AMA conference studies medical ethics

Physicians from across the country gathered in Philadelphia last weekend to celebrate the 150th anniversary of the American Medical Association and its Code of Ethics and to examine the ethical challenges facing the medical profession. The "Ethics and American Medicine" conference -- sponsored in part by the University's Center for Bioethics -- also featured a history of the ethical codes that have guided modern medicine. In a written release, Penn Center for Bioethics Director Arthur Caplan described the conference as "the historical/medical/ethical/philosophical event of the decade." Many of the event's speakers focused on the changes that have resulted from managed care by the large corporations that control many hospitals. "It all comes down to whether medicine is fundamentally a business or a profession," AMA Vice President and General Counsel Kirk Johnson said during an address to the conference. He also lamented the bureaucracy and lack of patient control that have commonly resulted from managed care. Johnson stressed that patients are not the only group harmed by managed care, citing attempts by health plans to "gag" doctors who disagree with their patient care policies. But many speakers disagreed with Johnson's argument for paying more attention to individual patients, pointing to the importance of keeping the good of the wider community in mind while allocating scarce financial resources. "We cannot and will not be able to do everything for everyone," Mount Sinai Medical Center Geriatrics Department Chairperson Christine Cassel said. Managed care policies were widely criticized by the conference's participants, with one member of the audience stating that "managed care is neither managed nor care." And Boston University Health Law Department Chairperson George Annas describing managed care as "deprofessionalized medicine," decrying the "change from fee-for-service to fee-for-no-service." University of Washington Medical History and Ethics Department Chairperson Albert Jonsen used his keynote address on the future challenges to medical ethics to remark that "the first generation of bioethics is ending." "The new ethicists will have to refresh the old commandments and show the way into the future," he said. But while several participants debated the ethical challenges posed by cloning, they expressed amazement at the manner in which the complex issue was treated in the mainstream media. Caplan -- who moderated the roundtable discussion on the future challenges facing medical ethics -- pointed to the "complete hyperventilation of a society over a particular scientific experiment." "I think the time has come? to really take stock? across society about who we have to be to go into this next technological revolution," he said. And during the panel, National Center for Human Genome Research Francis Collins explained that genetic research has tremendous potential for preventing disease. "Virtually every disease that afflicts us has genetic underpinnings," he said. "Even AIDS." But Collins warned that scientific information gained from genetic testing not be released to the public to guard against violating the "dual pillars" of personal privacy and anti-discrimination. The AMA also announced the creation of an Institute for Ethics which will research ethical issues and design practical policy initiatives with an immediate focus on educating physicians on caring for dying patients.