keeping with ethics guidance. AMA Principles of Medical Ethics: I,II 1.2.9 Use of Remote Sensing and Monitoring Devices Sensing and monitoring devices can benefit patients by allowing physicians and other health care professionals to obtain timely information about the patient’s vital signs or health status without requiring an in-person, face-to-face encounter. Implantable devices can also enable physicians to identify patients rapidly and expedite access to patients’ medical records. Devices that transmit patient information wirelessly to remote receiving stations can offer convenience for both patients and physicians, enhance the efficiency and quality of care, and promote increased access to care, but also raise concerns about safety and the confidentiality of patient information. Individually, physicians who employ remote sensing and monitoring devices in providing patient care should: (a) Determine whether using one or more such devices is appropriate in light of individual patients’ medical needs and circumstances, including patients’ ability to use the chosen device appropriately. (b) Explain how the device(s) will be used in the patient’s care and what will be expected of the patient in using the technology, and disclose any limitations, risks, or medical uncertainties associated with the device(s) and data transmission. (c) Obtain the patient’s or surrogate’s informed consent before implementing the device in treatment. Collectively, physicians should: (d) Support research into the safety, efficacy, and possible non-medical uses of remote sensing and monitoring devices, including devices intended to transmit biometric data and implantable radio frequency ID devices. (e) Advocate for appropriate oversight of remote sensing and monitoring devices. AMA Principles of Medical Ethics: I,III,V 1.2.10 Political Action by Physicians Like all Americans, physicians enjoy the right to advocate for change in law and policy, in the public arena, and within their institutions. Indeed, physicians have an ethical responsibility to seek change when they believe the requirements of law or policy are contrary to the best interests of patients. However, they have a responsibility to do so in waysthat are not disruptive to patient care. Physicians who participate in advocacy activities should: (a) Ensure that the health of patients is not jeopardized and that patient care is not compromised. (b) Avoid using disruptive means to press for reform. Strikes and other collection actions may reduce access to care, eliminate or delay needed care, and interfere with continuity of care and should not be used as a bargaining tactic. In rare circumstances, briefly limiting personal availability may be appropriate as a means of calling attention to the need for changes in patient care. Physicians should be aware that some actions may put them or their organizations at risk of violating antitrust laws or laws pertaining to medical licensure or malpractice. (c) Avoid forming workplace alliances, such as unions, with workers who do not share physicians’ primary and overriding commitment to patients. (d) Refrain from using undue influence or pressure colleagues to participate in advocacy activities and should not punish colleagues, overtly or covertly, for deciding not to participate. AMA Principles of Medical Ethics: I,III,VI 1.2.11 Ethically Sound Innovation in Medical Practice Innovation in medicine can span a wide range of activities. It encompasses not only improving an existing intervention, using an existing intervention in a novel way, or translating knowledge from one clinical context into another but also developing or implementing new technologies to enhance diagnosis, treatment, and health care operations. Innovation shares features with both research and patient care, but it is distinct from both. When physicians participate in developing and disseminating innovative practices, they act in accord with professional responsibilities to advance medical knowledge, improve quality of care, and promote the well-being of individual patients and the larger community. Similarly, these responsibilities are honored when physicians enhance their own practices by expanding the range of tools, techniques, or interventions they employ in providing care. Individually, physicians who are involved in designing, developing, disseminating, or adopting innovative modalities should: (a) Innovate on the basis of sound scientific evidence and appropriate clinical expertise. (b) Seek input from colleagues or other medical professionals in advance or as early as possible in the course of innovation. (c) Design innovations so as to minimize risks to individual patients and maximize the likelihood of application and benefit for populations of patients. (d) Be sensitive to the cost implications of innovation. (e) Be aware of influences that may drive the creation and adoption of innovative practices for reasons other than patient or public benefit. When they offer existing innovative diagnostic or therapeutic services to individual patients, physicians must: (f) Base recommendations on patients’ medical needs. (g) Refrain from offering such services until they have acquired appropriate knowledge and skills. (h) Recognize that in this context informed decision making requires the physician to disclose: (i) how a recommended diagnostic or therapeutic service differs from the standard therapeutic approach if one exists; (ii) why the