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Duke University School of Medicine Honor Code of Professional Conduct Preamble The Duke University School of Medicine strives to attract, matriculate, and train health professional students who have a high capacity for ethical professional behavior. Since training in professional behavior is a part of training in the health professions, professional conduct during training is an academic issue, and when a student accepts an offer of admission into these programs, he or she commits him or herself to comply with all regulations regarding conduct established by Duke University, the School of Medicine, and the individual's program. Despite these initial intentions, circumstances may arise during a student's enrollment that call into question the capacity or commitment to maintain this academic standard, and the school and training program retain the responsibility and authority to determine a student's fitness to continue in the program of study for a health profession. The rights and responsibilities of students with regard to University-wide regulations pertaining to student conduct can be found in the current Bulletin of Information and Regulations of Duke University. As a distinct learning community within the University, the School of Medicine has established an Honor Code of Professional Conduct, accompanied by specific policies and procedures, for the guidance and protection of students in two circumstances: 1. while they are enrolled as a student in the school, and 2. after they have left the school in matters pertaining to their credentials, transcripts, and degrees that have been granted by the school. The principles from which the Honor Code is derived include but are not limited to: 1. University regulations regarding student conduct 2. Guidelines for standards of conduct adopted by national organizations that accredit our programs (AAMC, LCME, ARC-PA and APTA) or license or certify our learners (USMLE, state licensing board) 3. Standards of ethical and professional behavior adopted by national or local professional organizations (AAPA, AMA, APTA) 4. Standards of fairness, privacy, and due process derived from the civil judicial system It is the responsibility of each matriculating student to review the honor code and its policies and procedures before beginning formal educational activities, and the responsibility of the school to ensure that students understand the code and document their understanding. Students should read and discuss the honor code and the rules and regulations of their chosen programs of study before beginning classes. Entering students will be asked to sign statements saying that they have read, understand and will abide by the Honor Code of the Duke University School of Medicine and the Rules and Regulations of their various programs. Matriculation in the Duke University School of Medicine constitutes de facto acceptance of this Honor Code and the policies and procedures involved in administering the Honor Code. A copy of each student's signed Honor Code Agreement will be retained in his or her permanent educational record. Scope of the Honor Code The Honor Code is intended to guide the professional behavior of students studying in the health professions programs and applies to all endeavors and conduct pertaining to those studies. It is not intended to guide behavior that is a part of a student's private life away from his or her studies in a direct way, but such behavior may come to the attention of the school in several ways and become the focus of an Honor Code investigation: • conduct may be reported to a member of the faculty or administration by a variety of sources (police, friends, parents, other agencies) that raises a concern about the student's capacity to continue his or her studies. If such reported conduct raises a significant concern about the safety of the student or the safety of others that the student may have contact with at the school, or includes behavior that could indicate a weakness of moral, ethical or personal values that would preclude functioning as a health care professional, an investigation may be done and action taken on the basis of the investigation. • if a student is charged with an offense in the civil justice system and the school becomes aware of and verifies this circumstance through self-report of the student or a reliable source of verification, the school will generally not pursue an investigation until the outcome of the civil court proceeding is known, unless the alleged offense is such that allowing the student to continue his or her studies could be detrimental to the safety of patients or other members of the school, as determined by the Vice Dean for Education.. • if a student is charged with a criminal offense, he or she is obligated to report this to the Vice Dean for Education immediately. If a matriculating student has been charged with a criminal offense between the time he/she wrote an application and the time he/she arrives at school, he/she should inform the Vice Dean before or upon arrival. If the school later discovers that a student has withheld disclosure of a criminal charge, he/she may be subject to immediate dismissal by the Vice Dean. In all situations, the student will not be allowed to continue the course of study until cleared of a criminal charge. This does not reflect a "guilty until proven innocent" standard, but rather, the obligation of the school to ensure the safety of patients and other members of the school. Statement of the Honor Code of Professional Conduct The students of the Duke University School of Medicine understand that it is a privilege to learn the practice of their chosen professions in a clinical setting. At the same time, they recognize the obligation that they have to the health and welfare of their patients and to their patients' families. As they enter professions in which they will have an extraordinary responsibility for others' lives and health, students will strive to hold themselves to the highest standards of academic integrity and conduct. As part of their education and training, students must begin to practice the ethic of service that they will uphold for the rest of their professional lives. Since training in ethical and professional behavior is integral to the education of the health professional, violations of this Honor Code will be considered as an academic issue and may jeopardize advancement and graduation in the same way as other academic matters. The Honor Code is written to promote a sense of intellectual honesty, trust, responsibility, and professionalism among students, faculty and staff of the School of Medicine. It should be understood that these guidelines represent standards to strive for, and that not every infraction will necessitate investigation. It should also be recognized that this honor code can not anticipate every potential offense and that unethical behavior not specifically mentioned in this code can still be investigated. Specific incidents will be considered in the context in which they occur. In addition, the magnitude and chronicity of infractions will be taken into account. To demonstrate intellectual integrity and honesty, the student will: • submit for course credit only one’s own work and not that of another, in whole or in part, and will give credit for passages taken either word-for-word or paraphrased from the work of another (i.e., plagiarizing other sources to write or present academic papers, research reports, or clinical reports is dishonest). • not collaborate with others on work that is claimed to be one’s own. Instructors will make clear when collaboration is permissible, and students should ask for clarification when in doubt. • give full and obvious acknowledgement to collaborators when collaboration to produce a project or report is permitted. • offer original work for course or research credit and not submit work done previously for credit in another course. • not use, give, or receive unauthorized materials or assistance to gain unfair academic advantage over colleagues prior to, during or after an examination or other evaluative procedure. • not take an examination nor complete an assignment for another person. • respect the intellectual property and learning materials of others understanding that to take, keep, tamper with or destroy such property would result in unfair academic advantage. • take all examinations when scheduled unless appropriately excused. Students should never delay taking examinations for the sole purpose of gaining academic advantage over colleagues. • not alter or falsify academic, research or patient documents. • not gain unauthorized access to academic or administrative files, patient medical records, or research documents, via computer or otherwise. • use only access codes, passwords, login codes, keys, and facility access cards issued to the student. • report promptly any suspected violations of the Honor Code to appropriate authorities. • refrain from other behaviors that clearly compromise intellectual integrity and honesty. To show concern for the welfare of others and act responsibly, the student will: • treat patients, research subjects, and their family members with respect and dignity both in their presence and in discussions with others. • undertake clinical duties and persevere to the best of the student’s ability, striving to recognize limits on the capacity to persevere due to limited knowledge or skills, exhaustion, or impairment. • strive to recognize the limitations of the student’s knowledge and skills, and seek supervision or advice before acting when appropriate. • learn to recognize when his/her ability to function effectively is compromised, ask for relief or help, and notify the responsible person if something interferes with the ability to perform clinical or research tasks safely and effectively. • not compromise patient care, interactions with members of the Duke community, nor his/her medical education through the use of alcohol or illegal substances • not engage in romantic, sexual, or other nonprofessional relationships with a patient, even upon the apparent request of a patient. Students should voluntarily remove themselves from patient care duties and seek professional help or advice from their program director, advisory dean or director of the Wellness Center when they recognize any physical, mental, or emotional problems that could impair effective patient care, their interactions with members of the Duke community, or their educational program. It is the obligation of the school and its officials to help the student seek appropriate help for an impairment, and the student would become subject to an Honor Code charge only if he/she did not follow recommendations and referrals for appropriate help. To demonstrate respect for the rights of others, build trust in professional relationships, and demonstrate professional demeanor, students will: • deal with professional, staff and peer members of the health care team in a considerate manner and with a spirit of cooperation. • act with an egalitarian spirit toward all persons encountered in a professional capacity regardless of race, religion, gender, sexual preference, disability or socioeconomic status. • avoid offensive language, gestures, or remarks, including those based on others’ race, religion, gender, sexual preference, disability, or socioeconomic status. • avoid disruptive behavior in the classroom, clinic, hospital, or laboratory that might interfere with the learning or clinical care of others • respect the right of the patient or research subject and his or her family to be informed about and participate in patient care. • respect patients' and research subjects’ modesty and privacy. • be truthful in communications with others, admit errors and not knowinglymislead others or promote themselves at the patient's expense. • maintain and safeguard the confidentiality of patient and research subject information, including paper records, computerized records, and verbal communication. • not misrepresent themselves as a licensed or certified health care provider. • strive to maintain their composure under pressures of fatigue, professional stress or personal problems. • maintain neat and clean appearance, and dress in attire that is acceptable as professional to the patient population served.
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