CODE OF ETHICS OF THE CHILEAN MEDICAL ASSOCIATION

Chilean Medical Association

1983

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Approved by the Honorable General Council in November 1983, the Code of Ethics of the Chilean Medical Association sets moral standards for the conduct of members of the association and "should only be used by and for physicians." Articles of particular note include: (1) article 25, which proscribes physician participation in torture; (2) article 26, which permits abortion only for therapeutic reasons and, along with articles 27–28, reflects the prevalence of Catholicism in Chile; (3) articles 27 and 28, which pertain to euthanasia and death with dignity; and (4) article 44, which provides for a patient or the patient's family to request a review board to investigate the clinical findings and recommendations of the attending physician.

Declaration of Principles

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A respect for life and the human person is the basic foundation for the professional practice of medicine.

The ethical principles that govern the conduct of physicians oblige them to protect the human being from pain, suffering, and death without any discrimination.

Decorum, dignity, honesty, and moral integrity, as imperative norms in the life of a doctor, are attributes the medical community deems fundamental in its professional practice.

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Title I

General Resolutions

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article 10. Doctor-patient confidentiality is both a right and an obligation of the profession. With respect to any patient this is imperative, even when the patient is no longer under a particular physician's care.

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If a patient communicates to a physician the intent to commit a crime, such communication is not protected by the right and duty of doctor–patient confidentiality, and the physician must reveal any information necessary for the prevention of a crime or to protect any person(s) in danger.

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Title II

On the Duties of the Doctor toward Patients

article 13. The physician must attend to the needs of any person requiring his or her services and, in the absence of another colleague able to care for the patient, may not deny such attention.

article 14. Physicians may not, under any circumstances, directly or indirectly reveal facts, data, or information that they have learned or that have been revealed to them in the course of their professional work, except by judicial order, or by freely expressed authorization by a patient who is of legal age and of sound mind.

Doctor-patient confidentiality is an objective right of the patient that the physician must absolutely respect as a natural right, based neither on promise nor on pact. Doctor-patient confidentiality includes the patient's name.

article 15. In cases where it may be therapeutically necessary to have recourse to treatments involving known risk or serious disfiguring of the patient, the physician may not act without the express and informed consent of the patient or responsible family members when the patient is a minor or otherwise unable to make such decisions.

In emergency situations or in the absence of responsible family members and without the possibility of communication with them, or in the event that there be no next of kin, the physician may proceed without the above-mentioned authorization and without prejudice, after attempting to obtain the concurring opinion of another colleague in the treatment.

article 16. No physician may participate or advise in any transaction involving the transplantation of organs if said transaction involves monetary gain.

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article 22. Scientific biomedical research on human beings is necessary; however, it is acceptable only when it does not involve serious health risks. It should always be carried out under direct medical supervision.

Its design and development should follow a strict protocol and be subject to scientific and ethical review. The patient or subject of the research must be informed of both potential risks and benefits, must give consent, and must reserve the right to abstain from any part of or withdraw from the study at any time.

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article 25. A physician shall not support or participate in the practice of torture or the infliction of any other cruel, inhumane, or degrading procedures, regardless of the offense(s) of which the victim of such procedures is accused or guilty, and regardless of the beliefs or motivation of the accused or guilty victim of such procedures, including armed conflict or civil war.

A physician must not provide any rationale, instrument, substance, or knowledge expertise that would facilitate the practice of torture or other forms of cruel, inhumane, or degrading treatment, or for the purpose of diminishing the victim's capacity to resist such treatment.

A physician must not be present before, during, or after any procedure in which torture or other forms of cruel, inhumane, or degrading treatment are used as a threat.

article 26. A physician must respect human life from the moment of conception. Abortion may be performed only under the following circumstances:

1. it is performed for therapeutic reasons;
2. the decision is approved in writing by two physicians chosen for their competence;
3. the procedure is carried out by a specialist in the field.

If a physician considers that it is against his or her convictions to perform an abortion, he or she must withdraw, permitting the patient to continue medical care with another qualified physician.

article 27. A physician must not under any circumstances deliberately end the life of a patient. No authority may order or permit a physician to do so. Furthermore, no patient or person responsible for making decisions for the patient may request this of a physician.

article 28. Every person has the right to die with dignity. Thus, diagnostic and therapeutic procedures must be proportionate to the results that can be hoped for from such procedures.

A physician must relieve a patient's pain and suffering even though this may involve the risk of shortening the patient's life.

In the event of an imminent and inevitable death, were routine life support interrupted, a physician may in good faith make the decision to withhold any treatment that would prolong a precarious and painful condition. In a case where the patient is proven to be brain dead, the physician is authorized to withhold any and all types of treatment.

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Title III

On Physicians' Relationship with Colleagues

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article 44. Any and all physicians must consult with one or more colleagues whenever the making of a diagnosis, the type of illness, or treatment requires such collaboration.

A patient or patient's family, with the knowledge of the attending physician, may ask that a Review Board be arranged if they deem it necessary.

It is a moral duty of the attending physician to accept the collaboration of colleagues convened on the Review Board, who shall examine the patient in the presence of the attending physician and one after the other, except in special cases. The findings of the Board shall be discussed among the attending and collaborating physicians before the Chief Physician makes them known to the patient or to the patient's family.

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