AMA <i>Code of Medical Ethics</i>’ Opinions Related to Health Ecology and Disease Transmission

Abstract

The AMA Code of Medical Ethics focuses primarily on physician responsibilities and obligations in the context of patient-physician and community-physician relationships. Nevertheless, key principles outlined in the AMA Code facilitate understanding of complex relationships among humans, nonhuman animals, and our ecosystem and offer guidance for both clinicians and professional bodies on changing ecological factors that impact individual health.One Health in Practice Since the onset of the COVID-19 pandemic, health professions communities have paid more attention to health ecology and One Health approaches to controlling infectious disease transmission. One Health has been defined as "the collaborative effort of multiple disciplines-working locally, nationally, and globally-to attain optimal health for people, animals and our environment." 1 Although One Health has been operationalized in medical spaces through an anthropocentric lens for the promotion of human health, it is important to note that each facet of the interdependent, triadic relationship between human, animal, and environmental health warrants moral consideration in its own right. 2,3 Because of the importance of this relationship for human health, 4 ecological influences on health are of heightened ethical concern and value to the American Medical Association's (AMA's) mission of promoting "the art and science of medicine and the betterment of public health." 5 The AMA Code of Medical Ethics outlines some of these considerations in relation to infectious disease transmission risk and prevention. Zoonotic TransmissionNonhuman to human animal disease transmission, known as zoonotic transmission, has heightened the threat to human well-being, as climate change and antimicrobial resistance increase risk of zoonosis. 6,7 Zoonotic pathogens often mutate in ways that increase risk of transmission; notable examples of this phenomenon include the influenza, SARS, COVID-19, and Ebola viruses. 8,9,10 Furthermore, current food system practices, such as factory farming, also increase the likelihood of zoonotic disease transmission. 11,12 Thus, physicians should learn about and acknowledge ecological impacts on human health in order to better serve patients whose health has been compromised by zoonotic and environmentally influenced diseases.