This presentation, given at the 2006 AAMSE National CEO Conference, presented the pros and cons for professional membership societies that implement established ethics policies and programs, and actively hold their members accountable to those policies.

1. 2006 AAMSE National Specialty CEO Meeting
Managing Your Ethics Programs
When Popular Programs and
Harsh Realities Collide
Thomas Marshall
Executive Director
American Association of
Neurological Surgeons
©American Association of Neurological Surgeons

2. The Collision
• What Members See: Your Ethics Process is
a banner proudly waved by your
Association
• What Members Don’t See: What IF: the
more you implement your Process, the
higher the fiscal and legal risk
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3. “Gentlemen of the Jury, there are three kinds
of liars: the Common Liar, the Damned Liar,
and the Scientific Expert.”
- Judge William L. Foster
Harvard Law Review, 1898
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4. from the AANS Code of Ethics:
E. Ethics as Related to the Physician and the
Legal Profession
2.The neurological surgeon, as an expert
witness, shall diligently and thoroughly prepare
himself or herself with the relevant facts so that
he or she can, to the best his or her ability,
provide the court with accurate and documental
opinions on the matters at hand.
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5. AANS Premise 1
Acting as an Expert Witness is, in fact,
practicing medicine.
Therefore, AANS believes its Code of Ethics
should apply in that venue as the other
provisions of the Code.
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6. AANS Premise 2
Ethics Code violations cannot be dealt with
effectively simply by prohibiting them.
It’s not a question of WHETHER violations
will exist, but how to deal with them when
they arise.
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7. The Mechanism
The Professional Conduct Committee:
• Loss of ABNS Certification
• Plagiarism
• “Typical” violations of Conduct Clause
• Violations of AANS Expert Witness
Guidelines
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8. Mechanism’s Process
• Has a highly structured set of procedures
• Like any other committee, makes
recommendations to Board of Directors
• Board can accept, reject, modify
• Is strictly structured to assure Due Process
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9. The Premises and Mechanism
Legally Challenged
Austin
v.
American Association of
Neurological Surgeons
2001
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10. 7th Circuit Court of Appeals
Austin v. AANS
“Judges need the help of professional
associations…the AANS knows a great deal
more about anterior cervical fusion than any
judge, and if the Association finds in a
proceeding that comports with the basic
requirements of due process of law that a member
gave irresponsible testimony, that is a datum that
judges, juries and lawyers are entitled to weigh
heavily.”
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11. American Association of Neurological Surgeons 11

12. Why Is Everybody So Happy?
• Fiscal Ramifications
• D & O Insurance
• Legal Costs
• Legal Ramifications
• Member “Satisfaction”?? “Dear Valued
Member: You must have missed your
annual dues statement…..”
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13. What Price Glory?
• To what extent is your culture willing to
enforce the Policies?
• Is your legal counsel afraid to end up in a
courtroom?
• What will your carrier do to your rates?
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14. What Price Glory?
• Will your Board use Reserves to defend
your Ethics program in Court?
• Will Leadership cut back other programs or
infrastructure if the finances suffer?
• What does the RANK AND FILE
MEMBERSHIP think of the program?
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15. “Don’t even go there…..”
• The “Cost/Benefit” factor:
Does actively implementing your Ethics
policy actually do what the association
thinks it does?
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16. The Good… The Bad…
• Hero • Villain
• Immense Member • Except for the
Pride Sanctioned Member
(and her/his friends)
• Striking a blow to • “A Lynch Mob intent
clean up The System on frontier justice”
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17. …and the Really Ugly
• Does Your Counsel like the Courtroom?
• Do you like paying your Insurance Carrier?
• Do you have the stomach for being dropped
by your Insurance Carrier?
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18. More Information…
• www.aans.org →about AANS→Governance
(AANS Code of Ethics; AANS Bylaws; Rules for
AANS Expert Opinion Services)
Thomas A. Marshall
AANS Executive Director
tam@aans.org 1.847.378.0502
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