5 October, 2016
The Singapore Medical Council ("SMC") has issued a revised version of the Ethical Code and Ethical Guidelines ("ECEG"), to address advancements in technology, aesthetic practices, telemedicine and fee-sharing, amongst others. The new ECEG ("2016 ECEG") is accompanied by the SMC Handbook on Medical Ethics ("2016 HME"), and both documents will come into force on 1 January 2017.
The ECE was last published in 2002. Some of the hot-topic issues that the 2016 ECEG and the 2016 HME address in greater detail are: Telemedicine – This is permitted as long as it is provided in a "responsible manner".
If the quality and standard of in-person medical care cannot be matched, the doctor's opinion must state any relevant limitations.
A doctor must also provide patients with sufficient information about telemedicine for them to give consent. Outsourcing diagnostic interpretation of results or other medical assessments of a patient to a service provider in a different country would also be considered telemedicine.
End-of-life care – Doctors must not commit or participate in any act where the primary intention is to hasten or bring about death, must respect patients' wishes not to receive specific treatments, and must offer good palliative care to minimise suffering, amongst others. Aesthetic medicine – The 2016 ECEG incorporates principles from the SMC's Guidelines on Aesthetic Practices for Doctors (issued in July 2016).
Social media use – Guidance on the ethical use of social media by a doctor covers advertising issues, patient confidentiality and patient-doctor relationships. Doctors are proscribed from initiating social media relationships with patients and from engaging in advertising tactics on social media in an unprofessional manner or in a manner which brings the profession into disrepute.
Medical certificates ("MCs") and prescriptions – Diagnoses must not be stated on MCs unless patients have consented to it. Electronic MCs and prescriptions are permitted, as long as there are safeguards in place to prevent fraudulent issuance of such MCs and prescriptions.
Fee-sharing – Doctors may pay managed care companies, third party administrators, insurance entities or patient referral services fees that reflect their actual work in handling and processing the patients.
Such fees must not be based primarily on the services the doctor provides, or the fees the doctor collects. Disclosure is required if such fees are passed on to patients, by itemising such fees in invoices.
The full text of the 2016 ECEG and 2016 HME can be found on the SMC's website here.
For further information, please contact:
Andy Leck, Principal, Baker & McKenzie.Wong & Leow
andy.leck@bakermckenzie.com
