Question: "A colleague asked for advice about operating on a family member. His parents recently relocated to his metro area and have yet to develop a relationship with a local ophthalmologist. I am not confident counseling him. What are the ethical ramifications of treating a family member? ”
Answer: Regarding an ophthalmologist operating on a family member, the AAO Code of Ethics is silent on this issue since the Code focuses on the care provided to a patient rather than the identity of the patient. However, the question is certainly one to ponder with great care.
The AMA’s Code of Medical Ethics Opinion 1.2.1, Treating Self or Family, cites "several challenges for physicians, including concerns about professional objectivity, patient autonomy, and informed consent", and later notes that “In general, physicians should not treat themselves or members of their own families…”.
If your colleague decides to proceed, he should follow all normal procedures, including each routine pre-, intra-, and post-operative procedure, diagnostic testing, proper documentation, informed consent, follow-up, and prompt referral in the postoperative period if anything looks amiss. During the informed consent conversation, he and the family member should have an honest discussion about what may happen to their relationship if there is an unexpected outcome. State licensing boards, surgical facilities, and risk management companies may have guidelines or prohibitions that should be explored prior to treatment. Last, reducing or waiving co-payments or deductibles for family members with Medicare and/or private health insurance plans is not allowed and is a violation of your contract. Medicare does not allow billing for services provided to family members by you, any of your associates or your professional corporation (and commercial plans agree).
To read the Code of Ethics, visit aao.org/ethics-detail/code-of-ethics.
To submit a question, email ethics@aao.org.