Should and Must: NMC proposes New Code of Medical Ethics in draft guidelines, Details

The National Medical Commission proposes this Code of Medical Ethics, which will serve as the set of commitments of the registered medical practitioner towards patients, society, professional colleagues, and self. NMC Code of Ethics is framed as a self-regulatory set of guidelines reflecting professional as well as social expectations.

The ethical principles that underpin this code of ethics include beneficence, empathy, non-maleficence, respect for patient autonomy and confidentiality, integrity, honesty, and justice. Medical practitioners are expected to uphold these principles for their inherent value in medical practice, and also to foster trust in patients, and maintain the dignity of the medical profession.

"NMC code of ethics is not intended to establish legal or clinical standards in practice but to provide a set of ethical guidelines according to which the doctor is expected to practice as a medical professional. Ethical guidelines must be differentiated from laws, as ethical standards expected of the medical professional may sometimes exceed legal requirements," The NMC clearly stated in its draft

The code of ethics says that the registered medical practitioner must provide care for the patient with compassion and respect, keeping the best interest of the patient in mind at all times. This should be respectful of the patient's rights and opinion, communicate clearly with the patient, and be honest and transparent in all professional interactions. Must protect patient confidentiality and privacy, and treat every patient equally, without discrimination. Shall ensure one's competency and fitness to practice, and keep up to date with advancements in medical practice. They shall consult with other health professionals, as and when required for the benefit of the patient. Should function in accordance with the laws of the land. When there is a conflict between ethics and law, the doctor is expected to advocate for changes in the law, in the interest of patient care.

The code of ethics carefully makes use of the English language to stress of the significance of certain points. The words 'must', 'shall / should 'and 'may 'are used purposefully in these guidelines and indicate the degree of obligation that the doctor has to follow the guidelines. The word 'must 'indicates a higher level of commitment and obligation required of the doctor, while in the case of 'shall/should 'the level of obligation is less and there could be room for individual judgment.

As per the Code of Ethics, the following are "Must" for Medical Practitioners

1. Must provide care for the patient with compassion and respect, keeping the best interest of the patient in mind at all times.

2. Must protect patient confidentiality and privacy, and treat every patient equally, without discrimination.

3. Must not refuse to treat a patient in case of medical emergency, nor discriminate between patients based on gender, race, religion, caste, social, economic or cultural grounds. No patient should be abandoned.

As per the Code of Ethics, the following are "Shall/Should" for Medical Practitioners

1. Shall ensure one's competency and fitness to practice, and keep up to date with advancements in medical practice. They shall consult with other health professionals, as and when required for the benefit of the patient.

2. Should be respectful of the patient's rights and opinion, communicate clearly with the patient, and be honest and transparent in all professional interactions.

3. Should function in accordance with the laws of the land. When there is a conflict between ethics and law, the doctor is expected to advocate for changes in the law, in the interest of patient care.

4. Shall be responsive to individual and community health needs, and advocate for patients and the wider community they serve in matters of health and welfare.

5. Should practice according to his conscience and ethical guidelines, free from external pressures. They should not provide treatments that are not medically indicated, and must not participate in any act of torture.

6. Should promote and model the ethical standards of the profession in the work place, mindful of the moral and professional obligation owed to the patient and society who have reposed trust in the profession.

7. Should not hesitate to report unethical acts, fraud, incompetence, dishonesty, exploitation or misconduct on part of other health care professionals that could result in harm to the patient.

8. Should recognize conflict of interest situations that may arise in practice as they are detrimental to the patient and should avoid or minimize them. In such situations, the patient's interest should take precedent over any other consideration.

9. Should not engage in endorsement or promotion of any drug or medical product for commercial purposes or for personal gains. In sharing findings of research with peers and scientific societies, the practitioner is expected to be neutral and unbiased in the interest of science and patient care.

10. Should protect and minimize risk of patients who participate in medical research, conscious that the dual role as researcher-practitioner would require disclosure to patients and additional regulatory and ethical compliance.

11. Should ensure that professional boundaries of the doctor patient relationship are respected and not violated.