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Student Honor Code

The Honor Code of the Stony Brook University Renaissance School of Medicine

Preamble

We, as medical students of Stony Brook University's Renaissance School of Medicine, 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 to. 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.

2. Communication

The written medical record is important in communication between health care providers and in 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. Additionally, 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 that it is in the best interest of student learning to limit access to some of those resources, he/she must make this explicit well in advance. We will abide by such policies.

A. Examinations

  1. Professors and proctors are expected to treat us respectfully; likewise we must demonstrate honor and integrity during examinations.
  2. 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, or otherwise conducting research into the questions posed in the examination.
    d. Violating any other policy of examinations.
  3. During examinations, professors, proctors and students have an obligation to maintain a non-disruptive atmosphere.
  4. 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.

B. Other Academic Work

  1. 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.
  2. 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.
  3. Unless a professor explicitly limits us, all assignments will be considered group work.

C. Role of the Committee

The Honor 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 in conjunction with the Course Representatives. The results of these actions will be made known to the students in a timely manner.

D. 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 Phase 1. Before the close of Phase 1, students will again elect four of their peers to sit as members of the Honor Committee for the duration of Phases 2 and 3.

The members of the Honor Committee will meet each January to select two co-chairs from amongst the committee members. One will be a preclinical (Phase 1) student, and the other a clinical (Phase 2 or 3) student. The co-chairs will be responsible for the general organization of the committee, and will serve as chairpeople for all hearings. Additionally, they will act as liaisons between the committee, student senate, and Deans, as necessary.

The Committee will aim to meet each semester in order to maintain continuity and organization.

The results of all elections will be kept on file by the Student Senate and/or Dean's’ Office for  the duration of the current term; in the event that a member of the Committee steps down, the first runner-up in their class’s 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.

E. Responsibilities of the Committee Members

1. 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 in order to facilitate their commitments to the community.

2. Within the Committee

The Honor Committee is responsible for interpreting the Code and attending to infractions of the Code. The Committee will consider each case individually and should be sensitive to both the community and the individual involved when making decisions.

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 interacting with 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.

A. Self-Reflection

If there is concern that our academic or social conduct represents a violation of the Honor Code, we are obligated to consult with 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, a concerned student is obligated to report the violation. The initial step may occur in one of three ways: 1) the concerned student may confront the individual in private (see IV.C, “Peer-Peer Confrontation”), 2) the concerned student may consult with a member of the Honor Committee and ask them to confront the individual, or 3) the concerned student may submit an email to the Honor Committee (honorcode@stonybrookmedicine.edu). Every effort will be made to keep the identity of the concerned student anonymous from individuals not involved in the process, if the concerned student chooses not to confront the individual in private.

C. Peer-Peer Confrontation

As confrontation is often a matter between two individuals or parties, medical students 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 10 days of the confrontation.

D. Involving an Impartial Mediator

In the event that a mutual understanding is not reached during the initial confrontation, or if the offending party has neglected to report his/her actions within the agreed-upon time frame, the confronting party must contact a the Honor Committee; if the Honor Committee is contacted by email initially, this same process will begin. At this time, an impartial mediator from a different class than the confronted party will be selected from current Honor Committee members. He/she may decline this position if he/she does not believe he/she can maintain impartiality.

Additionally, Honor Committee members who feel they cannot be impartial in the particular case will recuse themselves and will have no further involvement. 

The goal of mediation is to reach an agreement as to whether or not a violation of the Code has occurred. If the mediator feels 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 entire Honor Committee by the mediator.

In the event that a situation is being handled by an official entity outside of the Honor Committee, either party may seek non-disciplinary support from an Honor Committee member.

E. Role of the Faculty

If faculty members suspect Honor Code violations, they should confront the student and, if they feel that a violation has occurred, should consult with the Honor Committee using the same procedures as stated above. If faculty members reach out to the Dean’s Office prior to a student investigation, the Dean should involve the Honor Committee.

F. Role of AIMS

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 (Aid to Impaired Medical Student) 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 take necessary measures to clarify that participation in AIMS is NOT punitive. The Honor Committee will continue its 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 Committee encourages AIMS to urge the student to come forward and honorably declare the professional transgression. Confidentiality will not be breached and in deferral to AIMS policy.

G. Hearing Procedure and Violation Resolution

See Appendix A for a discussion of protocols in the case of Code violations. 

V. Ratification of the Code
This code was originally written by the SOM classes of 2004 and 2005. All incoming classes thereafter will be subject to this Code and will sign the pledge after fully engaging with the document and appreciating its gravity, in a manner specified by the School of Medicine.

VI. Amending the Code
This Code may be amended through a proposal and voting process; suggestions will be made to the Honor Code Committee, who will then lead the amendment process and petition the Senate to lead the voting. Amendments to the Code will be accepted by a two-third majority vote of all who cast votes from a quorum of 50% of all classes governed under the Code.

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, facilitated by the Honor Code Committee and voted on within a reasonably short period of time. Amendments may also be proposed by majority vote of the Honor Code Committee.

Once the Code has been amended, all current students will be provided with a copy of the new text and will sign the new document in order to reaffirm their commitment to the values articulated in the Code.

VII. 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 Renaissance 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.”

VIII. Acknowledgements
We wish to acknowledge the guidance and contributions provided by the codes, texts and other references that have preceded this document.

Appendix A
Hearing Procedure and Violation Resolution
Once the requisite data has been gathered by the impartial mediator, the mediator should lead a vote among members of the Honor Committee to determine if the case should proceed to a hearing. A vote by simple majority will determine the outcome, with the requirement that at least 1 member from each class be represented in the vote. The mediator will not vote except in the case of a tie. Should there be a tie, the mediator should serve as a tiebreaker. Should it be determined that the case should proceed to a hearing, all the parties involved must be notified via e-mail before pursuing further action.

1. Assigning a Chairperson
One of the two Honor Committee Chairpeople will be selected as Chairperson of the hearing. When a case reaches the Honor Committee, the Chairperson will convene the Committee for a Preliminary Meeting.

2. The Preliminary Meeting: The First Part of the Hearing
At the first meeting of the hearing, the Preliminary Meeting, the Chairperson will present all background information in the case. 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 this preliminary 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.

3. The Hearing 

Subsequent to the Preliminary Meeting, a Hearing will commence. It is the responsibility of the Chairperson to guide all involved 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 and Committee members, are expected to maintain the confidentiality of the proceedings.

a. Fact-finding

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 the voting members of the Committee (members present who had attended the preliminary meeting) will determine the following by a minimum of two thirds vote: 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 Circumstances phase.

b. Circumstances

The parties are asked to return so that 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.

c. Deliberation 

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, through a minimum two-thirds majority of eligible voting members, the following: What are the appropriate resolutions in this cases? Each resolution should be voted on, followed by a vote on the list of resolutions in their entirety.

d. Presentation of the Resolution

The parties will be asked to return to hear the Committee’s recommendation and reasons for their decisions.

4. Recommendation to the Associate Dean of Student Affairs (ADSA)

After review, the Honor Committee presents its recommendation, in writing, to the OSA within seven (7) days of the resolution presentation. The ADSA brings these recommendations to the Deans in the Office of Academic and Faculty affairs and, together, they take into account the Honor committee's recommendations in adjudicating the case and may choose to:

i. impose the Honor Committee’s recommendation wholly or in part,
ii. refer the issue for further decisions to Committee on Academic Policies and Procedures (CAPP).
iii. take additional action.

The Honor Committee does not have any authority to enforce any of their recommendations. The determinations of the Deans and the CAPP committee proceedings will follow the RSOM existing academic policies and procedures.

5. Repairing breaches of trust

With any violation of the Code, the offending party is obligated to repair breaches 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.