Updated ACP Ethics Manual addresses genetic testing, telemedicine, end-of-life care

The seventh edition of the ACP Ethics Manual reaffirms ethical tenets of medicine and reexamines their application in changing circumstances.


ACP offers ethical guidance on genetic testing, telemedicine, and end-of-life care, human subjects research, and more in its recently updated Ethics Manual. The seventh edition of the ACP Ethics Manual reaffirms ethical tenets of medicine and reexamines their application in changing circumstances and was published as a supplement to Annals of Internal Medicine on Jan. 15.

New or significantly expanded sections include those on precision medicine and genetic testing, research and protection of human subjects, telemedicine, electronic communications, social media and online professionalism, electronic health records, and physician volunteerism.

In the guidance regarding precision medicine, the manual states, “Testing should not be undertaken until the potential consequences of learning genetic information are fully discussed with the patient. For these and other reasons, patients should be aware that personal genomic direct-to-consumer testing should be approached with caution. Physicians should inform patients of genetic privacy risks and implications for themselves and family members, so that patients are able to make a well-informed decision about testing and disclosure of genetic information.”

In the guidance regarding telemedicine, the manual states, “The benefits of increased access to care through telemedicine must be balanced with risks from the loss of the in-person encounter, e.g., misdiagnosis potential; over-prescribing; absent in-person interactions including the therapeutic value of touch, body language; and continuity of care.”

An accompanying editorial said that “The American College of Physicians and the authors of the Ethics Manual have provided helpful, specific guidance on many difficult ethical issues that internists face in everyday practice as well as providing an explanation of the ethical principles and professional obligations that justify these recommendations.”

A related CME quiz and a Maintenance of Certification (MOC) module are available at annals.org for ACP members and subscribers to Annals of Internal Medicine. ACP also offers ethics case studies for CME credit and MOC points.