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Cited by 1,021Ethics in medical practiceEthics and bioethics in healthcareHealth, Medicine and Society

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Medical professionalism in the new millennium: a physician charter

ABIM Foundation, ACP-ASIM Foundation, European Federation of Internal Medicine·2002·Obstetrics & Gynecology
DOI 10.1016/s0029-7844(02)02082-3
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Abstract

Project of the ABIM Foundation, ACP–ASIM Foundation, and European Federation of Internal Medicine* To our readers: I write briefly to introduce the Medical Professionalism Project and its principal product, the Charter on Medical Professionalism. The charter appears in print for the first time in this issue of Annals and simultaneously in The Lancet .I hope that we will look back upon its publication as a watershed event in medicine. Everyone who is involved with health care should read the charter and ponder its meaning. The charter is the product of several years of work by leaders in the ABIM Foundation, the ACP‐ASIM Foundation, and the European Federation of Internal Medicine. The charter consists of a brief introduction and rationale, three principles, and 10 commitments. The introduction contains the following premise: Changes in the health care delivery systems in countries throughout the industrialized world threaten the values of professionalism. The document conveys this message with chilling brevity. The authors apparently feel no need to defend this premise, perhaps because they believe that it is a universally held truth. The authors go further, stating that the conditions of medical practice are tempting physicians to abandon their commitment to the primacy of patient welfare. These are very strong words. Whether they are strictly true for the profession as a whole is almost beside the point. Each physician must decide if the circumstances of practice are threatening his or her adherence to the values that the medical profession has held dear for many millennia. Three Fundamental Principles set the stage for the heart of the charter, a set of commitments. One of the three principles, the principle of primacy of patient welfare, dates from ancient times. Another, the principle of patient autonomy, has a more recent history. Only in the later part of the past century have people begun to view the physician as an advisor, often one of many, to an autonomous patient. According to this view, the center of patient care is not in the physician’s office or the hospital. It is where people live their lives, in the home and the workplace. There, patients make the daily choices that determine their health. The principle of social justice is the last of the three principles. It calls upon the profession to promote a fair distribution of health care resources. There is reason to expect that physicians from every point on the globe will read the charter. Does this document represent the traditions of medicine in cultures other than those in the West, where the authors of the charter have practiced medicine? We hope that readers everywhere will engage in dialogue about the charter, and we offer our pages as a place for that dialogue to take place. If the traditions of medical practice throughout the world are not congruent with one another, at least we may make progress toward understanding how physicians in different cultures understand their commitments to patients and the public. Many physicians will recognize in the principles and commitments of the charter the ethical underpinning of their professional relationships, individually with their patients and collectively with the public. For them, the challenge will be to live by these precepts and to resist efforts to impose a corporate mentality on a profession of service to others. Forces that are largely beyond our control have brought us to circumstances that require a restatement of professional responsibility. The responsibility for acting on these principles and commitments lies squarely on our shoulders.

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Metadata

Authors
ABIM Foundation, ACP-ASIM Foundation, & European Federation of Internal Medicine
Corresponding author
ABIM Foundation
Venue
Obstetrics & Gynecology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2002-07
Volume
100
Issue
1
Pages
170-172
ISSN
0029-7844 (ISSN-L)
DOI
10.1016/s0029-7844(02)02082-3
OpenAlex
W2921001134
Cited by
1,021
References
0
Citations by year
2025: 1 · 2023: 1 · 2022: 5 · 2021: 25 · 2020: 35 · 2019: 44 · 2018: 26 · 2017: 52 · 2016: 61 · 2015: 51 · 2014: 73 · 2013: 69 · 2012: 75
FWCI
100.56
Type
journal article
Language
en
Open access
closed
Locations
  • Obstetrics and Gynecology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
  • Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
Keywords
medical professionalism, patient well-being, patient autonomy, social justice, health care resource distribution, physician-patient relationship, health care delivery reform, physician commitment, medical ethics, patient-centered care, physician as leader
MeSH terms
Forecasting, Humans, Physician's Role, Professional Competence, Quality of Health Care, United States, Clinical Medicine, Ethics, Clinical

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