Analysis: The new guidelines testify to five years' work by the Medical Council, writes Muiris Houston.
The publication of a new edition of A Guide to Ethical Conduct and Behaviour by the Medical Council represents the swan-song of the current members of the statutory body charged with regulating the medical profession.
Their five-year term ends next month; 10 new members have been elected to serve on the next Medical Council. A further 15 members have yet to be nominated by the Minister for Health.
Traditionally, a council published an ethical guide towards the end of its term of office. It is seen as a legacy of its work and a reflection of the events that have occurred during its "watch". In the case of the present Medical Council, which has been in office since 1999, the area of fitness to practise has been especially busy.
While the case of Dr Michael Neary, the Drogheda obstetrician found guilty of professional misconduct, will long be remembered, there have been other notable cases as well. Among those, the hearing into the professional conduct of Dr Moira Woods, of the Sexual Assault Unit of the Rotunda Hospital, was a controversial one.
So what stands out in the new ethical guide? There is a brand new guideline on complementary medicine which says: "Doctors who practise or refer patients for complementary therapy must be aware of the efficacy and potential side-effects of those treatments and advise patients accordingly." By emphasising the referral of patients for complementary therapy, the guideline has cleared up a grey area. Heretofore, doctors were discouraged from formally referring patients to alternative therapists; now they will be expected to fulfil the obligations of the referral process, not least of which is the provision of a detailed referral letter, including past medical history and other relevant information, such as the existence of drug allergies. In addition, the new section places an onus on doctors to have a detailed knowledge of homeopathy, herbal medicine and other therapies prior to initiating the referral process.
Another new guideline of direct concern to patients is that dealing with the competence of medical practitioners. Where a colleague is unwell to the point that their professional competence is impaired, there is now a clear onus on those practising beside him to take remedial action. "Any dereliction of a doctor's responsibilities in this regard will be viewed seriously," the guide states - a clear indication that doctors who do not whistleblow on colleagues will themselves face a fitness to practise inquiry. This is a significant step forward and one that should prevent patient harm in the future.
The approval of electronic prescribing is welcome. As the outgoing president of the council, Prof Gerard Bury, remarked, doctors' handwriting has gone beyond a joke, so the electronic transmission of prescriptions from surgery and hospital to the pharmacy could help prevent a major cause of health service error.
While the issue of donating unused fertilised ova to childless couples was well flagged in advance of yesterday's formal publication, the advice to doctors to discuss it in full with couples undergoing IVF is welcome.
Undoubtedly the most significant change to the ethical guide is that dealing with the relationship between drug companies and doctors.
"Non-promotional educational grants represent the only acceptable mechanism for financial support by the pharmaceutical and medical manufacturing industries to individual doctors" is an uncompromising statement. It reflects a deep concern among Medical Council members that the relationship between the pharmaceutical industry and doctors has become too cosy. Tales of lavish entertainment, in breach of the pharmaceutical industry (IPHA) code of conduct, still exist.
The sponsorship of a doctor's entire expenses to attend international conferences has created a feeling of unease within the profession. By bringing in this new guideline, the council has sent a clear signal to both the profession and industry.
The new guide is a testimony to the considerable work undertaken by the Medical Council over the last five years. It is definitely a step in the right direction.