Neither ethics nor professionalism is new. We cannot take either of them for granted. At times it is necessary to discuss what they mean and how to safeguard our position in society, for we as surgeons will be judged more by our behaviour than by the technical aspects of our work. The medical defence insurers have data to support this claim.
Human behaviour is complex and there are competing forces. Not everything that can be done should be done and not everything that should be done can be done. We need to look after individuals, our society, and ourselves. We are governed by the law and by principles to which we subscribe. As a mature association, we need to articulate rules by which to live and work as colleagues, for we depend on each other in many ways.
Some of the most basic rules are: do no harm; tell the truth; respect others; and do not steal. One could expand on these and include: altruism, responsible decision-making; confidentiality; declaration of interests; knowing ones limitations, and many others. One of the differences between a trade and a profession are the moral principles and standards, which we profess to have. Most important of these is that we profess to act in the interest of our patients.
It is worth noting that law and morality (or ethics) are not the same. Laws are made by society, usually by a majority, and laws can change. Moral codes are less well defined and often influenced by philosophical or religious values. Not every illegal act is necessarily immoral, such as decisions about the end of life. Even though it may be legal to charge inflated fees, is it morally right to do so? Codes of conduct are sets of rules, which state a minimum standard of behaviour within an organisation. We should not only defend the letter, but the sprit of our code.
As doctors and surgeons, we are in a position of power through knowledge and through professional privileges vested in us. We must avoid even perceived exploitation of our patients for monetary or reputational gains. Codes of conduct help to maintain the trust of the public and give assurance to those, who act with conscience, that others will not undermine them.
As Australian surgeons, we have a number of codes to follow, from the Australian Medical Councile, the Australian Medical Association, the Royal Australasian College of Surgeons, and of course our own AOA Code of Conduct. The spirit of these codes is much the same. Some of our members assume that it is the job of the AOA to police our code and to reprimand renegade members. AOA has done so in the past and we will continue to defend our Code of Conduct. If an association is seen to uphold high ethical and professional standards, then the reputation of its members can only increase.