Code Of Ethics Of The Delhi Medical Council

Regulations for Professional Conduct, Etiquette and Ethics 2001


In exercise of the powers conferred under section 10(c) read with section 30(c) of the Delhi Medical Council Act 1997, passed by the Legislative Assembly Capital Territory of Delhi on 13th January, 1997 and assented to by the Lieutenant Governor of Delhi on 11 Feb., 1997, with the previous approval of the Govt. of NCT of Delhi, the Delhi Medical Council hereby lays down the following regulations relating to Professional conduct, etiquette and Ethics for registered medical practitioners.

Short Title and Commencement :
  1. These regulations may be called the Delhi Medical Council (professional conduct, etiquette and ethics) Regulations 2000.
  2. They shall come into force from the date of their publication in the official gazette.

Preamble to the Code of Ethics

The Webster dictionary defines ethics as "The body of moral principles or values governing or distinctive of a particular culture group".

The rules of conduct and the sense of values can neither be wholly prescriptive nor can be codified entirely. Nonetheless, Delhi Medical Council, describes the essential element of good standards of practice and care.

Being registered with the Delhi Medical Council gives medical professionals, rights and privileges, In return you must meet the standards of competence, care and conduct set by the Delhi Medical Council. The Code enlarges the general principles of good practice which all medical professionals are expected to follow while treating patients.

General Principles and Responsibilities :

The principal objective of the medical profession is to render service to humanity with full respect for the dignity of the person. Physicians should merit the confidence of the patients entrusted to their care, rendering to each, the full measure of service and devotion. Physicians should continuously try to improve their medical knowledge and skills and should make available to their patients and colleagues the benefits of their professional attainments. They should practice methods of healing found on scientific basis and should not associate professionally with anyone who violates this principle. The honoured ideals of the medical profession imply that the responsibilities of the physician extend not only to the individual but also to the society.

 

  1. No person other than a doctor processing registerable qualifications under the Medical Council of India and registered with the Delhi Medical Council. Persons obtaining qualification in alternative systems of medicine are not allowed to practice the modern system of medicine.
  2. As a registered member of the Delhi Medical Council, you must display your registration certificate / photocopy in all your place of work.
  3. You must display your consultation fee and charges for other services in your place of work.
  4. It is desirable that you maintain medical records pertaining to your patients for a period of three from the date of commencement of the treatment. These should be made available as and when required.
  5. You as an individual or part of a group should not solicit patients, directly or indirectly.
  6. You should not use / aid / permit others to use you, your name, your photograph in any form of advertising or publicity that draws attention to your professional position and/or qualification.
  7. You should refrain yourself from any action that can be construed as self-aggrandizement.
  8. In your interface with the media, print or electronic you should not contribute, lay press articles and give interviews, which may have the effect of advertising yourself or soliciting practice. However, you are free to deliver public lectures, give talks on radio broadcast, write articles for the press and also inform the public about such event.
  9. You may inform the public at large about the facts of the following :
    1. your availability for consultancy.
    2. your area of specialization.
    3. your change of address.
    4. your charges for various medical services.
    5. your temporary absence from work.
    6. your resumption of work.
    7. your succession to another's professional service.
    8. your appointing of temporary or permanent substitute or assistant.
    9. your publishing information about your services in directories / yellow pages.

Prescriptions
  1. You must provide every patient a proper prescription stating the drugs prescribed/dispensed.
  2. All your prescriptions should be legible dated and duly signed by you.
  3. As far as possible,you must make use of generic names of drugs in your advice / prescriptions.
  4. You should not prescribe / dispense a drug or a combination of drugs of which you are not aware of the constituents.
  5. You should not prescribe a course of treatment / a regimen / a drug about which your own skill / knowledge is inadequate.

Responsibility towards patients

Patients trust their doctors with their lives and well being. To justify this faith as a doctor you must conduct yourself responsibly. In your ministrations you must be mindful of the fact that the health and lives of those entrusted in your care depend on your skill and labour and sincerity. As a professional you must observe the following guidance /precepts in the discharge of your duties:

  1. You must make the care of your patient your first concern.
  2. You must work with colleagues in the ways that best serve patients interest.
  3. You must make sure that your personal beliefs do not prejudice your patients care.
  4. You must never abuse your position as a doctor.
  5. You must treat every patient politely and considerately.
  6. You must respect patients dignity and privacy.
  7. You must listen to patients and respect their views.
  8. You must give patients information in a way they can understand.
  9. You must respect the rights of patients to be fully involved in decisions about their care.
  10. You must respect and protect confidential information.
  11. You must protect patients from risks if you have good reasons to believe that you or your colleague may not be fit to practice.
  12. You must keep your professional knowledge and skills up to date.
  13. You must recognize the limits of your professional competence
  14. You should not publish photographs or case reports of your patients in any medical or journal in a manner by which their identity could be revealed, without their consent.

Patient Care
  1. Ordinarily you can decide whom you will treat but in an emergency situation you are expected to respond with alacrity to the calls of the sick and injured.
  2. In an emergency you must attend to a patient, in a manner which is within your comepetence and the facilities available.After providing essential life saving care,you may refer the patient to an appropriate level of care.
  3. You should neither exaggerate nor understate the gravity of a patients situation.You should assure yourself that the patient and his/her caregiver have such information that would serve the best interest of the patient.

Consultation
  1. In the course of your treatment,due to complexity and severity,if the situation warrants it, you must request consultation for your patient. The benefit to your patient should be your sole criteria.You, as the attending physician have to continue to take the responsibility.
  2. When you refer, recommend or procure investigative, medical, surgical or any other treatment for your patient, you must do it solely with the motive of it being benefical to your patient.
  3. You must not offer or receive any gift or consideration for refering, recommending or procuring any treatment for your patient.
  4. You should not refer, recommend any person, specimen, material for diagnostic or any other study with any vested interest.
  5. The patient and his care givers should be kept informed and be part of the collective decision as to the course of the treatment to be followed
  6. When the attending physician refers a patient to you, you should communicate your opinion on the matter,but not make it binding or conditional.
  7. You should refrain from direct/oblique references pertaining to the ability or the conduct of your co-professionals.
  8. In your temporary absence,you may instruct the care of your patients to another physician.
  9. You must attend to your pregnant patient in her confinement on terms agreed upon. If exceptional circumstances prevent you from providing your services,another physician may be sent for. When the delivery is accomplished,the visiting physician is entitled to his/her professional fees,but he/she must obtain consent from the patient to leave,when you arrive.

With reference to the public
  1. You must observe the laws of the country pertaining to the practice of medicine.You must cooperate in observance and enforcement fo the guidelines enunciated by the centre / state governments for e.g.
    1. The Drugs and Cosmetics Act.
    2. The Pharmacy Act.
    3. The Narcotics Drugs and Psychotropic Substances Act.
    4. The Medical Termination of Pregnancy Act.
    5. The Mental Health Act.
    6. The Environmental Protection Act including Rules for Biomedical Waste Management.
    7. The Persons with Disability Act.
    8. Rules concerning Organ Transplantation.
    9. Rules pertaining to Transfusions of Blood.
    10. Other Acts,Rules,Regulations made by the Central/State government and local administrative bodies from time to time.
    11. Amendments to such Acts as amended and notified from time to time for protection and/or promotion of public health.
  2. You being engaged in public health work should enlighten the public about quarantine regulations and measures for the prevention of epidemics and communicable diseases.
  3. In the event of an epidemic, you are expected to continue with your services, notwithstanding any concern fot your own health.

With reference to professional certificates, reports and other documents :
  1. You must maintain a record of medical certificates you issue and the issuance of such certificates should ben done in an appropriate form.
  2. You must enter the identification marks of the patients, his signature / or thumb mark, his / her address on the certificate, you would issue.
  3. In certain cases you may be bound by law to give official reports/depositions in your professional capacity.
  4. You should not issue certificates of efficiency in modern medicine to unqualified or non-medical persons.

(This provision does not apply to restrict proper training and instruction to bonafide students, employees, midwives, dispensers, surgical, attendants, or skilled mechanical and technical assistants and therapy assistants under your personal supervision.)

Obtaining Consent

Successful relationship between doctors and patient depends on trust.

  1. You must respect your patients autonomy, their right to decide whether or not to undergo any medical intervention.
  2. Patients must be given sufficient information in a way they can understand to enable them to exercise their right to make informed decision about their treatment.
  3. You must give patients details before he/she decides to consent to an investigation or a treatment
  4. You should give details of the diagnosis and prognosis of the disease, if left untreated.
  5. You must inform the common and serious side effect for each option available to the patient. And also of any lifestyle changes which may be caused by or necessitated by the treatment.
  6. You must respond honestly to any question the patient raises. You must answer such question as fully, accurately and objectively as possible.
  7. You must not exceed the scope of authority given it you by your patients, except in an emergency.

With reference to serious communicable disease

The term serious communicable disease applies to any disease which may be transmitted from human and which may result in death or serious illness. It particularly concerns, but is not limited to infections such as human immunodeficiency virus, tuberculosis, and Hepatitis B and C.

  1. You must keep yourself informed about serious communicable disease and particularly their means of transmission and control.
  2. You should always take appropriate measures to protect yourself and others from infections by adhering to infection control measures.
  3. You must make sure that any staff for whom you are responsible are also appropriately informed and cooperate with measures designed to prevent transmission of infection of other patients.
  4. You must not deny or delay investigations or treatment because you believe that the patient's actions or life style may have contributed to his / her condition.
  5. You must obtain consent from patients before testing for a serious communicable disease. The information you provide, when seeking consent, should be appropriate to the circumstances and the nature of the conditions being tested for. Some conditions such as HIV have serious social and financial as well as medical implications.
  6. When investigating / treating a child who cannot give or withhold consent, you should seek consent from a person with parental responsibility for the child.
  7. You must disclose information about serious communicable diseases in accordance with the law / general guidelines.
  8. If you are HIV positive or have contracted hepatitis B or C; you should refrain from performing interventional procedures, which carry a risk of transmission to your patients.

With reference to the Profession at large
  1. You are expected to uphold the dignity and honour of your profession.
  2. You should affiliate with medical societies, for the advantage of your profession. You should contribute your time, energy and means so that these societies may represent the ideals of your profession.
  3. You should not allow admission into your profession of persons who are deficient in moral character or education. Such persons should not be permitted to attend, assist, treat or perform practices / procedures which may be harmful to individuals or to public health.
  4. You should expose without fear or favour, incompetent, corrupt, dishonest or unethical conduct on the part of a member of the profession.
  5. If you held an official post ,and you have to examine and report upon an illness / injury and its treatment, you should communicate this to the attending physician. He / she should have an option of being present.

With reference to specific practice
  1. You may undertake in vitro fertilization and / artificial insemination with the informed consent of the patient and her spouse in writing. They should be explained, at their level of comprehension, about the purpose, method inconveniences, rate of success as well as probable and possible risks
  2. You must follow guidelines laid down by the Indian Council of Medical Research for research and therapeutics trials.

Prescribed Practices
  1. You must not attempt to mislead the public about your professional skills / qualifications.
  2. You should not give untrue, misleading, documents or opinions on any medical matters.
  3. You should not sell schedule poison under cover of your own qualifications to persons other than whom you are treating and who may need such drugs for medical reasons.
  4. You should not perform or enable unregistered persons to perform an abortion or any other procedure for which there is no medical,surgical or psychological indication.
  5. You cannot refuse on religious grounds to conduct or assist MTP,sterlization or craniotomy or other procedure when there is medical indication.
  6. You should not advise, assist or conduct sex determination tests.
  7. You must not advise, assist in selectives sex conception.
  8. You must not practice euthanasia, as it constitutes unethical conduct.
  9. You must not withdraw / or ask for withdrawal of life support devices of a brain dead patient on your own discretion in the capacity as the attending physician. Such a decision can be taken only by a team of physicians.
  10. You must not commit any impropriety or any act of indecorum in your association with a patient.
  11. You must not aid or abet torture or be a party to either infliction of mental or physical trauma or concealment of torture inflicted in violation of human rights.

Epilogue

The CODE should not be violated in letter or spirit. The CODE does not enlist an exhaustive enumeration of instances of professional misconduct. The Delhi Medical Council may on its part initiate enquiries upon receipt of a complaint of a malpractice of a medical practitioner.

Correspondingly, if a medical growth professional is impeded in his/her work, his/her professional growth obstructed; if he/she faces harassment; he/she is entitled to approach the Delhi Medical Council and the Council will consider his/her complaints, offer guidance and take protective measures to ensure that the said member can conduct his/her medical services without hindrance and hazards.