The Honor Code of the Stony Brook University School of Medicine
We, as medical students of Stony Brook University, believe there is a need to support and cultivate the high ethical standards of honor associated with the medical community.
This Honor Code intends to make explicit minimum standards to which we, as a community, will hold our colleagues and ourselves accountable. Personal and academic integrity are the foundation of the Code, with particular focus on respectful communication among peers.
We are aware that integrity, accountability, mutual respect and trust are essential to the medical profession and we will actively support and work to achieve these ideals throughout our professional career. The environment that we create is critical to this endeavor.
As members of our community, we realize that our actions affect those around us and the quality of the community.
This Code should supplement, but not supplant, our personal, religious, moral and ethical beliefs, nor is this Code meant to supersede any policies, regulations, codes, statutes or laws that exist within the Stony Brook University Hospital System, State University of New York at Stony Brook, New York state or federal jurisdiction.
I. Professional Conduct
Establishing and maintaining the highest concepts of honor and personal integrity during medical school are critical to our training as physicians. It is our responsibility to actively support these standards and it is reasonable to expect that our colleagues will do the same.
A. Respect for Patients
1. At the Bedside
We will take the utmost care to ensure patient respect and confidentiality. As medical students, we will demonstrate respect for patients through appropriate language and behavior, including that which is non-threatening and non-judgmental. Patient privacy and modesty should be respected as much as possible during history taking, physical examinations and any other contact, to maintain professional relationships with the patients and their families. It is also important that we be truthful and not intentionally mislead or give false information. With this in mind, we should avoid disclosing information to a patient that only the patient’s physician should reveal.
We should consult more experienced members of the medical team when unsure of a course of action or at the request of a patient. Appropriate medical and/or personal information about patients should only be shared with health professionals directly involved or for educational purposes.
The written medical record is important in communication between health care providers and effective patient care; it is also a legal document and available for patient review. As such, it is crucial that we maintain the integrity of patients' medical care through accurate reporting of all pertinent information about which we have direct knowledge. Written medical documents, including electronic correspondence pertaining to patients and their care must be legible, truthful, complete and accurate to the best of our knowledge and abilities. To avoid an accidental breach of confidentiality, we will not discuss patient care in common areas.
B. Respect for Faculty, Staff, Colleagues, and Hospital Personnel
We will exhibit respect for faculty, staff, colleagues and others, including hospital personnel, guests and members of the general public. This respect should be demonstrated by punctuality in relationships with patients and peers, prompt execution of reasonable instructions and deference to those with superior knowledge, experience or capabilities. In addition, we should make every effort to maintain an even disposition, display a judicious use of others' time and handle private information maturely.
We should express views in a calm, respectful and mature manner when in disagreement with another individual. Under this Code, “confrontation” is defined as the initiation of a constructive dialogue with another community member with the goal of reaching some common understanding by means of respectful communication. Confrontation is encouraged, though it should be understood that achieving a common understanding does not necessarily mean reaching agreement.
C. Respect for Self
We realize that a diversity of personal beliefs serves to enrich the medical profession, and therefore we encourage the upholding of personal ethics, beliefs and morals in both daily conduct and in our practice of this Code. For example, we have an obligation to inform patients and their families of all available treatment options that are consistent with acceptable standards of medical care. However, we are not required to perform procedures that conflict with our personal beliefs.
D. Respect for Laws, Policies and Regulations
Laws, policies and regulations at the University, local, state and federal levels benefit the community and are not to be disregarded or violated. Any matters under the jurisdiction of local, state or federal laws are explicitly deemed “outside the scope” of this Code.
II. Academic Standards
We are responsible for proper conduct and integrity in all scholastic and clinical work. As students, we are obligated to develop our medical knowledge and skills to the best of our ability, realizing that the health and lives of the persons committed to our charge could depend on our competence. Due to the teamwork inherent in the medical profession, we should work together and utilize all available resources. If a professor believes it is in the best interest of student learning to limit access to some of those resources then he/she must make this explicit well in advance. We will abide by such policies.
- Professors and proctors are expected to treat us respectfully; likewise we must demonstrate honor and integrity during examinations.
- We understand that examinations are meant to reflect our individual achievement. Cheating during examinations is unethical and is defined as doing any of the following without authorization:
a. Looking at the answers written by another student during an examination.
b. Communicating with another student about topics that might help to answer a question during an examination.
c. Referring to notes or textual matter during an examination.
d. Violating any other policy of examinations.
- During examinations, professors, proctors and students have an obligation to maintain a non-disruptive atmosphere.
- We will take care not to communicate specific information regarding an examination to a classmate who has not yet completed that examination during that academic year. Specific information includes form, content and degree of difficulty.
- At the end of each examination, we will provide a signed statement that affirms our conduct was in accordance with the Code.
B. Other Academic Work
- In deference to the scientists, doctors, and patients who have shared their knowledge and experience for the betterment of medical learning, we have a responsibility to not intentionally misrepresent the work of others nor claim it as our own.
- During medical training we will be provided with communal instructional material that will greatly aid our learning. We will therefore make every effort to protect and preserve these resources for the use of future peers and classmates.
- Unless a professor explicitly limits us, all assignments will be considered group work.
III. Social Behavior
Our social relationships should be based on mutual respect and concern. We must consider how our words and actions may affect the sense of acceptance essential to an individual’s or group’s participation in the community. Upon encountering actions or values that we find degrading to ourselves or to others, we should feel comfortable confronting our peers.
Our behavior and speech should demonstrate our respect for the diversity of our colleagues. We should avoid disparaging remarks or actions with regard to a person's race, age, gender, disability, national origin, position, religion or sexual orientation. We will strive to create an environment that fosters mutual learning, dialogue and respect, while avoiding verbal, written or physical contact that could create a hostile or intimidating environment.
Since our actions reflect upon us, we should adhere to our standards of Professional Conduct when within, representing or in any way impacting our community.
IV. Honor Code Violations and Accountability
Our honor as community members and professionals is maintained through accountability. We will act in accordance with this code and we expect our peers to do the same. We will act with honor to avoid burdening our peers with a responsibility for our own integrity. Actions not in accordance with the aforementioned standards constitute a violation of this Code.
If there is concern that our academic or social conduct represents a violation of the Honor Code, we are obligated to report our behavior by contacting an Honor Committee member.
B. Interactions with Others
If there is concern that a peer’s academic or social conduct is in violation of the Honor Code, we must privately confront that individual. It is sometimes difficult to challenge the behavior of a fellow community member. However, it is our responsibility to confront offending parties; failure to do so is a violation of the Code.
As confrontation is often a matter between two individuals or parties, we will exercise discretion and respect privacy when initiating a dialogue to address our concerns. It is essential that these steps of the confrontation involve respectful communication and interchange. During the initial confrontation, each party will attempt to achieve mutual understanding. If the parties realize that there has been no violation, the matter is dropped. If the parties realize that there has been a violation of the Code, the offending party is obligated to report his/her behavior by contacting an Honor Committee member within an agreed-upon time frame.
C. Involving an Impartial Mediator
In the event that mutual understanding is not reached during the initial confrontation, or if the offending party has neglected to report his/her actions, the confronting party must contact a member of the Honor Committee. At this time, an impartial mediator will be randomly assigned to the case, although he/she may decline this position if he/she does not believe he/she can maintain impartiality.
The goal of mediation is to reach an agreement as to whether or not a violation of the Code has occurred. If it is agreed that a violation did not occur, then both parties must feel comfortable with that resolution. If it is agreed that a violation did occur, or if an impasse persists after mediation, the case will be brought before the Honor Committee by the mediator.
In the rare cases where the confronting party believes that his/her personal safety may be threatened, he/she may ask a member of the Honor Committee to initiate or assist in the dialogue.
In the event that a situation is being handled by an outside authority, either party may seek non-disciplinary support from an Honor Committee member.
D. Role of the Faculty
In cases of suspected Code violations, members of the faculty will follow the same procedures as outlined above; privately resolved matters do not repair the breach of trust inflicted upon the greater community.
V. The Honor Committee and the Resolution of Violations
A case of a suspected violation may be brought to the Honor Committee through self-reporting or by the mediator, at which point the case proceeds to a hearing for resolution.
A. Procedures towards Resolution
- Assigning a Chairperson
The impartial mediator of the case will become the chairperson of the hearing. In the case of self-reporting, a Committee member will be randomly assigned the position of Chairperson and will no longer be a voting member of the case. He/she may decline if he/she does not believe he/she can maintain impartiality. When a case reaches the Honor Committee, the Chairperson will convene the Committee for a Preliminary Meeting. The details of the case will not be provided at this time.
- The Preliminary Meeting
All committee members are expected to attend the Preliminary Meeting. At the meeting, the chairperson will present all background information in the case. Members may remove themselves from participation due to a conflict of interest. As a minimum, the following conditions must be met:
a. At least half of the Committee must be present.
b. One voting member from the class(es) involved in the case must be present.
c. The parties involved in the case will not be present at this preliminary meeting.
Membership on the case will consist of those in attendance at the meeting. No additional members may join later case proceedings. In the event of extenuating circumstances, a Committee member may be excused from the Preliminary Meeting by the chairperson. Attendance at all subsequent meetings is expected; absences may constitute dismissal from the case at the discretion of the Chairperson.
At this point an Advocate will be appointed for each party, chosen from Committee members in attendance. These Advocates will no longer be voting members of the Committee for the case; rather each Advocate will aid and support his/her party and facilitate the presentation of the facts of the case. While we expect all parties will speak for themselves at the hearing, the Advocate may act on their party’s behalf as necessary, to ensure that the truth is adequately communicated. The Advocates will be present throughout all phases of the hearing.
3. Hearing procedures
Subsequent to the Preliminary Meeting, a hearing will commence. It is the responsibility of the Chairperson and the Advocates to guide the parties through the hearing process.
The Chairperson will serve as the facilitator of this meeting and all related meetings subsequent to these proceedings. At the beginning of a hearing, the Chairperson will give a brief overview of the purpose of the hearing, answer any procedural questions, and ask members of the Committee whether or not they feel they can be objective.
All persons involved in the hearing, including the parties themselves, Advocates and Committee members, are expected to maintain the confidentiality of the proceedings.
The first phase of the hearing will focus on establishing facts of the case. All parties will have the opportunity to express what they believe to be the facts of the incident. During this portion of the hearing, all Committee members are urged to ask questions in order to gain a clear understanding of the situation.
The Chairperson will then dismiss the parties and Advocates, and the voting members of the Committee will determine the following by consensus:
Has the Honor Code been violated in this case?
If no violation is found, the matter is dropped, and the relevant parties are so informed. If a violation is found, the hearing proceeds to the Evaluation phase.
The parties are asked to return, so the Committee may inquire as to the nature of the circumstances surrounding the incident in question. Each party will be asked to suggest and justify what he/she feels is a fair resolution of the problem. The Committee may also propose alternative resolutions with the parties.
When the parties and the Committee members believe that the necessary information has been shared, the parties will again be dismissed and the voting members of the Committee will determine the following by consensus:
What are the relevant circumstances in this case?
What is an appropriate resolution in this case?
After an initial consensus is reached, the Committee will adjourn for at least one day and refrain from discussing the details of the case. At this point, each Committee member will privately reconsider the issues involved in the case to reflect upon his/her endorsement of the consensus. The Committee will then reconvene and either reaffirm its position or reach consensus on another action.
d. Presentation of the Resolution
The parties will be asked to return to hear the Committee’s recommendation and reasons for their decisions.
e. Recommendation to the Dean
The recommendation will be presented in writing to the parties and the Dean of the School of Medicine within a reasonable time. The offending party has the right to appeal the recommendation to the Dean. If an appeal is made, the Dean may then uphold the Committee’s recommendation, send the recommendation back to the Committee for further consideration, or overturn the recommendation of the Committee. The community at large, including students, faculty and administrators, entrusts great responsibility to the Honor Committee in these matters.
4. Repairing breeches of trust
With any violation of the Code, the offending party is obligated to repair breeches of trust to the community at large. This will be accomplished by compliance with the final decision in the case and acceptable reaffirmation of the party’s commitment to the standards of the community.
B. Membership of the Committee
A total of four members from each class will serve on the Honor Committee. Incoming classes will elect four of their peers to the Committee for the duration of the first half of the academic year. Before the close of this term, another election will be held to select four classmates to serve until the beginning of the clinical years. Before the close of the second academic year, students will elect four of their peers to sit as members of the Committee for the duration of the clinical years.
The results of all elections will be kept on file for the duration of the current term; in the event that a member of the Committee steps down, the first runner-up in their most recent election will serve the remainder of the term. If there is no runner-up, a special election will be held within a reasonable time to elect a new Committee member to serve the remainder of the term.
Upon ratification of the Code, each ratifying class will elect four members to the Honor Committee to serve the term appropriate to their academic year as specified above.
C. Responsibilities of the Committee Members
- To the Community
The Honor Committee’s responsibilities to the community include: educating students and faculty about the Code, providing information and literature about the Code and assisting in maintaining awareness of the Code.
Committee members will also undergo appropriate training prior to their becoming active members of the Committee.
- Within the Committee
The Honor Committee is responsible for interpreting the Code. The Committee will consider each case individually and should be sensitive to both the community and the individual involved when making decisions.
VI. Ratification of the Code
Students of the Stony Brook University School of Medicine classes of 2004 and 2005 will ratify this Code by a two-thirds majority. All incoming classes will be subject to this Code and will sign the pledge upon acceptance of admission to the School of Medicine.
VII. Amending the Code
This Code may be amended through an annual proposal and voting process. Amendments to the Code will be accepted by a two-thirds majority vote of all classes governed under the Code.
VIII. The Pledge
Membership in the Stony Brook medical community is dependent on our commitment to the Honor Code, and confirmed by our signing the Honor Pledge card, which states: “I hereby accept the Stony Brook School of Medicine Honor Code, realizing that it is my duty to uphold the Code and the concepts of personal and collective responsibility upon which it is based.”
I. The Committee has the right and responsibility to negotiate and clarify faculty policies concerning homework assignments, use of old exams and answer keys, citations in group-work and other graded and non-graded assignments whenever necessary. The results of these actions will be made known to the students.
II. A student who is governed by the Code may propose an amendment at any time. An amendment may be brought to an immediate vote if it is signed by 20 or more students who are governed by the Code. If an amendment is brought to an immediate vote, it will be discussed in an open forum and voted on within a reasonably short period of time.
III. Cases referred to the honor committee involving substance abuse/mental health that do not involve an honor code infraction will be handed over to AIMS without further action by the honor committee.
For cases referred to the honor committee that involve a substance abuse/mental health component as well as an honor code infraction, the honor committee will expedite the student's entry into the AIMS process. The honor committee will take necessary measures to clarify that participation in AIMS is NOT punitive. The honor committee will continue involvement in the case in order to fulfill its function in remediating the professional transgression.
In cases that are referred first to the AIMS committee that include an honor code violation, the honor code does not expect AIMS committee members to violate confidentiality, although we do expect them to urge the student to come forward and honorably declare the professional transgession.
We wish to acknowledge the guidance and contributions provided by the codes, texts
and other references that have preceded this document.