Ethics in Optometry
Ethical issues have been discussed in optometry since the 1890s.1 Ethics, which comes from the Greek word “ethos”, is considered a branch of philosophy and deals with the fundamental questions of morality.3,4 While traditional ethics deals with the question of the “highest good”, the question of “right behavior” and the question of “free will”, today's so-called professional ethics is concerned with ethical principles within a profession as well as relevant issues that members of the profession should be orientated on.5,6 Members of healthcare professions have always been subject to ethical standards. In this context, Marckmann and Schildmann published an excellent paper on quality and ethics in healthcare in 2022.7 This naturally also applies to optometry.
In Germany, too, optometrists and ophthalmic opticians have always been dealing with ethical issues in their clinical practice.8,9 Topics in the context of a “professional code of conduct” and “professional ethics” were also discussed intensively within the Scientific Association for Optometry and Ophthalmic Optics (WVAO) in its journal “Optometrie” in the 1970s.10,11
A mandatory code of conduct for German optometrists can be found in the clinical guidelines for ophthalmic optics and optometry (AQRL) of the German Association of Ophthalmic Opticians and Optometrists (ZVA).12 These guidelines are the professional legal basis for the practice of optometry and ophthalmic optics in Germany. The last sentences of item 4 of these guidelines are particularly important in the code of conduct,
- Optometrists are primarily committed to their conscience and their profession. Commercial interests should be in line with the professional ethical responsibility of the optometrist, as this item describes the special responsibility of optometrists in their clinical practice.
Ethical behavior of healthcare professionals is of fundamental importance for a confidential relationship with patients. For optometrists, this means that the primary goal of optometric practice is to provide patients with the best possible treatment. New treatment and diagnostic methods in optometry must always be discussed in the context of ethical behavior. This certainly includes the current issue of implementing artificial intelligence (AI) into the overall complex of diagnosis, care and research.
Clinicians and scientists in optometry will sometimes have to deal with unexpected ethical challenges. However, the well-being and autonomy of patients should always be the maxim of their ethical conduct.
[1] Bailey, R. N. (2016). The History of Ethics and Professionalism within Optometry in the United States of America 1898-2015, Part 1. Hindsight, 47, 14-31.
[2] Bailey, R. N. T. (1994). The history of ethics in the American Optometric Association 1898-1994. J. Am. Optom. Assoc., 65, 427-444.
[3] Philosophie Magazin (2025). Ethik. https://www.philomag.de/lexikon/ethik, Referencing: March 2, 2025.
[4] Brockhaus Enzyklopädie (1988). Ethik. Brockhaus Band 6, pp 600-602, F.A. Brockhaus, Mannheim.
[5] Hamburger Fernhochschule (2025). Ethik – warum sie in fast allen Berufen wichtig ist. https://www.hfh-fernstudium.de/blog/ethikund-berufsethik, Referencing: March 2, 2025
[6] Parker, M. (2002). Ethics and Community in the Health Care Professions. Taylor & Francis e-Library, New York.
[7] Marckmann, G., Schildmann, J. (2022). Qualität und Ethik in der Gesundheitsversorgung [Quality and ethics in healthcare]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 65, 335-341.
[8] Geyer, H-U. (1988). Ein Leben für die Optometrie – Peter Abel und seine Zeit. H-U. Geyer, Fachveröffentlichungen, Fellbach.
[9] Preussner, E. (1997). One Century Contemporary History of Optometry by Comparison between Germany and the USA. Master of Science Thesis, Pennsylvania College of Optometry.
[10] Richter, G. (1975). Berufsordnung? Eine (noch) offene Frage für den Augenoptiker. Optomertrie, 3, 78.
[11] Richter, G. (1979). In Standesfragen Entwicklungsland? Optometrie, 1, 2.
[12] Zentralverband der Augenoptiker und Optometristen (ZVA) (2024). Arbeits- und Qualitätsrichtlinien für Augenoptik und Optometrie, 10. Auflage. https://www.zva.de/wp-content/uploads/ZVA-AQRL-2024_10.-Auflage.pdf Referencing: July 6, 2025