Ethical Responsibilities: Doctors

As a junior member of a medical team your ethical responsibilities include those of qualified doctors as described and published by the New Zealand Medical Council (Cole’s Medical Practice in New Zealand. 3rd edition (2001) edited by Ian St. George).
Like all doctors IMG House Officers must:
1. Identify themselves to their patients and explain their place in the team.
2. Explain a proposed examination or procedure.
3. Respect a patient's refusal to be examined or to submit to a particular procedure or to have you observing during an examination or procedure.
4. If you plan to approach a patient from another team, you should first speak with the clinicians of that team, as well as the senior nurse on duty and the nurse looking after the patient.
5. If this is after hours, or on the weekend, you should check with check with the charge nurse during the week.
When any difficulties arise in obtaining appropriate consent, you must consult more senior members of the clinical team to whom you are responsible. Depending on the circumstances this may be the Senior House Officer, Registrar or Consultant concerned.
If you are concerned in any way about ethical aspects of your clinical work, you should consult more senior members of your clinical team.

Excerpts from the Code of Ethics of the New Zealand Medical Association (NZMA)

Code of Ethics
Principles of Ethical Behaviour are applicable to all physicians including those who may not be engaged directly in clinical practice.

Consider the health and well-being of your patient to be your first priority.
Strive to improve your knowledge and skill so that the best possible advice and treatment can be afforded to your patient.
Honour your profession and its traditions.
Recognise both your own limitations and the special skills of others in the prevention and treatment of disease.
Protect the patient's secrets even after his or her death.
Let integrity and professional ability be your chief advertisement.

Guide to the Ethical Behaviour of Physicians

The Profession of Medicine has a duty to safeguard the health of the people and minimise the ravages of disease. Its knowledge and conscience must be directed to these ends. Ethical codes have developed to guide the members of the profession in achieving them. The Hippocratic Oath was an initial expression of such a code. More recent codes have developed from this and from a consideration of modern ethical dilemmas and these are embodied in the Declaration of Geneva (1948) and the World Medical Association International Code of Medical Ethics (1949, 1968 and 1983), and in the following statements by the World Medical Association which deal with particular issues: The Declaration of Helsinki dealing with biomedical research (1964, 1975 and 1983); the Declaration of Oslo dealing with therapeutic abortion (1970 and 1983); the Declaration of Tokyo dealing with a doctor's responsibility towards prisoners (1975); the Declaration of Lisbon dealing with patient's rights (1981); and the Declaration of Venice which deals with terminal illness (1983). These have been endorsed by each member organisation, including the New Zealand Medical Association, as general guides having worldwide application.

The New Zealand Medical Association accepts the responsibility of delineating the standard of ethical behaviour expected of New Zealand Medical Practitioners.

An interpretation of these principles is developed in the following pages, as a guide for individual doctors.

Responsibilities to the Patient

Standard of Care

Practice the science and art of medicine to the best of one's ability in full technical and moral independence and with compassion and respect for human dignity.
Continue self education to improve one's personal standards of medical care.
Ensure that every patient receives a complete and thorough examination into their complaint or condition
Ensure that accurate records of fact are kept.

Respect for Patient

Ensure that all conduct in the practice of the profession is above reproach, and that neither physical, emotional nor financial advantage is taken of any patient.
Recognise a responsibility to render medical service to any person regardless of colour, religion, political belief, and regardless of the nature of the illness so long as it lies within the limits of expertise as a practitioner.

Patients’ Rights

Accepts the right of all patients to know the nature of any illness from which they are known to suffer, its probable cause, and the available treatments together with their likely benefits and risks.
Allow all patients the right to choose their doctors freely.
Recognize one's professional limitations and, when indicated, recommend to the patient that additional opinions and services be obtained.
Keep in confidence information derived from a patient, or from a colleague regarding a patient, and divulge it only with the permission of the patient except when the law requires otherwise.
Recommend only those diagnostic procedures which seem necessary to assist in the care of the patient and only that therapy which seems necessary for the well-being of the patient. Exchange such information with patients as is necessary for them to make informed choices where alternatives exist.
When requested, assist any patient by supplying the information required to enable the patient to receive any benefits to which he or she may be entitled.
Render all assistance possible to any patient where an urgent need for medical care exists.

Continuity of Care

Ensure that medical care is available to one's patients when one is personally absent, when professional responsibility for an acutely ill patient has been accepted, continue to provide services until they are no longer required, or until the services of another suitable physician have been obtained.

Personal Morality

When a personal moral judgement or religious conscience alone prevents the recommendation of some form of therapy, the patient must be so acquainted and an opportunity afforded the patient to seek alternative care.