Are professional bodies legally able to limit what their members do professionally, o

[Skeptic Ginger]

So correct me if I'm wrong on this. The government permits you to practice*, and the professional body tells you how to practice. Is that a reasonable summation?

*ETA: within the limits of the law, of course.

Sort of. It differs a bit by state, especially with advanced practice nurses. The law spells out who (a board) oversees the practice and the general laws governing licensure. There are a few pages of laws re practice, licensing, etc.

There is a board of pharmacy that governs prescriptive authority. There are lots of laws re prescribing controlled substances that are federal laws. They recently got longer because they added paperwork including weekly documentation.

There are laws governing hospitals, clinics, and other out-patient facilities that include personnel/staffing laws.

IOW the law is a bit fragmented and one needs to know all the laws that apply to them.

But the scope of practice is not spelled out because that would be impossible. There can't be a law governing how to manage a patient with a stroke, for example, because there are too many variables. So practice is left up to the education and experience of the licensed professionals.

In my case for example, as an advanced practice nurse, I am licensed in this state to do anything a doctor can do. It's up to me to define my scope of practice and that differs by advanced practice specialty and practice location. Some ARNPs do medical rounds for the physicians that employ them. And that can include everything the doc would do on said rounds. The NPs can cover for the MDs which again means they do everything the docs do.

Other NPs provide a full scope of services in fields like women's health care, diabetes, or hospital intake and so on. In my case I started my own practice in occupational infectious disease. But I digress.

Bottom line there are no practice laws per se. Most laws are administrative. Practice laws boil down to 'you have experience and education, you can figure it out'.

 

[arthwollipot]

Interesting. Thanks.

 

[Chanakya]

Yes. They are free to define what ethical guidelines their members must uphold in order to remain members of that organization. See additional commentary at the bottom of this post.


Agreed. There is no legal or civil aspect to it which can be challenged, given the already stated requirement that such rules do not break the law themselves.


It wouldn't make sense to legally challenge the membership requirements of a private entity. These organizations have high profiles and are associated with professions that require a lot of trust from laypeople who don't have enough knowledge to determine whether or not the professional is doing the right thing on their own - and that makes it more complex in terms of what the general public understands about how it works. But for all intents, taking a legal challenge to the rules for membership in a private organization (when those rules do not violate any laws) would be akin to legally challenging ISF for their membership rules. I mean, you *could* do it if you really wanted to... but it's incredibly unlikely to get you anywhere. Membership rules in a private organization aren't a matter of legality.



Let me circle back to item 1. Yes, the AMA could make that rule. And the AMA could kick out any doctor that performs an abortion.

But the AMA doesn't make laws, nor do they enforce laws. And as SG pointed our earlier, the AMA doesn't grant licenses to practice, nor do they have the power to rescind them. There's a pretty reasonable chance that you'd end up with the AMA kicking out a whole lot of doctors who would then go on to continue practicing medicine whether they're members of AMA or not. I think there'd likely be a whole lot of arguments between the state and the AMA on the topic, and depending on the degree of support, AMA might end up backing down.

That said - it's a complicated relationship, and those relationships aren't the same for all professions with these sorts of governing bodies.

For instance... At both the state and federal level, some types of regulatory filings require a signature by an accredited Actuary in good standing. If the filings don't include a signatory with the right credentials, the filing will be rejected. Good standing means that they are a member of the American Academy of Actuaries and have not been censured or reprimanded in a way that precludes them doing work in that practice area. "Big A" Actuary means they've completed the examination process provided by one of the other actuarial organizations (there are several in the US, the biggest being the Society of Actuaries and the Casualty Actuarial Society).

Given the way the current regulations work... if the AAA were to introduce an ethical guidelines that was well beyond the scope of legality, and also rescinded the language allowing for law to take precedent, then it would be hypothetically possible for the AAA to reprimand or censure actuaries in a way that prevented them from complying with their regulatory obligations.

It's highly unlikely to happen though. Were that situation to arise, there'd be a material conflict between regulations and the governing body, which would at a minimum result in some very serious discussions. If the AAA didn't alter their guidelines in order to allow for compliance with regulatory requirements, we could very feasibly end up with a change to the regulations so that signatories were no longer required to be a member of AAA in the first place, but provided some other means for the signatory to demonstrate or affirm competence and requisite expertise. This in turn would weaken the standing of the AAA and that's something they would definitely not want to see happen.

That was a great post, thank you, Emily’s Cat. All of what I’d asked about, very clearly discussed.

Basis this, well not just this actually basis this whole thread, but as IMV nicely captured in your post, I think I’ll type out a post summarizing my takeaway/s from this thread, the answers I’ve arrived at to the question/s I’d been asking. As well as some further loose ends, as they appear to me. I’ll appreciate it if you could take a look. (Not just you, also anyone else who’s familiar with the industry, which would include you certainly, Skeptic Ginger, and who’d care to share their knowledge and understanding on this matter.) In the post immediately following.

 

[Chanakya]

Conclusion/s, and some loose ends

Some takeaways from this thread. From my perspective, and compared to where I'd been at the time I wrote the OP. Provisional conclusions, subject to correction, so please feel free to chime in if you disagree with or want to add to anything here.

(Oh, and thanks to everyone who’s contributed substantially in this thread. I’ve enjoyed this discussion, it was fun and illuminating, cheers.)



Conclusion 1: AMA doesn’t issue doctors’ licences, state medical boards do. And nor is AMA half as important as I’d imagined it was, with membership numbering at less than a third of all doctors.

Conclusion 2: Therefore, AMA guidelines have limited application. Should someone feel at all strongly about any extra-legal guidelines AMA might issue, I see no reason why it should overly constrain non-members; and indeed even for members it is certainly possible to leave off of membership but continue with whatever they’d been doing, whether practice or some hospital job.

Loose end 1: Is Conclusion #2 actually true? It would seem to follow, sure. But might AMA be able to punch above its membership strength basis intangibles?

Conclusion 3: AMA is perfectly free to frame whatever guidelines it wants to put in place.

Loose end 2: Is Conclusion #3 tied to Conclusion #2? That is, is the fact of AMA’s very limited impact --- assuming I’m actually correct in concluding that its impact is limited to its less than a third of all doctors, and that too not overwhelmingly so --- related to its being able to do as it pleases as far as its internal policies and guidelines? This relates to associations in general. Emily’s Cat suggests that her professional association might end up having its wings officially clipped, over and above less direct fallouts, should it try to pull an AMA. Do others concur?

Conclusion 4: Circling back to the discussion in the other thread, which is what led me to start this separate discussion here: Those who believe that doctors don’t assist with executions because doing that will cost them their licence, are plain wrong.

Loose end 3: What about medical boards? Are we sure they don’t throw in extra-legal “ethics” in their licencing requirements? So that, is it actually true, that doctors who ignore Hippocrates (or who abide by Hippocrates, but interpret it as far as executions, as minimizing pain and distress for those whose death is imminent and inevitable) are not actually risking their licence?

Conclusion 5: Further to Conclusion #4, doctors who go against AMA guidelines, and against mainstream interpretation of Hippocrates, and choose to assist with executions, while they may face some blowback, but there’s no reason why this should necessarily be overwhelming. So that, should a doctor’s principles lead them to conclude that they should help death row inmates face their inevitable end with dignity and with as less pain as possible, or should a doctor simply be tempted by money offered for such assistance, then there’s no reason why they necessarily shouldn’t do it.

Loose end 4: Is the reasoning in Conclusion #5 correct?

Loose end 5: It is fact that doctors don’t actually assist with executions. At least, I think it is. Why don't they? Should conclusion #5 be correct, then why aren’t some doctors stepping up to help?

Conclusion 5 (Which also doubles up as Loose End 5): Maybe if jails, or whichever department or body is in charge of actually carrying out the executions, were to offer significant sums of money to doctors for their services? Maybe that might help, and give doctors the incentive to step over this taboo and offer their services, some of them at any rate?

 

[Chanakya]

So correct me if I'm wrong on this. The government permits you to practice*, and the professional body tells you how to practice. Is that a reasonable summation?

*ETA: within the limits of the law, of course.

With one qualification. Yes, AMA tells doctors how to practice, sure. Except as a doctor you’re free to ignore them, as long as you don’t break the law. Ignoring AMA may not be 100% consequence-free; but nor will it be catastrophic to the said doctor’s career, AIUI. After all, more than two-thirds of doctors aren’t even members of AMA at all.

(Take this with a pinch of salt! This seems reasonable, basis what I take away from the discussion in this thread so far, see my post immediately preceding. But I’m only thinking this through, and don’t actually know this. If someone who’s aware of how this actually works, Skeptic Ginger for instance, disagrees with this, and should they be able to clearly explain their disagreement, then that’s what I’d go with.)

 

[Chanakya]

Sort of. It differs a bit by state, especially with advanced practice nurses. The law spells out who (a board) oversees the practice and the general laws governing licensure. There are a few pages of laws re practice, licensing, etc.

There is a board of pharmacy that governs prescriptive authority. There are lots of laws re prescribing controlled substances that are federal laws. They recently got longer because they added paperwork including weekly documentation.

There are laws governing hospitals, clinics, and other out-patient facilities that include personnel/staffing laws.

IOW the law is a bit fragmented and one needs to know all the laws that apply to them.

But the scope of practice is not spelled out because that would be impossible. There can't be a law governing how to manage a patient with a stroke, for example, because there are too many variables. So practice is left up to the education and experience of the licensed professionals.

In my case for example, as an advanced practice nurse, I am licensed in this state to do anything a doctor can do. It's up to me to define my scope of practice and that differs by advanced practice specialty and practice location. Some ARNPs do medical rounds for the physicians that employ them. And that can include everything the doc would do on said rounds. The NPs can cover for the MDs which again means they do everything the docs do.

Other NPs provide a full scope of services in fields like women's health care, diabetes, or hospital intake and so on. In my case I started my own practice in occupational infectious disease. But I digress.

Bottom line there are no practice laws per se. Most laws are administrative. Practice laws boil down to 'you have experience and education, you can figure it out'.

Skeptic Ginger, does AMA cover only doctors, or nurses as well? If yes, then fine; but if no, then do you guys have some similar association covering you, apart from the board proper that is? And does the association for nurses, should there be one, have any guidelines on executions?

(What I’m trying to get at is, regardless of what doctors might or might not do, can nurses go ahead and help with executions, if their own personal principles/ethics don’t stop them that is to say?)

 

[Emily's Cat]

Some takeaways from this thread. From my perspective, and compared to where I'd been at the time I wrote the OP. Provisional conclusions, subject to correction, so please feel free to chime in if you disagree with or want to add to anything here.

(Oh, and thanks to everyone who’s contributed substantially in this thread. I’ve enjoyed this discussion, it was fun and illuminating, cheers.)



Conclusion 1: AMA doesn’t issue doctors’ licences, state medical boards do. And nor is AMA half as important as I’d imagined it was, with membership numbering at less than a third of all doctors.

Conclusion 2: Therefore, AMA guidelines have limited application. Should someone feel at all strongly about any extra-legal guidelines AMA might issue, I see no reason why it should overly constrain non-members; and indeed even for members it is certainly possible to leave off of membership but continue with whatever they’d been doing, whether practice or some hospital job.

Loose end 1: Is Conclusion #2 actually true? It would seem to follow, sure. But might AMA be able to punch above its membership strength basis intangibles?

For clarity and concision, I'm snipping here I'd love for Skeptic Ginger to add their perspective, but here's my thoughts.

Even though AMA might only have a third of the docs in it (which is actually a whole lot of people, btw), I *think* AMA has a lot of influence over the licensing boards in various states. AMA is part oversight body, but also part lobbying body (same is true for AAA, although the nature of actuarial lobbying is a lot less media-friendly as we're boring and use a lot of numbers). So while AMA may not be able to actually yank a doctor's license to practice... they may very well have an extremely strong influence on the boards that can. I'm not sure it's as clear a distinction in practice as it is on paper.

 

[Skeptic Ginger]

Skeptic Ginger, does AMA cover only doctors, or nurses as well? If yes, then fine; but if no, then do you guys have some similar association covering you, apart from the board proper that is? And does the association for nurses, should there be one, have any guidelines on executions?

(What I’m trying to get at is, regardless of what doctors might or might not do, can nurses go ahead and help with executions, if their own personal principles/ethics don’t stop them that is to say?)

Not sure I should bother continuing to participate in this thread given you make only a cursory effort to discuss the issue. You keep barreling ahead with your initial POV and only barely address the facts: The AMA is a private organization when it comes to the legal issues governing doctors. Doctors can have their membership rejected by the AMA and that's the extent of their power over individuals. The AMA can participate with position papers over a variety of things and the death penalty is one of them.

Those positions are not legally binding preventing doctors from participating in an execution. How hard is that concept? It's black and white.
Like doctors, yes, there is an ANA. There are other organizations as well such as the AAFP, American Academy of Family Physicians, which publish practice positions. And there are other groups like the AOHN, Assoc of Occupational Nurses and groups of critical care nurses, of infection prevention nurses, of family practice nurses and so on. MDs also have other groups like the assoc of anesthesiologists.

Some of these groups publish research in their medical and nursing journals.

All of these groups develop practice positions. And one has to be careful because there are fake groups used to claim something is supported by or published by [fill in the fabricated group].


There is no legal reason doctors and nurses can't participate in an execution. But the professional organizations of both groups have the position it is unethical to participate in an execution.

 

[Chanakya]

For clarity and concision, I'm snipping here I'd love for Skeptic Ginger to add their perspective, but here's my thoughts.

Agreed, I’d loved to have her clearly enunciated perspective on this, as well. Which is why I expressly asked her, more than once. …Unfortunately, though, that perspective would seem not to be forthcoming! SG seems set on continuing with her weird obtuse-snippy persona, as opposed to responding constructively. I mean, I don’t see how it is physically possible to spell out my intentions or my questions any more clearly, and any more cordially, than I already have! (For instance, in the very post of mine that you’ve replied to.) …Heh, I’m starting to suspect she’s realized she’s actually far less knowledgeable about the full details of this business than she’d herself imagined; and is embarrassed about admitting to her ignorance about her own field of expertise; and hence this absurd snippiness, in order to somehow avoid getting into those details. …Well, either way, it is what it is, and if she won’t she won’t *shrugs*

Even though AMA might only have a third of the docs in it (which is actually a whole lot of people, btw), I *think* AMA has a lot of influence over the licensing boards in various states. AMA is part oversight body, but also part lobbying body (same is true for AAA, although the nature of actuarial lobbying is a lot less media-friendly as we're boring and use a lot of numbers). So while AMA may not be able to actually yank a doctor's license to practice... they may very well have an extremely strong influence on the boards that can. I'm not sure it's as clear a distinction in practice as it is on paper.

Ah. That’s exactly the aspect that I wanted to explore, in order to arrive at a picture of this business that actually reflects the reality on the ground.

Now I realize this isn’t your field, and I also realize that you’re only making informed guesses and conjectures here, that might not necessarily be 100% correct. And that’s perfectly fine! Still, if you wouldn’t mind exploring that impression of yours some more, then I’m curious what you think might be the exact nature and mechanism of that influence, when it comes to specifics. …For instance, AMA clearly thinks it unethical of doctors to assist with executions. Clearly it does not want them involved with that kind of thing. On the other hand, I *think* the licencing authority, which would be the state medical boards, have no such ethical requirements. So, do you think AMA might somehow prevail on medical boards to somehow take a position on that issue, to the extent of that affecting licences even? How exactly might it do that, by what mechanism; and /or to what extent exactly? (Again, I realize this isn’t your particular expertise, but I’m fine with listening to your tentative thoughts on this, if you’re okay with sharing those.)

 

[Chanakya]

Not sure I should bother continuing to participate in this thread given you make only a cursory effort to discuss the issue. You keep barreling ahead with your initial POV and only barely address the facts: The AMA is a private organization when it comes to the legal issues governing doctors. Doctors can have their membership rejected by the AMA and that's the extent of their power over individuals. The AMA can participate with position papers over a variety of things and the death penalty is one of them.

Those positions are not legally binding preventing doctors from participating in an execution. How hard is that concept? It's black and white.
Like doctors, yes, there is an ANA. There are other organizations as well such as the AAFP, American Academy of Family Physicians, which publish practice positions. And there are other groups like the AOHN, Assoc of Occupational Nurses and groups of critical care nurses, of infection prevention nurses, of family practice nurses and so on. MDs also have other groups like the assoc of anesthesiologists.

Some of these groups publish research in their medical and nursing journals.

All of these groups develop practice positions. And one has to be careful because there are fake groups used to claim something is supported by or published by [fill in the fabricated group].


There is no legal reason doctors and nurses can't participate in an execution. But the professional organizations of both groups have the position it is unethical to participate in an execution.

That’s okay, SG, you don’t have to engage constructively if you don’t want to, obviously. But I think you’re being objectively unfair in attributing the lack of constructive engagement on your part on to me, rather than on to yourself. …I really don’t think it’s possible for me to be any clearer about my intentions, or the specifics of the subject I’ve discussed and asked about, than I already have; nor any more cordial. For instance, my post #104, that you’ve simply ignored. Addressing that post clearly would have been a great way for you to share what you know about this; and, given you’re in this field already, and given that you already would be aware of this, I don’t think it should take any effort or time really for you to clearly discuss this.

But again, not to impose on you beyond what you’re comfortable with, absolutely not. If you’d care to address my post #104 in detail, then I’d love it, and so would Emily’s Cat. But if you’d rather not, then that’s fine too.


...Thanks for that info about the associations in your field, ANA and AAFP and AOHN. And also, thanks for the input, that all of them take the position that it unethical for you [generic] to assist with executions, much like AMA does. But again, what I was trying to get an understanding of, is why that would matter so very much, should you [generic] be inclined otherwise. (And, if it doesn’t in fact matter so very much, then why it is that no doctors and no nurses ever actually assist with executions? After all, that’s a point of ethics that arguably might swing either way. Or if you think I’m mistaken about that, and you believe some actually do so assist, then do please correct me on that.) And for the umpteenth time, I’m not challenging your view by saying this, I’m not doing the snide-internet-asshat thing, I’m *asking*. …For the last time, I invite you to check out and respond clearly to my post #104. And for the last time, I do that without meaning to impose. If after this you don’t, I won’t ask again. Either way, nice talking, cheers.

 

[Skeptic Ginger]

 

[Emily's Cat]

Now I realize this isn’t your field, and I also realize that you’re only making informed guesses and conjectures here, that might not necessarily be 100% correct. And that’s perfectly fine! Still, if you wouldn’t mind exploring that impression of yours some more, then I’m curious what you think might be the exact nature and mechanism of that influence, when it comes to specifics. …For instance, AMA clearly thinks it unethical of doctors to assist with executions. Clearly it does not want them involved with that kind of thing. On the other hand, I *think* the licencing authority, which would be the state medical boards, have no such ethical requirements. So, do you think AMA might somehow prevail on medical boards to somehow take a position on that issue, to the extent of that affecting licences even? How exactly might it do that, by what mechanism; and /or to what extent exactly? (Again, I realize this isn’t your particular expertise, but I’m fine with listening to your tentative thoughts on this, if you’re okay with sharing those.)

I really lack sufficient knowledge of the medical field...

I would speculate that AMA (and other medical oversight bodies as well, there are several as SG has already mentioned) take part in informing those licensing boards of what 'ought to be' required in order for a doctor to obtain a license in the first place, but also in shaping what kinds of breaches of practice 'ought to' lead to a doctor losing their license. There are cases of doctors losing their license for ethical misbehavior - a quick google search suggests that many of those are for have an inappropriate sexual relationship with a patient. I don't know to what extent the ethical misbehavior is influenced by AMA and similar organizations... but I speculate that it's at least plausible.

 

[ahhell]

So correct me if I'm wrong on this. The government permits you to practice*, and the professional body tells you how to practice. Is that a reasonable summation?

*ETA: within the limits of the law, of course.

This is basically correct. At least in the US with at least engineering, the States have all passed laws defining the practice of engineering and who gets to call themselves a "professional engineer" typically with a specialty. The professional and industry groups set the standards of practice but those are written into "model codes" which are typically adopted as law by the states.

For the most part those model codes don't include ethics rules but lots of states have "ethics" rules adopted as law but those are in my opinion not so much ethics as who gets to call themselves what and who gets to do what based on that.

 

[Skeptic Ginger]

I really lack sufficient knowledge of the medical field...

I would speculate that AMA (and other medical oversight bodies as well, there are several as SG has already mentioned)

Where do you get the idea the AMA is an oversight body? That is not what the AMA is and not what they do. This may be the underlying problem why Chan can't stop talking past me.

... take part in informing those licensing boards of what 'ought to be' required in order for a doctor to obtain a license in the first place, but also in shaping what kinds of breaches of practice 'ought to' lead to a doctor losing their license.

No, they don't do that either. Did you bother to look up their mission statement?

Founded in 1847, the American Medical Association (AMA) is the largest and only national association that convenes 190+ state and specialty medical societies and other critical stakeholders. Throughout history, the AMA has always followed its mission: to promote the art and science of medicine and the betterment of public health.

As the physicians’ powerful ally in patient care, the AMA delivers on this mission by representing physicians with a unified voice in courts and legislative bodies across the nation, removing obstacles that interfere with patient care, leading the charge to prevent chronic disease and confront public health crises, and driving the future of medicine to tackle the biggest challenges in health care and training the leaders of tomorrow. ...

Representing physicians with a unified voice does not mean they are an oversight body.

There are cases of doctors losing their license for ethical misbehavior - a quick google search suggests that many of those are for have an inappropriate sexual relationship with a patient. I don't know to what extent the ethical misbehavior is influenced by AMA and similar organizations... but I speculate that it's at least plausible.

No, the AMA is not the source of determining ethical behavior.

Is Sex with a Patient ALWAYS Unprofessional Conduct?

Most Boards of Medicine take a draconian view towards sex with patients. If a complaint is filed, and the sexual relationship began in the middle of a doctor-patient relationship, discipline likely will ensue. The interpretation is absolute. ...

... I understand the blanket prohibition if the patient is receiving some form of psychotherapy or is being treated for a life-threatening condition. There, it is easy to understand that patient is vulnerable and unable to provide meaningful consent. ...

... I understand the blanket prohibition if the patient is receiving some form of psychotherapy or is being treated for a life-threatening condition. There, it is easy to understand that patient is vulnerable and unable to provide meaningful consent.

Read the whole article for a better understanding of one ethical issue, a romantic relationship with your patients. Nowhere will you see anything about an AMA standard because the organization doesn't set the standard, the boards of medicine do. Same with NPs, the boards of nursing do and each state has their own boards of nursing.

 

[dudalb]

In some cases it is, like mine. To be an advanced practice licensed nurse I have to be certified in one or more categories of advanced practice.

But keep in mind that certification does not require I be a member of the related professional organizations.

My sister, who is an praticing attorney, says that Bar association is several states are looking at licencing system for Paralegals, who over the past few decades have assumed a more important role in the legal system. Right now there is no real qualification necessary execept convincing An Attorney or Law Firm to hire you.
There are certificate and educational programs for Paralegals, but they are not legally binding the way that a nurse's licence is. That might change.

 

[Skeptic Ginger]

My sister, who is an praticing attorney, says that Bar association is several states are looking at licencing system for Paralegals, who over the past few decades have assumed a more important role in the legal system. Right now there is no real qualification necessary execept convincing An Attorney or Law Firm to hire you.
There are certificate and educational programs for Paralegals, but they are not legally binding the way that a nurse's licence is. That might change.

You might find the history of nurses gaining the right to advanced practice interesting.

I don't know of a book or single source but I can tell you about some critical points. In about 1974 (give or take a year or two) a group of doctors sought to have a couple of nurse practitioners charged with practicing medicine without a license. More than a few physicians felt threatened by nurses encroaching on MD practice territory.

I don't recall exactly what happened but I don't believe the nurses were convicted.

NPs are licensed by each state. When I got my NP degree in family practice (1985), and subsequent NP license one of the advantages we had was the state definition of nursing practice said we work for the patient, not for the employer. That allowed NPs in this state (and at the time there were only about 3 states with the same definition) to set up our own practices. RNs could also work as independent contractors, again because of the state definition of nursing practice.


Dental hygienists are going through a similar process in this state. I'm not sure where in the process they are currently.


Another bit of trivia, PAs, physicians' assistants, cannot practice independently in this state. They must work for a physician and if they change jobs they have to get a new license.

 

[novaphile]

The AMA is the Doctors' union, but they can't say that, because 'Unions are bad, m'kay?'

And like other unions, they advocate and lobby for their members.

 

[theprestige]

The AMA is the Doctors' union, but they can't say that, because 'Unions are bad, m'kay?'

And also because they're not a union.

 

[Chanakya]

I really lack sufficient knowledge of the medical field...

I would speculate that AMA (and other medical oversight bodies as well, there are several as SG has already mentioned) take part in informing those licensing boards of what 'ought to be' required in order for a doctor to obtain a license in the first place, but also in shaping what kinds of breaches of practice 'ought to' lead to a doctor losing their license. There are cases of doctors losing their license for ethical misbehavior - a quick google search suggests that many of those are for have an inappropriate sexual relationship with a patient. I don't know to what extent the ethical misbehavior is influenced by AMA and similar organizations... but I speculate that it's at least plausible.

Yes, that would be interesting to know, which ethical considerations exactly, if any, are baked into medical boards' requirements for doctors getting and keeping their licences. And, to tie this back to the original question I was trying to answer, whether executions figure there at all.

Does AMA's writ --- for instance, that thing it has on its website about executions, that's linked to in the OP --- carry any weight beyond merely membership in that body? Does AMA membership determine how doctors are perceived by their patients or by their employers, and might it substantially affect their careers? I'd imagine not, given non-member doctors are twice as many as member doctors; but it would be good to actually know, one way or the other.

 

[Chanakya]

The AMA is the Doctors' union, but they can't say that, because 'Unions are bad, m'kay?'

And like other unions, they advocate and lobby for their members.

Yep, that's the conclusion I arrived at myself, that AMA seems to be little more than a glorified union-cum-lobby, and what's more with less powers than many unions as far as the livelihood of its members. Like I said upthread. Which is a very different picture than I'd had when I'd started this thread.

But that's a conclusion I'd basically thought through to; and what one thinks one's way to isn't always necessarily the correct picture, right? But so far, that thinking-through doesn't appear to have been mistaken, and what you say here adds to my (provisional) belief that I was right in concluding that.

__________

But that, in turn, raises two further questions. One specifically about AMA, and the other about associations and unions in general.

One: It would appear, then, that AMA’s writ on doctors’ participation in executions, for instance, should have limited influence. That is, should some doctor feel otherwise, whether on grounds of principle or even of money, then there would appear to be no reason for them to care overly much about AMA’s views about it. (And again, that’s only a thinking through, so far not actually validated against actual reality. So the question would be, is that conclusion correct?). …And further, why exactly is it, then, that no doctors ever do assist in executions? Is it because medical boards also reflect AMA’s views on this matter, and have baked this into licencing requirements? Because it seems unlikely that all doctors, without exception, would arrive at the same ethical conclusion as far as this question; or even that all doctors are necessarily so scrupulously mindful of ethics (unless that scrupulousness is somehow forced on them, in which case it no longer is a matter merely of personal ethics).

And two: This about unions and associations generally: Even if AMA writ may not matter all that much to doctors’ livelihoods; but when it comes to those unions and associations that actually do exercise that power: Are they free to include arbitrary points of ethics in their membership requirement? Or can the fact that membership directly impacts their members’ exercise of their profession mean that that ends up limiting their “freedom of association” to some extent?