conferences, except for justifiable absences.
  1. Collegiality
  • Cooperate with other members of the health care team in clinical activities, other members of the research team in research activities and other members of the teaching team in teaching activities.
  • Be prepared to teach others at all levels of education and training.
  • Be generous with your time to answer questions from trainees, patients, patients’ family members and others.
  • Shoulder a fair share of the institutional administrative burden.
  • Adopt a spirit of volunteerism and altruism in teaching and patient care tasks.
  • Use communal resources (equipment, supplies, and funds) responsibly and equitably.
  1. Personal Health
  • To the extent possible in the present context of your personal and professional life, develop a lifestyle of dietary habits, recreation, disease prevention, exercise, and outside interests to optimize physical and emotional health and enhance professional performance.
  1. Objectivity
  • Avoid providing professional care to members of your family or to persons with whom you have a romantic relationship.
  1. Responsibility to Society
  • Avoid unnecessary patient or societal health care monetary expenditures.
  • Never limit indicated individual patient care in any way to conserve monetary expenditures.
  • Provide services to all patients regardless of their ability to pay.
  • Within the limits of your personal competence and preferences, speak out on all social or public health issues to which your knowledge is relevant.

PROTOCOL FOR REPORTING SUSPECTED VIOLATIONS OF THE CODE OF ETHICS

The protocol described below is to be available to any student, staff, or employee who believes that he/she witnessed or has been subject to a violation of the Code of Ethics. It should be regarded as an informal mechanism for resolving conflicts prior to initiating any formal disciplinary action. Such informal action shall not be construed to be a part of the disciplinary procedure contained in any SJSM agreements or contracts with any parties. In no way does it replace any of the Policies or Procedures of Saint James School of Medicine, or supersede any current agreements or contracts.If the observer or the object of the unethical behavior is afraid, does not know to whom to report the incident, or feels that the issue has not been resolved satisfactorily by the above measures, the Dean of Student Affairs or the Dean of Administration or the Dean of Clinical Affairs can be consulted in a confidential manner.

  1. Each member of the medical school community who observes, or is the object of, a violation of the Code of Ethics, is advised to discuss the incident with the perpetrator, unless the member feels that this confrontation may result in personal harm and/or retribution.
  2. If the issue has not been resolved by direct discussion, or if the observer is unable to confront the perpetrator, the appropriate supervisor, department chair, and/or dean should be notified.
  3. If a violation of this code and/or unethical behavior has been observed, the observer is required to report the incident to the Dean of Student Affairs or the Dean of Administration or the Dean of Clinical Affairs.
  4. If the observer or the object of the unethical behavior is afraid, does not know to whom to report the incident, or feels that the issue has not been resolved satisfactorily by the above measures, the Dean of Student Affairs or the Dean of Administration or the Dean of Clinical Affairs can be consulted in a confidential manner.
  5. Once the unethical behavior has been reported to the appropriate Dean, the Dean will follow the Disciplinary Committee SOP in order to mediate or resolve the situation.

PROTOCOL FOR AMENDING THE CODE OF ETHICS

Proposals to amend the Code of Ethics must initially be channeled through the Faculty Affairs Committee, which shall review and discuss such at the first feasible monthly meeting thereafter. Based on the Decision Making Protocol, changes to the Code of Ethics would be considered a Level 4 decision and would ultimately have to be approved by all layers in the Decision Making Protocol, including the Board of Trustees.

Approved on the Board of Trustees Meeting

November 23rd 2015

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