AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. April 2001, Volume 3, Number 4.

Perspectives

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Through the Student's Eyes: Having a Voice in Revising The Code

A medical student serving on the AMA's Council on Ethical and Judicial Affairs describes the inner workings and responsibilities of the Council.

Matthew Weiss

When I applied for the student position on the AMA's Council on Ethical and Judicial Affairs (CEJA) during my second year of medical school, all I knew about the group was that it discussed and promulgated AMA ethics policy. After talking to people familiar with the Council and conducting further research on my own, it seemed that serving on CEJA would be a valuable opportunity for me to discuss issues of ethical import with other physicians. I also believed that it would be interesting to have a voice in setting policy that could potentially have wide-ranging effects on American medicine.

The policy discussions required some adjustment on my part. I was used to writing and talking about bioethics in a purely academic setting -- one where incisive analysis and cogent theorizing are highly valued. On CEJA, I quickly learned that I needed to adopt a more pragmatic mindset. While an issue's complexity was understood and appreciated, arriving at a workable solution and setting forth policy that could realistically be applied were priorities. The challenge of developing practical codes of conduct, I discovered, included weighing political concerns and ethical ones so that recommendations could be implemented in the real world of medical practice.

As I settled into my term on the Council, which is composed of 7 practicing physicians, 1 resident, and 1 student, I gained a great appreciation for the members and the staff. All are dedicated, talented, and passionate people who see the importance of our work and take pride in doing it well. It is also a very warm and friendly group, which made attending meetings a pleasure.

During my brief tenure on CEJA, we discussed a range of troubling and weighty topics. Typically, each issue is addressed in a report that the Council and staff put together collaboratively. Two members of CEJA acting as "shepherds" for the report bring it before the reference committee and House of Delegates. If the report is passed, its recommendations become opinions of CEJA and go into the AMA Code of Ethics. However, if the House votes down the report, the Council and staff revise it and reintroduce the it at the next meeting of the House of Delegates.

This discussing, writing, shepherding, and rewriting process comprises the bulk of the Council's work. As a student, I have a voice and a vote equal to those of Council members. Of course, lacking a long career in the practice of medicine but being intimately familiar with the current climate of academic medical centers, I have more insight into certain issues than into others. Because I am particularly concerned about policy relevant to training in medical school, I have consulted with the leadership of the AMA's Medical Student Section and worked to bring the concerns of the Section to the attention of the Council. CEJA has always tried to accommodate the students' viewpoint, and we have attempted (I think successfully) to strike an acceptable balance between the interests of medical education and those of ethical practice.

The other, less enjoyable though important, responsibility of the Council is its judicial function. CEJA is called upon to adjudicate certain conflicts and also to discipline AMA members who have exhibited egregious misconduct. Judicial hearings are conducted by conference call and, contrary to all other aspects of the Council's work, the student member does not vote in judicial matters unless the accused member is a medical student. I can, however, participate fully in the deliberations.

I have enjoyed my term on CEJA and am sorry to see it coming to an end. The members and staff of the Council have been a pleasure to work with, and I will miss seeing them regularly. Serving on CEJA has been a daunting responsibility, as well as a significant time commitment, but the full support of my medical school made the latter concern less onerous. Besides having the opportunity to think and talk about a number of complex ethical issues and have an impact on the practice of American medicine, I've learned a great deal about the inner workings of the AMA, a group for which CEJA is the institutional conscience.

The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.