This past December, the Board of Physicians of Spain published the new edition of the Code of Medical Ethics (CME) to replace the previous version from 2011. The new code integrates scientific and technical advances and addresses new rights and responsibilities for physicians and patients. For instance, we ought to highlight Chapter 23, devoted to telemedicine and information and communication technologies. As noted in article 1, all physicians currently practicing must know and adhere to the CME.1 Chapter 2 of the CME, General Principles, describes the main principles of medical practice (respect for life and human dignity, nondiscrimination, prudence, competence and diligence, etc).
Although the professional code of the Asociación Española de Pediatría (Spanish Association of Pediatrics) in its ethical framework covers aspects such as the humanization of paediatric care, transparency, the doctor-patient relationship, the relationship with the pharmaceutical industry, research, education and professional conduct2 with a focus on the child and the family, it seems appropriate to review the aspects included in the new CME that specifically concern minors.
Table 1 presents the articles that refer specifically to medical practice in the service of children and adolescents more or less explicitly.
Medical ethics code articles specifically concerning the paediatric population.
| Topic | Articles | Summary |
|---|---|---|
| Information and consent | 8.3 | A physician must be particularly diligent in providing information to the most vulnerable patients |
| 12.1 | Individuals aged 16 years or older have the capacity to make decisions about ordinary medical interventions. In younger individuals, their decision-making capacity will be determined based on their maturity | |
| 12.2 | In severe situations in individuals aged less than 18 years, a physician is obligated to inform the parents as well | |
| 12.3 | ||
| 12–4 | ||
| Health records | 14.5 | A physician has the responsibility to provide truthful and accurate clinical documentation on the request of the patient or the family |
| 17.1 | Between ages 16 and 18 years, minors have the right to confidentiality, except in situations posing a severe risk | |
| Quality of care | 22.1 | A physician must pursue and foster health promotion, prevention and education efforts |
| Sexuality and reproduction | 61.1 | Human beings are an end in themselves in every phase of biological development, from conception to death |
| 66 | Genital mutilation violates the dignity of the individual | |
| 68.1 | Gender-affirming treatment for children and adolescents will always be managed by physicians with experience in the field in collaboration with multidisciplinary committees |
As is the case in similar documents, most of the points have to do with decision-making and confidentiality in the care of minors.3
A medical ethics code does not cover—nor is this its purpose—every possible ethical dilemma that may arise in health care provision, but since it is based in the universal principles of medicine, is a good resource for the bioethical education of physicians and a guarantee of the expectations of society in regard to the practice of medicine.
