The Romanian College of Physicians publishes the draft of the new Medical Code of Ethics

The new document introduces stricter provisions regarding the professional independence of physicians, the doctor–patient relationship (including the prohibition of intimate relationships), conditions for advertising medical services, the obligation of informed consent, as well as regulations concerning medical research and the use of artificial intelligence.

The draft can be consulted here (Romanian version) – https://www.cmr.ro/transparenta-decizionala-cmr

The Medical Code of Ethics establishes the mandatory moral and professional conduct rules for all physicians who are members of the CMR. The updated draft, launched in public consultation on August 19, 2025, comes in the context of the need to align the old code (adopted in 2016) with recent developments in practice and legislation. The document can be consulted on the CMR website, and proposals and comments regarding this draft may be submitted until August 29, 2025, at propuneri@cmr.ro, for the purpose of finalizing and adopting the final version.

Professional independence of the physician

The draft reaffirms the liberal nature of the medical profession and the physician’s decision-making independence. Physicians have both the right and the duty to defend their professional independence, being entitled to refuse any economic or administrative interference or pressure that may affect the medical act. They are free to make medical decisions they deem necessary for the patient’s benefit, within the limits of the law and in accordance with guidelines and protocols, without financial gain being the primary purpose of the medical act. Furthermore, the non-commercial nature of medical practice is emphasized – medicine cannot be exercised as a business, as it is by definition an activity dedicated exclusively to the patient’s well-being, not to profit. The Code also lists situations that may endanger professional independence (e.g., onerous agreements between doctors or with other entities to obtain advantages) and obliges physicians to avoid such conflicts of interest.

The doctor–patient relationship

The new draft emphasizes that the doctor–patient relationship is strictly professional, based on the physician’s competence and on the patient’s compliance with medical recommendations, after giving informed consent. Any involvement of the physician in an intimate relationship with a patient under their care is explicitly prohibited and qualifies as a serious breach of ethics. Physicians are also prohibited from taking advantage of patients or their families in any way – financially, professionally, or socially. These provisions are intended to protect the integrity of the therapeutic relationship and maintain patient trust, preventing abuse and exploitation of patient vulnerability. Physicians are also forbidden from accepting material or moral benefits in order to direct patients to a particular colleague or healthcare facility, ensuring that referrals to consultations or services are made solely in the interest of the patient, not for personal gain.

Advertising of medical services

The draft code introduces detailed rules on advertising in the medical field, in order to preserve professional ethics in the public communication of physicians. It is stipulated that the advertising of medical services has an exclusively informative role, limited to the objective presentation of the physician’s or medical unit’s activity and competences. Content permitted in advertising materials is restricted to factual information such as: medical services offered (authorized by law), the physician’s specialty and competences, scientific titles, professional experience (CV), working hours, contact details, and possibly a decent slogan or logo. Advertising must be truthful, decent, and not misleading: false information, guaranteed results, or the use of superlatives and derogatory comparisons are prohibited. For example, physicians are forbidden from falsely claiming primacy in performing certain procedures or from referring to titles or positions unrelated to medical practice for promotional purposes. The permitted channels for promotion are also defined – from office signs and professional websites to participation in radio/TV shows or social media – provided that any public appearance of the physician has an educational/informative purpose, not commercial self-promotion. These measures aim to prevent misinformation and excessive advertising in medical practice, preserving the dignity of the profession and the primacy of the patient’s interest.

Patient’s informed consent

A distinct chapter of the draft is dedicated to informed consent, emphasizing the physician’s obligation to obtain the patient’s free and conscious agreement before any medical intervention, except in cases of vital emergencies. According to the new provisions, “any medical intervention may only be carried out after the patient has given informed consent knowingly.” Patients have the right to refuse or withdraw their consent at any time, even after procedures have begun, by assuming responsibility in writing, and the physician must respect this decision. The Code details the procedure for obtaining consent in special situations: for minor patients, consent is given by the legal representative (parent/guardian), except in life-threatening medical-surgical emergencies. However, minors with sufficient understanding capacity must be involved in the decision, and in certain special cases (emergencies when parents cannot be contacted, or reproductive health issues in adolescents over 16), the minor may give their own consent. For adult patients without decision-making capacity (e.g., unconscious or with impaired judgment), medical interventions may only be carried out with the consent of the legal representative, except in life-threatening emergencies. Physicians are also obliged to provide patients with all relevant information, in adapted language, so that they fully understand the medical situation and the implications of the medical act before giving consent. These clarifications strengthen the respect for patient autonomy and the physician’s responsibility to ensure free, informed, and retractable consent at any time during the medical act.

Medical research and the use of artificial intelligence

The draft of the new Code of Ethics also addresses modern ethical challenges related to scientific research on human subjects and emerging technologies. A chapter dedicated to medical research is introduced, aligning physicians’ practices with international ethical standards (the Helsinki Declaration, the Oviedo Convention, etc.). Any clinical research activity must strictly respect the dignity and safety of the human being, taking precedence over scientific or societal interests. For studies involving individuals capable of consenting, the Code explicitly sets cumulative conditions: the risks to participants must not be disproportionate to the potential benefits of the research, the project must be approved by an ethics committee (national bioethics committee or local committees), and subjects must be properly informed of their rights and the safeguards protecting them. Participation is only allowed after subjects have given their explicit, specific, freely expressed, and written consent, being informed that they may withdraw at any time without consequences. The chapter also sets requirements for research involving vulnerable persons who cannot consent (incompetent adults or minors): they may only be included in studies with the legal representative’s consent and only if no alternative exists to obtain similar results on capable subjects. Explicit prohibitions are also introduced regarding forbidden experiments – e.g., any genetic intervention aimed at altering descent or creating human clones, the creation of embryos for research purposes, or any other practice that would harm the human species is considered contrary to medical ethics.

Regarding the use of artificial intelligence (AI) in medical practice, the proposed code briefly stipulates the obligation for physicians to use AI tools in compliance with applicable legal provisions. Although succinct, this article implies that physicians must integrate AI technologies into medical practice responsibly, taking into account current legal and ethical norms – from data confidentiality and patient safety to assuming responsibility for AI-assisted medical decisions. By including this provision, the CMR acknowledges technological advances in medicine and the need for AI applications (such as decision support systems, diagnostic algorithms, or medical robots) to be used under the physician’s supervision and responsibility, for the patient’s benefit and in compliance with legislation.

Public consultation

The College of Physicians invites all professionals in the field to analyze the draft Code of Ethics and provide feedback. Proposals and comments may be submitted until August 29, 2025, to the email address propuneri@cmr.ro. Subsequently, the CMR will analyze the received suggestions and finalize the updated Code of Ethics, after which the final version will be submitted for approval and later implemented. This participatory approach aims to ensure that the new Medical Code of Ethics reflects the current values and needs of the medical community, while also strengthening public trust in the medical profession.