Missouri State Tumor Registrars Association Code of Ethics
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Adapted from the National Tumor Registrar's Association Guide to the Interpretation
of The Code of Ethics 1986
GUIDE TO THE INTERPRETATION OF THE CODE OF
I. CONDUCT MYSELF IN THE PRACTICE OF THIS PROFESSION SO AS TO BRING
HONOR AND DIGNITY TO MYSELF, THE TUMOR REGISTRY PROFESSION, AND THE ASSOCIATION.
- The tumor registrar should maintain high standards of conduct,
integrity and fairness in all professional actions and decisions so as to
establish and sustain an irreproachable, professional reputation. Examples:
Business on behalf of the employer should be conducted in an honest
and ethical manner, declining favors which will influence any decisions,
and avoiding commercialization of one's position.
A member has the obligation to refrain from commenting disparagingly,
without justifications, about the professional work of another member.
Evaluation of performance of another tumor registrar should be
done fairly and with objectivity. Example:
- Make judgments and decisions without personal bias or prejudice.
- Give primary consideration in all decisions as to the affect
actions may have on a patient's health and welfare.
Tumor registrars shall use professional titles and degrees consistent
with the dignity of the profession. A certified tumor registrar should use
the letters CTR.
A tumor registrar shall not exert undue pressure in obtaining
clients/employment. Advertising should contain only the registrar's name,
degrees (if desired), addresses, nature of services offered, and professional
memberships. If requested, a resume and list of references may be furnished.
Qualifications listed should be those for which supporting evidence is available.
Distribution of announcements concerning the formal organization
and availability of tumor registry consultant services is ethical. Repeated
distribution of unsolicited announcements is unethical. Any distribution
should be in keeping with the practice of other health related professionals
in the community.
Use of business cards and letterhead stationary is acceptable
but should not promote a commercial endeavor which may tend to lower public
esteem for the profession. MoSTRA logo or address may not be used in this
A member has the obligation to appropriately recognize the contributions
of fellow members and co-workers in their efforts to advance tumor registry
practice. Publications should give credit where due to one's peers.
A member has the right to speak out against any policies espoused
by the Association, but in this respect, it is unethical to represent one's
own view as that of the Association or the majority of the members.
- Never let personal prejudice influence the type of evaluation
or reference given.
- Offer only job-related solicited information.
II. UPHOLD THE DOCTRINE OF CONFIDENTIALITY AND THE INDIVIDUAL'S RIGHT
TO PRIVACY IN THE DISCLOSURE OF PERSONALLY IDENTIFIABLE MEDICAL AND SOCIAL
- The patient has a right to feel confident that all identifiable
information about him possessed by the tumor registry will be kept confidential
unless he waives the privilege, or release of the information is compelled
by statute, regulations, or other legal means.
- Release of identifiable and non-identifiable information should
be in accordance with the established institutional policies. Example:
Written policies on the use and proper release of patient information,
together with active educational programs for all personnel on the institution's
staff, should be upheld by the tumor registrar.
Every effort must be made to ensure that the computerization of
tumor registry information is accomplished in a manner which protects the
confidence of patient information.
Actively participate in establishing controls to protect the patient's
privacy when electronic information processing is initiated.
- Providing lists of patients' names for marketing research or other commercial
use is not proper function of a health institution and such lists should
not be released by a tumor registrar without approval of the chief executive
III. COOPERATE WITH OTHER HEALTH PROFESSIONS AND ORGANIZATIONS TO
PROMOTE THE QUALITY OF HEALTH CARE PROGRAMS AND THE ADVANCEMENT OF MEDICAL
CARE, ENSURING RESPECT AND CONSIDERATION FOR THE RESPONSIBILITY AND THE DIGNITY
OF MEDICAL AND OTHER HEALTH PROFESSIONS .
- Cooperation with other professions and entities engaged in or
supportive of health services is an essential factor in the tumor registry
profession's greater aim of improving health services and supporting research
relevant to the advancement of medical care. Example:
Courtesy, respect and cooperation should govern the relationships
of fellow tumor registrars.
- Accept the right of other health professions to have purpose in their
occupation and attempt to understand the thinking and work patterns of
professional groups whose primary interest may be different from yours.
- Treat all members of the medical and component professional staff with
equal respect and due recognition of the status, privilege, and authority
belonging to their respective professions.
- Refrain from making decisions or expressing opinions for which you are
- Accept the obligation to assist the medical staff and/or institution
in working with other professional groups or entities engaged in utilization
review and patient care evaluation, continuing education or professional
staff, health services planning, clinical studies, proposed legislation
or regulations affecting medical and statistical record systems, and like
- Recognize there may be differences of opinion between consultants or
co-workers regarding certain proposals or recommendations and prevent such
differences from leading to utterances or actions inconsistent with the
professional stature and dignity of a colleague.
- Do not, however, place loyalty above duty by protecting a fellow tumor
registrar who is guilty of unfair or unethical practices. Questions of
such conduct should be referred to the Executive Committee for review and
I. RECOGNIZE THE SOURCE OF AUTHORITY AND POWERS DELEGATED TO ME AND
CONSCIENTIOUSLY DISCHARGE THE DUTIES AND RESPONSIBILITIES THUS ENTRUSTED .
- It is the tumor registrar's duty to give loyal service and to
competently carry out the responsibilities of this position. It is unethical
to accept a position for which one is inadequately prepared, or to vacate
a position without responsibility vested in the position or with the policies
of the institution.
- In carrying out the duties entrusted to him/her in a responsible
manner, the tumor registrar should always:
For the protection of the employer/client and tumor registrar
(including consultants and part-time supervisors), an agreement* should specify
responsibilities, functions, objectives, and terms of service to be fulfilled.
Where desirable, the contract may be in writing.
- Render a truthful accounting of the status of the work over which one
- Assist the medical staff and other health professional staff in programs
related to cancer patient care, cancer education, research, and committee
activities in accordance with assigned responsibilities.
- Resort to the special knowledge, skill, or experience of fellow professionals
for referral, counsel, guidance, or consultation when one lacks in some
detail the capability required to serve an employer.
* Agreement (contract): An understanding, preferably in writing, between
consultant and client which spells out responsibilities, functions, objectives,
and terms of the relationship including financial arrangements and charges.
Relationships with tumor registry or other institutional personnel
should be characterized by courtesy and respect. In carrying out one's duties
as a consultant, part-time supervisor, or official surveyor/observer, one's
responsibility and authority for seeking and obtaining certain information,
files, and statistical data should be tempered with respect for another individual's
tenable position and the institution's good name in the community.
The tumor registrar, including consultants and other advisors,
should maintain personal integrity and should not hesitate to advise the
employer/client if, in the professional judgment of the registrar, the facility
is in danger of errors of commission or omission.
II. PRESERVE AND SECURE TUMOR REGISTRY RECORDS, THE INFORMATION CONTAINED
THEREIN, AND THE APPROPRIATE SECONDARY RECORDS IN MY CUSTODY IN ACCORDANCE
WITH PROFESSIONAL MANAGEMENT PRACTICES, EMPLOYER'S POLICIES, AND EXISTING
LEGAL PROVISIONS .
- The tumor registrar should at all times support and uphold the
professional standards which would produce complete, accurate, and timely
information to meet the health and related needs of the patient.
- A tumor registrar should not participate in any improper preparation,
alteration, or suppression of medical/health records or official minutes
duly maintained as part of the operation of the health institution.*
* Institution: A public or private organization of facilities and/or staff
established to ensure continuity of program; a legally established agency
III. PRESERVE THE CONFIDENTIAL NATURE OF PROFESSIONAL DETERMINATIONS
MADE BY OFFICIAL COMMITTEES OF HEALTH AND HEALTH-SERVICE ORGANIZATIONS .
- The tumor registrar should abstain from revealing or discussing
observations, comments, or findings concerning the practice of individual
members of the health professions resulting from committee activities such
as medical audit findings, individual patient care, professional standards
review recommendations or obtained from any other source, except to the designated
appropriate authority of the institutions.
IV. DISCLOSE TO NO ONE BUT PROPER AUTHORITIES ANY EVIDENCE OF CONDUCT
OR PRACTICE OBSERVED OR REVEALED IN MEDICAL REPORTS WHICH INDICATES POSSIBLE
VIOLATION OF ESTABLISHED RULES AND REGULATIONS OF THE EMPLOYER OR PROFESSIONAL
- Discretion should be exercised in the release or discussion of
sensitive information acquired during the course of employment or fulfillment
of contracted services which concern the administrative conduct or professional
practices within the health institution. Examples:
Disclose to proper regulatory or law enforcement agencies the
conduct or practices believed to be illegal only when, after informing the
health institution, no corrective action has been enacted.
- Disclose only to proper authorities the conduct or practices believed
to be in violation of the institution's internal policies and rules.
I. PLACE SERVICE BEFORE MATERIAL GAIN AND STRIVE AT ALL TIMES TO PROVIDE
SERVICES CONSISTENT WITH THE NEED FOR QUALITY HEALTH CARE AND TREATMENT TO
ALL WHO ARE ILL WITH CANCER OR OTHER NEOPLASMS .
- The tumor registrar should place primary importance on providing
a high standard of professional services; financial considerations are secondary
to this objective.
II. ACCEPT COMPENSATION ONLY IN ACCORDANCE WITH SERVICES ACTUALLY
PERFORMED OR NEGOTIATED WITH THE HEALTH INSTITUTION.
- A tumor registrar shall not accept anything of any value from
a third party provider of services nor products to the health institution
when that third party is functioning for the health institution.
- Unless openly engaged in placement bureau service, refuse to accept
finder and referral fees. Refuse acceptance or offer to divide tumor registrar
service fees with another party who is not a partner in or an associate of
a medical consultant group.
- The tumor registrar should endeavor to avoid conflict of interest
by providing full disclosure to the employer or client of any interest in
any provider of services or products.
I. REPRESENT TRUTHFULLY AND ACCURATELY PROFESSIONAL CREDENTIALS, EDUCATION,
AND EXPERIENCE IN ANY OFFICIAL TRANSACTION OR NOTICE, INCLUDING OTHER POSITIONS
AND DUALITY OF INTERESTS.
- Misrepresentation of one's professional qualifications, employment,
and interests reflect adversely on the profession as well as on oneself and
lowers the public esteem for the profession.
- A statement of any other positions of duality of interest in the
health or health related field, both remunerative or non-remunerative in
nature, should be made available on request of the employer. Examples of
duality of interests: outside consultation services, committee appointments,
advisory positions, elected office, business enterprise interests, and the
- Credentials, professional education, and experience are to be
stated truthfully and accurately in any official transaction with MoSTRA
or any other professional association, any employer or prospective employer,
and any program coordinator or publisher.
- Those documents which authenticate registration, accreditation,
academic achievements, and membership status in recognized professional organizations
may be displayed. Displays which imply qualifications not possessed are unethical.
II. STRIVE TO INCREASE THE PROFESSION'S BODY OF SYSTEMATIC KNOWLEDGE
AND INDIVIDUAL COMPETENCY THROUGH CONTINUED SELF-IMPROVEMENT AND APPLICATION
OF CURRENT ADVANCEMENTS TO THE CONDUCT OF TUMOR REGISTRY PRACTICES .
- The achievements and preservation of professional status is accomplished
through the mastery of tumor registry activities competently applied and
the continual striving for the application of new knowledge and increased
Advancements in the knowledge and practice of tumor registry administration
emerge through participating in studies and projects related to the principles
and practices underlying its activities. Examples:
- Acquire information by reading pertinent literature.
- Attend workshops, institutes, and other continuing education programs.
- Examine and scrutinize functions performed as a tumor registrar for purpose
of self-evaluation in carrying out professional duties.
Information on changes and new developments in methods and procedures
should be made available to fellow tumor registrars for purpose of increasing
the knowledge and skills of the profession in accordance with the purpose
of the profession's occupation, exercising due care to distinguish sharing
new knowledge, and developments in tumor registry practice from that of promoting
products or services of your employer or favorite commercial firm.
The tumor registrar should endeavor to provide the professional
growth and development of those under her/his supervision.
- Promote and/or participate in advancing the development, maintenance,
use, and preservation of tumor registry practices.
- Foresee subjects necessary in current and future training of tumor registrars.
III. PARTICIPATE IN DEVELOPING AND STRENGTHENING PROFESSIONAL MANPOWER
AND APPROPRIATELY REPRESENT THE PROFESSION IN PUBLIC.
- The foreseeable future of the profession is dependent upon the
affirmative and responsible activities of members to recruit and train fellow
tumor registrars. Example:
- Encourage and assist in the recruitment of students for professional
training, so long as the need exists.
- Help the student and the new tumor registrar to participate in activities
and services for their continued development as tumor registrars.
- Use your special skills and knowledge to enhance the status and productivity
of professional colleagues through participating in continuing education
programs and publication of scholarly papers.
- Promote understanding of, respect for, and interest in the profession
within one's community.
I. DISCHARGE HONORABLY THE RESPONSIBILITY OF ANY ASSOCIATION POSITION
TO WHICH I AM APPOINTED OR ELECTED .
- The Association has a dual responsibility: safeguarding the members
of the profession and promoting the services to be rendered by the professional
to the health field. These two functions should be borne in mind in any deliberation
undertaken by members, committees, officers, or delegates of the Association.
- Discharge one's obligation to the profession with integrity, discretion,
and by one's best endeavors in representing the Association.
- Perform conscientiously the duties of any Association office to which
elected or the assignments of any committee to which appointed.
- Resign one's office or assignment if unforeseen circumstances prevent
one from carrying out the responsibilities of an office or committee after
the acceptance of the post.
- Preserve the confidentiality of any privileged information obtained in
an official capacity as a member of the Executive Board or of a committee
or other empanelled group.
II. UPHOLD THE STANDARDS OF THE PROFESSION BY REPORTING TO THE EXECUTIVE
COMMITTEE OF THIS ASSOCIATION ANY BREACH OF THIS CODE OF ETHICS BY FELLOW
MEMBERS OF THE PROFESSION.
- Any evidence of illegal, unfair, or incompetent practice or unethical
conduct of fellow members of this Association should be reported to the Executive
Board of the Missouri State Tumor Registrars Association.
- Transmit all referrals in writing, accompanied by supportive evidence
of the unethical behavior or alleged violation.
- Do not shield an individual guilty of unfair or unethical practices.
- Judgments of unethical behavior and recommendations for sanction are
the responsibility of the Executive Board rather than of individuals.
PROCEDURES FOR REPORTING
AND PROCESSING VIOLATIONS OF THE MOSTRA CODE
- A signed, dated Letter of Complaint, containing details of the
nature, facts, and circumstances of the complaint and any supporting documentation
shall be sent by certified mail to the President of the Association.
- The President shall:
- Forward a copy of all materials received to the members of the
Executive Board within thirty (30) days of receipt.
- Notify the accused of the nature of the complaint and the name
of the accuser by certified mail within fifteen (15) days of the receipt
of the complaint.
- Request the accused to present his/her defense, in writing,
to the President within thirty (30) days of the notification of complaint.
- Forward a copy of the defense submitted by the accused to the
members of the Executive Board within fifteen (15) days of receipt.
- The members of the Executive Board shall review the complaint,
the supporting documents, and the defense submitted by the accused with regard
to their relevance to the Code of Ethics or Bylaws within thirty (30) days
- Within thirty (30) days of receipt of written defense from the
accused, the President will initiate a meeting or a telephone survey with
the board members to discuss the complaint and make recommendations for action
to be taken.
- The President shall notify the accused of the Board's decision
of action to be taken by certified mail within thirty (30) days of the meeting.
The accuser shall also be notified of the decision by the President.
The level of disciplinary action shall be at the discretion of the Board
- Letter of intent to appeal the Board of Directors' ruling must
be submitted by the accused for receipt by the President within ten (10)
days of the accused's receipt of decision of the Board of Directors.
- The Board shall review all relevant material regarding the appeal.
The decision shall be communicated to the accused by certified mail, and
to the accuser, via the President. Within thirty (30) days of receipt of
the accused's letter of intent to appeal.
- This decision shall be binding on all parties except where expulsion
is recommended. The accused may further appeal an expulsion.
- All materials and discussion relevant to the complaint, investigation,
and disciplinary action shall be confidential. Disclosure to unauthorized
persons, (any individual who is not a Board member, the accused or the accuser)
shall constitute a violation of the Code of Ethics. Upon closure of the case,
all documents shall be placed in a sealed file, identified only by the nature
of the case and action taken. The file may be opened and used only by the
Board of Directors if needed as precedent.
- The President and President-Elect should be the only individuals
who know the names of the accuser and the accused.