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hello and thank you very much for allowing me to speak with you today as you prepare to welcome visitors from around the world its an honor to be with you i would like to first tell you that i have no conflicts of interest but i dont think that thats a particular interest to you and again as we talk about the american medical association i just want to locate the council on ethical and judicial affairs briefly we are part of the house of delegates part of the governance and policy structure of the ama and charged specifically with developing ethics policy for the organization and for american physicians so some of what i say will be drawing on the code of medical ethics but i will be looking at sources from around the world as well and i think one of the things we tend to think about informed consent is that its a formality its a signed document i want to move us off of that perspective because i believe a more helpful way to think about informed consent is to think about the goa