The Medical Council has for the first time issued ethical guidelines to doctors in relation to the terms on which they may accept sponsorship from drug companies.
The guidelines, published yesterday, restate that any financial interest a doctor may have in the pharmaceutical or allied industry must not influence him or her when recommending therapy for patients.
But they add for the first time that "non-promotional educational grants represent the only acceptable mechanism for financial support by the pharmaceutical and medical manufacturing industries to individual doctors".
Prof Gerard Bury, president of the Medical Council, said that there was "no good evidence of awfully bad practice" in this area, but patients might be concerned about an "overly cosy" relationship between the two given that drug companies sponsored doctors' travel to conferences and funded research.
"We believe it is appropriate to disentangle that relationship somewhat," Prof Bury said.
The council's latest ethical guidelines for doctors also refer to a host of other topics for the first time, including the "head-hunting" of doctors by one hospital from another, the displaying of doctors' fees, doctors' websites, whistle-blowing by doctors on colleagues, electronic prescribing, the use of spare embryos and the need for doctors to obtain consent from patients with disabilities.
The guidelines state that a doctor, having formally accepted any post - even a locum post - must not then withdraw "without due cause" unless the employer has time to make other arrangements to ensure that patient care is not compromised.
The chairwoman of the council's ethics committee, Senator Geraldine Feeney, said that this had been a particular problem with non-consultant hospital doctors (NCHDs) who, when due to turn up at a job in one hospital on July 1st, would actually turn up at another, leaving hospitals and patients in the lurch. Patients were actually being put at risk, she said.
The guidelines state that the council welcomes the provision of appropriate information to patients, including the displaying of professional fees.
The handbook states that electronic prescribing is acceptable if it meets legal and best-practice clinical standards. It adds that a prescription must be legible, dated and signed by a registered medical practitioner. Prof Bury said: "Doctors' handwriting is gone beyond being a joke."
The guidelines also state that where a doctor believes a colleague's conduct or competence poses a risk to a patient, the doctor should express his or her concern initially to the colleague concerned and advise on remedial action. "Where local systems of support or remediation are available, they should be availed of as the next step. Should the colleague's response be unsatisfactory, then the doctor should refer the matter to the Medical Council."
Prof Bury said that if any patient came to harm while a doctor hesitated to act in relation to a colleague, he or she could be dealt with critically.
Under the guidelines, doctors can set up websites to provide information to patients as long as their site is not self-promotional.
There are also references for the first time to complementary medicine. Doctors who refer patients for such therapy must be aware of the efficacy and potential side effects of the treatment and advise patients accordingly.
It is also stated that doctors should offer a chaperone to a patient, irrespective of their age or gender, before conducting an intimate examination on them.
Main points: Medical Council's latest guide to ethical conduct and behaviour by doctors
Couples may consider donating spare embryos, produced during IVF procedures, to others.
Any fertilised ovum must be used for normal implantation and must not be deliberately destroyed.
On cloning, it says the creation of new forms of life for experimental purposes or the deliberate and intentional destruction of in-vitro human life already formed constitutes professional misconduct.
A doctor who has a financial interest in a private clinic, hospital, pharmacy or any institution to which he/she is referring patients for investigation or therapy has a duty to declare such an interest to patients. Such doctors must take exceptional care to prevent their financial interests influencing their management of patients.
Doctors' prescriptions must be legible.
Electronic prescribing is acceptable.
Doctors can set up websites as long as they are not self-promoting.
Doctors providing telemedicine services to patients in Ireland must be registered with the Medical Council.
The only acceptable mechanism of financial support by the pharmaceutical and medical manufacturing industries to individual doctors is by way of non-promotional educational grants.
Any decision on intervention/non-intervention in the case of a person with a disability requires his or her consent.
Any intimate examination should be accompanied by an explanation. The patient, irrespective of age or gender, should be offered a chaperone.
Doctors should not assist in judicial execution.
Doctors must ensure they have adequate professional indemnity for the work they do.
A doctor should act if he/she has concerns about the conduct or competence of a colleague.
Doctors referring patients for complementary medicine must be aware of the efficacy and potential side-effects of same and advise patients accordingly.
Consultants should not normally accept a patient without referral from a GP.
Informed consent can only be obtained by a doctor who has sufficient training and experience to be able to explain the intervention, the risks and benefits and the alternatives.
Medical students should adhere to the principles in the ethical guide.