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October 24, 1986

Recent Opinions of the Council on Ethical and Judicial Affairs

Author Affiliations

From the Council on Ethical and Judicial Affairs, American Medical Association, Chicago.

JAMA. 1986;256(16):2241. doi:10.1001/jama.1986.03380160099028

THE COUNCIL on Ethical and Judicial Affairs has given careful consideration to the following opinions and submits them to the House of Delegates for its information. Ethical pronouncements of the Council on Ethical and Judicial Affairs should not be interpreted, construed, or applied to encourage conduct that violates the law.

Referral of Patients—Disclosure of Limitations  When a physician agrees to provide treatment, he thereby enters into a contractual relationship and assumes an ethical obligation to treat the patient to the best of his ability. Preferred provider organization (PPO) and health maintenance organization (HMO) contracts generally restrict the participating physician's scope of referral to medical specialists, diagnostic laboratories, and hospitals that have contractual arrangements with the PPO or HMO. Some plans also restrict the circumstances under which referrals may be made to contracting medical specialists. If the PPO or HMO does not permit referral to a noncontracting medical specialist or to