Holding Clinicians in Public Office Accountable to Professional Standards

Abstract

Clinicians using governing authority to make public health policy are ethically obliged to draw upon scientific and clinical information that accords with professional standards. Just as the First Amendment does not protect clinicians who provide advice that fails to express standard care, so it does not protect clinician-officials who offer information to the public that a reasonable official would not provide.The American Medical Association designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™ available through the AMA Ed Hub TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity. Clinician-Governor LeadershipEver since Benjamin Rush signed the Declaration of Independence, physicians have played an important role in American public life. Many have held elected or appointed positions at the federal, state, or local level. The leadership and expertise of such physicians who guide health agencies, such as the Centers for Disease Control and Prevention (CDC) and local boards of health, can be very valuable, especially during a pandemic.Unfortunately, not all physician-officials provide the public with medically sound information and guidance. Since the start of the COVID-19 pandemic, several physicians in public office have made false or misleading statements or have given potentially harmful advice about masking, vaccines, and COVID-related treatments. For example, in 2020, Scott Atlas, a neuroradiologist who served as an advisor to then-President Trump, claimed that children cannot transmit SARS-CoV-2. 1 Senator Rand Paul, one of 4 physicians in the Senate in 2021, said that most masks available for purchase over the counter "don't prevent infection." 2 And former Louisiana Congressman Ralph Abraham tweeted in 2020: "Abortions nearly always have a fatal outcome for the baby, and many times it's the same for the mother." 3 We suggest that, with respect to the provision of health-related information and advice, the relationship between physician-officials and the public resembles that between physicians and patients. Building on that analogy, we argue that physician-officials have an ethical duty to offer medically sound information and advice to the public. We also