RELEVANCE OF MEDICAL ETHICS CODE IN DAY TO DAY PRACTICE

Professional Oath:

At the time of registration, each applicant shall be given a copy of the following declaration by the Registrar concerned and the applicant shall read and agree to abide by the same:

• I solemnly pledge myself to consecrate my life to service of humanity. Even under threat, I will not use my medical knowledge contrary to the laws of Humanity.

• I will maintain the utmost respect for human life from the time of conception.

• I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient.

• I will practice my profession with conscience and dignity.

• The health of my patient will be my first consideration.

• I will respect the secrets which are confined in me.

• I will give to my teachers the respect and gratitude which is their due.

• I will maintain by all means in my power, the honour and noble traditions of medical profession.

• I will treat my colleagues with all respect and dignity.

• I shall abide by the code of medical ethics as enunciated in the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002.

• I make these promises solemnly, freely and upon my honour.

Medical council of India (MCI) fixed some practice code in 2002. Any practitioner who defies the rule is punishable. How many doctors follow it? Very few. So the dignity of doctors is decreasing very rapidly. If we look into the different article of Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations 2002 and their violation by doctors, then we can somehow realize the graveness of condition.

7 . 6 Sex Determination Tests:

On no account sex determination test shall be undertaken with the intent to terminate the life of a female foetus developing in her mother’s womb, unless there are other absolute indications for termination of pregnancy as specified in the Medical Termination of Pregnancy Act, 1971. Any act of termination of pregnancy of normal female foetus amounting to female foeticide shall be regarded as professional misconduct on the part of the physician leading to penal erasure besides rendering him liable to criminal proceedings as per the provisions of this Act.

Degrees and fellowship:

3.7.2 A physician shall write his name and designation in full along with registration particulars in his prescription letter head.

Note: In Government hospital where the patientload is heavy, the name of the prescribing doctor must be written below his/her signature.

Degrees or mere Alphabets!

  • MBBS(Bachelor of medicine & bachelor of surgery),
  • BAMS(Bachelor of ayurvedic medicine & surgery),
  • BHMS(Bachelor of homeopathic medicine &surgery),
  • BUMS( Bachelor of Unani medicine and surgery),
  • BSMS(Bachelor of siddha medicine & surgery),
  • BYNP(Bachelor of yoga and naturopathy).
  • But what is FARS?
  • MBBS(Bio),FWT,FARP,FARCS????

DOCUMENTATION:

1.3.3 A Registered medical practitioner shall maintain a Register of Medical Certificates giving full details of certificates issued. When issuing a medical certificate he / she shall always enter the identification marks of the patient and keep a copy of the certificate. He / She shall not omit to record the signature and/or thumb mark, address and at least one identification mark of the patient on the medical certificates or report. The medical certificate shall be prepared as in Appendix 2.

1.3.4 Efforts shall be made to computerize medical records for quick retrieval.

Don’t ask before 72 hours!

2.3 Prognosis : The physician should neither exaggerate nor minimize the gravity of a patient’s condition. He should ensure himself that the patient, his relatives or his responsible friends have such knowledge of the patient’s condition as will serve the best interests of the patient and the family.

Responsibility V Stigmatization

2.2 Patience, Delicacy and Secrecy : Patience and delicacy should characterize the physician. Confidences concerning individual or domestic life entrusted by patients to a physician and defects in the disposition or character of patients observed during medical attendance should never be revealed unless their revelation is required by the laws of the State. Sometimes, however, a physician must determine whether his duty to society requires him to employ knowledge, obtained through confidence as a physician, to protect a healthy person against a communicable disease to which he is about to be exposed. In such instance, the physician should act as he would wish another to act toward one of his own family in like circumstances.

Late comers always have Long Queue of Patients

3.3 Punctuality in Consultation : Utmost punctuality should be observed by a physician in making themselves available for consultations .

6.4.2 Provisions of para 6.4.1 shall apply with equal force to the referring, recommending or procuring by a physician or any person, specimen or material for diagnostic purposes or other study / work. Nothing in this section, however, shall prohibit payment of salaries by a qualified physician to other duly qualified person rendering medical care under his supervision.

3.1 Unnecessary consultations should be avoided

3.1.1 However in case of serious illness and in doubtful or difficult conditions, the physician should request consultation, but under any circumstances such consultation should be justifiable and in the interest of the patient only and not for any other consideration. 3.1.2 Consulting pathologists /radiologists or asking for any other diagnostic Lab investigation should be done judiciously and not in a routine manner.

Suppliers of

  • 7.10 A registered medical practitioner shall not issue certificates of efficiency in modern medicine to unqualified or non medical person.
  • (Note: The foregoing does not restrict the proper training and instruction of bonafide students, midwives, dispensers, surgical attendants, or skilled mechanical and technical assistants and therapy assistants under the personal supervision of physicians.)
  • Qualified practitioners in suburban area are the source of quacks. Having minimal educational qualifications the so called assistant of these doctors start practice in remote areas within a year. How far they contribute in rural health service is debatable but they do a lot of harm undoubtedly to the patients due to insufficient knowledge. They used to prescribe same medicine of different brand, antitussive and expectorant, same group of drugs at a time; excessive use of so called tonics, delay referring to the patients to higher health centres, wrong diagnosis examples are endless.

3.7 Fees and other charges : 3.7.1 a physician shall clearly display his fees and other charges on the board of his chamber and/or the hospitals he is visiting. Prescription should also make clear if the Physician himself dispensed any medicine.

Public Toilet Treaty!!!

1.8 Payment of Professional Services : The physician, engaged in the practice of medicine shall give priority to the interests of patients. The personal financial interests of a physician should not conflict with the medical interests of patients. A physician should announce his fees before rendering service and not after the operation or treatment is under way. Remuneration received for such services should be in the form and amount specifically announced to the patient at the time the service is rendered. “no cure no payment”. It is unethical to enter into a contract of Physician rendering service on behalf of the state shall refrain from anticipating or accepting any consideration.

1 2 ka 4

1.5 Use of Generic names of drugs Every physician should, as far as possible, prescribe drugs with generic names and he / she shall ensure that there is a rational prescription and use of drugs.

Sapne paowa Rajkanya

6.5 Secret Remedies : The prescribing or dispensing by a physician of secret remedial agents of which he does not know the composition, or the manufacture or promotion of their use is unethical and as such prohibited. All the drugs prescribed by a physician should always carry a proprietary formula and clear name.

Megalomaniac

• 7.11 A physician should not contribute to the lay press articles and give interviews regarding diseases and treatments which may have the effect of advertising himself or soliciting practices; but is open to write to the lay press under his own name on matters of public health, hygienic living or to deliver public lectures, give talks on the radio/TV/internet chat for the same purpose and send announcement of the same to lay press.

• 4.5 Visiting another Physician’s Case: When it becomes the duty of a physician occupying an official position to see and report upon an illness or injury, he should communicate to the physician in attendance so as to give him an option of being present. The medical officer / physician occupying an official position should avoid remarks upon the diagnosis or the treatment that has been adopted.

Mujhe Marne Do

6.7 Euthanasia : Practicing euthanasia shall constitute unethical conduct. However on specific occasion, the question of withdrawing supporting devices to sustain cardiopulmonary function even after brain death, shall be decided only by a team of doctors and not merely by the treating physician alone. A team of doctors shall declare withdrawal of support system. Such team shall consist of the doctor in charge of the patient, Chief Medical Officer / Medical Officer in charge of the hospital and a doctor nominated by the incharge of the hospital from the hospital staff or in accordance with the provisions of the Transplantation of Human Organ Act, 1994.

Cross -o Pathy

  • 1.1.3 No person other than a doctor having qualification recognised by Medical Council of India and registered with Medical Council of India/State Medical Council (s) is allowed to practice Modern system of Medicine or Surgery. A person obtaining qualification in any other system of Medicine is not allowed to practice Modern system of Medicine in any form.
  • 7.24 If a physician posted in a medical college/institution both as teaching faculty or otherwise shall remain in hospital/college during the assigned duty hours. If they are found absent on more than two occasions during this period, the same shall be construed as a misconduct if it is certified by the Principal/Medical Superintendent and forwarded through the State Government to Medical Council of India/State Medical Council for action under these Regulations.
  • 1.2.3 A Physician should participate in professional meetings as part of Continuing Medical Education programmes, for at least 30 hours every five years, organized by reputed professional academic bodies or any other authorized organisations. The compliance of this requirement shall be informed regularly to Medical Council of India or the State Medical Councils as the case may be.

Albida

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