Doctors should have to tell patients when they have a financial interest in the treatment they are recommending, the Medical Council has been told.
In its submission to the council, whch is currently reviewing its ethical guidelines, the Adelaide Hospital Society says patients should be aware of doctors' potential conflicts of interest.
The document states: "These may arise when doctors have a financial itnerest in certain healthcare facilities. We submit that the Medical Council should give ethical guidance to the effect that where a doctor has a financial interest in a healthcare facility, or course of treatment, and where they are recommending patients to receive care in such a facility or obtain such a course of treatment, that such an interest would be declared."
Stressing the ethical need for doctors to press for adequate and appropriate care for all patients, it says: "There are major ethical dilemmas for doctors when financial pressures prevent timely and/or appropriate care to patients. Such advocacy will be ethical and effective when it is informed by social justice principles, adequate research and analysis and is not directly related to the remuneration of doctors themselves."
The society also recommends that doctors be involved in publicly advocating appropriate and accessible healthcare for all, especially the less well-off, without directly seeking more money for doctors.
The Medical Council called for submissions as part of its five-yearly updating of the Ethical Guide, last updated in 1998.
The Adelaide Hospital Society is a charitable organisation and reflects the Protestant ethos in medicine.
It was formerly involved in the Adelaide Hospital, and now is a central part of the management of Tallaght Hospital, which incorporated the Adelaide, Meath and National Children's Hospitals.
The submission states that the section of the Ethical Guide relating to reproductive medicine will have to be totally revised to reflect the fact that the Medical Council now recognises that termination of pregnancy is ethical where there is a substantive risk to the life of the mother.
The society favours legislation to reflect the judgment in the X case, permitting abortion where suicide is a real threat to the mother's life.
The submission stresses the importance of doctor/patient confidentiality. It warns against the possible breach of this confidentiality by ethical committees in certain hospitals.
It urges that doctors not be required to sign codes of ethics which would inevitably mean breaches of confidentiality to such ethical committes.
The society enclosed its submission to the Commission on Assisted Human Reproduction, where it stressed that there should be no direct State interference.