





































 V38 N4 / 2023 

©2023 American Medical Writers Association. All rights reserved.  
ISSN 2163-5315

AMWAJournal.org     4

THEME ARTICLE

Ethical principles can be traced as far back as the ancient 
philosophers, including Plato and Aristotle, who believed 
in virtue as a guide for ethical action, and Kant, who 
developed the concept that obligation instructs us how 
to behave.1 The terms “professional ethics” and “medical 
ethics” were created by English physician Thomas Percival 
in 1803, which led to the adoption of the first code of ethics 
by the American Medical Association in 1847.2 
 Today, many corporations and organizations have estab-
lished a code of ethics for employees and members. These 
codes provide a guide on what to do, as well as what not to 
do, in a given situation. Adherence to these values strength-
ens the company culture, minimizes risk, and helps protect 
the company’s reputation. In addition to potential damage 
to image and public trust, the financial consequences of 
unethical behavior can be extensive. One medical device 
manufacturer and its subsidiaries have paid more than $60 
million in settlements due to kickback and fraud allega-
tions.3 Even though many organizations have established 
codes of conduct for their associates, they do not eliminate 
the potential for misconduct. In 2020, the Harvard Business 
Review reported the results of a national survey on busi-
ness practices conducted with more than 14,500 employees 
across many industries. Nearly 1 in 4 survey respondents 
felt pressured to do things they knew were wrong.4

 Two articles in this ethics-themed issue present some 
ethical challenges for medical communicators. The first 
article by Blair Hesp and Jonathan Lee discusses how 
differences in cultural contexts can alter the interpretation 
and application of ethical publication practices in the Asia-
Pacific region. This topic expands on the articles published 
in the previous themed issue of the AMWA Journal on global 
medical communication. However, addressing cultural 
differences can be particularly challenging because many 
of these engagements are conducted virtually. The authors 
provide recommendations on effective navigation of cultural 
differences to ensure that contributions are included from all 
stakeholders and engaging with colleagues in other regions to 
develop culturally appropriate processes that can strengthen 
working relationships and expedite project completion.

 Continuing medical education (CME) is an essential  
component of ongoing professional development for 
health care providers. However, industry support of CME 
has raised concerns about the integrity of the content. The 
second article by Eve Wilson explores some of the require-
ments intended to prevent industry bias in continuing  
education (CE)/CME. Medical writers may play a key role  
in the development of CME materials; practical steps are 
presented for medical writers to ensure that CE/CME  
content is fair, balanced, unbiased, and accurate. 
 I wish to thank the authors of these articles for their  
time and efforts. I also encourage any feedback from  
AMWA members on any personal ethical challenges  
they’ve encountered in their everyday interactions. 

Author declaration and disclosures: The author notes no  
commercial associations that may pose a conflict of interest in 
relation to this article.

Author contact: Julie.Ravo@bd.com

References
1.  Mintz S. Principles of ethical behavior. Ethics Sage. Published 

November 1, 2016. Accessed October 21, 2023. https://www.
ethicssage.com/2016/11/everyday-ethics-.html

2.  Baker R, Emanuel L. The efficacy of professional ethics: the AMA 
code of ethics in historical and current perspective. Hastings Cent 
Rep. 2000;30(4):S13-S17. 

3.  Wallace C. Medtronic’s $60M in fraud, kickback settlements: a 
timeline. Becker’s ASC Review. Published July 12, 2023. Accessed 
October 21, 2023. https://www.beckersasc.com/asc-news/
medtronics-60m-in-fraud-kickback-settlements-a-timeline.html

4.  Ivcevic Z, Menges JI, Miller A. How common is unethical behavior 
in US organizations? Harvard Business Review. Published March 
20, 2020. Accessed October 21, 2023. https://hbr.org/2020/03/
how-common-is-unethical-behavior-in-u-s-organizations

Julie Ravo / Medical Writer, Franklin Lakes, NJ

Preserving Ethics in a Not So Ethical World

FROM THE GUEST EDITOR

http://www.amwajournal.org
https://www.ethicssage.com/2016/11/everyday-ethics-.html
https://www.ethicssage.com/2016/11/everyday-ethics-.html
https://www.beckersasc.com/asc-news/medtronics-60m-in-fraud-kickback-settlements-a-timeline.html
https://www.beckersasc.com/asc-news/medtronics-60m-in-fraud-kickback-settlements-a-timeline.html
https://hbr.org/2020/03/how-common-is-unethical-behavior-in-u-s-organizations
https://hbr.org/2020/03/how-common-is-unethical-behavior-in-u-s-organizations



