Code of Ethics

An ophthalmic surgeon must, at all times, act in the best interests of the patient. A surgeon’s professional conduct and clinical care should therefore protect, support, and respect the health, wellbeing, dignity, and autonomy of the patient.

When advising a patient about potential treatment or care, an ophthalmic surgeon should never over-treat or harm the patient. In that regard, a surgeon should strive to minimise intervention and to weigh the risks of treatment against the potential benefit of that treatment. Such advice should be independent of any potential financial benefit to the surgeon.

No ophthalmic surgeon should provide treatment outside of her or his competency. No ophthalmic surgeon should allow a trainee ophthalmic surgeon under her or his supervision to provide treatment unless satisfied that the trainee is competent to do so, whether with or without immediate supervision.

Ophthalmic surgeons should respect the autonomy of their patients at all times. In every case where a patient can consent to a proposed treatment, the surgeon should seek such consent after informing the patient of: the nature, extent, and reason for the treatment, any reasonable alternatives to the proposed treatment, and the risks and benefits of the proposed treatment and any alternatives. A surgeon should also disclose to the patient any involvement of a trainee surgeon in the patient’s care. In those cases where a patient cannot consent to treatment, surgeons should practice in accordance with the best interests of the patient and any applicable laws, medical guidelines, or legal advice.

Ophthalmic surgeons should respect the privacy of their patients at all times and comply with all applicable data protection laws and guidelines. Except in those cases where such laws, or guidelines dictate otherwise, a surgeon should keep all patient information confidential. In cases where other practitioners are treating the patient, the surgeon should disclose only that information required by the other practitioner to treat the patient. A surgeon should, unless applicable laws or guidelines provide otherwise, not disclose patient information to anyone not involved in the medical care of the patient without the consent of the patient.

Although a surgeon should strive to personally provide care immediately before and after eye surgery, a surgeon can delegate such duties to another eye care professional after deeming the professional to be fully competent to assess and counsel the patient. In delegating any role, however, the surgeon should ensure that the professional will refer the patient back to the surgeon for any issues outside the professional’s competency. The auditing of clinical outcomes is an integral part of patient care. Ophthalmic surgeons should participate in clinical audits and adjust their practice in accordance with audit findings.

Whenever a patient requests a second opinion, the ophthalmic surgeon should welcome the request, provide to the patient the names and contact details of appropriate surgeons, and provide all necessary documentation to the patient to facilitate the patient’s obtaining of a second opinion. In any case where the care of a patient exceeds the competence of an ophthalmic surgeon, she or he should refer that patient to an appropriate colleague for further treatment with all necessary information and documentation. Any ophthalmic surgeon who provides a second opinion should, in providing the opinion, avoid criticism of the treatment or advice provided by the initial treating surgeon.

Ophthalmic surgeons should, whenever possible, undertake and support research. In that regard, they should ensure that they or any person under their supervision involved in clinical research comply with the provisions of the “Declaration of Helsinki,” as amended, and all other applicable ethical guidelines, laws, and legal advice. Further, ophthalmic surgeons should ensure that they or any person under their supervision involved in research involving animals comply with the provisions of the “EU Directive on the Protection of Animals Used for Scientific Purposes,” as amended, and all other applicable laws, ethical guidelines, and legal advice. Further, ophthalmic surgeons engaged in research should ensure that that any studies in which they are involved have effective safeguards against research misconduct, including falsification, fabrication, and plagiarism.

Any ophthalmic surgeon with a physical or mental condition should withdraw from adversely affected professional and clinical activities until such condition no longer impairs such activities.

Where allowed by applicable laws or guidelines, an ophthalmic surgeon should ensure that any advertising, marketing, advice, or other communication to patients, colleagues, or the public are founded on fact and are never misleading or inaccurate. In that regard, surgeons should never guarantee the outcome of any procedure or treatment.

An ophthalmic surgeon should never allow any offer, inducement, or promise from any industry or business to affect his or her independence in professional judgment, clinical practice, choice of treatment, or referral of patients.

Whenever an ophthalmic surgeon faces a conflict of interest between her or his personal, professional, or financial interest and the best interests of a patient, the surgeon must disclose that to the patient.

Participants in Society-sponsored events – including participants who are not members of the Society – should disclose to the Society – in the manner and form as may be required by the Society – potential conflicts between their personal, professional, or financial interests and the best interests of their patients.

Potential conflicts of interest can arise when Society members or participants benefit from a relationship that could influence how they treat patients, advise colleagues, or communicate to the public.

Potential conflicts of interest can arise from receipt of any payment, inducement, benefit, gift, or reward, including cash, honoraria, commissions, salaries, shares, or other interest in a company, loans, sponsorship, interest, dividends, hotel expenses, and travel costs. Such conflicts can also arise when a business partner, family member, friend, investor, or employer of a Society member or participant receives any such payment, inducement, benefit, gift, or reward. The Society reserves the right to decide what constitutes a potential conflict of interest in any given circumstance.

In any presentation at a Society-sponsored event, presenters – regardless of their membership of the Society – should disclose all conflicts between their financial interests and the best interests of their patients. Such disclosure would include conflicts of interest involving:

• The financial relationship of the presenter with the manufacturer or supplier of a medical device, product, or service included in the presentation;
• The financial relationship of the presenter with the manufacturer or supplier of a competing medical device, product, or service;
• The financial relationship of the presenter’s business partner, family member, investor, employer, or employee with the manufacturer or supplier of the medical device, product, or service included in the presentation;
• The financial relationship of the presenter’s business partner, family member, investor, employer, or employee with the manufacturer or supplier of a competing medical device, product, or service.
• The financial relationship of the presenter with any person or entity where the relationship could be reasonably interpreted by the ESCRS as a potential conflict of interest with the presenter’s professional and clinical duties.

The list of examples is not exhaustive. Should any Society member or participant in a Society-sponsored event be in any doubt about the application of this Code of Ethics, she or he should contact the Society at ethics@escrs.org.