1.  All complaints alleging unethical behavior on the part of members of The Society of Thoracic Surgeons (hereinafter “STS” or “Society”) are addressed to the STS Standards and Ethics Committee (hereinafter the “Committee”).  (STS Bylaws Article XI.)

2.  Any physician or the Committee may initiate an ethics complaint.  It is the complainant's obligation to provide supporting records and other evidence.  Any such materials must be de-identified and otherwise submitted in accordance with the applicable privacy regulations issued under the Health Insurance Portability and Accountability Act of 1996.  A complaint relating to expert witness testimony may be submitted only after final resolution of litigation in which an STS member has provided expert testimony (in written documents, depositions or trial transcripts) that the complainant deems unethical (as described in the Society’s Statement on the Physician Acting as an Expert Witness).  Once submitted, a complaint cannot be withdrawn unilaterally by the complainant in view of the Society’s independent interest in the ethical conduct of its members.

3.  The initial complaint, with supporting documentation, will first be reviewed by the Chair of the Committee and the STS Executive Director, in consultation with STS legal counsel. Reasonable efforts will be made to complete the initial review within thirty (30) days after the Society’s receipt of the complaint.  The initial review will determine only whether the complaint is consistent with these guidelines and any other applicable STS Bylaws, policies, or guidelines, and whether the alleged misconduct, if proven, reasonably could be deemed to constitute a breach of the accused member’s legal obligations, the Bylaws of the Society or the policies of the Society (including the STS Code of Ethics and the STS Statement on the Physician Acting as an Expert Witness).  If these conditions are met, the complainant and the member accused of unethical behavior (the “respondent”) will be notified by the Chair of the Committee that the complaint warrants further investigation; if they are not met, only the complainant will be notified that the complaint does not warrant further review. A decision that the complaint does not warrant further review will be final.  If the complaint warrants further review, the complainant and respondent will also be advised that the disciplinary proceedings are confidential until the final disposition of the complaint, at which time Section 13 of these guidelines will govern any publication of the decision if displinary action is taken. In addition, a copy of these guidelines and other relevant documents (e.g., Article XI of the STS Bylaws and/or the STS Statement on the Physician Acting as an Expert Witness) will be sent to the respondent. 

4.  The respondent will be asked to reply in writing within thirty (30) days after receiving notification of a complaint, unless extenuating circumstances warrant a delay (the duration of which delay, if any, will be determined at the sole discretion of the Chair of the Committee).  The Chair of the Committee will appoint a “Preliminary Review Panel” (hereinafter referred to as “the Panel”) composed of three members of the Society, at least one of whom is familiar with the technical aspects of the complaint. If the complaint pertains to expert testimony, one of the three Panel members will be the Chair of the Expert Witness Subcommittee. Any member of the Panel who is found to be in direct economic competition with the respondent or has any other conflict of interest will be replaced by a member of the Society who does not have a conflict of interest.  Members of the Panel, in consultation with the Chair of the Committee and STS legal counsel, will convene within a reasonable period of time, not to exceed forty-five (45) days, after they have received the complaint and the reply, if any.  They will determine by majority vote whether the documents demonstrate that the respondent breached his or her legal obligations, the Bylaws of the Society or the policies of the Society and, if so, what disciplinary action (from the options listed in Section 9), if any, should be imposed.  If the Panel finds that there was no such breach, then such decision will be final.  If the Panel finds that there was such a breach, then the Panel will send its report, including a summary of its findings and its recommendations, to the Chair of the Committee, who will (a) forward a copy of the report to both the complainant and respondent and (b) notify the respondent that s/he has the right to request a hearing before the full Committee within thirty (30) days after receipt of the notice.  A copy of the procedures to be followed (“Procedural Guidelines for Handling Ethics Complaints Against STS Members”) will be included with the notice.
5.  If the respondent does not request a hearing in a timely manner, s/he will be deemed to have waived the right to a hearing, and the Committee will make its decision based on the evidence before it and the findings and recommendations of the Preliminary Review Panel. 
6.  If a timely request for hearing is submitted, the Committee will send the complainant and the respondent one or more additional notices stating the place, date, and time of the hearing.  Ethics hearings will generally be held only twice a year, around the time and location of the STS and American Association for Thoracic Surgery Annual Meetings, when the full Committee normally meets.  In no event will the hearing be scheduled less than thirty (30) days following the date of the notice of the results of the preliminary review. The full Committee will be sent all pertinent documents prior to the hearing.  Any additional documents related to the complaint, as well as a list of witnesses (if any) must be submitted to STS no later than ten (10)  business days in advance of the hearing.  The members of the Panel also will be asked to attend the hearing and participate in the Committee’s deliberations.  The Chair of the Committee will chair the hearing.  Members of the Committee, including the Chair, who are in direct economic competition with the respondent or have any other conflict of interest, may not be present or have any other involvement in the hearing and the subsequent executive session.  The hearing shall be closed to all except the Committee members, members of the Panel who are not Committee members, the complainant, the respondent, witnesses, legal counsel, and STS staff. Formal legal rules of evidence will not apply, but the Chair may exclude testimony that is not relevant.  The complainant and the respondent will be advised that no new matters, evidence or witnesses may be introduced in the hearing if they have not been previously disclosed in the documents supporting and denying the charges.  

7.  At the hearing, a representative of the Panel may be asked to make a presentation.  Legal counsel will be permitted for both sides and may ask questions of the physicians under examination, but will not be permitted to make presentations. The complainant and the respondent may each make a presentation, not to exceed twenty (20) minutes, in the presence of the other party as well as the Committee as a whole.  Questions by Committee members, attorneys, and the opposing side will be permitted.  Witnesses will be permitted, but a time limit of thirty (30) minutes for each side to present its case and to respond to questions will be absolute, excepting that the Chair may allot additional time for members of the Committee to ask questions.  At the Chair’s discretion, witnesses may be excluded from the hearing except when they are called to testify. 

8.  Professional recording of the hearing will be the responsibility of STS. The complainant and the respondent will be responsible for their own expenses, including those of legal counsel.  A copy of the transcript will be provided to the complainant and the respondent upon request.  If any party fails to appear at a duly scheduled hearing for any reason, the Committee may still proceed, and shall consider the previously submitted material furnished by the absent party.  The Chair of the Committee may reschedule the hearing date if, in the sole judgment of the Chair of the Committee, sufficient cause is shown.

9.  After the hearing, the members of the Committee, with the Panel, STS legal counsel, and STS staff in attendance, will go into executive session, which will not be recorded. The facts and issues will be discussed, including but not limited to the charges of the complainant, the reply of the respondent, and the findings and recommendations of the Panel, and a decision will then be made by majority vote of only the members of the Committee, under sealed ballot, as to whether the respondent has breached his or her legal obligations, the Bylaws of the Society or the policies of the Society.  If no such breach is found, the Committee’s decision will be to dismiss the complaint.  If such a breach is found, the Committee may or may not decide to take disciplinary action against the respondent; disciplinary options available to the Committee are: a) admonition, b) censure, c) probation, d) suspension, or e) expulsion, all as defined in STS policy.  This second vote shall also be taken under sealed ballot.

10.  Whether or not a hearing takes place, the Committee’s decision must be based on a reasonable belief that the action is warranted by the facts presented. 

11.  No disciplinary action of the Committee will be deemed final until reviewed for procedural fairness and approved by the STS Executive Committee.  Within thirty (30) days after the date of any such review, the Committee’s written findings and decision, with any modifications by the Executive Committee included, will be sent to both sides of the dispute. 

12.  An accused member may not escape this process by resigning membership in the Society.  The Board may refuse to accept a member’s resignation so long as an ethics investigation or proceeding is pending. (STS Bylaws Article III, Section 8.)

13.  Admonition and censure will not be reported to authorities outside the Society, but the Society will report probation, suspension, and expulsion to the National Practitioner Data Bank, the medical board of the respondent’s state(s) of licensure, and such other authorities as the Board deems appropriate.  STS may also publish a notice of its decision in the STS News, on the STS Web site, and through other appropriate media.  The notice of decision in STS publications will contain a brief description of each disciplinary action, accompanied by the name of the disciplined member in cases of probation, suspension, and expulsion.  The name of the disciplined member will not be published in cases of admonition or censure.

Amended by the Executive Committee of The Society of Thoracic Surgeons: June 7, 2017