participants at risk of injury. Physicians can provide valuable information to help sports participants, dancers, and others make informed decisions about whether to initiate or continue participating in such activities. Physicians who serve in a medical capacity at athletic, sporting, or other physically demanding events should protect the health and safety of participants. In this capacity, physicians should: (a) Base their judgment about an individual’s participation solely on medical considerations. (b) Not allow the desires of spectators, promoters of the event, or even the injured individual to govern a decision about whether to remove the participant from the event. AMA Principles of Medical Ethics: I,VII 1.2.6 Work-Related and Independent Medical Examinations Physicians who are employed by businesses or insurance companies, or who provide medical examinations within their realm of specialty as independent contractors, to assess individuals’ health or disability face a conflict of duties. They have responsibilities both to the patient and to the employer or third party. Such industry-employed physicians or independent medical examiners establish limited patient-physician relationships. Their relationships with patients are confined to the isolated examination; they do not monitor patients’ health over time, treat them, or carry out many other duties fulfilled by physicians in the traditional fiduciary role. In keeping with their core obligations as medical professionals, physicians who practice as industryemployed physicians or independent medical examiners should: (a) Disclose the nature of the relationship with the employer or third party and that the physician is acting as an agent of the employer or third party before gathering health information from the patient. (b) Explain that the physician’s role in this context is to assess the patient’s health or disability independently and objectively. The physician should further explain the differences between this practice and the traditional fiduciary role of a physician. (c) Protect patients’ personal health information in keeping with professional standards of confidentiality. (d) Inform the patient about important incidental findings the physician discovers during the examination. When appropriate, the physician should suggest the patient seek care from a qualified physician and, if requested, provide reasonable assistance in securing follow-up care. AMA Principles of Medical Ethics: I 1.2.7 Use of Restraints All individuals have a fundamental right to be free from unreasonable bodily restraint. At times, however, health conditions may result in behavior that puts patients at risk of harming themselves. In such situations, it may be ethically justifiable for physiciansto order the use of chemical or physical restraint to protect the patient. Except in emergencies, patients should be restrained only on a physician’s explicit order. Patients should never be restrained punitively, for convenience, or as an alternate to reasonable staffing. Physicians who order chemical or physical restraints should: (a) Use best professional judgment to determine whether restraint is clinically indicated for the individual patient. (b) Obtain the patient’s informed consent to the use of restraint, or the consent of the patient’s surrogate when the patient lacks decision-making capacity. Physicians should explain to the patient or surrogate: (i) why restraint is recommended; (ii) what type of restraint will be used; (iii)length of time for which restraint is intended to be used. (c) Regularly review the need for restraint and document the review and resulting decision in the patient’s medical record. In certain limited situations, when a patient poses a significant danger to self or others, it may be appropriate to restrain the patient involuntarily. In such situations, the least restrictive restraint reasonable should be implemented and the restraint should be removed promptly when no longer needed. AMA Principles of Medical Ethics: I,IV 1.2.8 Gifts from Patients Patients offer gifts to a physician for many reasons. Some gifts are offered as an expression of gratitude or a reflection of the patient’s cultural tradition. Accepting gifts offered for these reasons can enhance the patient-physician relationship. Other gifts may signal psychological needs that require the physician’s attention. Some patients may offer gifts or cash to secure or influence care or to secure preferential treatment. Such gifts can undermine physicians’ obligation to provide services fairly to all patients; accepting them is likely to damage the patient-physician relationship. The interaction of these factors is complex and physicians should consider them sensitively before accepting or declining a gift. Physicians to whom a patient offers a gift should: (a) Be sensitive to the gift’s value relative to the patient’s or physician’s means. Physicians should decline gifts that are disproportionately or inappropriately large, or when the physician would be uncomfortable to have colleagues know the gift had been accepted. (b) Not allow the gift or offer of a gift to influence the patient’s medical care. (c) Decline a bequest from a patient if the physician has reason to believe accepting the gift would present an emotional or financial hardship to the patient’s family. (d) Physicians may wish to suggest that the patient or family make a charitable contribution in lieu of the bequest, in