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A Physician Charter(Lancet)
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Perspective
Lancet. 2002 Feb 9;359(9305):520-2.

Medical Professionalism in the New Millennium: A Physician Charter
Project of the ABIM Foundation, ACP–ASIM Foundation, and European Federation of Internal Medicine*

To our readers: I write briefly to introduce the Medical Professionalism Project and its principal product, the Charter on
Medical Professionalism. The charter appears in print for the firsttime in this issue of Annals and simultaneously in The Lancet. I
hope that we will look back upon its publication as a watershed
event in medicine. Everyone who is involved with health careshould read the charter and ponder its meaning.
The charter is the product of several years of work by leadersin the ABIM Foundation, the ACP–ASIM Foundation, and theEuropean Federation of Internal Medicine. The charter consistsof a brief introduction and rationale, three principles, and 10commitments. The introduction contains the following premise:
Changes in the health care delivery systems in countries throughout the industrialized world threaten the values of professionalism. The document conveys this message with chilling brevity.
The authors apparently feel no need to defend this premise, perhaps because they believe that it is a universally held truth. Theauthors go further, stating that the conditions of medical practice
are tempting physicians to abandon their commitment to theprimacy of patient welfare. These are very strong words. Whether
they are strictly true for the profession as a whole is almost besidethe point. Each physician must decide if the circumstances ofpractice are threatening his or her adherence to the values thatthe medical profession has held dear for many millennia.
Three Fundamental Principles set the stage for the heart ofon the globe will read the charter. Does this document represent
the traditions of medicine in cultures other than those in theWest, where the authors of the charter have practiced medicine?
We hope that readers everywhere will engage in dialogue about
the charter, and we offer our pages as a place for that dialogue totake place. If the traditions of medical practice throughout theworld are not congruent with one another, at least we may makeprogress toward understanding how physicians in different cultures understand their commitments to patients and the public.
Many physicians will recognize in the principles and commitments of the charter the ethical underpinning of their professional relationships, individually with their patients and collectively with the public. For them, the challenge will be to live by
these precepts and to resist efforts to impose a corporate mentality on a profession of service to others. Forces that are largely
beyond our control have brought us to circumstances that requirea restatement of professional responsibility. The responsibility for
acting on these principles and commitments lies squarely on ourshoulders.
—Harold C. Sox, MD, EditorPhysicians today are experiencing frustration as changes
in the health care delivery systems in virtually all indus-

Medical Professionalism in the New
Millennium: A Physician Charter
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