Ethics guide takes account of shifting healthcare realities

The publication once every five years of an updated ethics guide by the Medical Council is important for both patients and doctors. Although not a legal code, the eighth edition sets out the principles of professional practice and conduct all doctors registered with the Medical Council are expected to adhere to.

The document is designed to underpin more detailed practice guidance for doctors.

Traditionally scrutinised for any changes in the area of reproductive health, with an update in the area of abortion introduced some 18 months ago, there is nothing new to report in this section of the guide. But many sections have been updated and the following areas added: social media, equality and diversity, doctors in leadership and management, and doctors as trainers.

Principles

The section on “Clinical Handover” is new and interesting. Influenced by the circumstances surrounding the tragic death of Galway dentist

Savita Halappanavar

and

World Health Organisation

principles on the safe handover of patients, it says “when you hand over care for a patient to another healthcare professional, team and/or institution you should check that they understand and accept responsibility for the patient’s care. You should pass on all relevant information about the patient and the patient’s care. When discharging patients back to primary care you should give all relevant information promptly.”

This section will be welcomed by GPs increasingly having to deal with fallout from quite sick patients being turned away from hospitals or prematurely discharged.

Equality and diversity

How does the new professional practice guide look through the prism of consumerism? A new section on equality and diversity suggests a need for doctors to understand the cultural needs and contexts of different patients. Notably, it states “patients have the right to be offered all treatment options that are likely to be of benefit to them”.

This dovetails with a separate paragraph on resources and doctors as advocates, which includes: “If you work in a facility that is not suitable for patients or for the treatment provided, you have a responsibility to advocate on behalf of your patients for better facilities.”

This Medical Council has carried out a number of surveys of non-consultant hospital doctors during its time in office. They reveal a worrying culture of bullying and the undermining of younger doctors (and medical students) by a minority. The guide states bullying or sexual harassment is unacceptable.

The layout is undoubtedly more user-friendly than its predecessor. It has benefited from the input of the National Adult Literacy Agency.

Five years is a long time for a document to stay relevant. No matter how up-to-date the eighth edition of the guide may be, it will benefit from interim updates in its lifetime.

Dr Muiris Houston is a member of the Registration and Continuing Practice Committee of the Medical Council