February 26, 2014

Integrated Health Care Requires Unified Code of Ethics

APA executive calls for transdisciplinary professionalism statement

WASHINGTON — As the health care system evolves into more team-based models of care, there needs to be a cross-disciplinary code of ethics that applies to all the relevant professions, including nursing, medicine, psychology and others, according to a top executive of the American Psychological Association.

Cynthia Belar, PhD, APA’s executive director of education, co-authored a column in the Feb. 26 issue of the Journal of the American Medical Association, calling for this unified code of ethics. 

“Society and the health system are undergoing substantial shifts today, not merely because of the Patient Protection and Affordable Care Act of 2012 but from forces including the advent of increasingly complex and expensive treatment options, increasing cost pressures, faster and more voluminous information flow, more patients with chronic conditions, and larger number of highly educated practitioners from diverse disciplines caring for patients together,” the authors wrote. “Yet, while health care professional codes of ethics often include statements on shared decision making and team-based care, none have recognized a need for fundamental, structural changes to the social contracts that govern the work of health care professionals and their roles and relations in society.”

The traditional approach in health care has siloed the professions according to education and credentialing, the authors note. “This separation has allowed groups at times to ignore, show little regard for, or even be overtly hostile toward the roles of other groups,” they write. “This approach is counterproductive in today’s health care environment, which demands teamwork.”

In addition to a transdisciplinary code of ethics, Belar and the others propose “an ongoing multidisciplinary forum” to define, distribute and enforce the standards. Finally, they call for reciprocity among the health care professions and broad public input in developing the new code. 

The co-authors of the column, entitled “A Unified Code of Ethics for Health Professionals: Insights from an IOM Workshop,” are Matthew K. Wynia, MD, MPH, of the American Medical Association, and Sandeep P. Kishore, PhD, of Weill Cornell Medical College, Rockefeller University and Sloan-Kettering Institute and Young Professionals Chronic Disease Network. All three authors were expressing personal opinions and not writing on behalf of the organizations with which they are affiliated. 

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes more than 134,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives.