In response to a number of recent lawsuits related to brain death determination, the American Academy of Neurology Ethics, Law, and Humanities Committee convened a multisociety quality improvement summit in October 2016 to address, and potentially correct, aspects of brain death determination within the purview of medical practice that may have contributed to these lawsuits. This article, which has been endorsed by multiple societies that are stakeholders in brain death determination, summarizes the discussion at this summit, wherein we (1) reaffirmed the validity of determination of death by neurologic criteria and the use of the American Academy of Neurology practice guideline to determine brain death in adults; (2) discussed the development of systems to ensure that brain death determination is consistent and accurate; (3) reviewed strategies to respond to objections to determination of death by neurologic criteria; and (4) outlined goals to improve public trust in brain death determination.
The American Academy of Neurology (AAN) developed the Code of Professional Conduct to formalize the standards of professional behavior for AAN members to help them in their pursuit of providing the highest quality of patient-centered neurologic care. The goal of this code is to establish the professional standards that AAN members must or should observe in their clinical, academic, scientific, and personal activities.Violations of these standards may serve as the basis for disciplinary action as provided in the AAN's Bylaws 1 and Disciplinary Action Policy. 2 The code applies to all categories of AAN membership, to the extent the AAN member is participating in the relevant activity addressed by the code. This code embodies traditional standards of medical ethics, dating from the time of Hippocrates and adapted to align with contemporary medical practice and ethical values. It is written in broad language to apply principles of medical ethics to the specific demands of neurologic practice.In this code, use of the word "must" indicates that an action is ethically obligatory for AAN members; such actions are near-absolute obligations, not matters about which AAN members may use judgment or discretion. Use of the word "should" indicates an action that is ethically permissible, preferable, and strongly recommended; such actions are subject to exceptions only under special circumstances based on the AAN member's ethical judgment and discretion, exercised on behalf of the best interests of the patient. 3 When the code uses the word "including" to refer to specific examples, the word should be understood to mean "including but not limited to." The code is intended to be generally consistent with the American Board of Internal Medicine Foundation's Medical Professionalism in the New Millennium: A Physician Charter, which is endorsed by the AAN. 4 Any reference to the law in this code is for illustrative purposes only: the statements do not describe legal obligations or the consequences of violating those obligations, both of which can vary by jurisdiction. The code is not intended to establish standards of clinical practice for use in criminal or civil proceedings. If any provision of this code conflicts with state or federal law, the relevant laws will govern in any judicial proceeding.Where relevant, AAN members are encouraged to seek guidance from documents referenced in this code.
Objective: To examine the American Academy of Neurology (AAN)'s prevention and limitation of conflicts of interest (COI) related to relationships with pharmaceutical and medical device manufacturers and other medically related commercial product and service companies (industry). The American Academy of Neurology and its affiliated organizations (AAN) have relationships with industry, including pharmaceutical and medical device manufacturers and other medically related commercial product and service companies, which have mutual benefits, but carry the risk of conflicts of interest (COI). COI may cause unintended harm by creating bias, favoritism, undue influence, and a resulting loss of public and member confidence in the integrity and objectivity of the AAN. In recognition of these risks, the AAN has longstanding policies to prevent and limit COI and their consequences, including strict enforcement mechanisms to guarantee that the policies are followed. Methods:In this article, we highlight the response of the AAN to the heightened concern about industry COI through an AAN Board of Directors-appointed task force, a review of existing policies, and the implementation of newly revised policies governing AAN relationships with industry. We also note what we consider important issues regarding COI and biases that have not yet been appropriately addressed. PROMOTING AND PROTECTING THE AANS MISSIONThe AANЈs vision is to be indispensable to its members. This goal is accomplished by promoting the highest quality patient-centered neurologic care and
Objective: To review the disciplinary process by which the American Academy of Neurology (AAN) enforces its formalized standards of professional conduct. Methods:We reviewed the AANЈs Disciplinary Action Policy. We tracked the elapsed time from receipt to final decision of all allegations ("complaints") of improper conduct by AAN members submitted from 2004 to 2009. We placed each complaint into 1 of 4 categories: allegations of 1) improper expert witness testimony; 2) substandard care; 3) unprofessional conduct; 4) or both 2 and 3. We noted the type of complainant (AAN member or nonmember) and the final outcome for each complaint. Results:The AANЈs disciplinary process is a 5-step procedure with multiple reviewing bodies.
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