Medical care should not be ‘tool of the State’, ethics guide states

Doctors must tell patients about any financial interest they have in a clinic, hospital or other institution before referring them there, according to new ethics guidelines for the medical profession.

Financial considerations should not influence, or appear to influence, how doctors manage patients and they must not accepts gifts or hospitality from drugs and medical device companies, the guide says.

The guidelines issued by the Medical Council say doctors are not prevented from attending educational meetings or being paid "reasonable expenses" for professional services, but they should tell patients about these professional relationships in order to avoid conflicts of interest.

The eight edition of the Guide to Professional Conduct and Ethics for Registered Medical Practitioners contains new sections on the use of social media, telemedicine, and equality and diversity, as well as revisions to existing sections stressing the importance of good professional practice.

It directs doctors to act as advocates for patients, both for individuals and by supporting the fair distribution of limited resources and access to care.

‘Obligation’

Council president Prof Freddie Wood said doctors had a "primary obligation" to speak out for patients and medical care should not be used as a tool of the State.

The guide says doctors have duty to promote and support a culture of open disclosure, but it does not require them to inform patients of serious adverse events. This is proposed in the new Programme for Government.

On social media, it says doctors should maintain the same professional standards expected in other forms of communication and should always think about the possible impact before publishing on sites.

Research published by the council appears to show the public continues to display high levels of trust in the medical profession, with 91 per cent of people saying they trust a doctor to tell the truth.

Levels of trust in doctors were higher than for any other profession. Teachers earned an 85 per cent trust rating, judges were trusted by 75 per cent of people and business leaders by 40 per cent. The lowest levels of trust were in journalists (39 per cent) and politicians (18 per cent).

Four in 10 patients believed doctors’ practice had improved in the past five years, and doctors were more likely than patients to think practice had deteriorated.

Ethical duty

On abortion, the guide says doctors have an ethical duty to make every reasonable effort to protect the life and health pregnant women and their unborn babies. Where interventions are required that may result in there being little or no hope of the baby surviving, “it may be necessary to terminate the pregnancy to protect the life of the mother while making every effort to preserve the life of the baby.”

The guide includes a conscientious objection clause and says doctors must not take part in the “deliberate killing” of a patient.

Where adult patients disclose historic abuse, doctors must assess the current risk to the patient and others, and report this to the authorities if they consider anyone is at risk.

A section on relationships between colleagues advises that before entering a sexual relationship, supervisors and their trainees should consider the power imbalance in the relationship and the potential for exploitation or conflicts of interest.