SIR Code of Ethics

The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, an Interventional Radiologist must recognize responsibility not only to patients, but also to society, to other physicians, to other health professionals, and to self. The following Principles adopted by SIR are standards of conduct that define the essentials of honorable behavior for the Interventional Radiologist.

1. An Interventional Radiologist shall be dedicated to providing competent medical service with compassion and respect for human dignity.

2. An Interventional Radiologist shall deal honestly with patients and colleagues.

3. An Interventional Radiologist shall respect the law and also recognize a responsibility to seek changes in those requirements that are contrary to the best interests of the patient.

4. An Interventional Radiologist shall respect the rights of patients, of colleagues, and of other health professionals, and shall safeguard patient confidences within the constraints of the law.

5. An Interventional Radiologist shall continually study, apply and advance scientific knowledge, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.

6. An Interventional Radiologist shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical services.

7. An Interventional Radiologist shall recognize a responsibility to participate in activities contributing to an improved community.

8. An Interventional Radiologist shall perform research with integrity and report results honestly reported. No claim shall be made to research or intellectual property that is not theirs; plagiarism, or the use of others' research, without permission and recognition of the source is unethical.

9. An Interventional Radiologist shall not use any forum or medium of public communication to advertise himself/herself through deceptive, misleading or untruthful information.

10. An Interventional Radiologist who chooses to provide expert testimony in legal cases shall be as objective as possible and not accept a contingency fee for his/her services or other compensation that is linked to the outcome of the case. An expert should be appropriately qualified and thoroughly prepared with relevant facts so that he or she can, to the best of his or her ability, provide the court with opinions that are accurate and capable of substantiation with respect to the matters at hand. The expert also should be engaged in the active practice of interventional radiology and should be able to demonstrate a thorough knowledge of current practice. Expert testimony should promote the truth, not the cause of either party. It should reflect the community standard and generally not represent the expert's personal views as the only acceptable ones.

It is the policy of SIR to encourage every member's full compliance with these principles, to counsel members as appropriate and to assist them to achieve full compliance with these principles.

Disciplinary Procedures

A member or fellow of the Society may be disciplined or expelled for conduct, which the Society considers unprofessional, unethical, or offensive to the dignity or contrary to the best interests of the Society.

Disciplinary action may be initiated by any one or more violations of the Code of Ethics of the Society of Interventional Radiology. Without restricting the general definition of the foregoing, the following shall automatically be considered not in the best interest or inconsistent with the purposes of the Society:

· Suspension or revocation of any right to practice medicine in any state, province or country by reason of a violation of a medical practice act, statute or government regulation.

· Conviction of a felony relating to or arising out of the practice of medicine or of moral turpitude.

If the Executive Council receives credible, verifiable evidence that a member or fellow has been involved in one of the two situations described above, such situation shall be considered grounds for automatic expulsion. The Executive Council shall initiate a notification process to the individual as detailed below.

Disciplinary Options

The Executive Council may apply the following disciplinary options to any fellow or member for due cause. Disciplinary proceedings shall be considered confidential. The following levels of disciplinary action are available and defined as follows:

Expulsion: An expelled fellow or member shall no longer be a member of the Society and will be removed from the membership roster. He/she will not be entitled to the benefits of Society membership and shall return to the Society all certificates of membership or fellowship awarded by the Society. Grounds for expulsion are not limited to the two situations outlined above, but may also be invoked by the Executive Council where violations of the Society's Code of Ethics have occurred.

Suspension: Suspension shall cause the fellow or member to lose all membership benefits for a minimum of one year, or longer, as determined by the Ethics Committee. At the end of the determined suspension period, the Ethics Committee may consider a petition for reinstatement if the individual can show that during his/her suspension he/she has demonstrated the necessary modifications to his/her behavior and has adhered to the ethical principals of the Society. Provided the individual meets the membership criteria then in force, he/she may be fully reinstated as a member upon review by the Executive Council of the Ethics Committee recommendations.

Probation: Probation is for a stated period of time, and causes the fellow or member to lose the right to hold office, serve on committees, or participate in Society-sponsored programs as a presenter, moderator, or panelist. The individual shall retain any other rights, privileges and obligations of membership. During this period, the individual shall be monitored by the Society, and will be eligible for reinstatement to full membership privileges by the Ethics Committee at the end of the stated term.

Censure: Censure is a written reprimand of the fellow or member from the president of the Society with no loss of fellowship or membership. Such censure is made part of the membership file of the fellow or member.

No Action Indicated: After careful consideration of a complaint, the Ethics Committee may decide that no action is necessary.

Disciplinary Process

Ethics Committee Evaluation: Complaints of ethical misconduct by a member or fellow of the Society shall be filed in writing with the chairman of the Ethics Committee. The Ethics Committee shall evaluate the merits of the complaint and decide whether any further action is necessary. If the Ethics Committee finds that there is merit to the complaint, it will schedule a hearing on the matter. Written notice of the complaint and hearing shall be sent to the accused physician and the complainant not less than forty-five (45) days prior to the hearing before the Ethics Committee. Such notification shall require proof of delivery to the physician.

The notice shall state:

1. The time and place of the hearing,
2. The nature of the charges against him/her and any witnesses that are expected to testify against him/her,
3. That the physician may appear in person either alone or accompanied or represented by another person including legal counsel,
4. That he/she may submit such evidence determined to be relevant by the Chair of the Ethics committee, regardless of its admissibility in a court of law,
5. That he/she may call, examine, and cross-examine witnesses (subject to reasonable limits set by the Chair of the Ethics Committee),
6. That the physician may have a record made of the proceedings, copies of which may be obtained by the physician upon payment of any reasonable charges associated with the preparation thereof, and
7. That he/she may submit a written statement at the close of the hearing.

A copy of these guidelines will be included with the notice.

No member of the Ethics Committee who is in direct economic competition with the accused physician, or otherwise has a conflict of interest, shall participate in the review of the complaint. The parties will bear their own expenses with respect to the Ethics Committee hearing, as well as any other aspect of this disciplinary process, including any hearing before the Executive Council. The hearing will be conducted by the Chair of the Ethics Committee with the assistance of the Society's legal counsel, and must be held in executive session as an in-person meeting. If the member or fellow fails to appear at the hearing, he/she will be deemed to have waived his/her right to a hearing before either the Ethics Committee or the Executive Council, and the Ethics Committee may proceed to consider the charges based on the written evidence and other testimony it receives, or the Chair of the Ethics Committee may reschedule the hearing for good cause shown. The Ethics Committee may also hear from the complainant. After careful deliberations by the Ethics Committee, the Ethics Committee shall, within 30 days after the date of the hearing, inform the accused member or fellow and the Executive Council in writing of its findings and proposed decision to expel, suspend, or otherwise discipline the member or fellow, or dismiss the complaint. Such notification shall require proof of delivery to the physician and shall include the justification for the Ethics Committee's proposed action.

Appeal to the Executive Council: If the physician wishes to appeal the decision, he/she shall have thirty (30) days from receipt of the Ethics Committee findings to appeal the decision to the Executive Council. If the physician does not file an appeal, the Ethics Committee decision will become final upon the expiration of the thirty (30)-day period. If a timely appeal is filed, the Executive Council shall notify the member or fellow not less than thirty (30) days prior to a meeting of the Executive Council that it will consider the appeal. Such notification shall require proof of delivery to the physician.

The notice shall:

1. State the time and place of the meeting,
2. State the nature of the charges against him/her,
3. Inform the physician that he/she may appear in person either alone or accompanied or represented by another person including legal counsel if, and only if, he/she appeared in person before the Ethics Committee as outlined above,
4. Inform the physician that he/she may submit such argument and evidence as he/she deems appropriate (subject to reasonable limits set by the Chair of the Executive Council) to show that the decision of the Ethics Committee should be reversed and that no disciplinary action should be taken against him/her. In cases where new evidence comes forward after the Ethics Committee has made its decision, the Executive Council has the discretion to remand the case and the new evidence back to the Ethics Committee for review.

If a majority of the members of the Executive Council determines that the findings and determinations of the Ethics Committee are supported by the evidence presented at this meeting and are the result of fair procedures, the Executive Council shall affirm the expulsion or disciplinary action. If the required majority is not reached, the Executive Council shall reverse the expulsion or disciplinary action, may remand the issue in whole or in part for further proceedings before the Ethics Committee, and/or may dismiss the matter in whole or in part. There shall be no appeal from the decision of the Executive Council.

Members of the Executive Council who are a) members of the Ethics Committee, b) are in direct economic competition with the member or fellow, or c) otherwise have a conflict of interest in the matter, shall be disqualified from participating in the appeal to the Executive Council. The fellow or member shall be informed in writing of the Executives Council's decision within thirty (30) days of the hearing. Such notification shall require proof of delivery to the physician and shall include the reasons for the Executive Council's decision.

Reporting the Decision: Where appropriate, the Society shall report its decision to the National Practitioner Data Bank and the relevant state medical licensing bodies. The decision may also be reported to the American Board of Radiology and/or state or local radiology societies if the circumstances so warrant.

SIR Policy on Abstract or Presentation Discrepancy

Underlying Principles

1. Abstracts are a part of the citable literature on interventional radiology.
2. The quality of abstracts accepted for the SIR sponsored meetings directly impacts upon how the Society itself is viewed. Currently the SIR Annual Meeting is the premier forum for the interventional community. The quality of this and other society-sponsored meetings is a direct result of the quality of the presentations. Any blemish on the honesty or validity of the presentations diminishes the status of the meeting and the Society that produces it.
3. Abstracts may be the only exposure to the authors' work available to those not attending the presentation. A larger audience than the attendees views abstracts. Since scientific abstracts are a part of the medical literature, patient care decisions or future research may potentially be made based on the abstract results or conclusions. Erroneous abstract information may lead to sub-optimal patient care decisions.
4. A policy on abstract discrepancy should be structured to address truly unethical research practices, and reviews will adhere to principles of due process.

Definition of Discrepancies

A definition of discrepancy must take into account that there is a significant time interval between the deadline for abstract submission and the time of the actual presentation. During this time period, additional patients may be accrued or procedures performed that may be beneficial to add into the cohort of patients reported. Addition of patients/procedures into a study may strengthen the conclusions of the study or may change the conclusions. If the conclusions in the abstract are altered by the additional data, it might be considered unethical to fail to report such changes since patient care decisions or future research may be based on the reported data.

Thus, a discrepancy will be defined as:
1. Any unexplained deletion of data from the original abstract.
2. Any unexplained change in the totals, percentages, or statistics that cannot be accounted for by the simple addition of more patients or procedures.
3. Obvious changes in the data indicating that the abstract had been written before the data were actually acquired.

Discovery of Discrepancies

If an author(s) discovers a discrepancy prior to the meeting, he or she is encouraged to contact the Scientific Program Chairman to discuss the options. Session moderators will be the primary source of reporting of discrepancies. If the moderator has a concern about a possible discrepancy, the moderator should ask the speaker for clarification of the presented data immediately after the scientific session. If an attendee believes that there is a significant discrepancy, he or she may independently report it to the SIR Scientific Program Chairman.

Review Process

Initial Report
Any perception of possible discrepancies should be reported to the Scientific Program Chairman. A complaint should include the complainant's name, identification of the abstract in question, the session in which the presentation occurred, the name of the presenter, and the moderator's name. The nature of the discrepancy should be described in detail including specific discrepancies in the numbers, findings, or conclusions reported and how they differed from the abstract. The person filing the complaint should also indicate what manner of discrepancy they suspect has occurred (i.e., data from abstract were eliminated, abstract written before data acquired, etc.).

Review
The author(s) will be contacted by the Scientific Program Chairman to notify them of the complaint and to verify that the numbers, statistics, findings, or conclusions in question are what they actually reported. The author(s) will be asked to provide in writing (within 2 weeks) an explanation of the apparent discrepancy between the data published in the abstract and that presented at the meeting. The program chairman will then forward the initial material to the SIR Ethics Committee for further review pursuant to the disciplinary procedures set forth above (except as otherwise specified below). If no significant discrepancy is found, the Ethics Committee will transmit their decision to the author(s) as well as the SIR Office, the Scientific Program Chairman, and the Executive Council. If a significant discrepancy is found, the Ethics Committee will submit their decision to the Executive Council with recommendations for disciplinary action. The author(s) shall be notified by registered mail to ensure receipt by the author(s).

Appeal
If the author(s) disagree with the review judgment, the author(s) may file an Appeal to the Executive Council. An appeal should include the author's explanation of why they believe no discrepancy existed or if there was a discrepancy, how it occurred without unethical conduct. The Executive Council shall follow the disciplinary procedures set forth above in reviewing the author's appeal, except as otherwise specified below.

Timeliness
Timeliness is crucial to proper resolution of any report of discrepancies. Reports should be filed within one week of the end of the meeting. The review should be completed and a report filed within two months. If an appeal is to be filed, the author(s) must submit the appeal within two weeks of notification of the review judgment.

Penalties
If an author(s) is found to be in violation of the policies, the author(s) will be subject to the disciplinary options outlined above. In addition, the author(s) will not be allowed to submit abstracts to SIR sponsored meetings for a period of up to three years. Also, an erratum may be published in JVIR to serve as a correction of the abstract previously published in the JVIR Program Supplement. Copies of the Ethics Committees and Executive Council's disciplinary action will be forwarded to the department chairman of the author's institution.

Approved by SIR's Executive Council in February 2003