CODE OF MEDICAL ETHICS CODE OF MEDICAL ETHICS

ADOPTED AT THE
41ST ANNUAL GENERAL MEETING
HELD ON 26TH - 27TH MAY 2001
IN SEREMBAN, NEGERI SEMBILAN
REVISED EDITION
PRINTED IN FEBRUARY 2002
1
CODE OF MEDICAL ETHICS (THE CODE)
THE MALAYSIAN MEDICAL ASSOCIATION
CONTENTS
SECTION I GOOD MEDICAL PRACTICE
Individual Responsibility
The MMA and Medical Ethics
Summary of Duties of Doctors to the Patient,
Profession and Oneself
SECTION II ETHICAL OBLIGATION OF DOCTORS TO THE PATIENT
onsent for Medical E!amination and Treatment
"ees
Professional onfidence
The Doctor and the #a$ ourts
Dyin% Patient
Statutory Re&uirements as to Disclosin%
Medical Records and Reports
Medical ertificates
Privile%ed ommunication
Medical Research
Doctor and 'on(Orthodo! "orms of )ealthcare
Telemedicine
Transplantation
Intimate E!amination
Termination of Pre%nancy
2
SECTION III DOCTORS AND HIS COLLEAGUES
E!amination in onsultation
Acceptance of Patient
E!aminin% Medical Officers
Doctor in Relationship $ith Third Party Payers
Panel Doctors
The Doctor and the Mana%ed are Or%ani*ation
"ee Splittin% and+or Any "orm of Incentive as an Inducement for
Referrin% a Patient
SECTION IV RELATIONSHIP OF DOCTORS !ITH OTHER
PROFESSIONALS
Dental Sur%eon
Ministers of Reli%ion
Pharmaceutical hemists
'urses and other )ealth Professionals
SECTION V RELATIONSHIP OF DOCTORS !ITH COMMERCIAL
UNDERTA"INGS
Pharmaceutical Services, Products and Medical E&uipment
ommercial Enterprises
Reprints
Medical Instruments
'ursin% )omes and Medical Institutions
SECTION VI ADVERTISING AND CANVASSING
Indirect Methods of Advertisin%
3
SECTION VII SETTING UP PRACTICE
Settin% up Practice
'otices
'ameplates
Si%nboards
,-()our linics
Maternity )omes
Telephone Directories
Professional allin% ards
SECTION VIII ETHICS COMMITTEE OF MMA
Disputes bet$een Doctors
Disputes bet$een a Doctor and his Patient
APPENDI#ES
Appendi! I . Perspectives in Medical Ethics
Appendi! II . ode of Professional onduct
( Malaysian Medical ouncil
Appendi! III . /uidelines on Public Information by Private )ospitals, linics,
Radiolo%ical linics and Medical #aboratories
Appendi! I0 . Declarations
Appendi! 0 . Rules of Ethics ommittee
1Appendi! 2 of the MMA onstitution3
4
MALAYSIAN MEDICAL ASSOCIATION
THE CODE
SECTION I GOOD MEDICAL PRACTICE
The medical profession since time immemorial has conducted itself $ith a hi%h level of
ethical behaviour that has earned the trust that patients have in doctors today4 Medical
ethics is defined, as a civil code of behaviour considered correct by members of the
profession for the %ood of both the patient and profession4 This trust %oes beyond
$ritten $ords and leads the public at lar%e to e!pect of the doctor to have not only a
hi%h standard of medical ability and s5ill but also impeccable behaviour4 The need for
patient6s trust in his doctor is the basis for ethical codes from many centuries a%o as
manifested in the traditions of all the ma7or civili*ations4 In recent times, national,
re%ional and $orld associations of doctors as $ell as other health care professionals
have revised e!istin% codes of ethics and formulated ne$ ones to 5eep up $ith
advances in medical 5no$led%e, medical practice and research as $ell as chan%es in
society4 All doctors subscribe to the spirit of carin% and confidentiality that re%ulate the
doctor(patient relationship and these values continue to be accepted by all those $ho
practice the art of medicine4
A ne$ doctor enterin% the profession of medicine 7oins a fraternity dedicated to the
service of humanity4 )e $ill be e!pected to subordinate his personal interests to the
$elfare of his patients, and, to%ether $ith his fello$ practitioners see5 to raise the
standard of health in the community $here he practices4 )e inherits traditions of
professional behaviour on $hich he must base his o$n conduct, and $hich he must
pass on untarnished to his successors4
Malaysia is a multiracial, multireli%ious and culturally diverse nation $ith 8belief in /od8
bein% the first tenet of the country %uidin% principles 1Ru5une%ara34 There are many
core values runnin% throu%h the ethical beliefs of the various communities in Malaysia,
$hich are $orthy of emulation4 Some of these values are e!tracted here for the
%uidance of our doctors4
5
The Physician must maintain the utmost respect for human life and the human
person4
The Physician must stay abreast and practice in accordance $ith current medical
5no$led%e, continually improve his s5ills and see5 help $henever needed4
The Physician should not recommend nor administer any harmful material and
should render help re%ardless of the financial ability, ethnic ori%in or reli%ious belief
of the patient4
The Physician should protect the patient6s confidentiality and adopt an appropriate
manner of communication4 )e should e!amine a patient of the opposite se! in the
presence of a third person $henever feasible4
)e should not critici*e another Physician in the presence of patients or health
personnel4
)e should adhere to these core values and see5 %uidance $henever in doubt4
I$%&'&%()* R+,-.$,&/&*&01
"ormulation of rules is one thin%, observance of them in the rou%h and tumble of
professional practice is &uite another4 A measure of the inte%rity of the medical
profession can be found in the de%ree to $hich each practitioner reco%ni*es his
personal responsibility for the preservation, throu%h his o$n e!ample, of the honour and
di%nity of the profession, and the fact that serious breaches of The ode are relatively
rare4
The value of mutual %ood$ill in the fello$ship of medicine cannot be over(emphasi*ed4
6
T2+ M)*)1,&)$ M+%&3)* A,,.3&)0&.$ )$% M+%&3)* E02&3,
9hile a formal code of ethics may provide the doctor $ith a standard, problems $ill
al$ays arise in the course of his professional $or5 on $hich he needs specific %uidance4
They may occur, for e!ample, in the doctor(patient relationship, in contacts $ith the
%eneral public, settin% up of a practice, relationship $ith collea%ues, dealin%s $ith official
bodies and in numerous other $ays4 One of the most important functions of the
Malaysian Medical Association is to advise and assist its members on ethical problems4
The ode of the Malaysian Medical Association sets %uidelines for the proper conduct of
the doctor practicin% in Malaysia4 The ode is not, and cannot be, e!haustive4 Its
statements are %eneral in nature, to be interpreted and applied in particular situations4
The conduct of the physician should find inspiration in the e&uilibrium and interplay
bet$een science and practice, a middle %round conducive to the fulfillment of the
patient6s best interests and to responsible medical performance4
Physicians may e!perience conflict bet$een different ethical principles, bet$een ethical
and le%al or re%ulatory re&uirements, or bet$een their o$n ethical convictions and the
demands of patients, pro!y decision ma5ers, other health professionals, employers or
other involved parties4 The doctor should study the ode to ma5e decisions, $hich are
in the best interest of the patient4 In cases of doubt, consultation $ith senior collea%ues,
the Malaysian Medical ouncil, the Ethics ommittee of the Malaysian Medical
Association or others $ho have e!pertise in these matters is recommended4
S(44)51 .6 D(0&+, .6 D.30.5, 0. 02+ P)0&+$0,, P5.6+,,&.$ )$% O$+,+*6
Patients trust doctors $ith their lives and $ell bein%4 To 7ustify the trust, $e as a
profession have a duty to maintain a %ood standard of practice, care and behaviour4
The principles you must observe for %ood medical practice are as follo$s .
7
Duties to Patient
ma5e the care of your patient your first concern
treat every patient politely and considerately
respect patients6 di%nity and privacy
listen to patients and respect their vie$s
%ive patients information in a $ay they can understand
be responsible for $hatever form of therapy %iven to patients
respect the ri%hts of patients to be fully involved in decisions about their care4
Duties to Profession and Oneself
5eep your professional 5no$led%e and s5ills up(to(date
reco%ni*e the limits of your professional competence
be honest and trust$orthy
respect and protect confidential information
ma5e sure that your personal beliefs do not pre7udice your patients6 care
act to protect patients from ris5 if you have %ood reason to believe that you or a
collea%ue may not be fit to practice
avoid self(publicity in any matter relatin% to your professional practice
$or5 $ith collea%ues in $ays that best serve patients6 interests
8
build a professional reputation based on inte%rity and ability
refrain from ma5in% comments $hich may needlessly dama%e the reputation of a
collea%ue or cause a patient an!iety
report to the appropriate body of peers any unethical or unprofessional conduct by a
collea%ue
$here a patient alle%es misconduct by another doctor, ensure that the patient is
fully informed about the appropriate steps to ta5e to have that complaint
investi%ated
be a$are that your personal conduct may affect your reputation and that of your
profession4
A member of the Association $ho has an ethical problem or $ho has any doubt on the
line of conduct he should adopt in any professional matter is ur%ed to see5 advice from
the Ethics ommittee of the Malaysian Medical Association4 A full and fran5 $ritten
statement of the facts of the problem $ill be of %reat assistance to the Ethics
ommittee in formulatin% and issuin% a suitable reply4
All doctors should also be conversant $ith the ode of Professional onduct issued by
the Malaysian Medical ouncil 1see Appendi! II3 and the /uidelines on Public
Information by Private )ospitals, linics, Radiolo%ical linics and Medical #aboratories4
1See Appendi! III34
9
SECTION II ETHICAL OBLIGATION OF DOCTORS TO THE PATIENT
17 C.$,+$0 6.5 M+%&3)* E8)4&$)0&.$ )$% T5+)04+$0
/ood communication bet$een the doctor and patient is essential for consent4 Patients
should be %iven ade&uate information in a $ay they can understand to enable them to
ma5e decisions about their medical care4 It is a %eneral rule that doctors should
e!amine and treat patients only $ith their consent4 'o consent is valid if obtained
under the follo$in% conditions .
1i3 $hen there is coercion or threat or force
1ii3 $hen the party %ivin% consent is not a$are of the full implications of consent4
9hen the patient is incompetent and therefore cannot %ive a valid consent, then
consent should be obtained from the ne!t(of(5in4
In a %rave situation $here consent cannot be obtained at all, it is difficult to lay do$n any
%eneral principle4 The matter is $ithin the discretion of the individual doctor $ho should
never hesitate to e!ercise his discretion havin% re%ard to his duty as the protector of the
life and health of his patient4 :nder such circumstances, consultation $ith a collea%ue is
advisable4
27 F++,
Reasonable char%es can be made for services provided and it is in the best interest of
the practitioner to discuss this $ith the patient prior to investi%ation or treatment4
Doctors should abide by the MMA Schedule of "ees4
97 P5.6+,,&.$)* C.$6&%+$3+
The basis of the relationship bet$een a doctor and his patient is that of absolute
confidence and mutual respect4 The patient e!pects his doctor not only to e!ercise
professional s5ills, but also to observe secrecy $ith respect to the information he
ac&uires as a result of his e!amination and treatment of the patient4 On the doctor6s
10
side, an a$areness of the patient6s trust serves to invo5e the observation of ethical
standards and the need to act al$ays in the best interests of the patient4
Professional confidence implies that a doctor shall not disclose voluntarily $ithout the
consent of the patient, preferably in $ritin%, information that he has obtained in the
course of his professional relationship $ith the patient4
9here the medical condition of the patient is li5ely to pose a ris5 to others, the doctor
should see5 to persuade the patient to discontinue all such behaviour $hich put others
at ris5 or to disclose the information to parties at ris5 or to consent to the doctor so
doin%4 If the patient refuses, the doctor may e!ercise discretion to breach confidentiality
in order to protect other people4
9hen in doubt concernin% matters that has le%al implications, or especially $hen the
patient specifically forbids a breach of confidentiality, a doctor may also $ish to consult
the medical indemnity or%ani*ation of $hich he is a member or see5 advice from
collea%ues or professional bodies4 Doctors $ho decide to disclose confidential
information must be prepared to e!plain and 7ustify their decision4
)o$ever, $here possible, doctors should see5 to persuade the patient to discontinue all
behaviour, $hich put others at ris5, %ive permission to disclose the information or to
provide consent to the doctor so doin%4
Modern medical practice usually involves teams of doctors, other healthcare $or5ers,
and sometimes people from outside the healthcare profession4 To provide patients $ith
the best possible care, it is often essential to convey relevant information to members of
the team4 If a patient does not $ish the doctor to share particular information $ith the
other members of the team, the doctor must respect those $ishes4 All medical
members of a team have a duty to ma5e sure that other team members understand and
observe confidentiality4
11
47 T2+ D.30.5 )$% T2+ L): C.(50,
The doctor6s usual course $hen as5ed in a court of la$ for medical information
concernin% a patient in the absence of that patient6s consent is to demur on the %round
of professional secrecy4 The presidin% 7ud%e ho$ever may overrule this contention and
direct the medical $itness to supply the re&uired information4 The doctor has no
alternative but to obey unless he is $illin% to accept imprisonment for contempt of court4
;7 T2+ D1&$< P)0&+$0
9here death is deemed to be imminent and $here curative or life(prolon%in% treatment
appears to be futile, ensure that death occurs $ith di%nity and comfort4 Such futile
therapy could be $ithheld, $ithdra$n or one may allo$ irreversible patholo%y to continue
$ithout active resuscitation4 One should al$ays ta5e into consideration any advance
directives and the $ishes of the family in this re%ard4 In any circumstance, if therapy is
considered to be life savin%, it should never be $ithheld4
67 S0)0(0.51 R+=(&5+4+$0, ), 0. D&,3*.,&$<
/enerally spea5in%, the State has no ri%ht to demand information from a doctor about
his patient save $hen some notification is re&uired by statute, as in the case of
infectious disease4
77 M+%&3)* R+3.5%, )$% R+-.50,
/ood medical records are an indication of %ood practice4 The doctor is encoura%ed to
record all relevant details of his mana%ement of a patient4 Accurate, le%ible,
comprehensive and contemporaneous notes are advised4 Doctors have obli%ations
relatin% to the stora%e, access and use of health information available in the patients6
records4
The patient is entitled to a $ritten report of the care that has been %iven to him4 The
doctor is obli%ated to provide him such a report speedily, $ithout any unreasonable
delay4 The $ithholdin% of information of the care %iven to the patient is unethical4
12
The doctor can be held responsible for any breaches of confidentiality of medical
records4 Medical information can be released to a third party only $hen $ritten consent
has been %iven by or on behalf of the patient4 Third parties $ho fre&uently see5
information from a doctor are employers $ho re&uest reports on the medical condition of
absent or sic5 employees, insurance companies re&uirin% particulars about the history
of proposers for life assurance or deceased policy holders, medical boards and other
a%encies see5in% medical information about individuals associated $ith it as $ell as
solicitors to consider and assess claims4 "ees may be char%ed for medical reports or
opinions re&uested by third parties4
9here medical information is sou%ht, the doctor should ma5e it a rule to refuse to %ive
any information in the absence of the $ritten consent of the patient or the competent
relative4
>7 M+%&3)* C+50&6&3)0+,
Medical practitioners are constantly as5ed for certificates of various 5inds and should be
continually on their %uard a%ainst carelessness and inaccuracies in certifyin%4 Medical
certification should not be sub7ected to any form of pressure but should be carried out
purely on medical %rounds4 The practitioner should never certify a statement $hich he
does not personally 5no$ to be a fact; he should never put heresay information into a
certificate, unless e!pressly so stated4 )e should e!ercise the most scrupulous care in
issuin% medical certificates especially in relation to any statement that a patient has
been e!amined on a particular date4 The nature of the patient6s illness should not be put
on the certificate $ithout the permission of the patient4 The patient should be advised
about the implication of revealin% the dia%nosis4
It must be stressed that the %ivin% of sic5 certificates to patients $ithout a medical
e!amination is unethical and may lead to disciplinary action by the Malaysian Medical
ouncil4
The practice of countersi%nin% or endorsin% another medical practitioner6s certificate is
unnecessary and inappropriate4
13
?7 P5&'&*+<+% C.44($&3)0&.$
The Malaysian Medical Association considers that the e!chan%e of medical information
concernin% patients should ta5e place only bet$een doctors loo5in% after the same
patient4 This shall be re%arded professionally as privile%ed communication and no prior
consent of patient is necessary4 Such communication can be made in the interest of the
care of the patient4
107 M+%&3)* R+,+)532
In any research on human bein%s, each potential sub7ect must be ade&uately informed
of the aims, methods, anticipated benefits and potential ha*ards of the study and the
discomfort it may entail4 )e or she should be informed that he or she is at liberty to
abstain from participation in the study and that he or she is free to $ithdra$ from the
study at any time4 The practitioner should then obtain the sub7ect6s informed consent in
$ritin%4
A medical practitioner shall use %reat caution in divul%in% discoveries or ne$ techni&ues
or treatment throu%h non(professional channels4 A practitioner should ensure that
research results are first communicated to appropriate peer %roups so that a balanced
vie$ can be obtained before communication to the public4
ommunication of such a discovery and ne$ techni&ues to the public should be throu%h
a professional body after they have been revie$ed and %enerally accepted by the
profession4 The results of any research on human sub7ects should not be suppressed
$hether adverse or favourable4
117 D.30.5 )$% N.$-O502.%.8 F.54, .6 H+)*023)5+
'on(Orthodo! 1traditional3 medicine is healthcare that lies for the most part outside the
mainstream of orthodo! or conventional medicine4 There are many modalities of
traditional medicine includin% herbal medicines4 Many patients resort to traditional
medicines for a $ide variety of conditions4 It is also 5no$n that there are many patients
$ho ta5e both conventional and traditional medicine at the same time4 The ma7ority of
14
traditional medicine practitioners is not trained and is not sub7ect to any re%ulations to
%uide their practice4
The doctor is responsible for the mana%ement of his patient includin% 5no$in% about the
safety and efficacy of the modalities of treatment or medication that he prescribes4 A
doctor should not practice or prescribe any form of traditional therapy unless he has
underta5en reco%ni*ed trainin% and be sanctioned by re%istration $ith any future
re%ulatory body that may be set up under the la$s of this country4
It is unethical for a doctor to care for his patient 7ointly $ith a traditional medicine
practitioner or share premises $ith a traditional medicine practitioner4 Any re%istered
medical practitioner $ho, either by administerin% anesthetics or other$ise, assists an
un&ualified or unre%istered person to attend, treat or perform an operation upon any
other person in respect of matters re&uirin% professional discretion or s5ill $ill be liable
to disciplinary punishment by the Malaysian Medical ouncil 1refer to no4 24-4< of the
ode of Professional onduct, MM34 Attention is also dra$n to Section 0 para = of
this ode in relation to the association of a medical practitioner $ith a traditional
medicine practitioner4
127 T+*+4+%&3&$+
Telemedicine provides the tool to e!chan%e medical information as part of the
consultation $ith distant medical e!perts, be it forei%n or local, in the course of treatment
of patients4 It is a rapidly evolvin% area of medical practice4 )o$ever, most clinical
applications of telemedicine have not been sub7ected to systematic comparative studies
that assess their impact on the &uality, accessibility, acceptability and cost of healthcare4
The onus is on the medical practitioner to ensure that the principles of %ood ethical
conduct should apply in the area of telemedicine as $ell4 These $ould include .
1i3 The doctor re&uestin% the consultation should be responsible for the professional
care of the patient4
1ii3 Any consultation usin% this modality should be $ith the consent of the patient4
1iii3 Ensurin% confidentiality of patient information4
15
1iv3 Ensurin% that the appropriate choice of treatment is based on sound scientific
evidence4
1v3 /uardin% a%ainst self(laudatory activities as $ell as advertisin%4
1vi3 'ot associatin% $ith commercial concerns in such a $ay as to let it influence or
appear to influence the treatment of patient4
1vii3 The use of email should not diminish the &uality of care patients receive4
1viii3 onsultation and prescribin% by email may seriously compromise standards of
care $here .
a3 The patient is not previously 5no$n to the doctor4
b3 There is little or no provision for appropriate monitorin% of the patient or
follo$(up care4
c3 The patient cannot be e!amined4
Doctors $ho $ish to provide online services should consider carefully $hether such a
service $ill serve their patients6 interests, and if necessary, see5 advice from their
professional association or Medical Defence Society4
The practitioner should strive to benefit from telemedicine6s potential $hile avoidin% its
pitfalls4
197 T5)$,-*)$0)0&.$
Ethical issues have been associated $ith or%an transplantation from the be%innin% and
$ill continue to be a ma7or consideration in this field4 Doctors practicin% in this field must
be a$are of all the issues and ensure that they do not trans%ress any ethical principles4
If you are carin% for a donor, you must provide to the donor, and+or their relatives $here
appropriate, a full disclosure of the intent of transplant or%ans, the purpose of the
procedure and, in the case of a livin% donor, the ris5s of the procedure4 In facilitatin%
the potential donor to ma5e a free and informed decision on or%an donation, the
institution should provide him+her $ith ade&uate information on all aspects of donor
16
sur%ery includin% short and lon% term ris5s4 Many institutions provide 8donor advocates8
$ho are physicians independent of the team loo5in% after the recipients or the transplant
team4 These donor advocates help the potential donors $ith their decision(ma5in% by
providin% independent and ob7ective advice4 Potential donors should have access to
other members of team such as nurses and social $or5ers to $hom they may find
easier to relate4 "inally, the potential donor should be assured that at any time he
chan%es his mind on donatin% an or%an, his $ishes $ould be respected4 Persons $ho
are mentally incompetent to decide should not be allo$ed to donate4
In cadaver or%an transplantation, definition of death is crucial as or%ans are best
removed $hen the heart is still beatin% but the patient is already brain dead4 It is
important that pronouncement of brain death is done usin% ri%id criteria and persons
performin% tests to determine brain death are independent of the transplant team as $ell
as the team loo5in% after the recipient4
Donor families have made an important contribution to the health of others in very
difficult circumstances4 They must be offered on(%oin% counselin% and appropriate
support4
In decidin% on or%an allocation, the principles of utility, 7ustice and autonomy must be
used4 The utility principle may ma5e use of medical indicators, $hich predict better
outcome as 7ustification for %ivin% an or%an to a particular recipient4 The principle of
7ustice attempts to ensure e&uitable access of patients to an or%an sharin% system4 The
principle of autonomy may be applied $hen a patient refuses to receive an or%an
allocated to him, in $hich case it can be %iven to the ne!t suitable candidate4 In %eneral,
in any %iven situation, all the principles should be considered to%ether and a consensus
achieved4
147 I$0&4)0+ E8)4&$)0&.$
9hen conductin% an intimate e!amination, the doctor should .
a3 E!plain to the patient that an intimate e!amination needs to be done and $hy4
b3 E!plain $hat the e!amination $ill involve4
17
c3 Ensure that the patient has a%reed for an e!amination4
d3 Al$ays have a chaperon present4
e3 /ive the patient privacy to undress and dress4
f3 >eep the discussion relevant4
%3 Avoid unnecessary comments4
1;7 T+54&$)0&.$ .6 P5+<$)$31
The Penal ode 1Amendment3 Act 2?@? effected a chan%e in the la$ relatin% to
abortion4 It $ould not be an offence to carry out a miscarria%e if .
a3 a medical practitioner re%istered under the Medical Act 2?A2 underta5es the
procedure; and
b3 such practitioner is of the opinion, formed in %ood faith, that the continuance of
the pre%nancy $ould involve ris5 to the life of the pre%nant $oman, or in7ury to
the mental or physical health of the pre%nant $oman, %reater than if the
pre%nancy $ere terminated4
A doctor procurin% a miscarria%e may la$fully do so only if he acts in %ood faith, and
e!ercises sound clinical 7ud%ement in accordance $ith the principles imposed by the
la$4
The Malaysian Medical ouncil re%ards induced non(therapeutic abortion a serious
infamous conduct and if proved to the satisfaction of the ouncil, a practitioner is liable
to disciplinary action4 A criminal conviction in Malaysia or else$here for the termination
of pre%nancy in itself affords %rounds for disciplinary action4
18
SECTION III DOCTOR AND HIS COLLEAGUES
Modern medicine cannot be practiced by a doctor in isolation4 )e is in continual contact
$ith his collea%ues for many purposes4 )e may need to have a patient e!amined by a
consultant; it may be necessary for a patient to be e!amined by a medical officer
representin% some third party, or if the patient is in industrial employment, a medical
officer at his place of $or5 may have a continuin% interest in his health4 9henever t$o
doctors are simultaneously concerned $ith a patient, each is under certain ethical
obli%ations and is e!pected to observe certain ethical rules of conduct4
A code of recommendations to %uide the practitioner $ho may be called upon to
e!amine another doctor6s patient is as follo$s4
A7 E8)4&$)0&.$ &$ C.$,(*0)0&.$
The custom of consultation is very old and throu%h the years, the profession has
evolved a mode of conduct that should be follo$ed meticulously4 "ailure to observe the
established procedure may lead to difficulties or unpleasantness bet$een doctors4
24 A practitioner consulted is a practitioner $ho, $ith the ac&uiescence of the
practitioner already in attendance, e!amines a patient under this practitioner6s
care and, either at a meetin% of the t$o practitioners or by correspondence, co(
operates in the formulation of dia%nosis, pro%nosis, and treatment of the case4
The term 8consultation8 means such a co(operation bet$een practitioners4 In
domiciliary consultations, it is desirable that both practitioners should meet and in
other circumstances similar arran%ements should obtain $herever practicable4
,4 It is the duty of an attendin% practitioner to propose a consultation $here
indicated, or to ac&uiesce in any reasonable re&uest for consultation e!pressed
by the patient or his representatives4
<4 The attendin% practitioner should nominate the practitioner to be consulted and
should advise accordin%ly, but he should not unreasonably refuse to meet a
re%istered medical practitioner selected by the patient or the patient6s
representatives, althou%h he is entitled, if such is his opinion, to ur%e that the
19
practitioner has not the &ualifications or the e!perience demanded by the
particular re&uirements of the case4
-4 The arran%ements for consultation should be made or initiated by the attendin%
practitioner4 The attendin% practitioner should ac&uaint his patient of the
appro!imate e!penses, $hich may be involved in specialist consultation4
=4 In cases $here the consultant and the attendin% practitioner meet and personally
e!amine the patient to%ether, the follo$in% procedure is %enerally adopted and
should be observed, unless in any particular instance there is substantial reason
for departin% from it4
1i3 All parties meetin% in consultation should be punctual, and if the
attendin% practitioner fails to 5eep the appointment, the practitioner
consulted, after a reasonable time, may e!amine the patient, and should
communicate his conclusions to the attendin% practitioner in $ritin% and in
a sealed envelope4
1ii3 If the consultation ta5es place at the patient6s residence, the attendin%
practitioner should, on enterin% the room of the patient, precede the
practitioner consulted, and after the e!amination, the attendin%
practitioner should be the last to leave the room4
1iii3 The dia%nosis, pro%nosis and treatment should be discussed by the
practitioner consulted and the attendin% practitioner in private4
1iv3 The opinion on the case and the treatment as a%reed should be
communicated to the patient or the patient6s representatives, $here
practicable, by the practitioner consulted in the presence of the attendin%
practitioner4
1v3 It is duty of the attendin% practitioner loyally to carry out the measures
a%reed at, or after, the consultation4 )e should refrain from ma5in% any
radical alteration in these measures e!cept upon ur%ent %rounds or after
ade&uate trial4
20
B4 If for any reason the practitioner consulted and the attendin% practitioner cannot
e!amine the patient to%ether, the attendin% practitioner should send to the
practitioner consulted a brief history of the case4 After e!aminin% the patient, the
practitioner consulted should for$ard his opinion, to%ether $ith any advice as to
treatment, in a sealed envelope addressed to the attendin% practitioner4 )e
should e!ercise %reat discretion as to the information he %ives to the patients or
the patient6s representatives and, in particular, he should not disclose to the
patient any details of any medications, $hich he has advised4
In cases $here the attendin% practitioner accepts the opinion and advice of the
practitioner consulted, he should carry out the measures $hich have been
a%reed bet$een them; ho$ever, if the attendin% practitioner finds he is in
disa%reement $ith the opinion and advice of the practitioner consulted, he should
by suitable means communicate his disa%reement to the practitioner consulted4
A4 Should the practitioner consulted and the attendin% practitioner hold diver%ent
vie$s, either on the dia%nosis or on the treatment of the case, and should the
attendin% practitioner be un$illin% to pursue the course of action advised by the
practitioner consulted, this difference of opinion should be communicated to the
patient or his representatives by the practitioner consulted and the attendin%
practitioner 7ointly, and the patient or his representatives should then be advised
either to choose one or other of the su%%ested alternatives or to obtain further
professional advice4
@4 In the follo$in% circumstances, it is especially desirable that the attendin%
practitioner should endeavour to secure consultation $ith a collea%ue4
1i3 9hen the propriety has to be considered of performin% an operation or of
adoptin% some course of treatment $hich may involve considerable ris5
to the life of the patient or may permanently pre7udice his activities or
capacities and particularly $hen the condition $hich it is sou%ht to relieve
by the treatment is not itself dan%erous to life;
1ii3 9hen any procedure li5ely to result in death of a foetus or of an unborn
child is contemplated, especially if labour has not commenced;
21
1iii3 9hen continued administration of any dru% of addiction is deemed
desirable for the relief of symptoms of addiction;
1iv3 9hen there is reason to suspect that the patient .
1a3 has been sub7ected to an ille%al operation; or
1b3 is the victim of criminal poisonin% or criminal assault4
?4 Arran%ements for any future consultation or additional investi%ation should be
effected only $ith the fore 5no$led%e and cooperation of the attendin%
practitioner4
2C4 The practitioner consulted should not attempt to secure for himself the care of a
patient seen in consultation4 It is his duty to avoid any $ord or action, $hich
mi%ht disturb the confidence of the patient in the attendin% practitioner4 The
practitioner consulted should not communicate $ith the patient or the patient6s
representatives subse&uent to the consultation e!cept $ith the consent of the
attendin% practitioner4
224 The attendin% practitioner should carefully avoid any remar5 dispara%in% the s5ill
or 7ud%ement of the practitioner consulted4
2,4 E!cept by mutual consent, the practitioner consulted shall not supersede the
attendin% practitioner durin% the illness $ith $hich the consultation $as
concerned 1see also ne!t Section34
2<4 The consultant is normally obli%ed to consult the referrin% practitioner before
other consultants are called in4
B7 A33+-0)$3+ .6 P)0&+$0
2-4 9hen a doctor in practice is plannin% to be a$ay on other business or on
vacation, he should formally appoint another doctor $ho $ill a%ree to loo5 after
his patients durin% his absence4
22
2=4 The e!amination of another doctor6s patient may occasionally result in the patient
bein% attracted to the e!aminer6s o$n practice4 Members are advised that the
$illful enticement of patients from a fello$ practitioner, or the employment of
touts, or a%ents to attract patient to one6s practice, are most unethical4
2B4 9hen a practitioner is called to attend a patient $hose re%ular medical attendant
is temporarily unavailable, the practitioner should render $hatever treatment may
for the time be re&uired, and should subse&uently notify the patient6s re%ular
doctor of the steps he has ta5en in the treatment of the patient4
C7 E8)4&$&$< M+%&3)* O66&3+5,
2A4 It often happens that a doctor6s patient has to be e!amined for some particular
purpose by a medical officer representin% an interested third party4 These
e!aminations may occur in connection $ith life assurance or superannuation,
entry into certain employment, liti%ation or re&uests from the police4 The
follo$in% ode of Medical Ethics %overnin% special situations is approved4 It
does not apply to e!aminations performed under statutory re&uirements4
Para%raphs 2?, ,C, ,2 and ,, do not apply to pre(employment e!aminations, or
to those connected $ith superannuation, Employees Provident "und, SOSO or
$ith proposals for life or sic5ness assistance4
2@4 "or the purpose of this code, an e!aminin% medical officer is a practitioner
underta5in% the e!amination of a patient of another practitioner at the re&uest of
a third party $ith the e!ception of e!aminations under statutory re&uirements4
2?4 An e!aminin% practitioner must be satisfied that the individual to be e!amined
consents, personally or throu%h his le%al representative, to submit to medical
e!amination, and understands the reason for it4
,C4 9hen the individual to be e!amined is under medical care, the e!aminin%
practitioner shall cause the attendin% practitioner to be %iven such notice of the
time, place and purpose of his e!amination as $ill enable the attendin%
practitioner to be present should he or the patient so desire4 1Preferably such
notice should be sent to the attendin% practitioner throu%h the post, or by
23
telephone, but in certain circumstances a communication mi%ht properly be
conveyed by the patient34
,24 E!ceptions to this are .
1i3 9hen circumstances 7ustify a surprise visit;
1ii3 9hen circumstances necessitate a visit $ithin a period, $hich does not
afford time for notification4
,,4 9here the e!aminin% practitioner has acted under 1i3 or 1ii3, he shall promptly
inform the attendin% practitioner of the fact of his visit and the reason for his
action4
,<4 If the attendin% practitioner fails to attend at the time arran%ed, the e!aminin%
practitioner shall be at liberty to proceed $ith the e!amination4
,-4 An e!aminin% practitioner must avoid any $ord or action $hich mi%ht disturb the
confidence of the patient in the attendin% practitioner and must not $ithout the
consent of the attendin% practitioner, do anythin% $hich involves interference
$ith
the treatment of the patient4
,=4 An e!aminin% practitioner shall confine himself strictly to such investi%ation and
e!amination as is necessary for the purpose of submittin% an ade&uate report4
,B4 Any proposal or su%%estion, $hich an e!aminin% practitioner may $ish to put
for$ard re%ardin% treatment, shall be first discussed $ith the attendin%
practitioner either personally or by correspondence4
,A4 9hen in the course of an e!amination there come to li%ht material clinical
findin%s, of $hich the attendin% practitioner is believed to be una$are, the
e!aminin% practitioner shall, $ith the consent of the patient inform the attendin%
practitioner of the relevant details4
,@4 An e!aminin% practitioner shall not utili*e his position to influence the person
e!amined to choose him as his medical attendant4
24
,?4 9hen the terms of contract $ith his employin% body interfere $ith the free
application of this code, an e!aminin% officer shall ma5e an honest endeavour to
obtain the necessary amendment of his contract himself or throu%h the
Malaysian Medical Association4
D7 D.30.5 &$ R+*)0&.$,2&- :&02 T2&5% P)501 P)1+5,
<C4 Many commercial firms, estates, mines and industries en%a%e company doctors
to supervise the health and $elfare of the employees and the environmental
conditions of their $or54 The position of the company doctor is such that $ithout
constant care, a conflict of loyalties is liable to arise, for, $hile he holds his
appointment from the mana%ement, the ob7ect of his duties is the $elfare of the
$or5ers, individually and collectively, and in the course of his duties, he $ill come
into contact $ith the family doctors of individual $or5ers4 As a doctor, his
paramount concern must be for the patient, and his behaviour should be %uided
by the customary ethical rules of his profession4 To assist him in his special
duties, the follo$in% set of rules are recommended4
<24 Sub7ect to statutory re&uirements, these rules shall, $here e!istin% ethical rules
or custom fail to cover the circumstances, %overn the professional relationship of
industrial medical officers $ith their medical collea%ues in other branches of
medical practice, $ith those employees under their professional care, and $ith
mana%ement6s4 The rules apply not only to $hole(time officers, but also to those
employed part(time or in any other capacity4
<,4 1i3 9hen a company doctor renders advice or treatment to an employee at
the place of employment, and $hen in the employee6s o$n interests he
deems it advisable, he shall inform the employee6s o$n doctor of the
material facts4
1ii3 9hen a company doctor finds on e!amination that an employee is unfit
for $or5, he shall advise the employee to consult his o$n doctor or he
may, in an emer%ency, send him direct to hospital4
25
1iii3 If an employee is under the care of his o$n doctor or of a hospital, and if
at the place of employment there are special facilities and e&uipment for
continuin% treatment, the company doctor may arran%e for such
treatment $ith the approval of the doctor or hospital concerned4
<<4 9hen in the course of an e!amination of an employee for superannuation
purposes, retirement or special duty, material clinical findin%s come to li%ht, the
company doctor should, $ith the consent of the person e!amined, inform his
doctor of the relevant details4
<-4 E!cept in an emer%ency, a company doctor shall not underta5e any treatment
that is normally the responsibility of the employee6s o$n doctor, unless it be $ith
his a%reement4
<=4 In his capacity as a company doctor, he shall not underta5e treatment of any
member of an employee6s family $ho is not employed at the same place of $or54
<B4 A part(time company doctor shall not utili*e his position to influence an employee
to choose him as his medical attendant4
<A4 A company doctor shall not, e!cept in an emer%ency, or $here a prior
understandin% $ith local practitioners e!ists, send any employee direct to
hospital4 9hen he considers that attendance at hospital is necessary or
advisable, he shall refer the employee to his o$n doctor, to $hom he may ma5e
a su%%estion to this effect4 9hen, in an emer%ency, a company doctor sends an
employee to hospital, he shall inform the relatives 1if the patient is li5ely to be
detained3 and also the employer6s o$n doctor, $here 5no$n4
<@4 9hen a company doctor is as5ed by his mana%ement to report on the condition
of an employee $ho is absent from $or5 for health reasons and under the care
of his o$n doctor, the company doctor, before e!aminin% the patient, shall first
communicate $ith the employee6s doctor, informin% him of the time of his
intended e!amination4
26
<?4 A company doctor should $henever possible, respond to an invitation for
consultation $ith an employee6s o$n doctor4
-C4 A company doctor shall not carry out any personal preventive measure $hich is
purely e!perimental $ithout the consent of the employee, and, $here desirable,
the consent of the employee6s o$n doctor4
-24 1i3 The personal medical records of employees maintained by a company
doctor for his professional use is confidential documents4 Access to them
must not be allo$ed to any other person e!cept $ith the consent of the
employee concerned4
1ii3 A company doctor shall at all times be responsible for the safe custody of
his records4 On the termination of his appointment, he shall hand over
his records only to the company doctor $ho shall succeed him in the
appointment4
1iii3 If there is no successor to his appointment, the company doctor retains
his responsibility for the safe custody of his records or for their
destruction4
-,4 A company doctor shall not disclose his 5no$led%e of industrial processes
ac&uired by virtue of his appointment e!cept $ith the permission of his
mana%ement or $hen so re&uired in courts of la$4
-<4 9hen a company doctor has e!amined an applicant for employment and as a
result of the e!amination, employment is subse&uently refused, the company
doctor should disclose his decision to the applicant and, $hen authori*ed, may
disclose the findin%s to the patient6s doctor4
--4 9hen a company doctor addresses a communication to the employee6s o$n
doctor and receives no reply $ithin a reasonable time, he shall be at liberty to
assume that the employee6s o$n doctor ta5es no e!ception to the contents of his
communication4 It is important in the employee6s interest that no opportunity of
useful co(operation bet$een the employee6s doctor and the company doctor
27
should be ne%lected4 Such co(operation may be of particular value $hen an
employee is under treatment for an occupational disease of $hich the company
doctor has special e!perience4
-=4 ompany doctors should not ma5e statements as to liability in the case of
accidents at the place of $or5 e!cept $hen so re&uired in courts of la$4
-B4 In Malaysia, the role of a company doctor differs considerably from that in other
parts of the $orld4 The custom has evolved $hereby medical officers visitin%
estates, mines, factories, etc4, are called upon, not only to advise the
mana%ement on %eneral health matters, but also to treat the employees in a
%eneral practitioner6s capacity4 In vie$ of the fact that many employees cannot
afford to consult a private practitioner, it is not unethical for this practice to
continue4
-A4 If, ho$ever, the patient is already under treatment from another doctor, it is
recommended that the company doctor does not treat the patient $ithout
consultin% the patient6s o$n doctor, and that any clinical findin%s $hich come to
li%ht durin% routine medical e!amination be communicated to the patient6s o$n
doctor4
E7 P)$+* D.30.5,
-@4 Doctors in solo or %roup practice are often appointed on the panel of companies
or corporate bodies to provide healthcare for the employees4 The contractual
a%reements of such doctors $ith the employers often stipulate certain conditions,
$hich the doctor may accept as lon% as such conditions do not affect his ethical
conduct4
F7 T2+ D.30.5 )$% 02+ M)$)<+% C)5+ O5<)$&@)0&.$
-?4 A Mana%ed are Or%ani*ation is defined as any or%ani*ation or body contracted
or arran%ed, or intended to contract or arran%e, to provide specified types and+or
&uality and+or &uantity of healthcare $ithin a specified financin% system throu%h
one or a combination of the follo$in% mechanisms .
28
1i3 deliverin% or %ivin% healthcare to consumers throu%h o$n or a third party
healthcare provider1s3 in accordance $ith contractual a%reements
bet$een all parties concerned;
1ii3 mana%in% healthcare funds of payers 1employers and+or financiers3 to
provide healthcare to employees 1or enrollees3 in accordance $ith
contractual a%reements bet$een all parties concerned;
1iii3 any other types of healthcare delivery arran%ements, $hich the Minister
of )ealth may, from time to time, by notification in the /a*ette declare to
be a mana%ed care or%ani*ation4
=C4 "or operational purposes, the term Mana%ed are Or%ani*ation includes all
varieties and hybrids of healthcare mana%ement or%ani*ations $here third
parties 1includin% private healthcare facilities and medical practitioners3 are
involved in an administrative control capacity in the delivery of healthcare by
doctors4
=24 The MMA, ho$ever, asserts that the medical practitioner, $hether in solo or
%roup practice, directly 1$ithout third party mana%ers or financiers3 providin%
healthcare to employees of corporate bodies 1or individual enrollees3, throu%h
the panel contractual system, should not be considered a mana%ed care
or%ani*ation, in the conte!t of the above definition and its specific implications4
=,4 Doctors participatin% in providin% patient care $ith MOs should abide by the
follo$in% %uidelines .
1i3 It is the medical practitioner6s responsibility to ensure that, in his
association $ith MOs, his clinical practice does not violate the ode of
Professional onduct of the MM and the ode of the Association4
1ii3 Irrespective of $hichever healthcare system the medical practitioner
practices, he must place the interest of the patient first4 In this conte!t .
29
1a3 he should not enter into any contractual a%reement that poses a
conflict on interest bet$een his professional practice and the
provision of care for his patient;
1b3 he should not participate in schemes that encoura%e or re&uire
him to practice belo$ his professional standard or beyond his
clinical capability4
1iii3 /ood clinical practice should be the basis of care rather than enticement
$ith financial incentive or financial disincentive4
1iv3 Doctors should avoid actions+commitments $hich endan%er
doctor+patient relationship, and $hich allo$ for breach of confidentiality4
1v3 Doctors should not allo$ themselves to commit either directly or indirectly
advertisin% in any form as a mar5etin% strate%y of mana%ed care
or%ani*ations4
G7 F++ S-*&00&$< )$%A.5 )$1 F.54 .6 I$3+$0&'+ ), )$ I$%(3+4+$0 6.5
R+6+55&$< ) P)0&+$0
=<4 "ee splittin% or any form of 5ic5bac5 arran%ement as an inducement to refer a
patient to another practitioner or facility is unethical4 The premise for referral
must be &uality of care and the best interest of the patient4 0iolation of this $ill
be considered as infamous conduct in a professional respect4

30
SECTION IV RELATIONSHIP OF DOCTORS !ITH OTHER
PROFESSIONALS
The doctor is fre&uently in contact $ith members of other professions, e4%4 nurses,
dentists, pharmacists and the cler%y4 These relationships %ive rise to ethical problems4
Some illustrations of ho$ the doctor should conduct himself in such inter(professional
relationships are mentioned belo$4
D+$0)* S(5<+.$
The follo$in% rules apply for the professional conduct of doctors in relation to Dental
Sur%eons .
O'S:#TATIO'S
24 9hen a patient, in the opinion of his medical attendant needs dental treatment, the
patient should be referred in all but e!ceptional circumstances to his o$n dental
sur%eon4 In the event of the patient havin% no re%ular dentist, there is no ob7ection
to a doctor recommendin% a dental sur%eon of his o$n choice4
,4 9hen on behalf of one of his patients a doctor $ishes to consult a dental sur%eon,
the doctor should communicate in the first instance $ith the patient6s o$n dental
sur%eon4 In the event of the patient havin% no re%ular dentist, there is no ob7ection
to the doctor consultin% the dental sur%eon of his o$n choice4
<4 9here the dental sur%eon has reason to believe that the patient has some
constitutional disorders and considers some ma7or dental procedures are necessary,
he should consult the patient6s doctor before carryin% out such treatments4
-4 9here there is a conflict of opinion bet$een a doctor and a dental sur%eon
concernin% the dia%nosis and+or treatment of the condition of a patient, they should
consult $ith each other to reach an a%reement, $hich is satisfactory to both4
31
=4 9here the conflict of opinion remains unresolved, the patient should be so informed
and invited to choose one of the alternatives or assisted to obtain other professional
advice4
A'AEST)ETIS
B4 9here an anaesthetic is advised by the dental sur%eon, it is competent for him to
select the anaesthetist, but if such an anaesthetist is not the patient6s doctor, no
ob7ection should be ta5en to the patient invitin% his doctor to be present4 9here
the operation proposed is a ma7or one, or if it is 5no$n to the dental sur%eon that
the patient is under medical care, the dental sur%eon should consult the patient6s
doctor upon the operation proposed and should invite him to be present if the
patient so desires4 Similarly, $here the patient is under dental care and the doctor
advises operative or other ma7or treatment arisin% from the patient6s dental
condition, the dental sur%eon should be consulted4
A4 On the completion of any dental operation and especially if there is any reason to
thin5 that post(operative complications may ensue, the patient should be advised to
consult the dental sur%eon immediately if such complications arise and the dental
sur%eon should ta5e all reasonable steps to facilitate such consultation4
M&$&,0+5, .6 R+*&<&.$
@4 Doctors should co(operate $ith the cler%y of the patient in the care of the patient4
Indeed, such co(operation is specially desirable $hen the doctor believes that
reli%ious administration may be conducive to his patient6s health and peace of mind,
or may assist recovery4
P2)54)3+(0&3)* C2+4&,0,
?4 ollusion bet$een doctors and pharmaceutical chemists for financial %ain is
reprehensible4 A doctor should not arran%e $ith a chemist for the payment of a
commission on business transacted, nor should he hold a financial interest in a
chemist6s shop in the area of his practice4 Professional cards should not be handed
32
to chemists for further distribution4 It is undesirable for messa%es for a doctor to be
received and left at a chemist6s shop4
N(5,+, )$% O02+5 H+)*02 P5.6+,,&.$)*,
2C4 Reco%ni*in% that patient care involves a multi(disciplinary approach, it is desirable
that doctors $or5 closely $ith nurses and other health professionals in the delivery of
patient care4 Mutual understandin% and respect for each other6s responsibilities and
capabilities $ill enhance the $or5in% relationship bet$een nurses, other health
professionals and doctors4
33
SECTION V RELATIONSHIP OF DOCTORS !ITH COMMERCIAL
UNDERTA"INGS
24 A %eneral ethical principle is that a doctor should not associate himself $ith
commerce in such a $ay as to let it influence or appear to influence his attitude
to$ards the treatment of his patient4 It is improper for an individual practitioner to
accept from a pharmaceutical firm monetary %ifts or loans or e!pensive items of
e&uipment for his personal use4
/ifts, hospitality or subsidies offered to doctors by the pharmaceutical industry ou%ht
not be accepted if acceptance mi%ht influence or appear to others to influence the
ob7ectivity of clinical 7ud%ement4 A useful criterion in determinin% acceptable
activities and relationship is, 89ould you be $illin% to have these arran%ements
%enerally 5no$nD8
Some of the particular directions in $hich dan%ers of unethical conduct may arise
are as follo$s4
P2)54)3+(0&3)* S+5'&3+, P5.%(30, )$% M+%&3)* E=(&-4+$0
,4 It is undesirable for a doctor to have a special direct and personal financial interest in
the sale of any pharmaceutical preparation or medical e&uipment he may have to
recommend to a patient4 If such be unavoidable for any %ood and sufficient reason,
he should disclose his interest $hen orderin% that preparation or article4 This is not
held to apply to the ac&uisition of shares in a public company mar5etin%
pharmaceutical products4
<4 Testimonials $ritten by doctors on the value of proprietary products have often been
abused by the manufacturers4 A doctor should refrain from $ritin% a testimonial on
a commercial product unless he receives a le%ally enforceable %uarantee that his
opinion $ill not be published $ithout his consent4
34
C.44+53&)* E$0+5-5&,+,
-4 The Ethics ommittee disapproves of the direct association of a medical practitioner
$ith any commercial enterprise en%a%ed in the manufacture or sale of any
substance $hich is claimed to be of value in the prevention or treatment of disease
and $hich is recommended to the public in such a fashion as to be calculated to
encoura%e the practice of self(dia%nosis and of self(medication or is of undisclosed
nature or composition4
=4 The Ethics ommittee ta5es a similar vie$ of association of a medical practitioner
$ith any system or method of treatment $hich is not under medical control and
$hich is advertised in the public press4
The practitioner is the trustee for the patient and accordin%ly must avoid any
situation in $hich there is a conflict of interest $ith patient care4
A %eneral ethical principle is that a practitioner should not associate himself $ith
commerce in such a $ay as to let it influence, or appear to influence, his attitude
to$ards the treatment of his patients4
The association of a practitioner $ith any commercial enterprise en%a%ed in the
manufacture or sale of any substance $hich is claimed to be of value in the
prevention or treatment of disease but is unproven or of an undisclosed nature or
composition may be considered as infamous conduct in a professional respect4
A practitioner has a duty to declare an interest before participatin% in discussion,
$hich could lead to the purchase by a public authority of %oods, or services in $hich
he, or a member of his immediate family, has a direct or indirect pecuniary interest4
'on(disclosure of such information may, under certain circumstances, amount to
infamous conduct in a professional respect4 9here the practitioner has a financial
interest in any facility or service to $hich he refers patients for dia%nostic tests, for
procedures or for in(patient care, it is ethically necessary for him to disclose his
interest in the institution to the patient4
35
B4 In none of the above findin%s does the Ethics ommittee pretend to interfere $ith
the ri%ht of a medical practitioner to be associated 1save as above3 $ith any le%itimate
business enterprise, but if such enterprise concerns the sale of a medicine or food, the
practitioner should not allo$ his professional status or &ualifications to be used for
advertisin% purposes outside the medical press4
R+-5&$0,
A4 Issues of Reprints or Abstracts . The ommittee is fully a$are of the desire of a
pharmaceutical house to establish authenticity for reports on its products and to
support the promotion of the product in all proper $ays4 A possible method of
achievin% this is to issue a reprint or abstract of an article, bearin% the name and
perhaps de%rees and appointment of the re%istered medical practitioner4
@4 The Position of the doctor . The Ethics ommittee considers it as unethical $hen
names of practitioners are associated $ith advertisin% and mar5etin% of proprietary
products4 It appears to the recipients of the material that the names of the authors
$ere bein% placed before them unsolicited and in a prominent manner4 "urther it
leaves the $ay open to firms to sei*e upon this method of use of doctors6 names as
a means of enhancin% their business4 On both these counts, it is felt that the
practitioner author is bein% placed in dan%er of an accusation of unethical conduct4
?4 Reasonable Euotations . The Ethics ommittee raises no ob7ection to reasonable
&uotations so lon% as they are not e!tensive and li5e$ise raises no ob7ection to
reference to doctors6 names in a biblio%raphy of published $or5s4
2C4 9hereas the Ethics ommittee ta5es no ob7ection to the mention of doctors6 names
in a biblio%raphy, the ommittee ta5es e!ception to the use of doctors6 names in a
prominent manner in promotion material, as for e!ample at the headin% of reprints or
abstracts, especially $hen these are circulated as separate items4
224 E!port Promotion . In some forei%n countries, promotion material and sales are not
permitted unless supported by authentic reports bearin% the $riter6s name and
establishin% the clinical uses of the products4
36
2,4 The Ethics ommittee raises no ob7ection to variations of custom of the country
concerned4
M+%&3)* I$,05(4+$0,
2<4 In the course of practice, some doctor desi%n instruments for special purposes and
$ish to ma5e them available for use by their collea%ues4 The best method of placin%
an instrument on the mar5et is to sell the interest outri%ht to a manufacturer; this is
preferable to collectin% royalties4 After the financial interest is renounced, there is no
ob7ection to the inventor6s name bein% attached to the instrument if he so desires4 If,
ho$ever, the demand for the instrument is uncertain, the manufacturer may not be
prepared to buy the interest; in that case the royalty system may be used initially4
N(5,&$< H.4+, )$% M+%&3)* I$,0&0(0&.$,
2-4 There is no ob7ection to the practice of providin% information in the medical press, or
in other publications primarily intended for the medical profession, institutions
professin% to provide medical advice or treatment4 Such information may include the
names and &ualifications of the resident and attendin% medical officers, but there
should be no laudatory statement of the form of treatment %iven or the address of
the consultin% rooms or the hours of a member of the medical staff at $hich he sees
private patients4
2=4 "urther, no e!ception need be ta5en to the association of re%istered medical
practitioners $ith an institution for the treatment of patients by physical therapy and
electrical methods, provided the follo$in% essential conditions are strictly conformed
to .
1i3 That the institution is not in any $ay advertised to the lay public4
1ii3 That the treatment of all patients is under the direct control of a re%istered
medical practitioner $ho accepts full responsibility for their treatment4
37
1iii3 That the relation bet$een the medical officer of the institution and private
practitioners conforms to the usual ethical procedure bet$een consultant and
practitioner4
2B4 If a medical practitioner has a financial interest in any institution to $hich he refers a
patient, it is desirable that he should disclose this fact to the patient4
38
SECTION VI ADVERTISING AND CANVASSING
Modern life brin%s the doctor into contact $ith the %eneral public in numerous $ays, both
directly and indirectly, and raises for him problems of conduct un5no$n to his
predecessors4 The %eneral public interest in medical 5no$led%e, the dissemination of
medical information throu%h radio and television, print, electronic media and press
intervie$, all demand the e!ercise of the utmost caution by the doctor, $hose
professional standards condemn self(advertisement and publicity4
I$%&5+30 M+02.%, .6 A%'+50&,&$<
:ltimate responsibility in all these matters rests $ith the individual concerned, but
practitioners findin% themselves in any difficulty in decidin% upon their course of action
or in doubt as to the safe%uards necessary are advised to see5 %uidance from the
Secretary of the Association4
24 Advertisin% and anvassin% . The practices by a re%istered medical practitioner
1i3 Of advertisin% $hether directly or indirectly for the purpose of obtainin% patients
or promotin% his o$n professional advanta%e; or, for any such purpose, of
procurin% or sanctionin%, or ac&uiescin% in, the publication of notices
commendin% or directin% attention to the practitioner6s professional s5ill,
5no$led%e, services or &ualifications, or deprecatin% those of others; or of bein%
associated $ith, or employed by those $ho procure or sanction such advertisin%
or publication; and
1ii3 Of canvassin% or employin% any a%ent or canvasser or distributin% visitin% cards
for the purpose of obtainin% patients; or of sanctionin%, or of bein% associated
$ith or employed by those $ho sanction, such employment, are discreditable to
the medical profession and are contrary to the public6s interest4
,4 Definition of Advertisin% . The $ord 8advertisin%8 in connection $ith the medical
profession must be ta5en in its broadest sense to include all those $ays by $hich a
person is made publicly 5no$n, either by himself or by others $ithout ob7ection on
his part, in a manner $hich can fairly be re%arded as for the purpose of obtainin%
39
patients or promotin% his o$n professional advanta%e, or as appearin% to be for
these purposes4
<4 Accepted ustoms . It is %enerally accepted by the profession that certain customs
are so universally practiced that it cannot be said that they are for the person6s o$n
advanta%e, as for instance, a doorplate $ith the simple announcement of the
doctor6s name and &ualifications4 Even this, ho$ever, may be abused by undue
particularity or elaboration4
-4 Public )ealth Medical Officers . Publicity is necessary in carryin% out the duties of
medical officers of health and other medical men $ho hold posts in the public health
or other public services4 Provided that this is not used for the individual6s
advancement in his profession, this may be ri%htly allo$ed4
=4 )oldin% of Public Office . It is the reco%ni*ed duty of a medical man to ta5e his share
as a citi*en in public life and to hold public office should he so desires, but it is
essential that the holdin% of public office is not used as a means of advertisin%
himself as a doctor or his professional services4
B4 Statement . It is conceded that practitioners may properly place their vie$s on
medical sub7ects before the public $hen they can do so $ith authority4 In so doin%, it
behoves each one to avoid methods $hich could be fairly re%arded as for the
purpose of obtainin% patients or other$ise promotin% his o$n professional
advanta%e4 It should also be remembered that there are many thin%s innocent in
themselves, $hich may, by the manner or fre&uency of their doin%, %ravely
contravene the principles that medical practitioners should not advertise4
Discussions in the lay press on controversial points of medical science and
treatment should be avoided by practitioners4 Such matters are more appropriate to
medical 7ournals and for discussion in professional societies4
40
A4 Articles, ontributions and Foo5s for the #ay Public .
1i3 The publication of contributions to the lay press and of boo5s or articles on
medical, or semi(medical topics that are of %eneral public interest re&uirin%
medical 5no$led%e for their proper presentation are reco%ni*ed as ethically
le%itimate, sub7ect to the avoidance of methods tendin% to promote the
professional advanta%e of the authors4
1ii3 It is permissible for the author6s name, desi%nation and place of practice
to be published4 These should not be unduly emphasi*ed by lar%e or
heavy type4
1iii3 There must not be any laudatory editorial reference to the author6s
professional status or e!perience4
1iv3 It is necessary strictly to observe those principles of medical eti&uette,
$hich demand modesty concernin% personal attainments and
achievements and courtesy in reference to collea%ues4
1v3 The author should not enter into private correspondence $ith lay readers
on clinical matters arisin% out of his contributions4
1vi3 9here the publication has arisen as a result of research on any
instrument or dru% provided by a commercial firm, this should be stated
and a disclaimer re%ardin% any financial interest of the authors $ith the
firm be inserted4
Irrespective of the vie$s e!pressed above as to $hat could properly appear on the title
pa%e of boo5s or the headin% of an article, the Ethics ommittee is conscious of the fact
that certain contributions may promote the professional advanta%e of the author $ho
must shoulder responsibility for any such result and be prepared if challen%ed to ans$er
for it before a professional tribunal4 The publication of boo5s and articles by a named
author $ho poses as an authority on the treatment of a disease may constitute self(
advertisement and thus be unethical4
41
@4 #ectures to #ay Public .
1i3 It is a $ise precaution for a practitioner $ho proposes to deliver a lecture
to re&uest the hairman beforehand to be circumspect in any
introductory remar5s concernin% his professional status or attainments4
1ii3 There is special reason for care in the presentation of material $hen it is
5no$n in advance that a press reporter is present4 If so, he should
indicate that he does not desire any report of the tal5 to carry his
&ualifications, professional status or place of practice4
1iii3 Such lectures can be publici*ed in any media to inform the public of the
name and appointment of the spea5er as $ell as the venue, date and
time of the lecture4 The place of practice of the spea5er should not be
published as this may be construed as advertisin%4
1iv3 The onus is on the medical practitioner to ensure that the above advice is
follo$ed4
?4 #ectures to Doctors . Medical practitioners may be in a position to educate their
fello$ collea%ues of advances in medical 5no$led%e4 This is laudatory, as the
education of his fello$ collea%ues $ill only lead to benefit the patient4 )o$ever, the
medical practitioner should be$are of some pitfalls, $hich may lead to alle%ations of
association $ith commercial enterprises or advertisin% by his fello$ collea%ues4
)e should ensure that the follo$in% advice is follo$ed .
1i3 Such tal5s are or%ani*ed only throu%h professional bodies or hospitals
and not solely by commercial enterprises4
1ii3 Information about such tal5s may be circulated throu%h the professional
bodies or hospitals only4
42
1iii3 There should not be any laudatory reference to the spea5er6s
professional &ualification, status or e!perience in publicity materials about
the tal54 Medical eti&uette demands modesty concernin% personal
achievements as $ell as courtesy in reference to collea%ues4
1iv3 Any reference to such tal5s in the press should not carry the spea5er6s
&ualifications or place of practice4 It is advisable that the spea5er caution
a%ainst the press reportin% any unproven modalities of mana%ement or
treatment such that it appears that he advocates such treatment to the
public4
It is incumbent upon the practitioner to ensure that the above advice is follo$ed4
2C4 Press Intervie$s . A practitioner should e!ercise the %reatest caution in %rantin%
press intervie$s as it may be construed as self(advertisement4 The same %eneral
principles as applicable to the publication of $ritten articles should be scrupulously
observed4 A seemin%ly innocuous remar5 or casual remar5 is often open to
misinterpretation and easily form the sub7ect of a dama%in% headlines4 This may
place the practitioner in a position of embarrassment4 In certain circumstances, it
may be preferable to promise a prepared statement than to %ive an impromptu
intervie$, or if an intervie$ $ere %ranted, to as5 for an opportunity to approve the
statement in proof before it is published4 It is permissible for the name of the
medical practitioner, desi%nation and place of practice to be published4
224 Photo%raphs . A practitioner6s photo%raph may appear in connection $ith an
intervie$ or an article published in the lay press on professional sub7ects4 Every
reasonable precaution should be ta5en to ensure that such photo%raphs do not
dra$ attention to the professional s5ills or place of practice of the practitioner4
2,4 ondonation of Publicity in the Press . E!ception cannot reasonably ta5en to
publication in the lay press of a doctor6s name in connection $ith a factual report of
events of public concern4 On occasion, ho$ever, in press reports, articles, or social
columns, statements are made commentin% favorably on the professional activities
or success of medical practitioners4
43
These statements cannot fail to place the named practitioner in a critical and
embarrassin% situation, and should not be allo$ed to pass unchallen%ed4 It is $ise
precaution for a doctor $ho is involved in an event of public interest to inform the
media coverin% the event to be circumspect in their remar5s and not print anythin%
that may be constructed as advertisin%4
2<4 Advertisements in the #ay Press .
1i3 'o member shall publish any advertisement concernin% his profession or
practice e!cept throu%h the Ethics ommittee of the Malaysian Medical
Association4 Advertisements shall be confined to announcements of
commencement of practice, resumption of practice, chan%e of address,
or chan%e of telephone number or such other conditions of practice as
are from time to time approved by the Ethics ommittee4 The Ethics
ommittee shall determine the number of insertions of any such
advertisement and such insertions shall be in consecutive issues of the
ne$spaper or ne$spapers circulated in Malaysia and shall be inserted
simultaneously4 Any member desirin% an advertisement to be published
shall for$ard the necessary particulars to the )onorary Secretary of the
Ethics ommittee $ho shall, sub7ect to the control of the Ethics
ommittee, prepare the advertisement and arran%e for its publication4
The )onorary Secretary of the Ethics ommittee shall inform the member
of the cost of the advertisement, $hich shall be paid to the )onorary
Secretary of the Ethics ommittee forth$ith4
1ii3 Every such advertisement shall be 8run on8 $ithout spacin% and $ithout
display or not lar%er than , columns by B centimeters4 The type shall be
that used for non(displayed advertisement of the ne$spaper in $hich it is
inserted4 The name shall be in the same type as the rest of the
advertisement4 #etters of abbreviation or $ords indicatin% medical,
sur%ical or other &ualifications, shall not be added, nor the name of any
&ualifyin% body or university or colle%e4
44
1iii3 "or the purposes of this Fy(#a$s, 8chan%e of address8 shall mean,
8chan%e of place of practice $ithin Malaysia8, 8commencement of
practice8 shall mean 8commencement of practice in Malaysia8,
8resumption of practice8 shall mean 8resumption of practice in Malaysia
after an absence of more than thirty days84
1iv3 The $ord 8ne$spaper8 shall mean daily ne$spapers as approved by the
Ethics ommittee from time to time4
2-4 Froadcastin%, Telecommunications, Television and Electronic Media
1i3 The Association accepts the vie$ held by many in the profession that
medical practitioners $ho possess the necessary 5no$led%e and talent
should be permitted to participate in pro%rammes throu%h
telecommunications, radio, television and electronic media, provided they
observe appropriate ethical safe%uards and do not see5 to place
themselves in an advanta%eous position over their collea%ues4
1ii3 The public has le%itimate interest in the advances made in science and
art of medicine and it is of advanta%e that medical information, discreetly
presented, should reach the public throu%h the medium of broadcastin%,
telecommunications, television and the electronic media both for the
%eneral instruction of the en&uirin% layman and for the particular purpose
of 8health education84 /reat caution is necessary in public discussion on
theories and treatment of disease o$in% to the misleadin% interpretation
that may be put upon these by an uninformed public to the subse&uent
embarrassment of the individual doctor and the individual patient4
1iii3 All practitioners ta5in% part in such pro%rammes should observe
appropriate ethical safe%uards such as not directin% attention to the
practitioner6s professional s5ills, 5no$led%e, services or &ualifications or
deprecatin% those of others4 9here patients or health facilities are
involved in the pro%ramme prior consent from such parties should be
obtained4
45
1iv3 Association of Medical Practitioners $ith ommercial Enterprises .
The Ethics ommittee disapproves of the direct association of a medical
practitioner $ith any commercial enterprise en%a%ed in the manufacture
or sale of any substance $hich is claimed to be of value in the prevention
or treatment of disease and $hich is recommended to the public in such
a fashion as to be calculated to encoura%e the practice of self(dia%nosis
and of self(medication or is of undisclosed nature or composition4
The Ethics ommittee ta5es a similar vie$ of the association of a medical
practitioner $ith any system or method of treatment $hich is not under
medical control and $hich is advertised in the public press4 In neither of
the above findin%s does the Ethics ommittee pretend to interfere $ith
the ri%ht of a medical practitioner to be associated 1save as above3 $ith
any le%itimate business enterprise, but if such enterprise concerns the
sale of a medicine or food, the practitioner should not allo$ his
professional status or &ualifications to be used for advertisin% purposes
outside the medical press4
This remains the policy of the Association4 )ence, conse&uently, it is
unethical for a practitioner to participate in such pro%rammes, $hich are
bein% presented for, or on behalf of, firms usin% the above media as a
means of advertisin%4
1v3 There is a $ide ran%e of sub7ects unrelated, or only remotely related, to
the practice of medicine $here there may $ell be no ob7ection to the
announcement of the name and desi%nation of a doctor $ho is an
authority on the particular sub7ect4 There should be nothin% in the
announcement or presentation of the sub7ect, $hich could be re%arded as
promotin% his professional advanta%e4
2=4 E!ample of Senior Practitioners4 There is a special duty upon practitioners of
established position and authority to observe these conditions, for their e!ample
must necessarily influence the action of their less reco%ni*ed collea%ues4
46
2B4 Dan%ers . The particulars in each of these fields of activity are referred to the
precedin% para%raphs4 Fut, in every case, the %uidin% principles should be that a
practitioner should not sanction or ac&uiesce in anythin% $hich comments or directs
attention to his professional s5ill, 5no$led%e, services, or &ualifications, or
deprecates those of others or be associated $ith those $ho procure or sanction
such advertisin% or publicity4
2A4 /eneral . After ma5in% all allo$ances for all those modes of publicity for $hich there
may be some 7ustification, there remain many instances $hich can be re%arded as
contravenin% the spirit of The ode4 The Association is convinced that in ta5in% up
the attitude of determined opposition to undesirable methods of publicity, it is actin%
in the best interest of the public as $ell as of the medical profession4 Advertisin% by
the profession in %eneral $ould certainly destroy those traditions of di%nity and self(
respect, $hich have helped to %ive the medical profession its hi%h status4 The
Association, therefore, dra$s the attention of the profession to the dan%er of these
ob7ectionable methods, and stresses the need for every member of the professional
to offer a firm resistance to them4
2@4 Participation in any form of mar5etin% schemes, involvin% free %ifts, discounts and
other forms of inducements to attract patients, is considered unethical4

47
SECTION VII SETTING UP PRACTICE
S+00&$< U- P5)30&3+
24 Even in the absence of an a%reement, there is an ethical obli%ation on a doctor not
to dama%e the practice of a collea%ue $ith $hom he has been en%a%ed lately in
professional association4
,4 :nless the $ritten consent of the principal or partner or partners is obtained, a
doctor $ho has acted as an assistant to or locum tenens for that principal or as a
member of a partnership should not set up in practice in opposition to his former
principal or partner in the area of practice of that principal or partner4 A course of
action ta5en by a doctor may not be contrary to the la$, yet may be considered
unethical by his collea%ues to such a de%ree as to constitute %rounds for a formal
complaint to the Association4
<4 As locum tenens are introduced in confidence to the practice of $hich he ta5es
char%e, it must be presumed on principles of common e&uity that he cannot, $ithout
dishonour, commence practice in the nei%hbourhood $here he has acted unless
$ith a $ritten consent obtained either from the practitioner $hose substitute he has
been or from the le%al representatives of his practitioner4 If any such plea for the
rela!ation of the rule in any individual case can be advanced, the facts should be
stated to the Ethics ommittee and the 7ud%ement of the Ethics ommittee on the
point be accepted as final4
N.0&3+,
-4 A practitioner commencin% practice is allo$ed to announce this in the press only
throu%h the MMA and as specified under Section 0I 12<34
=4 "rom time to time, it may happen that a doctor, $hether in %eneral or consultant
practice, $ishes to ma5e some formal announcement about his practice to his
patients or his collea%ues4 A %eneral practitioner, for e!ample, may need to notify
his patients of a chan%e of address or of sur%ery or consultin% hours, or perhaps he
may be chan%in% to consultant practice4 In any such case, the notification should
48
be sent as a circular letter, under cover, to the patients of the practice, that is, to
those $ho are on its boo5s and are not 5no$n to have transferred themselves to
another doctor4 There is no ob7ection to a suitable notice bein% placed in the
$aitin% room4
B4 On no account should the lay press be used for the purpose of ma5in% an
announcement4 Even if a rumour or an ill(informed statement in a ne$spaper
appears to re&uire correction, the doctor should still refrain from ma5in% any
comment to the press4 )e should instead see5 advice from the MMA4
A4 A practitioner $ho $ishes to dra$ the attention of his collea%ues in the profession
to the fact that he has recently commenced or intends to practice any particular
branch of medical or sur%ical $or5, or to ac&uaint his collea%ues of the services he
proposes to ma5e available, may do so in any or all of the follo$in% $ays .
1i3 Fy callin% upon practitioners already established in the area and %ivin% a
personal e!planation of his arran%ements and plans;
1ii3 Fy sendin% a sealed postal notification to those practitioners $ho may be
e!pected to be interested, provided such a communication contains no
laudatory allusion to himself or his $or5;
1iii3 Fy communications on professional sub7ects presented to the local
branch of the MMA or to other medical or%ani*ations; and
1iv3 Fy sendin% reprints of his published $or5 to those practitioners $ho may
be e!pected to be interested4
1v3 Fy publication in the Ferita MMA+MGM $ithin %uidelines set by the Ethics
ommittee4
49
P5+4&,+
@4 In selectin% the premises for his sur%ery, a doctor should preserve the di%nity of his
profession and bear in mind certain ethical considerations4
?4 The sharin% of the premise by medical practitioners and non(medical practitioners is
unethical4
N)4+-*)0+,
2C4 1i3 'ameplates shall be plain and shall not e!ceed ?<C4,= s&4 cm 12 s&4
ft3 in area4
1ii3 The nameplate may bear the follo$in% .
The medical practitioner6s name
)is re%istrable &ualifications in small letters
)is title+s if any
1iii3 There is no ob7ection to the inclusion of phrases such as 8Sur%eon8,
8Psychiatrist8, by a practitioner $ho is solely en%a%ed in the practice of
that specialty4
1iv3 "or every additional practitioner, an additional nameplate conformin% to
the above mentioned standards may be e!hibited4
1v3 'ameplates of practitioners $ho do not practice in the clinic should not be
e!hibited4 0isitin% practitioners may have their nameplates, provided the
day1s3 and hour1s3 of practice are stated4
1vi3 A separate si%nboard to indicate consultation hours not e!ceedin%
?<C4,=(s&4 cm 12 s&4 ft3 is permitted4
50
224 9here it is considered necessary for an assistant to have his o$n nameplate, the
normal rules relatin% to plates continue to apply4
S&<$/.)5%,
2,4 The use of a lar%e si%nboard to indicate a private medical practice is considered
unethical in many parts of the $orld4 )o$ever, as the custom is already prevalent
in Malaysia, and as a si%nboard does help patients to find a doctor, it is
recommended that their use should continue, provided .
1i3 There shall not be more than t$o si%nboards to indicate the identity of the
practice4
1ii3 Si%nboards may be illuminated4
1iii3 The total si*e of the si%nboard or si%nboards, if there are t$o, shall not
e!ceed ,4A@A s&4 meters 1<C(s&4 ft34
1iv3 9here si%ns are painted on $alls, the perimeter of the letterin% should
not enclose an area in e!cess of those specified in 2< 1iii34
1v3 9hen the practice is $ithin a commercial comple!, there is no ob7ection
to the clinic name appearin% in the %eneral directory si%nboard in the
lobby4
1vi3 The use of the $ord 8Pharmacy8 bein% a contravention of the Pharmacy
Act, its use is ille%al unless the premise is in fact a Dispensin%
Pharmaceutical hemists Shop4
1vii3 The use of the Red ross+Red rescent on any private medical premise
is a contravention of the /eneva onvention and is ille%al4
51
24 H.(5, C*&$&3
2<4 'o additional si%nboards are permitted4
2-4 'otification of the availability of ,-(hour service should be on the nameplate
pertainin% to consultation hours or on the e!istin% clinic si%nboards4
2=4 Eualified and re%istered practitioners should be available at all times and his
availability should be $ithin a reasonable period of time, not e!ceedin% thirty 1<C3
minutes4
2B4 A practitioner may not operate more than one ,-(hour clinic at the same time4
2A4 In the event that an emer%ency arises, re&uirin% the practitioner to be called a$ay,
the clinic should do one of the follo$in% .
2A42 not to accept any ne$ patients until the practitioner is bac5 in the clinic;
2A4, inform intendin% patients that the practitioner is not available4
M)0+5$&01 H.4+
2@4 Since maternity homes provide ,- hours services, the above re%ulations in respect
of ,-(hour clinic $ould also apply to maternity homes4
T+*+-2.$+ D&5+30.5&+,
2?4 Doctors are sometimes uncertain about the form of entry they should allo$ in
telephone directories4 The entry form should appear in the ordinary small type4 'o
special type or special entry should be permitted4
,C4 There is no ob7ection on ethical %rounds to the listin% of professional telephones in
the Hello$ Pa%es of the Telephone Directory, provided they conform to the
follo$in% provisions .
52
1i3 'ame and address of clinic and telephone number+s are allo$ed4
1ii3 Address, telephone numbers of doctors6 practices and residence are
allo$ed4
1iii3 'ames, addresses and telephone numbers of branch practices are
allo$ed4
1iv3 Emer%ency ans$erin%(service telephone number+s and pa%er numbers
are allo$ed4
1v3 All entries in the Hello$ Pa%es must be classified only under the headin%
8Medical Practitioners ( Re%istered84
1vi3 'o entry pertainin% to clinics in the Hello$ Pa%es must be classified
under other headin%s, e4%4 clinics, doctors, opticians, contact lens
practitioners, etc4
1vii3 'o entry pertainin% to clinic hours is permitted4
All entries should appear in ordinary small type4 'o bold types, special display,
bo!ed entries shall be permitted for a doctor or his practice4
All entries listed under 8Re%istered Medical Practitioners8 should be confined to
doctors re%istered $ith the MM and should not include homeopathy practitioners,
dental practitioners, traditional medicine practitioners, etc4
L.3)* D&5+30.5&+,
,24 It is permissible for a doctor6s name to be included in a handboo5 of local
information, purportin% to contain a list of all local medical practitioners, provided
the list is open to the $hole of the profession in the area and publication of names
is not dependent on the payment of a fee4
53
P5.6+,,&.$)* C)**&$< C)5%,
,,4 allin% card should only contain the name of the practitioner, re%istrable
professional &ualifications, state and national a$ards, home, practice and
email address1es3, telephone and facsimile numbers4 It $ould be unethical to use
callin% cards to solicit patients4
L+00+52+)%,
,<4 The letterhead may contain the name of the clinic, address1es3, telephone and fa!
numbers, email address and the names of the doctors practicin% in that clinic $ith
their re%istrable &ualifications, state and national a$ards and clinic hours4
B)$$+5,
,-4 A temporary banner to announce the openin% of a ne$ clinic+hospital may be
allo$ed for the purpose of public information4 The si*e should conform to that
allo$ed for a si%nboard4 It should not be displayed for a period lon%er than one 123
calendar month prior to the date for openin%4 The banner is only permitted to be
displayed at the entrance of the premise4 It should only contain the date of openin%
and the name of the clinic+hospital4 Any other information is unethical4
54
SECTION VIII ETHICS COMMITTEE OF MMA
R.*+ )$% O/B+30&'+,
24 To promote ethical conduct and provide counsel and advice for medical
practitioners4
,4 To offer advice and counsel to medical practitioners involved in activities that may be
construed or are a breach of ethics4
<4 To educate medical practitioners and the medical community on desirable ethical
conduct4
-4 To deliberate and $here possible resolve amicably disputes involvin% issues on
ethics4
=4 To advise ouncil on the ethical implications of issues, $hich it may be, re&uired to
ta5e a position4
D&,-(0+, /+0:++$ D.30.5,
24 "rom time to time, doctors $or5in% to%ether in a practice or in the same locality find
themselves at variance $ith one another4 "riction may arise in many $ays and often
&uite unnecessarily4 "or instance, clashes of personality and temperament bet$een
doctors in nei%hbourin% practices may ma%nify triflin% differences into an%ry
&uarrels; the hasty acceptance from patients of rumours or uncorroborated reports
of another doctor6s utterances or actions may lead the practitioner to ma5e un7ust
accusations a%ainst a collea%ue4 If animosities are allo$ed to fester, they not only
embitter local practice but also dama%e the reputation of the profession in the eyes
of the public4 It is important, therefore, that disputes should be resolved &uic5ly
$ithin the profession itself; and $henever possible, amicably4
,4 Most of these disputes concern relationships not %overned by la$ but by the
traditions of the profession and harmony can be best restored by reference to some
medical person or authority $ith e!tensive 5no$led%e and e!perience of medical
55
ethics and customs4 To provide the profession $ith an ad7udicatin% body, the
Association, throu%h the Ethics ommittee, has devised 8ethical machinery8 based
on the e!perience of many years4 The procedure should not be re%arded as a
7udicial trial but as a service attemptin% reconciliation throu%h impartial ad7udication4
<4 The machinery consists of the Ethics ommittee itself, $hich is a standin%
committee of the ouncil $ith detailed uniform rules of procedure for the
investi%ation of complaints4
-4 Friefly, the complainant must $rite to the respondent 1statin% the complaint in terms
sufficiently specific to enable the respondent to reply3 and intimatin% that he
contemplates the initiation of a complaint throu%h the ethical machinery of the
Association4 A copy of the letter of complaint, to%ether $ith any reply, must be
submitted to the )onorary Secretary of the appropriate branch of the Association4
The )onorary Secretary must then send the correspondence to the )ead Office and
obtain instructions on the steps to be ta5en in dealin% $ith the matter and must ta5e
no other action $hatsoever in connection $ith the complaint e!cept that prescribed
in the advice and instructions he receives from the )ead Office4 The Association
$ill not accept responsibility for any conse&uence in ethical proceedin%s not so
referred4
D&,-(0+, /+0:++$ ) D.30.5 )$% H&, P)0&+$0
=4 9here a dispute arises bet$een a doctor and his patient and a complaint is brou%ht
to the Ethics ommittee, the doctor should respond to &ueries of the Ethics
ommittee as soon as possible, as provided in the Rules of the Ethics ommittee
1see MMA onstitution ( Articles I Fy(#a$s34
56
APPENDI# I
PERSPECTIVES IN MEDICAL ETHICS
A7 T2+ H&--.35)0&3 O)02
9hile the methods and details of medical practice chan%e $ith the passa%e of time and
the advance of 5no$led%e, the fundamental principles of professional behaviour have
remained unaltered throu%h the recorded history of medicine4 "rom time to time,
attempts have been made to codify the standard of conduct e!pected of the doctor in
the practice of his profession, the most celebrated bein% that attributed to )ippocrates in
the =th entury F44 This ta5es the form of an oath intended to be affirmed by each
doctor on entry to the medical profession, and in translation reads as follo$s .
8I s$ear by Apollo the physician, and Aesculapius and )ealth, and All(heal, and all the
%ods and %oddesses, that, accordin% to my ability and 7ud%ement, I $ill 5eep his Oath
and this stipulation ( to rec5on him $ho tau%ht me this Art e&ually dear to me as my
parents, to share my substance $ith his, and relieve his necessities if re&uired; to loo5
upon his offsprin% in the same footin% as my o$n brothers, and to teach them this Art, if
they shall $ish to learn it, $ithout fee or stipulation; and that by precept, lecture, and
every other mode of instruction, I $ill impart a 5no$led%e of the Art to my o$n sons, and
those of my teachers, and to disciples bound by a stipulation and oath accordin% to the
la$ of medicine, but to none others4 I $ill follo$ that system of re%imen $hich,
accordin% to my ability and 7ud%ement, I consider for the benefit of my patients, and
abstain from $hatever is deleterious and mischievous4 I $ill %ive no deadly medicine to
anyone if as5ed, nor su%%est any such counsel; and in li5e manner I $ill not %ive to a
$oman a pessary to produce abortion4 9ith purity and $ith holiness, I $ill pass my life
and practice my Art4 I $ill not cut persons labourin% under the stone, but $ill leave this
to be done by men $ho are practitioners of this $or54 Into $hatever houses I enter, I $ill
%o into them for the benefit of the sic5, and $ill abstain from every voluntary act of
mischief and corruption; and, further, from the seduction of females or males, of
freemen or slaves4 9hatever, in connection $ith my professional practice, or not in
connection $ith it, I see or hear, in the life of men, $hich ou%ht not to be spo5en of
abroad, I $ill not divul%e, as rec5onin% that all such should be 5ept secret4 9hile I
57
continue to 5eep this Oath unviolated, may it be %ranted to me to en7oy life and the
practice of the Art, respected by all men, in all fumes4 Fut should I trespass and violate
this Oath, may the reverse be my lot48
This Oath has endured throu%h the centuries, and $hether or not the modern doctor
formally affirms it at &ualification, he accepts its spirit and intentions as his ideal
standard of professional behaviour4
B7 I$0+5$)0&.$)* C.%+ .6 M+%&3)* E02&3,
The lapses from the )ippocratic ideal on the part of the profession in certain countries
durin% the Second 9orld 9ar and the perpetration of crimes a%ainst the individual in the
name of race or reli%ion have sho$n the need for a modern restatement of the Oath and
a rea$a5enin% of the sense of the hi%h callin% and the ethical responsibilities of the
doctor4 Accordin%ly, one of the first acts of the 9orld Medical Association, formed in
2?-A, $as to produce a modern restatement of the )ippocratic Oath, 5no$n as the
8Declaration of /eneva8 and to base upon it an International ode of Medical Ethics
$hich applies both in times of peace and $ar4
The En%lish te!t of the International ode of Medical Ethics is as follo$s .
D(0&+, .6 D.30.5, 0. 02+ S&3C
1i3 A DOTOR M:ST A#9AHS bear in mind the obli%ations of preservin% human life4
1ii3 A DOTOR O9ES to his patient complete loyalty and all the resources of his
science4 9henever an e!planation or treatment is beyond his capacity, he should
summon another doctor $ho has the necessary ability4
1iii3 A DOTOR S)A## preserve absolute secrecy on all he 5no$s about his patient
because of the confidence entrusted to him4
1iv3 A DOTOR M:ST %ive emer%ency care as a humanitarian duty unless he is
assured that others are $illin% and able to %ive such care4
58
D(0&+, .6 D.30.5, &$ G+$+5)*
1i3 A DOTOR M:ST al$ays maintain the hi%hest standards of professional conduct4
1ii3 A DOTOR M:ST practice his profession uninfluenced by motives of profit4
1iii3 T)E "O##O9I'/ PRATIES are deemed unethical .
1a3 Any self(advertisement e!cept such as is e!pressly authori*ed by the
'ational ode of Medical Ethics4
1b3 ollaboratin% in any form of medical service in $hich the doctor does not
have professional independence4
1c3 Receivin% any money in connection $ith services rendered to a patient
other than a proper professional fee, even $ith the 5no$led%e of the
patient4
1iv3 A'H AT, OR AD0IE $hich could $ea5en the physical or mental resistance of a
human bein% may be used only in his interest4
1v3 A DOTOR IS AD0ISED to use %reat caution in divul%in% discoveries or ne$
techni&ues of treatment4
1vi3 A DOTOR S)O:#D certify or testify only to that $hich he has personally verified4
59
D(0&+, .6 D.30.5, 0. E)32 O02+5
1i3 A DOTOR O:/)T to behave to his collea%ues as he $ould have them behave to
him4
1ii3 A DOTOR M:ST 'OT entice patients from his collea%ues4
1iii3 A DOTOR M:ST OFSER0E the principles of 8The Declaration of /eneva8
approved by the 9orld Medical Association4
Source : World Medical Association, 1947
D+3*)5)0&.$ .6 G+$+')
At the time of bein% admitted as Member of the Medical Profession .
1i3 I solemnly pled%e myself to consecrate my life to the service of humanity;
1ii3 I $ill %ive to my teachers the respect and %ratitude $hich is their due;
1iii3 I $ill practice my profession $ith conscience and di%nity;
1iv3 The health of my patient $ill be my first consideration;
1v3 I $ill respect the secrets, $hich are confided to me;
1vi3 I $ill maintain by and the means in my po$er the honour and the noble traditions of
the medical profession;
1vii3 My collea%ues $ill be my brothers;
1viiii3 I $ill not permit considerations of reli%ion, nationality, race, party politics or social
standin% to intervene bet$een my duty and my patient;
60
1i!3 I $ill maintain the utmost respect for human life from the time of conception; even
under threat, I $ill not use my medical 5no$led%e contrary to the la$s of humanity;
1!3 I ma5e these promises solemnly, freely and upon my honour4
Source : World Medical Association, 1948, 1968, 1983
OATHSAGUIDELINES OF DIFFERENT CULTURES
MUSLIM
T2+ O)02 .6 ) M(,*&4 P21,&3&)$
In the name of Allah, Most /racious, Most Merciful
Praise be to Allah, the Sustainer of )is reation, the All(>no$in%
/lory be to him, the Eternal, the All(Pervadin%
O Allah, Thou art the only )ealer,
I serve none but Thee, and, as the instrument of
Thy 9ill, I commit myself to Thee
I render this Oath in Thy )oly 'ame and I underta5e .
To be the instrument of Thy 9ill and Mercy, and, in all humbleness, to e!ercise 7ustice,
love and compassion for all Thy reation; To e!tend my hand of service to one and all,
to the rich and to the poor, to friend and foe ali5e, re%ardless of race, reli%ion or colour;
To hold human life as precious and sacred, and to protect and honour it at all times and
under all circumstances in accordance $ith Thy #a$; To do my utmost to alleviate pain
and misery, and to comfort and counsel human bein%s in sic5ness and in an!iety; To
respect the confidence and %uard the secrets of all patients; To maintain the di%nity of
health care, and to honour the teachers, students, and members of my profession; To
strive in the pursuit of 5no$led%e in Thy name for the benefit of man5ind, and to uphold
human honour and di%nity; To ac&uire the coura%e to admit my mista5es, mend my
$ays and to for%ive the $ron%s of others; To be ever(conscious of my duty to Allah and
)is Messen%er 1S4A493, and to follo$ the precepts of Islam in private and in public4
61
O Allah, %rant me the stren%th, patience and dedication to adhere to this Oath at all
times4
Source : World Conference of Islamic Medical Associations, Kuait, 1981
T2+ O)02 .6 02+ D.30.5
I s$ear by /od44444444The /reat
To re%ard /od in carryin% out my profession
To protect human life in all sta%es and under all circumstances, doin% my utmost to
rescue it from death, malady, pain and an!iety44
To 5eep peoples6 di%nity, cover their privacies and loc5 up their secrets44
To be, all the $ay, an instrument of /od6s mercy, e!tendin% my medical care to near
and far, virtuous and sinner and friend and enemy44
To strive in the pursuit of 5no$led%e and harnessin% it for the benefit but not the harm of
Man5ind44
To revere my teacher, teach my 7unior, and be a brother to members of the Medical
Profession 7oined in piety and charity44
To live my "aith in private and in public, avoidin% $hatever blemishes me, in the eyes of
/od, )is apostle and my fello$ "aithful4
And may /od be $itness to this Oath4
Source : !irst International Conference of Islamic Medicine, Kuait, 1981
62
CHINESE
FIVE COMMANDMENTS
24 Physicians should be ever ready to respond to any calls of patients, hi%h or lo$, rich
or poor4 They should treat them e&ually and care not for financial re$ard4 Thus
their profession $ill become prosperous naturally day by day and conscience $ill
remain intact4
,4 Physicians may visit a lady, $ido$ or nun only in the presence of an attendant but
not alone4 The secret diseases of female patients should be e!amined $ith a ri%ht
attitude, and should not be revealed to anybody, not even to the physician6s o$n
$ife4
<4 Physicians should not as5 patients to send pearl, amber or other valuable
substances to their home for preparin% medicament4 If necessary, patients should
be instructed ho$ to mi! the prescriptions themselves in order to avoid suspicion4 It
is also not proper to admire thin%s $hich patients possess4
-4 Physicians should not leave the office for e!cursion and drin5in%4 Patients should be
e!amined punctually and personally4 Prescriptions should be made accordin% to the
medical formulary, other$ise a dispute may arise4
=4 Prostitutes should be treated 7ust li5e patients from a %ood family and %ratuitous
services should not be %iven to the poor ones4 Moc5in% should not be indul%ed for
this brin%s loss of di%nity4 If the case improves, dru%s may be sent but physicians
should not visit them a%ain for le$d re$ard4
"ef# : C$en S$i$%Kun& % An 'rt$odo( Manual of Sur&er), circa 1613
Source : Cross%Cultural *ers+ecti,e in Medical
-t$ics : "eadin&s, "o.ert M /eact$, 1989
63
TEN REDUIREMENTS
24 A physician or sur%eon must first 5no$ the principles of the learned4 )e must study
all the ancient standard medical boo5s ceaselessly day and ni%ht, and understand
them thorou%hly so that the principles enli%hten his eyes and are impressed in his
heart4 Then he $ill not ma5e any mista5e in the clinic4
,4 Dru%s must be carefully selected and prepared accordin% to the refinin% process of
#ei >un%4 Remedies should be prepared accordin% to the pharmaceutical formulae
but may be altered to suit the patient6s condition4 oncoctions and po$ders should
be freely made4 Pills and distilled medicine should be prepared in advance4 The
older the plaster is, the more effective it $ill be4 Tampons become more effective on
standin%4 Don6t spare valuable dru%s; their use is eventually advanta%eous4
<4 A physician should not be arro%ant and insult other physicians in the same district4
)e should be modest and careful to$ards his collea%ues; respect his seniors, help
his 7uniors, learn from his superiors and yield to the arro%ant4 Thus, there $ill be no
slander and hatred4 )armony $ill be esteemed by all4
-4 The mana%in% of a family is 7ust li5e the curin% of a disease4 If the constitution of a
man is not $ell cared for and becomes over(e!hausted, diseases $ill attac5 him4
Mild ones $ill $ea5en this physi&ue, $hile serious ones may result in death4
Similarly, if the foundation of the family is not firmly established and e!trava%ance is
indul%ed in, reserves $ill %radually drain a$ay and poverty $ill come4
=4 Man receives his fate from )eaven4 )e should not be un%rateful to the )eavenly
decree4 Professional %ains should be approved by the conscience and conform to
the )eavenly $ill4 If the %ain is made accordin% to the )eavenly $ill, natural affinity
ta5es place4 If not, offsprin% $ill be condemned4 Is it not better to ma5e li%ht of
professional %ain in order to avoid the evil retribution4
B4 /ifts, e!cept in the case of $eddin%s, funerals and for the consolation of the sic5,
should be simple4 One dish of fish and one of ve%etable $ill suffice for a meal4
This is not only to reduce e!penses but also to save provisions4 The virtue of a man
lies not in %raspin% but rather in economy4
64
A4 Medicine should be %iven free to the poor4 E!tra financial help should be e!tended
to the destitute patients, if possible4 9ithout food, medicine alone cannot relieve
the distress of a patient4
@4 Savin%s should be invested in real estate but not in curios and unnecessary
lu!uries4 The physician should also not 7oin the drin5in% club and the %amblin%
house, $hich $ould hinder his practice4 )atred and slander can thus be avoided4
?4 Office and dispensary should be fully e&uipped $ith necessary apparatus4 The
physician should improve his 5no$led%e by studyin% medical boo5s, old and ne$,
and readin% current publications4 This really is the fundamental duty of a physician4
2C4 A physician should be ready to respond to the call of %overnment officials $ith
respect and sincerity4 )e should inform them the cause of the disease and
prescribe accordin%ly4 After healin%, he should not see5 for a complimentary tablet
or plead e!cuse for another6s difficulty4 A person $ho respects the la$ should not
associate $ith officials4
"ef# : C$en S$i$%Kun&# An 'rt$odo( Manual of Sur&er), circa 1613
Source : Cross Cultural *ers+ecti,e in Medical
-t$ics : "eadin&s, "o.ert M /eact$, 1989
65
P5.6+,,&.$)* E02&3, &$ A$3&+$0 I$%&)$ M+%&3&$+
hara5a Samhita contains an Anushasana ( the Atreya Anushasana 1seventh century
F3 ( predatin% the famous )ippocratic Oath by t$o centuries4 This oath bears
testimony to the hi%h level of professional ethics in ancient India4
The ancient oath from the hara5a 1or hara5a, as this translator spells it3 Samhita of
$hich >4 R4 Sri5anta Murthy spo5e deserves closer e!amination4 The translation
presented here is by A4 Menon and )4 "4 )aberman4 It reveals some uni&uely )indu
elements such as the obli%ation to remain celibate, eat no meat, and carry no arms4
haracteristics of )indu thou%hts, there is an e!plicit prohibition on causin% another6s
death4 There are some passa%es remar5ably similar to )ippocratic commitments 1the
commitment to be devoted entirely to brin% helpful to the patient3, but there are also
some dramatic contrasts4 'ote especially the re&uirements that 8'o persons $ho are
hated by the 5in% or $ho are haters of the >in% or $ho are hated by the public or $ho
are haters of the public shall receive treatment48 An understandin% of the )indu doctrine
of 5arma, of rebirth in a position based on the $ay one has led his previous life, may be
necessary to understand the moral meanin% of such a sentence4
O)02 .6 I$&0&)0&.$
"ROM T)E ARA>A SAM)ITA
24 The teacher then should instruct the disciple in the presence of the sacred fire,
Frahmanas 1Frahmins3 and physicians4
,4 1sayin%3 8Thou shalt lead the life of a celibate, %ro$ thy hair and beard, spea5 only
the truth, eat no meat, eat only pure articles of food, be free from envy and carry no
arms4
<4 There shalt be nothin% that thou should not do at my behest e!cept hatin% the 5in%,
causin% another6s death, or committin% an act of %reat unri%hteousness or acts
leadin% to calamity4
66
-4 Thou shalt dedicate thyself to me and re%ard me as thy chief4 Thou shalt be sub7ect
to me and conduct thyself forever for my $elfare and pleasure4 Thou shalt serve
and d$ell $ith me li5e a son or a slave or a supplicant4 Thou shalt behave and act
$ithout arro%ance, $ith care and attention and $ith undistracted mind, humility,
constant reflection and un%rud%in% obedience4 Actin% either at my behest or
other$ise, thou shalt conduct thyself for the achievement of thy teacher6s purposes
alone, to the best of thy abilities4
=4 If thou desire success, $ealth and fame as a physician and heaven after death, thou
shalt pray for the $elfare of all creatures be%innin% $ith the co$s and Frahmanas4
B4 Day and ni%ht, ho$ever thou mayest be en%a%ed, thou shalt endeavour for the relief
of patients $ith all thy heart and soul4 Thou shalt not desert or in7ure thy patient for
the sa5e of thy life or thy livin%4 Thous shalt not commit adultery even in thou%ht4
Even so, thou shalt not covet others6 possessions4 Thou shalt be modest in any
attire and appearance4 Thou shouldst not be a drun5ard or a sinful man nor
shouldst thou associate $ith the abettors of crimes4 Thou shouldst spea5 $ords that
are %entle, pure and ri%hteous, pleasin%, $orthy, true, $holesome and moderate4
Thy behaviour must be in consideration of time and place and heedful of past
e!perience4 Thou shalt act al$ays $ith a vie$ to the ac&uisition of 5no$led%e and
fullness of e&uipment4
A4 'o persons, $ho are hated by the 5in% or $ho are haters of the 5in% or $ho are
hated by the public or $ho are haters of the public shall receive treatment4 Similarly,
those $ho are e!tremely abnormal, $ic5ed and of miserable character and conduct,
those $ho have not vindicated their honour, those $ho are at the point of death, and
similarly $omen $ho are unattended by their husbands or %uardians shalt not
receive treatment4
@4 'o offerin% of presents by a $oman $ithout the behest of her husband or %uardian
shalt be accepted by thee4 9hile enterin% the patient6s house, thou shalt be
accompanied by a man $ho is 5no$n to the patient and $ho has his permission to
enter; and thou shalt be $ell(clad, bent of head, self(possessed, and conduct thyself
only after repeated consideration4 Thou shalt thus properly ma5e thy entry4 )avin%
entered thy speech, mind, intellect and senses, thou shalt be entirely devoted to no
67
other thou%ht than that of bein% helpful to the patient and of thin%s concernin% only
him4 The peculiar customs of the patient6s household shalt not be made public4
Even 5no$in% that the patient6s span of life has come to its close, it shalt not be
mentioned by thee there, $here if so done, it $ould cause shoc5 to the patient or to
others4
Thou%h possessed of 5no$led%e, one should not boast very much of one6s
5no$led%e4 Most people are offended by the boastfulness of even those $ho are
other$ise %ood and authoritative4
?4 There is no limit at all to the Science of #ife, Medicine4 So thou shouldst apply
thyself to it $ith dili%ence4 This is ho$ thou should act4 Also thou shouldst learn the
s5ill of practice from another $ithout carpin%4 The entire $orld is the teacher to the
intelli%ent and the foe to the unintelli%ent4 )ence, 5no$in% this $ell, thou shouldst
listen and act accordin% to the $ords of instruction of even an unfriendly person,
$hen his $ords are $orthy and of a 5ind as to brin% to you fame, lon% life, stren%th
and prosperity4
2C4 Thereafter, the teacher should say this ( 8Thou shouldst conduct thyself properly $ith
the %ods, sacred fire, Frahmanas, the %uru, the a%ed, the scholars and the
preceptors4 If thou have conducted thyself $ell $ith them, the precious stones, the
%rains and the %ods become $ell disposed to$ards thee4 If thou shouldst conduct
thyself other$ise, they become unfavourable to thee48 To the teacher that has
spo5en thus, the disciple should say, 8Amen48
Source : Cross Cultural *ers+ecti,es in Medical -t$ics : "eadin&s, "o.ert M
/eact$, 1989
68
APPENDI# II
CODE OF PROFESSIONAL CONDUCT
MALAYSIAN MEDICAL COUNCIL
FORE!ORD
The members of the medical profession are e!pected to abide by a code of ethics
established by the profession itself4 The purpose of the code is to safe%uard the public,
ensure propriety in professional practice and to prevent abuse of professional privile%es4
This revised ode of Professional onduct $as adopted by the Malaysian Medical
ouncil at its -Bth meetin% on ?th December 2?@B4 The ne$ ode is more
comprehensive and %ives more details for the %uidance of practitioners4 'e$
provisions, not previously mentioned, have been included in the ne$ ode4
In conductin% a disciplinary en&uiry, the Malaysian Medical ouncil $ill be %uided by the
ne$ ode of Professional onduct4 I ur%e all practitioners to be familiar $ith the ne$
ode and to abide by it at all times4
This ne$ ode of Professional onduct replaces the 2?A= Medical Ethics of the
Malaysian Medical ouncil, $hich is hereby $ithdra$n4

Tan Sri Datu5 1Dr3 Abdul >halid bin Sahan
PSM, P/D>, GSM, ASD>, >M'
President
Malaysian Medical ouncil
April, 2?@A
69
INTRODUCTION
The practice of Medicine is an ancient profession and the community has %reat
e!pectations of its practitioners and places %reat trust in them4 9ithout this trust, it
$ould be impossible to practice medicine and the profession as such e!pects a hi%h
standard of professional and personal conduct from its members4 These are embodied
in various odes of Ethics, $hich vary in detail from country to country, but all place first
and foremost, the health and $elfare of the individual and the family under the care of a
practitioner4 The Malaysian Medical ouncil endorses the Declaration of /eneva, $hich
embodies these ideals 1Appendi! I34
:nderpinnin% the ode of Ethics are statutes, $hich ma5es it an offence punishable
under the la$ of the country to trans%ress certain outer limits of the e!pected norms of
professional conduct4 These minimum standards of conduct are assessed by their
peers in the profession, assembled as the Malaysian Medical ouncil established under
the Medical Act 2?A24 Freaches of these minimum standards are referred to as
6infamous conduct in a professional respect6 or 6serious professional misconduct64
This boo5let, issued under the authority of the Malaysian Medical ouncil, outlines the
outer limits of conduct that $ill ma5e a practitioner liable, after proper in&uiry, to be
found %uilty of serious professional misconduct4 It follo$s that these %uidelines discuss,
not ideal behaviour, but the minimum standards of conduct e!pected of a re%istered
medical practitioner4 Fy publishin% this boo5let, it is the desire of the Malaysian Medical
ouncil that no practitioner $ill have committed professional misconduct on %rounds of
i%norance of the e!pected standards of professional conduct in this country4
All medical practitioners on the Medical Re%ister should obtain a copy of these
%uidelines4 'e$ly re%istered practitioners $ill receive a copy upon re%istration4 The
ouncil e!pects that all re%istered practitioners $ill study these %uidelines and direct any
en&uiries to the Secretary of the ouncil4 Medical practitioners may also $ish to consult
the Ethics ommittee of the Malaysian Medical Association4
70
PART 1
PO!ERS OF THE MALAYSIAN MEDICAL COUNCIL
D&,3&-*&$)51 E(5&,%&30&.$ .6 02+ C.($3&*
Disciplinary 7urisdiction over re%istered medical practitioners is conferred upon the
Malaysian Medical ouncil by Sec4 ,? of the Medical Act 2?A2, $hich reads as follo$s .
24 The ouncil shall have disciplinary 7urisdiction over all persons re%istered under this
Act4
,4 The ouncil may e!ercise disciplinary 7urisdiction over any re%istered person $ho .
1a3 has been convicted in Malaysia or else$here of any offence punishable $ithin
imprisonment 1$hether in itself only or in addition to or in lieu of a fine34
1b3 has been %uilty of infamous conduct in any professional respect4
1c3 has obtained re%istered re%istration by fraud or misrepresentation4
1d3 has not at the time of his re%istration entitled to be re%istered; or
1e3 has since been removed from the Re%ister of Medical Practitioners maintained in
any place outside Malaysia4
71
THE MEANING OF INFAMOUS CONDUCT IN A PROFESSIONAL
RESPECT
The phrase 8infamous conduct in a professional respect8 $as defined in 2@?- by
#ord Gustice #ope* as follo$s .
8If a medical man in the pursuit of this profession has done somethin%
$ith re%ard to it $hich $ill be reasonably re%arded as dis%raceful or
dishonourable by his professional brethren of %ood repute and
competency, then it is open to the /eneral Medical ouncil, if that be
sho$n, to say that he has been %uilty of infamous conduct in a
professional respect48
In another 7ud%ement delivered in 2?<C, #ord Gustice Scrutton stated that .
8Infamous conduct in a professional respect means no more than serious
misconduct 7ud%ed accordin% to the rules, $ritten or un$ritten, %overnin%
the profession48
CONVICTIONS IN A COURT OF LA!
In considerin% conviction, the ouncil is bound to accept the determination of any court
of la$ as conclusive evidence that the practitioner $as %uilty of the offence $hich he
$as convicted4 Practitioners $ho face a criminal char%e should remember this if they
are advised to plead %uilty, or not to appeal a%ainst a conviction to avoid publicity or a
severe sentence4 It is not open to a practitioner $ho has been convicted of an offence
to ar%ue before the Preliminary Investi%ation ommittee or the Malaysian Medical
ouncil that he $as in fact innocent4 It is therefore un$ise for a practitioner to plead
%uilty in a court of la$ to a char%e to $hich he believes that he has a defence4
72
PART II
FORMS OF INFAMOUS CONDUCT
This part mentions certain 5inds of criminal offences and of infamous conduct in a
professional respect 1or professional misconduct3 $hich have in the past led to
disciplinary proceedin%s or $hich in the opinion of the ouncil could %ive rise to such
proceedin%s4 It does not pretend to be a complete code of professional ethics, or to
specify all criminal offences or forms of professional misconduct, $hich may lead to
disciplinary action4 To do this $ould be impossible because from time to time $ith
chan%in% circumstances, the ouncil6s attention is dra$n to ne$ forms of professional
misconduct4
Any abuse by a practitioner of any of the privile%ed and opportunities afforded to him or
any %rave dereliction of professional duty or serious breach of medical ethics may %ive
rise to a char%e of infamous conduct in a professional respect4 In dischar%in% their
respective duties, the Preliminary Investi%ation ommittee and the Malaysian Medical
ouncil must proceed as 7udicial bodies4 Only after considerin% the evidence in each
case can this ommittee or ouncil determine the %ravity of a conviction or decide
$hether a practitioner6s behaviour amounts to infamous conduct in a professional
respect4
In the follo$in% para%raphs, areas of professional conduct and personal behaviour,
$hich need to be considered, have been %rouped under four main headin%s .
24 'e%lect or disre%ard of professional responsibilities
,4 Abuse of professional privile%e and s5ills
<4 onduct dero%atory to the reputation of the medical profession
-4 Advertisin%, canvassin% and related professional offences4
73
17 NEGLECT OR DISREGARD OF PROFESSIONAL RESPONSIBILITIES
171 R+,-.$,&/&*&01 6.5 S0)$%)5%, .6 M+%&3)* C)5+ 0. P)0&+$0,
In pursuance of its primary duty to protect the public, the ouncil may institute
disciplinary proceedin%s $hen a practitioner appears seriously to have
disre%arded or ne%lected his professional duties to his patients4
The public is entitled to e!pect that a re%istered medical practitioner $ill provide
and maintain a %ood standard of medical care4 This includes .
1a3 conscientious assessment of the history, symptoms and si%ns of a
patient6s condition;
1b3 sufficiently thorou%h professional attention, e!amination and $here
necessary, dia%nostic investi%ation;
1c3 competent and considerate professional mana%ement;
1d3 appropriate and prompt action upon evidence su%%estin% the e!istence of
a condition re&uirin% ur%ent medical intervention; and
1e3 readiness, $here the circumstances so $arrant, to consult appropriate
professional collea%ues4
A comparable standard of practice is to be e!pected from medical practitioners
$hose contributions to a patient6s care are indirect, for e!ample, those in
laboratory and radiolo%ical specialties4
Apart from a practitioner6s personal responsibility to his patients, practitioners
$ho underta5e to mana%e, or to direct, or to perform clinical $or5 for
or%ani*ations offerin% private medical services should satisfy themselves that
those or%ani*ations provide ade&uate clinical and therapeutic facilities for the
services offered4
74
The ouncil is not ordinarily concerned $ith errors in dia%nosis or treatment, or
$ith the 5ind of matters $hich %ive rise to action in the civil courts for ne%li%ence,
unless the practitioner6s conduct in the case has involved such a disre%ard of his
professional responsibility to his patients or such a ne%lect of his professional
duties as to raise a &uestion of infamous conduct in a professional respect4
A &uestion of infamous conduct in a professional respect may also arise from a
complaint or information about the conduct of a practitioner $hich su%%ests that
he has endan%ered the $elfare of the patient by persistin% in independent
practice of a branch of medicine in $hich he does not have the appropriate
5no$led%e and s5ill and has not ac&uired the e!perience $hich is necessary4
172 T2+ P5)30&0&.$+5 )$% R+=(+,0, 6.5 C.$,(*0)0&.$
24,42 In conformity $ith his o$n sense of responsibility, a medical practitioner
should arran%e consultation $ith a collea%ue $henever the patient or the
patient6s ne!t(of(5in desire it, provided the best interests of the patient are
so served4 It is al$ays better to su%%est a second opinion in all doubtful,
difficult or an!ious cases4 It should be remembered that a practitioner
suffers no loss of di%nity or presti%e in referrin% a patient to a collea%ue
$hose opinion could contribute to the better care of the patient4
24,4, The attendin% practitioner may nominate the practitioner to be consulted,
and should advise accordin%ly, but he should not refuse to refer to a
re%istered medical practitioner selected by the patient or ne!t(of(5in4
24,4< The arran%ements for consultation should be made or initiated by the
attendin% practitioner4 The attendin% practitioner should ac&uaint his
patient of the appro!imate e!penses, $hich may be involved in specialist
consultations and e!aminations4
24,4- It is the duty of the practitioner consulted to avoid any $ord or action,
$hich mi%ht disturb the confidence of the patient in the attendin%
practitioner4 Similarly, the attendin% practitioner should carefully avoid
75
any remar5 or su%%estion, $hich $ould seem to dispara%e the s5ill or
7ud%ement of the practitioner consulted4
24,4= The practitioner consulted shall not attempt to secure for himself the care
of the patient seen in consultation4 At the end of consultation or further
mana%ement $here mutually a%reed upon specifically bet$een the
referrin% practitioner and the consultant, the patient should be returned to
the referrin% practitioner $ith a report includin% results of investi%ations
and advice on further care of the patient4
24,4B The consultant is normally obli%ed to consult the referrin% practitioners
before other consultants are called in4
179 T2+ P5)30&0&.$+5 )$% H&, P5)30&3+
Partners, Assistants and #ocum Tenens4
There is an ethical obli%ation on a practitioner not to dama%e the practice of a
collea%ue $ith $hom he has been in professional association lately4
174 I4-5.-+5 D+*+<)0&.$ .6 M+%&3)* D(0&+,
17471 E4-*.14+$0 .6 U$=()*&6&+% .5 U$5+<&,0+5+% P+5,.$,
The employment by a re%istered practitioner in his professional practice,
of persons not &ualified or re%istered under the Medical Act 2?A2, and the
permittin% of such un&ualified or unre%istered person to attend, treat or
perform operations upon patients in respect of matters re&uirin%
professional discretion or s5ill, is in the opinion of the ouncil in its nature
fraudulent and dan%erous to the public4 Any re%istered practitioner $ho
shall be proven to the satisfaction of the ouncil to have so employed an
un&ualified or unre%istered person $ill be liable to disciplinary
punishment4
76
17472 C.'+5&$<
Any re%istered practitioner $ho by his presence, countenance, advice,
assistance or co(operation, 5no$in%ly enables an un&ualified or
unre%istered person, $hether described a an assistant or other$ise, to
attend, treat, or perform operation upon a patient in respect of any matter
re&uirin% professional discretion or s5ill, to issue or procure the issue of
any certificate, notification, report, or other document of a 5indred
character, or other$ise to en%a%e in professional practice as if the said
person $ere duly &ualified and re%istered, $ill be liable, on proof of the
facts to the satisfaction of the ouncil, to disciplinary punishment4
17479 A,,.3&)0&.$ :&02 U$=()*&6&+% .5 U$5+<&,0+5+% P+5,.$,
Any re%istered medical practitioner $ho, either by administerin%
anaesthetics or other$ise, assists an un&ualified or unre%istered person
to attend, treat, or perform an operation upon any other person in respect
of matters re&uirin% professional discretion or s5ill, $ill be liable on proof
of the facts to the satisfaction of the ouncil to disciplinary punishment4
The fore%oin% part of this para%raph does not purport to restrict the
proper trainin% and instruction of bona fide medical students, or the
le%itimate employment of mid$ives, medical assistants, nurses,
dispensers, and s5illed mechanical or technical assistants, under the
immediate personal supervision of a re%istered medical practitioner4
17; M+%&3)* R+,+)532
In the scientific application of medical research carried out on a human bein%, it
is the duty of the practitioner to remain the protector of the life and health of that
person on $hom biomedical research is bein% carried out4
24=42 In any research on human bein%s, each potential sub7ect must be
ade&uately informed of the aims, methods, anticipated benefits and
potential ha*ards of the study and the discomfort it may entail4 )e or she
77
should be informed that he or she is at liberty to abstain from participation
in the study and that he or she is free to $ithdra$ his or her consent to
participation at any time4 The practitioner should then obtain the sub7ect6s
freely %iven informed consent, preferably in $ritin%4
24=4, The practitioner can combine medical research $ith professional care,
the ob7ective bein% the ac&uisition of ne$ medical 5no$led%e, only to the
e!tent that medical research is 7ustified by its potential dia%nostic or
therapeutic value for the patient4
24=4< A medical practitioner shall use %reat caution in divul%in% discoveries or
ne$ techni&ues or treatment throu%h non(professional channels4
24=4- The results of any research on human sub7ects should not be suppressed
$hether adverse or favourable4
176 T2+ P5)30&0&.$+5 )$% 02+ P2)54)3+(0&3)*AM+%&3)* E=(&-4+$0 I$%(,051
The medical profession and the pharmaceutical industry have common interests
in the research and development of ne$ dru%s of therapeutic value4
24B42 A prescribin% practitioner should not only choose but also be seen to be
choosin% the dru% or appliance $hich, in his independent professional
7ud%ement, and havin% due re%ard to economy, $ill best serve the
medical interests of his patient4 Practitioners should therefore avoid
acceptin% any pecuniary or material inducement $hich mi%ht
compromise, or be re%arded by others as li5ely to compromise, the
independent e!ercise of their professional 7ud%ement in prescribin%
matters4
24B4, It is improper for an individual practitioner to accept from a
pharmaceutical firm monetary %ifts or loans or e!pensive items of
e&uipment for his personal use4
78
24B4< 'o ob7ection can, ho$ever, be ta5en to %rants of money or e&uipment by
firms to institutions such as hospitals, health care centres and university
departments, $hen they are donated specifically for purposes of research
or patient care4
79
27 ABUSE OF PROFESSIONAL PRIVILEGES AND S"ILLS
271 A/(,+ .6 P5&'&*+<+, C.$6+55+% /1 L):
27171 P5+,35&/&$< .6 D5(<,
The prescription of controlled dru%s is reserved to members of the
medical profession and of certain other professions, and the
prescribin% of such dru%s is sub7ect to statutory restrictions4
The ouncil re%ards as infamous conduct in a professional
respect the prescription or supply of dru%s includin% dru%s of
dependence other$ise than in the course of bona fide treatment4
Disciplinary proceedin%s may also be ta5en a%ainst practitioners
convicted of offences a%ainst the la$s $hich control dru%s $here
such offences appear to have been committed in order to %ratify
the practitioner6s o$n addiction or the addiction of other persons4
27172 D)$<+5.(, D5(<,
The contravention by a re%istered practitioner of the provision of
the Dan%erous Dru%s Ordinance and the Re%ulations made
thereunder may be the sub7ect of criminal proceedin%s, and any
conviction resultin% therefrom may be dealt $ith as such by the
ouncil in e!ercise of their po$ers under the Medical Act 2?A24
Fut any contravention of the Ordinance or Re%ulations, involvin%
an abuse of the privile%es conferred thereunder upon re%istered
practitioners, $hether such contravention has been the sub7ect of
criminal proceedin%s or not, $ill if proved to the satisfaction of the
ouncil, render a re%istered practitioner to disciplinary
punishment4
80
27179 S)*+ .6 P.&,.$,
The employment for his o$n profit and undercover of his o$n
&ualifications by any practitioner $ho 5eeps a medical hall, open
shop, or other place in $hich scheduled poisons or preparations
containin% scheduled poisons are sold to the public, of assistants
$ho are left in char%e but are not le%ally &ualified to sell
scheduled poisons to the public is in the opinion of the ouncil, a
practice professionally discreditable and frau%ht $ith dan%er to the
public, and any re%istered practitioner $ho is proved to the
satisfaction of the ouncil to have so offended $ill be liable to
disciplinary punishment4
27174 C+50&6&3)0+,, N.0&6&3)0&.$,, R+-.50,, +037
Re%istered practitioners are in certain cases bound by la$ to %ive,
or may from time to time be called upon or re&uested to %ive
particulars, notifications, reports and other documents of a 5indred
character, si%ned by them in their professional capacity, for
subse&uent use either in the ourts or for administrative
purposes4
Practitioners are e!pected by the ouncil to e!ercise the most
scrupulous care in issuin% such documents, especially in relation
to any statement that a patient have been e!amined on a
particular date4
Any re%istered practitioner $ho shall be proved to the satisfaction
of the ouncil to have si%ned or %iven under his name and
authority any such certificate, notification, report or document of a
5indred character, $hich is untrue, misleadin% or improper, $ill be
liable to disciplinary punishment4
81
2717; I$%(3+% N.$-T2+5)-+(0&3 A/.50&.$
The Medical ouncil re%ards induced non(therapeutic abortion a
serious infamous conduct and if proved to the satisfaction of the
ouncil, a practitioner is liable to disciplinary action4 A criminal
conviction in Malaysia or else$here for the termination of
pre%nancy in itself affords %rounds for disciplinary action4
272 A/(,+ .6 P5&'&*+<+, C.$6+55+% /1 C(,0.4
27271 A/(,+ .6 T5(,0
Patients %rant practitioners privile%ed access to their homes and
confidence and some patients are liable to become emotionally
dependent upon the practitioner4 /ood medical practice depends
upon the maintenance of trust bet$een practitioners and patients
and their families, and the understandin% by both that proper
professional relationships $ill be strictly observed4 In this
situation, practitioners must e!ercise %reat care and discretion in
order not to dama%e this crucial relationship4 Any action by a
practitioner, $hich breaches this trust, may raise the &uestion of
infamous conduct in a professional respect4
27272 A/(,+ .6 C.$6&%+$3+
A practitioner may not improperly disclose information, $hich he
obtained in confidence from or about a patient4
27279 U$%(+ I$6*(+$3+
A practitioner may not e!ert improper influence upon a patient to
lend him money or to obtain %ifts or to alter the patient6s $ill in his
favour4
82
27274 P+5,.$)* R+*)0&.$,2&-, B+0:++$ P5)30&0&.$+5, )$% P)0&+$0,
A practitioner may not enter into an emotional or se!ual
relationship $ith a patient 1or $ith a member of a patient6s family3
$hich disrupts that patient6s family life or other$ise dama%es, or
causes distress to the patient or his or her family4
97 CONDUCT DEROGATORY TO THE REPUTATION OF THE
PROFESSION
The medical practitioner is e!pected at all times to observe proper standards of
behaviour in 5eepin% $ith the di%nity of the profession4
971 R+,-+30 6.5 H(4)$ L&6+
The utmost respect for human life should be maintained even under
threat, and no use should be made of any medical 5no$led%e contrary to
the la$s of humanity4
The practitioner shall not countenance, condone or participate in the
practice of torture or other forms of cruel, inhuman or de%radin%
procedures, $hatever the offence of $hich the victim of such procedures
is suspected, accused or %uilty, and $hatever the victim6s beliefs or
motives and in all situations, includin% armed conflict and civil strife4
The practitioner shall not provide any premises, instruments, substances
or 5no$led%e to facilitate the practice of torture or other forms of cruel,
inhuman or de%radin% treatment or to diminish the ability of the victim to
resist such treatment4
83
972 P+5,.$)* B+2)'&.(5
The public reputation of the medical profession re&uires that every
member should observe proper standards of personal behaviour, not only
in his professional activities but at all times4 This is the reason $hy the
conviction of a practitioner for a criminal offence may lead to disciplinary
proceedin%s even if the offence is not directly connected $ith the
practitioner6s profession4
97271 P+5,.$)* M&,(,+ .5 A/(,+ .6 A*3.2.* .5 O02+5 D5(<,
In the opinion of the ouncil, conviction for drun5enness or other
offences arisin% from misuse of alcohol 1such as drivin% a motor
car $hen under the influence of drin5s3 indicate habits $hich are
discreditable to the profession and may be a source of dan%er to
the practitioner6s patients4 onvictions for dru% abuse and
drun5enness may lead to an in&uiry by the Malaysian Medical
ouncil4
A practitioner $ho treats patients or performs other professional
duties $hile he is under the influence of alcohol or dru%s, or $ho
is unable to perform his professional duties because he is under
the influence of alcohol or dru%s is liable to disciplinary
proceedin%s4
97272 D&,2.$+,01 I4-5.-+5 F&$)$3&)* T5)$,)30&.$,
A practitioner is liable to disciplinary proceedin%s if he is convicted
of criminal deception 1obtainin% money or %oods by false
pretences3, for%ery, fraud, theft or any other offence involvin%
dishonesty4
The ouncil ta5es a particularly serious vie$ of dishonest acts
committed in the course of a practitioner6s professional practice or
a%ainst his patients or collea%ues4 Such acts, if reported to the
84
ouncil, may result in disciplinary proceedin%s4 Amon% the
circumstances, $hich may have this result, are the improper
demand or acceptance of fees from patients contrary to the
statutory provisions, $hich re%ulate the conduct of health services
of the /overnment of Malaysia4
The ouncil also ta5es a serious vie$ of the prescribin% or
dispensin% of dru%s or appliance for improper motives4 A
practitioner6s motivation may be re%arded as improper if he has
prescribed a dru% or appliance purely for his financial benefit or if
he has prescribed a product manufactured or mar5eted by an
or%ani*ation from $hich he has accepted an improper
inducement4
The ouncil also re%ards fee splittin% or any form of 5ic5bac5
arran%ement as an inducement to refer a patient to another
practitioner as unethical4 The premise for referral must be &uality
of care4 0iolation of this $ill be considered by the ouncil as
infamous conduct in a professional respect4
)o$ever, fee sharin% $here t$o or more practitioners are in
partnership or $here one practitioner is assistant to or actin% for
the other is permissible4
97279 I$%+3+$31 )$% V&.*+$3+
Any conviction for assault or indecency $ould render a practitioner
liable to disciplinary proceedin%s, and $ould be re%arded $ith
particular %ravity if the offence $ere committed in the course of a
practitioner6s professional duties or a%ainst his patients or
collea%ues4
85
979 I$3.4-+0+$3+ 0. P5)30&3+
9here a practitioner becomes a$are of a collea%ue6s incompetence to
practice, $hether by reason of ta5in% dru%s or by physical or mental
incapacity, then it is the ethical responsibility of the practitioner to dra$
this to the attention of a senior collea%ue $ho is in a position to act
appropriately4
974 T2+ P5)30&0&.$+5 )$% C.44+53&)* U$%+50)C&$<,
The practitioner is the trustee for the patient and accordin%ly must avoid
any situation in $hich there is a conflict of interest $ith the patient4
A %eneral ethical principle is that a practitioner should not associate
himself $ith commerce in such a $ay as to let it influence, or appear to
influence, his attitude to$ards the treatment of his patients4
The association of a practitioner $ith any commercial enterprise en%a%ed
in the manufacture or sale of any substance $hich is claimed to be of
value in the prevention or treatment of disease but is unproven or of an
undisclosed nature or composition $ill be considered as infamous
conduct in a professional respect4
A practitioner has a duty to declare an interest before participatin% in
discussion, $hich could lead to the purchase by a public authority of
%oods, or services in $hich he, or a member of his immediate family, has
a direct or indirect pecuniary interest4 'on(disclosure of such information
may, under certain circumstances, amount to infamous conduct in a
professional respect4
9here the practitioner has a financial interest in any facility to $hich he
refers patients for dia%nostic tests, for procedures or for in(patient care, it
is ethically necessary for him to disclose his interest in the institution to
the patient4
86
47 ADVERTISING, CANVASSING AND RELATED PROFESSIONAL
OFFENCES
The medical profession in this country has lon% accepted the convention
that doctors should refrain from self(advertisement4 In the ouncil6s
opinion, self(advertisement is not only incompatible $ith the principles,
$hich should %overn relations bet$een members of a profession but
could be a source of dan%er to the public4 A practitioner successful at
achievin% publicity may not be the most appropriate doctor for a patient to
consult4 In e!treme cases, advertisin% may raise illusory hopes of a cure4
471 A%'+50&,&$< )$% C)$'),,&$<
-4242 Advertisin%, $hether directly or indirectly, for the purpose
of obtainin% patients, or promotin% his o$n professional
advanta%e, or for any such purpose, of procurin% or
sanctionin%, or ac&uiescin% in, the publication of notices
commendin% or directin% attention to the practitioner6s
professional s5ill, 5no$led%e, services, or &ualification, or
depreciatin% those of others, or of bein% associated $ith,
or employed by, those $ho procure or sanction such
advertisin% or publication, and canvassin%, or employin%
any a%ent or canvasser, for the purpose of obtainin%
patients; or of sanctionin%, or of bein% associated $ith or
employed by those $ho sanction, such employment, e4%4
private hospitals, clinics and other medical institutions are
in the opinion of the ouncil contrary to the public interest
and discreditable to the profession of medicine, and any
re%istered medical practitioner $ho resorts to any such
practice renders himself liable, on proof of the facts to the
satisfaction of the ouncil to disciplinary punishment4
87
-424, The ouncil reco%ni*es that the profession has a duty to
disseminate information about advances in medical
sciences and therapeutics provided it is done in an ethical
manner4
472 A$$.($3+4+$0 &$ 02+ L)1 P5+,, R+<)5%&$< P5)30&3+
An announcement by the Malaysian Medical Association on the
commencement or chan%e of address of practice is permissible
as a service to the community4
479 P5.6+,,&.$)* C)**&$< C)5%,
A practitioner may carry callin% cards but he should not distribute
callin% cards $ith the purpose of solicitin% patients4 The
information permitted on a professional callin% card is contained in
Appendi! II4
474 S&<$/.)5%,
A si%nboard for the purpose of assistin% patients to locate a
practitioner is permissible provided it conforms to the limits laid
do$n by the ouncil as contained in Appendi! III4
47; N)4+ P*)0+,AD..5-*)0+,
These should conform $ith the limits laid do$n by the ouncil as
contained in Appendi! I04
476 24-H.(5 C*&$&3,
These should conform $ith the re&uirements laid do$n by the
ouncil as contained in Appendi! 04

88
PART III
DISCIPLINARY PROCEDURE
17 PRELIMINARY INVESTIGATION COMMITTEE
In accordance $ith re%ulation ,B, Medical Re%ulations 2?A- .
123 The President of the ouncil from time to time appoint a committee
from amon% practitioners $ho are $illin% to act, $hich committee shall be
5no$n as a Preliminary Investi%ation ommittee 1hereinafter referred to
as 8ommittee83 $hose function shall be to ma5e a preliminary
investi%ation into complaints or information touchin% any disciplinary
matter4
1,3 A ommittee shall consist of such number of members not bein%
less than three, or more than si!, as the President may from time to time
thin5 fit and shall be appointed in connection $ith one or more than one
complaint or information touchin% any disciplinary matter4
1<3 The President may at any time revo5e the appointment of any member of
any ommittee or may remove any member of a ommittee or fill any
vacancy in any ommittee or sub7ect to sub(re%ulation 1,3, increase the
number of members of a ommittee .
Provided that no act done or proceedin% ta5en under these Re%ulations
shall be &uestioned on the %round of any vacancy in the membership of
or any defect in constitution of such ommittee4
1-3 The &uorum of a ommittee shall be t$o4
1=3 The President shall nominate a practitioner from amon% members of a
ommittee to be the hairman of such ommittee4
89
1B3 The hairman shall preside at all meetin%s of such ommittee .
Provided that in the absence of the hairman, the most senior
practitioner present at that meetin% of such ommittee shall preside4
1A3 The decision of a ommittee shall be unanimous or by a ma7ority4
171 C.4-*)&$0 )<)&$,0 P5)30&0&.$+5,
In accordance $ith Re%ulation ,A, Medical Re%ulations 2?A-, $here a
complaint or information is made a%ainst any practitioner alle%in% that
such a person .
1a3 has been convicted in Malaysia or else$here of any offence
punishable $ith imprisonment 1$hether in itself only or in addition
to or in lieu of a fine3;
1b3 has been %uilty of infamous conduct in any professional respect;
1c3 has obtained re%istration by fraud or mis(representation;
1d3 has since been removed from the re%ister of medical practitioners
maintained in any place outside Malaysia;
Such complaint or information shall be for$arded by the President
to the hairman of the ommittee4
172 S(44)51 D&,4&,,)* .6 C.4-*)&$0
In accordance $ith Re%ulation ,@, Medical Re%ulations 2?A- .
123 The ommittee to $hich such complaint or information has been
for$arded, may summarily dismiss any complaint or information if it is
satisfied .
90
1a3 that the name and address of the complainant is un5no$n
or untraceable;
1b3 that even if the facts $ere true, the facts do not constitute a
disciplinary matter; or
1c3 for reasons $hich must be recorded, that there is reason to
doubt the truth of the complaint or the facts alle%ed by him4
179 P5.3+%(5+ .6 I$=(&51
In accordance $ith Re%ulation ,?, of the Medical Re%ulations 2?A- .
123 9here the ommittee has reason to believe that the complaint or
information is probably true, it shall .
1a3 by order in $ritin% re&uire the attendance before the
ommittee, on a date and time and at a place to be
specified therein, of the complainant and any person $ho
from the complaint or information %iven or other$ise
appears to be ac&uainted $ith the circumstances;
1b3 inform the practitioner a%ainst $hom the alle%ations are
made, the substance of the complaint or information, the
date, time and place at $hich the in&uiry into the complaint
or information shall be made and of his ri%hts to be present
$ith or $ithout counsel, to cross(e!amine such persons
$ho may be called at the in&uiry4
1,3 The ommittee shall convene on the date, time and place
specified in the order and shall proceed to in&uire into the
alle%ation made a%ainst the practitioner4
91
1<3 The ommittee shall e!amine the complainant and the
persons in support of the alle%ation, $ho may in turn be cross(
e!amined for the practitioner and if necessary re(e!amined
and shall reduce to $ritin% the statement made by the
complainant and such persons e!amined4
1-3 After ta5in% the statements of the complainant and the
persons in support of the alle%ation, the ommittee shall .
1a3 if it finds that there are not sufficient %rounds to
support the alle%ation, recommend to the ouncil that
no action be ta5en; or
1b3 if it finds that the statements support the alle%ation,
frame the char%e and e!plain to the practitioner that
he is at liberty to state his defence on the char%e
framed a%ainst him4
1=3 If the practitioner after bein% informed of his ri%ht under sub(
re%ulation 1-3 elects not to ma5e a statement, the ommittee
shall recommend that there shall be an in&uiry by the ouncil4
1B3 If the practitioner elects to ma5e his defence before the
ommittee, the ommittee shall record his statement as far
as possible, $ord for $ord4
1A3 After ta5in% the practitioner6s name, the ommittee shall .
1a3 if it finds that there are no sufficient %rounds to
support the char%e, recommend to the ouncil that no
action be ta5en; or
1b3 if it finds that there are %rounds to support the char%e,
recommend to the ouncil that there shall be an in&uiry
by the ouncil4
92
174 R+3.5%, .6 I$=(&51 0. /+ T5)$,4&00+% 0. 02+ C.($3&*
In accordance $ith Re%ulation <C of the Medical Re%ulations 2?A-, the
records of any preliminary in&uiry by the ommittee shall be prepared
and sent to the ouncil $ithin si!ty days of completion of such in&uiry4
27 ENDUIRY BY THE COUNCIL
In accordance $ith Re%ulation <2 of the Medical Re%ulation 2?A- .
123 The ouncil shall, $here the ommittee recommends that there
shall be an in&uiry, and may, for reasons to be recorded, in cases
$here the ommittee, after hearin% the statements of the
complainants and other persons in support of the alle%ation has
recommended that no action be ta5en, hold a disciplinary in&uiry
a%ainst the practitioner4
1,3 The ouncil shall cause to be served on the practitioner a notice
specifyin% the date, time and place of in&uiry and shall provide such
practitioner $ith a copy of the char%e or char%es framed by the
ouncil after a consideration of the records submitted by the
ommittee4
1<3 The ouncil shall not, on the date of the in&uiry re&uire any further
statement to be recorded or made by the complainant or such
persons $ho have made statements before the ommittee .
Provided that it may call for and shall record any statement from any
such person if it is of the opinion that it $ould be fair and 7ust to do
so4
93
1-3 The ouncil shall, if after considerin% the statements made by the
complainant and other persons in support of the alle%ations as found
in the records of the preliminary in&uiry by the ommittee, it is
satisfied that there are %rounds to support the char%e call upon the
practitioner to ma5e any further statement as he deems necessary
and to call such other persons as he may re&uire to support his
defence and shall record such further statement or fresh statement4
1=3 If at the close of the in&uiry, the ouncil finds that no case has been
made out a%ainst the practitioner, it shall direct that the char%es be
dismissed and shall inform the practitioner accordin%ly4
1B3 If at the close of the in&uiry, the ouncil finds the practitioner %uilty
of any disciplinary matter specified in Section ,? 1,3 of the Act, it
shall inform the practitioner of its findin% and the %rounds for its
decision and shall re&uest such practitioner to ma5e any plea in
miti%ation as he deems fit4
1A3 The ouncil shall, after hearin% any plea in miti%ation, e!ercise any
of its po$er specified in Section <C of the Act4
97 DISCIPLINARY PO!ERS OF THE COUNCIL
In accordance $ith Section <C of the Medical Act 2?A2, the ouncil may, in the
e!ercise of its disciplinary 7urisdiction, impose any of the follo$in% punishments .
1i3 order the name of such re%istered person to be struc5 off from the
Re%ister; or
1ii3 order the name of such re%istered person to be suspended from the
Re%ister for such period as it may thin5 fit; or
1iii3 order the re%istered person to be reprimanded; or
94
1iv3 ma5e any such order as aforesaid but suspend the application thereof,
sub7ect to such conditions as the ouncil may thin5 fit, for a period, or
periods in the a%%re%ate, not e!ceedin% t$o years;
any $ay, in any case, ma5e such order as the ouncil thin5s fit $ith re%ard to the
payment of the costs of the Re%ister and of any complainant or of the re%istered
person, and any costs a$arded may be recovered as a civil debt4
47 APPEAL AGAINST ORDERS OF THE COUNCIL
In accordance $ith Section <2 of the Medical Act 2?A2 .
123 Any person $ho is a%%rieved by any order made in respect of him by the
ouncil in the e!ercise of its disciplinary 7urisdiction may appeal to the
)i%h ourt, and the )i%h ourt may thereupon affirm, reverse or vary the
order appealed a%ainst or may %ive such direction in the matter as it
thin5s proper; the cost of the appeal shall be in the discretion of the )i%h
ourt4
1,3 The decision of the )i%h ourt upon such appeal shall be final4
1<3 The practice in relation to any such appeal shall be sub7ect to the rules of
court applicable in the )i%h ourt4
Provided that the )i%h ourt shall not have po$er to hear any appeal
a%ainst an order made under Section <C unless notice of such appeal
$as %iven $ithin one month of the service of the order in the prescribed
manner4
95
;7 RESTORATION OF NAME TO REGISTER
In accordance $ith Section <2A of the Medical Act 2?A2 .
123 'o person $hose name has been struc5 off from the Re%ister under the
provisions of para%raph 1i3 of Section <C shall thereafter be entitled to be
re%istered as a medical practitioner under the provisions of the Act, but
the ouncil may, if it thin5s fit in any case to do so, on the application of
the person concerned, order that the name of such person be restored to
the Re%ister; and $here the name of a person has been suspended from
the Re%ister under para%raph 1ii3 of that Section such person shall be
entitled at the e!piration of period of suspension, but not earlier, to apply
for the certificate of re%istration and the annual practicin% certificate 1if
the period for $hich it is issued is still une!pired3 to be returned to him4
1,3 An application under Sub(Section 123 shall be made in such manner or
form and accompanied by such documents, photo%raphs, particulars and
fees as may be prescribed4
67 APPOINTMENT OF LEGAL ADVISER
In accordance $ith Re%ulation <, of the Medical Re%ulations 2?A- .
123 The ouncil or any ommittee may appoint a le%al adviser to assist the
ouncil or ommittee durin% any in&uiry touchin% on disciplinary matter4
1,3 The ouncil or ommittee may appoint any person $ho is and has been
an advocate and solicitor for a period of not less than five years to advise
it on .
1a3 all &uestions of la$ ensuin% in the course of the in&uiry; and
1b3 the meanin% and construction of all documents produced durin%
the in&uiry4
96
77 MEMBERS !HO ARE DISDUALIFIED FROM ANY MEETING OF THE
COUNCIL INDUIRING INTO ANY DISCIPLINARY MATTER
In accordance $ith Re%ulation << of the Medical Re%ulations 2?A-, no member of
the ouncil or the ommittee shall attend or participate in any meetin% of the
ouncil or the ommittee in&uirin% into any disciplinary matter if .
1a3 he $as the complainant;
1b3 he is personally ac&uainted $ith any relevant fact;
1c3 he has appeared before the ommittee for the purpose of ma5in%
any statement;
1d3 he $as a member of the ommittee ma5in% preliminary investi%ation
into the complaint or information; or
1e3 the complainant, the persons appearin% before the ommittee for
the purpose of ma5in% any statement or the re%istered person is his
partner or relative4
97
A--+$%&8 I
DECLARATION OF GENEVA
Adopted by the ,nd /eneral Assembly of the 9orld Medical Association, /eneva,
S$it*erland, September 2?-@, amended by the ,,nd 9orld Medical Assembly, Sydney,
Australia, Au%ust 2?B@, and the <=th 9orld Medical Assembly, 0enice, Italy, October
2?@<4
AT THE TIME OF BEING ADMITTED AS A MEMBER OF THE MEDICAL
PROFESSION
I SOLEMNLY PLEDGE myself to consecrate my life to the service of humanity;
I !ILL GIVE to my teachers the respect and %ratitude $hich is their due;
I !ILL PRACTICE my profession $ith conscience and di%nity;
THE HEALTH OF MY PATIENT $ill be first consideration;
I !ILL MAINTAIN by all the means in my po$er, the honour and the noble traditions
of the medical profession;
MY COLLEAGUES $ill be my brothers;
I !ILL NOT PERMIT consideration of reli%ion, nationality, race, party politics or social
standin% to intervene bet$een my duty and my patient;
I !ILL MAINTAIN the utmost respect for human life from its be%innin% even under
threat and I $ill not use my medical 5no$led%e contrary to the la$s of humanity;
I MA"E THESE PROMISES solemnly, freely and upon my honour4
98
A--+$%&8 II
PROFESSIONAL CALLING CARDS
The callin% cards should only contain the name of the practitioner, re%istrable
professional &ualifications, State and 'ational a$ards, home address and telephone
number1s3, practice address1es3 and telephone number1s34
A--+$%&8 III
SIGNBOARDS
The ouncil a%rees to the follo$in% limits to si%nboards for re%istered practitioners .
123 There shall not be more than t$o 1,3 si%nboards to indicate the identity of the
medical clinic or practice4
1,3 It+They shall not be floodlit or illuminated4
1<3 The total combined area of the si%nboard or si%nboards 1if , si%nboards are used3
should 'OT e!ceed ,4A@A s&4 meters 1<C(s&4 ft434 This includes letterin% fi!ed or
painted on $alls or any other bac5in% $here the perimeter enclosin% the letterin%
should not e!ceed ,4A@A s&4 meters 1<C(s&4 ft43 in total4
The ouncil felt that clinics may actually re&uire more than one si%nboard and a%reed
that it be restricted to a ma!imum of t$o provided the total combined areas of the t$o
si%nboards do not e!ceed ,4A@A s&4 meters 1<C s&4 ft434
Ado+ted .) Council at its 30t$ Meetin& on 19t$ 2ul) 1980#
99
A--+$%&8 IV
NAMEPLATESADOORPLATES
24 'ameplates should be plain and should not e!ceed ?<C4,=(s&4 cm4 12 s&4 ft43 in
dimension4
,4 The nameplates may bear the follo$in% .
,42 the practitioner6s name
,4, his re%istrable &ualifications in small letters
,4< titles may be included4
<4 A separate doorplate not e!ceedin% ?<C4,=(s&4 cm4 12 s&4 ft43 is permitted to indicate
his consultation hours4
-4 9here it is considered necessary for an assistant to have his o$n nameplate, the
normal rules relatin% to plates continue to apply4
=4 0isitin% practitioners may have their nameplates, provided the day1s3 and hour1s3 of
practice are stated4
B4 'ameplates of practitioners $ho do not practice in the clinic are not permitted to be
e!hibited4
Ado+ted .) Council at its 30t$ Meetin& on 19t$ 2ul) 1980#
100
A--+$%&8 V
24-HOUR CLINIC
24 'o additional si%nboards are permitted4
,4 'otification of the availability of ,-(hour service should be on the doorplate
pertainin% to consultation hours or on the e!istin% clinic si%nboard4
<4 Eualified and re%istered practitioners should be available at all times and his
availability should be $ithin a reasonable period of time not e!ceedin% thirty 1<C3
minutes4
-4 A practitioner may not operate more than one ,-(hour clinic at the same time4
=4 In the event that an emer%ency arises re&uirin% the practitioner to be called a$ay,
the clinic should do one of the follo$in% .
=42 not to accept ne$ patients until the practitioner is bac5 in the clinic;
=4, inform intendin% patients that the practitioner is not available4
Ado+ted .) Council at its 30t$ Meetin& on 19t$ 2ul) 1980#
101
REFERENCES
24 #a$s of Malaysia4 Act =C ( Medical Act 2?A24
,4 Malaysian Medical ouncil, Medical Ethics, 2?A=4
<4 Malaysian Medical Association, ode of Medical Ethics, 2?@=4
-4 /eneral Medical ouncil, Professional onduct and Discipline . "itness to Practice,
#ondon . /M, 2?@=4
=4 Australian Medical Association, ode of Ethics, 2?@C4
B4 Report of Malaysian Medical ouncil Sub(ommittee on 8Si%nboards8 adopted by
ouncil at its <=th meetin% on ,?th Guly 2?@=4
A4 The 9orld Medical Association, )andboo5 of Declarations, 2?@=4
102
APPENDI# III
GUIDELINES ON PUBLIC INFORMATION BY PRIVATE HOSPITALS,
CLINICS, RADIOLOGICAL CLINICS AND MEDICAL LABORATORIES
17 E#EMPTIONS
These %uidelines do not apply to the follo$in% .
242 The current practice of information bein% circulated $ithin the profession
throu%h medical 7ournals and ne$sletters $hich are published by medical
bodies4
24, The present arran%ement $here the Malaysian Medical Association and
Malaysian Dental Association have been %ranted approval by the
)onourable Minister of )ealth to publish advertisements4
27 GENERAL PRINCIPLES
,42 The purpose shall be to inform the public about the type and nature of
health care services available to them4 The information should ho$ever
be %eneral in nature4
,4, The authenticity and the accuracy of the information imparted should be
verifiable by the controllin% Foard4 The Public should not be misled into
dra$in% false impressions of the private hospital+clinic+radiolo%ical clinic
and medical laboratory4
,4< The information provided shall be in strict adherence to these set
%uidelines4
,4- The information shall be in any media $hich is based, re%istered and
published or circulated in Malaysia, and approved by the Foard,
Announcement over the Radio, Television, Rediffusion or inema is
103
prohibited4 The use of billboards, banners and similar devices are also
prohibited4
,4= :nsolicited communication $ith potential clients for the purpose of toutin%
and enticin% patients is prohibited4
,4B Information about advances in medical services and therapeutics is best
conducted throu%h the appropriate medical forums to avoid the ris5 of
unbalanced and inaccurate reportin%4
,4A In conductin% openin% ceremonies, it is the responsibility of the
mana%ement to ensure that it does not result in undue publicity4 The
mana%ement should also not allo$ the insertion of con%ratulatory
messa%e4
97 INFORMATION !HICH MAY BE DISCLOSED IN THE ANNOUNCEMENT
ARE AS FOLLO!S
971 G+$+5)* I$6.54)0&.$
1a3 'ame and location
1b3 Telephone number
1c3 )ours of service
1d3 Types of accommodation and facilities
1e3 har%es for the various services and facilities4
972 P5.6+,,&.$)* S+5'&3+,
e4%4 Sur%ical, Maternity, Accident I Emer%ency, Rehabilitation4
47 INFORMATION !HICH IS NOT PERMITTED
-42 The use of comparison, either direct or by implication bet$een one
hospital, clinic, radiolo%ical clinic or medical laboratory and another is
104
prohibited4 The use of superlative in describin% the available services or
facilities are also not permitted4
-4, There should be no mention of names and personal references of
doctors associated $ith the hospital, clinic, radiolo%ical clinic or medical
laboratory4 Testimonials from patients shall not be published or printed4
;7 MEDIA
;71 P5&$0 M+%&)
;7171 L)1 P5+,, (N+:,-)-+5,)
1a3 Ma!imum si*e . 'o restriction
1b3 "re&uency . the announcement shall only
be allo$ed on the
commencement or chan%e of
address of practice4 The
approved information can be
published for < consecutive
days4 If it should appear in
separate papers, it should be
on the same < consecutive
days4
1c3 olour . 'o restriction
1d3 Photo%raphs . Permitted
1e3 #o%os . ould be used
1f3 ontent . As approved by the Foard
105
1%3 han%e of telephone . Such announcement to be
number allo$ed but the si*e shall be
limited to @ cm ! = cm4
;7172 Y+**.: P)<+, )$% O02+5 D&5+30.5&+,
1a3 Ma!imum si*e . 'ot e!ceedin% one
pa%e
1b3 "re&uency . At every edition of the yello$
pa%es
1c3 olour . 'o restriction
1d3 Photo%raphs . 'ot permitted
1e3 #o%os . ould be used
1f3 ontent . As approved by the Foard
;7179 P)4-2*+0, )$% B5.32(5+,
1a3 olour . 'o restriction
1b3 Photo%raphs . Permitted
1c3 #o%os . ould be used
1d3 ontent . As approved by the Foard
1e3 #ocation map . Permitted
106
1f3 Distribution . Pamphlets+brochures approved by
the Foard could be allo$ed $ithin
the premises of the practice+hospital,
hotel and travel a%encies but should
not be distributed to the public at
lar%e4
;7174 M+%&3)* P(/*&3)0&.$,
Only medical 7ournals and ne$sletters $hich are published by
medical bodies for circulation to doctors are allo$ed4 The
information published in these medical 7ournals+ne$sletters shall
not be reproduced and distributed4
1a3 Ma!imum si*e . 'ot e!ceedin% one
pa%e
1b3 "re&uency . 'o restriction
1c3 olour . 'o restriction
1d3 Photo%raphs . Permitted
1e3 #o%os . ould be used
1f3 ontent . As approved by the Foard
1%3 han%e of telephone . Such announcement to be
number allo$ed but the si*e shall be
limited to @ cm ! = cm
107
;717; M)<)@&$+AH)$%/..C
1a3 Ma!imum si*e . 'ot e!ceedin% one pa%e
1b3 olour . 'o restriction
1c3 Photo%raphs . Permitted
1d3 #ocation map . Permitted
1e3 Telephone+"a!+ . Permitted
Email
1f3 ontent . As approved by the Foard
1%3 Distribution . Allo$ed for distribution $ithin
the premises of the
practice+hospital only if it
involves one hospital or a
%roup of hospitals under the
same
mana%ement+company4
Allo$ed for distribution
outside of the hospital if it
involves many hospitals 1not
under the same
mana%ement+company3
;72 D&,-*)1&$< B.)5%
1a3 olour . 'o restriction
1b3 #o%os . ould be used
1c3 ontent . As approved by the Foard
108
1d3 #ocation . 9ithin the premises or outside front $all of
the premise
;79 !+/,&0+AH.4+-)<+
1a3 olour . 'o restriction
1b3 Photo%raph . Permitted
1c3 #o%os . ould be used
1d3 ontent . As approved by the Foard
;74 O02+5 M+%&)
1a3 olour . 'o restriction
1b3 Photo%raphs . Permitted
1c3 #o%os . ould be used
1d3 ontent . As approved by the Foard
1e3 Distribution . As approved by the Foard
67 REVIE!
These %uidelines may be revie$ed as and $hen necessary4
Source : Medical Ad,ertisements 3oard, Ministr) of 4ealt$, 19 Marc$ 1999#
109
APPENDI# IV
DECLARATIONS
17 DECLARATIONS BY PROFESSIONAL MEDICAL ASSOCIATIONS
)7 THE !ORLD MEDICAL ASSOCIATION
Declaration of /eneva
T$elve Principles of Provision of )ealth are in any 'ational )ealth are
System
International ode of Medical Ethics
Re%ulations in Time of Armed onflict
Declaration of )elsin5i
1Recommendations /uidin% Physicians in Fiomedical Research Involvin%
)uman Sub7ects3
Recommendations oncernin% Medical are in Rural Areas
Statement on "amily Plannin%
Declaration of Sydney Statement on Death
Declaration of Oslo Statement on Therapeutic Abortion
Statement on the :se of omputers in Medicine
Declaration of To5yo 1/uidelines for Medical Doctors oncernin% Torture and
Other ruel, Inhumane or De%radin% Treatment or Punishment in relation to
Detention and Imprisonment3
Statement on the :se and Misuse of Psychotropic Dru%s
Declaration of Sao Paulo Statement on Pollution
Resolution on Physician Participation in apital Punishment
Declaration on Principles of )ealth are for Sports Medicine
Declaration of 0enice on Terminal Illness
Recommendations oncernin% Fo!in%
Statement on Medical Manpo$er I
Statement on Medical Manpo$er II
Statement on hild Abuse and 'e%lect
Statement on "reedom to Attend Medical Meetin%s
110
Statement on Medical Manpo$er III
Declaration on )uman Ri%hts and Individual "reedom of Medical Practitioners
Statement on #ive Or%an Trade
Declaration on Physician Independence and Professional "reedom
Declaration on Madrid on Professional Autonomy and Self(Re%ulation
Declaration on Rancho Mira%e on Medical Education
Statement on In(0itro "ertili*ation and Embryo Transplantation
Declaration on Euthanasia
Declaration on )uman Or%an Transplantation
9orld Medical Association Interim Statement on AIDS
Statement on /enetic ounselin% and /enetic En%ineerin%
Statement of Policy on Infant )ealth
Statement on Access to )ealth are
Statement on the Professional Responsibility of Physicians in Treatin% AIDS
Patients
Statement on Academic Sanctions or Foycotts
Resolution on Medical /roup Practice
9orld Medical Association Resolution
Statement on )ealth )a*ards of Tobacco Products
Declaration on the Role of Physicians in Environmental and Demo%raphic
Issues
Statement on Animal :se in Fiomedical Research
Statement on /eneric Dru% Substitution
Statement on "etal Tissue Transplantation
Statement on Persistent 0e%etative State
Statement of Policy on the are of Patients $ith Severe hronic Pain in
Terminal Illness
Statement on Tobacco Manufacture, Import, E!port, Sale and Advertisin%
Declaration of )on% >on% on the Abuse of the Elderly
Declaration of hemical and Fiolo%ical 9eapons
Resolution on )uman Ri%hts
Resolution on Therapeutic Substitution
Statement on Traffic In7ury
Declaration on In7ury ontrol
Statement on Adolescent Suicide
111
Declaration of Malta on )un%er Stri5ers
Declaration of 9MA "ifth 9orld onference on Medical Education
Resolution to Prohibit Smo5in% on International "li%hts
Declaration on the )uman /enome Pro7ect
Statement on Physician(Assisted Suicide
Statement on )ome Medical Monitorin%
Telemedicine and Medical Ethics
Resolution of the ouncil of the 9orld Medical Association
Statement on 'oise Pollution
Statement on Medical Malpractice
Statement on Alcohol and Road Safety
Statement on Issues Raised by the )I0 Epidemic
Statement on Fody Searches of Prisoners
Statement on Patient Advocacy and onfidentiality
Statement on Safety in the 9or5place
Statement on ondemnation of "emale /enital Mutilation
Statement on the Ri%ht of a 9oman to ontraception
Resolution on Rededication to the Principles of the 9orld Medical Association
Ethical Standards
Resolution on the Refu%ee Problem Around the 9orld
Resolution on Physician6s onduct oncernin% )uman Or%an Transplantation
Statement on Medical Ethics in the Event of Disasters
/7 !ORLD PSYCHIATRY ASSOCIATION
9PA Statement and 0ie$points on the Ri%hts and #e%al Safe%uards of the
Mentally Ill
Declaration of )a$aii+II
Declaration on the Participation of Psychiatrists in the Death Penalty
112
37 ACOEM - CODE OF ETHICAL CONDUCT
This ode establishes standards of professional ethical conduct $ith $hich each
member of the American olle%e of Occupational and Environmental Medicine
1AOEM3 is e!pected to comply4 These standards are intended to %uide
occupational and environmental medicine physicians in their relationship $ith the
individuals they serve employers and $or5ers6 representatives, collea%ues in the
health professions, the public and all levels of %overnment includin% the 7udiciary4
27 DECLARATIONS BY UNITED NATIONS
Principles of Medical Ethics
The Protection of Persons $ith Mental Illness and the Improvement of Mental
)ealth are
Principles for the Protection of Persons $ith Mental Illness and for the
Improvement of Mental )ealth are
97 DECLARATIONS BY COUNCIL OF EUROPE
Recommendation @2@ 12?AA3 on the Situation of the Mentally Ill
Recommendation 2C-B 12?@B3 on the :se of )uman Embryos and "etuses for
Dia%nostic, Therapeutic, Scientific, Industrial and ommercial Purposes
Recommendation 'o4 R 1A@3 ,? on )armoni*ation of #e%islation6s of Member
States Relatin% to Removal /raftin% and Transplantation of )uman Substances
Recommendation 'o4 R 1@23 2 to Member States on Re%ulations for Automated
Medical Data Fan5s
Recommendation 'o4 R 1@<3 , to the Member States oncernin% Jthe #e%al
Protection of Persons Sufferin% from Mental Disorder Placed as Involuntary
Patients
113
Recommendation 'o4 R 1?C3 < to Member States oncernin% Medical Research
on )uman Fein%s
Recommendation 'o4 R 1@C3 2= to Member States oncernin% a Fetter
Distribution of Medical are Inside and Outside )ospitals
Recommendation 'o4 R 1?C3 2< to the Member States on Prenatal /enetic
Screenin%, Prenatal /enetic Dia%nosis and Associated /enetic ounselin%
Hou can peruse copies of these Declarations at the MMA Secretariat4
114
APPENDI# V
RULES OF THE ETHICS COMMITTEE
1APPE'DIK I O" T)E MMA O'STIT:TIO'3
RULE 1
1i3 9here a complaint is brou%ht to the notice of the )onorary /eneral Secretary of
the Association re%ardin% the professional conduct of a member of the profession,
a direction shall be obtained by the Secretary from the hairman of the Ethics
ommittee as to $hether in his opinion there is a prima facie for investi%ation by the
Association4 If the complaint is unsi%ned or does not contain the ori%inal
ne$spaper cuttin% 1in the case of a complaint relatin% to alle%ed advertisin%3, the
Secretary $ill $rite to the complainant to rectify such defects before proceedin%
further on any complaint4 All anonymous complaints, i4e4 $ithout a name or contact
address $ill not be further acted upon, save at the discretion of the Ethics
ommittee in matters of serious concern to the Association4 The Secretary shall
5eep the hairman of the Ethics ommittee informed of all correspondence on
matters related to the Ethics ommittee4
1ii3 In a case submitted by a member of the profession 1hereinafter called 8the
complainant83 $ho considers that he has been 1or is3 directed affected by $hat he
alle%es to be unprofessional conduct of another member of the profession, it shall
be the duty of the )onorary Secretary of the Association before ta5in% any further
action to ascertain $hether the complainant has communicated in $ritin% $ith the
other member of the profession 1thereinafter called 8the respondent83 intimatin% that
he contemplates the initiation of a complaint throu%h the ethical machinery of the
Association4 If the complainant fails to ta5e this step $ithin t$o 1,3 $ee5s, the
propriety of his action in havin% made the complaint may itself be made a matter for
consideration4 A copy of such a letter should be e!tended to the )onorary /eneral
Secretary4
115
1iii3 If any information is brou%ht to the notice of the hairman of the Ethics ommittee
$hereby it appears that the professional conduct of a member of the profession has
been open to &uestion, it shall be competent for the hairman to direct that the
matter be treated as a complaint $ithin the meanin% of para%raph 1i3 hereof and 1if
necessary3 further to direct the )onorary /eneral Secretary or such other member
of the secretariat staff of the Association as he may appoint, shall perform such of
the duties of a complainant as he may be necessary under these Rules4
1iv3 If the hairman or the )onorary Secretary of the Ethics ommittee or a Franch
Ethics Sub(ommittee is a$are of any information either in $ritin% or verbally or
becomes a$are of any publication or circulars or stationery or of any broadcast in
Radio or Television or of any si%n or notice or $ritin% on or near the premises of a
Medical Practitioner, or of any publication in any other communication media, and if
any of these appear to refer to one or more than one Medical Practitioner and it
appears to be in contravention of The ode or the ode of Professional onduct of
the Malaysian Medical ouncil, the hairman or the )onorary Secretary of the
ommittee or ommittees above said shall $rite confidentially and by re%istered
letter to the Medical Practitioner or Practitioners concerned settin% forth the above
said information and %ivin% the Medical Practitioner t$o $ee5s to confirm or deny
the truth of the information4 If from the information supplied by the Medical
Practitioner, it appears his professional conduct is open to &uestion, or if the
Medical Practitioner fails to reply $ithin fourteen days, the matter may be treated as
a complaint under para 1i3 and 1ii3 hereof4
RULE 2
omplaints re%ardin% the professional conduct of individual members of the profession
shall be considered by the Ethics ommittee in the follo$in% circumstances .
i3 :pon reference from a Franch ommittee4
ii3 :pon a report bein% made to the ouncil of the Association by a Franch ommittee
that the propriety of a member of the Association remainin% a member may be
called into &uestion4
116
iii3 :pon a report from a member or non(member of the Malaysian Medical Association
or a member of the public, $hether the complainant is personally affected or not4
iv3 9here a matter is treated as a complaint under the provision of Rule 2 1iii34
RULE 9
An investi%ation re%ardin% the professional conduct of a member of the profession may
be held either at an ordinary meetin% of the Ethics ommittee or at a special meetin%, at
the discretion of the hairman of the Ethics ommittee4 'ot less than t$enty(one day6s
notice of the meetin% shall be %iven a$ay to every member of the committee and to all
parties concerned4
RULE 4
&) I$ 3),+, .02+5 02)$ )--+)* 0. 02+ C.($3&* .6 02+ A,,.3&)0&.$
1a3 The )onorary /eneral Secretary of the Association shall inform the
respondent that a complaint re%ardin% his conduct is to be brou%ht to the
notice of the Ethics ommittee and shall invite him to submit his $ritten
observation on the matter or to supplement any e!planation he has %iven
on a previous occasion4 If a reply is not received $ithin 2- days, a further
t$o reminders $ill be sent allo$in% an e!tension of 2- days each4 Such
letters shall be titled 8"irst Reminder8 and 8"inal Reminder84
1b3 Each party shall send to the )onorary /eneral Secretary not less than 2-
days prior to the date of the meetin% of the ommittee at $hich the
complaint is to be investi%ated copies of all documents on $hich he
intends to reply4 E!cept $ith the consent of the hairman and of other
party, no other documents shall be considered but it may be considered
or heard at an ad7ourned4
117
1c3 The committee shall investi%ate the facts of the case and shall ta5e such
evidence as shall be deemed by the ommittee necessary for the
purpose4
1d3 The hearin% of an appeal shall be held as a hearin% de novo, but no party
shall be entitled to adduce evidence additional to that called before the
Ethics ommittee by $hom the case has previously been investi%ated
$ithout the permission of the President of the ouncil4 Any application
for permission to adduce additional evidence shall be made to the
)onorary /eneral Secretary not less than fourteen days before the date
fi!ed for the hearin% of the appeal4
1ii3 In cases of Appeal .
a4 The )onorary /eneral Secretary of the Association shall inform both the
complainant and the respondent that the appeal is to be considered by
the ouncil of the Malaysian Medical Association and shall invite them to
supplement any observation or e!planations %iven on any previous
occasion in $ritin%4
b4 Para%raphs 1i3 1b3 shall apply to the ouncil of the Association $hen
hearin% an appeal4
c4 Para%raphs 1i3 1c3 and 1i3 1d3 shall apply only as re%ards documents not
relied on before the Ethics ommittee4
d4 'o party shall be entitled to adduce evidence additional to that called
before the Ethics ommittee by $hom the case has previously been
investi%ated $ithout the permission of the President of the ouncil4 Any
application for permission to adduce additional evidence shall be made to
the )onorary /eneral Secretary not less than 2- days before the date
fi!ed for the hearin% of the appeal4
1iii3 #e%al assistance either paid or unpaid is not permitted on either side at the hearin%,
but the President may allo$ any person concerned in the investi%ation to be
118
assisted in presentin% his case by a collea%ue $ho, e!cept by permission of the
ouncil, shall not be permitted to address the ouncil or to e!amine or cross
e!amine $itnesses4
RULE ;
9here the case is one affectin% only the parties concerned, it shall be competent for the
ommittee after due investi%ation and investi%ation of the case under these Rules to
approach both the complainant and the respondent $ith su%%estions or advice re%ardin%
an amicable resolution of the dispute for their acceptance4 If all parties adopt and
subse&uently put into effect such su%%estions or advice the ommittee may at its
discretion, declare the case to be finally resolved4 On receipt of information that such
su%%estions or advice have not been put into effect, the ommittee shall $ith the
permission of the hairman, further consider the case at a further meetin% of $hich
notice shall be %iven under Rule < and for $hich the procedures shall be as laid do$n in
Rule -4
RULE 6
The ommittee or ouncil shall, sub7ect in Rule = after due investi%ation adopt a
resolution in one of the follo$in% forms or in such other form as it may consider
appropriate .
(I) IN ALL CASES OTHER THAN CASES OF APPEAL
1i3 That in the opinion of the ommittee, the complaint has not been
established, and that the case be dismissed4
1ii3 That in the opinion of the ommittee, there has been no violation of the
Articles, Rules 1or Resolutions3 of the Association or Franch, or of the
%enerally accepted principles of professional conduct, and that no action
be ta5en4
119
1iii3 That in the opinion of the ommittee, the complaint is frivolous, and that
the case be dismissed4
1iv3 That in the opinion of the ommittee4444has committed an indiscretion and
error of 7ud%ement in that he has44444but that his conduct does not call for
censure4
1v3 That in the opinion of the ommittee4444has violated .
1a3 the Articles, Rules 1or Resolutions3 of the Association or Franch
1and3
1b3 the %enerally accepted principles of professional conduct, in that
he has444444444444444but that, in consideration of faults on the part of
others concerned, the case be dismissed4
1vi3 That in the opinion of the ommittee44444444444444has violated .
1a3 the Articles, Rules 1or Resolutions3 of the Association or Franch
1and3
1b3 the %enerally accepted principles of professional conduct, in that
he has44444444444444and that he be, and hereby is censured4
1vii3 That in the opinion of the ommittee4444444444444444has violated .
1a3 the Articles, Rules 1or Resolutions3 of the Association or Franch
1and3
1b3 the %enerally accepted principles of professional conduct, in that
he has4444444444444444and that he be and hereby be referred to the
Malaysian Medical ouncil4
120
1viii3 That in the opinion of the ommittee, the conduct of 44444444has been 1or is3
1a3 in violation of the Articles, Rules 1or Resolutions3 of the
Association or Franch 1and3
1b3 detrimental to the honour or interests of the Association 1and3
1c3 detrimental to the honour or interests of the medical profession in
that he has44444and 1if a member3 resolve that he be informed of
this findin% of the ommittee and allo$ed until4444444444444444to
consider his position; that the )onorary /eneral Secretary of the
Association be instructed to report in due course to the ommittee
upon his reply if any, and that, if upon, such further report the
ommittee shall consider his reply unsatisfactory, or if no reply be
received $ithin the time specified, it be recommended to the
ouncil of the Association that the ouncil in the e!ercise of its
po$er under the Articles of the Association do e!pel444444444444from
membership of the Malaysian Medical Association4
1i!3 That it is recommended to the ouncil of the Association that the ouncil
in the e!ercise of its po$ers under the Articles of Association do e!pel
from membership of the Malaysian Medical Association44444of44444a member
of the 444444Franch, on the %round that his conduct is deemed by the
ouncil to have been 1or to be3 .
1a3 detrimental to the honour and interests of the Association, 1and3
1b3 detrimental to the honour and interests of the medical profession,
1and3
1c3 calculated to brin% the profession into disrepute, 1and3
1d3 such that he has $ilfully and persistently refused to comply $ith
the Re%ulations of the Association 1or the Rule of the44444444444444444Franch34
121
In all cases in $hich a resolution is adopted by the ommittee in terms of one of
the alternatives contained in sub(para%raph 1vii3 or 1i!3 hereof the ommittee
shall prepare a statement for the information of the ouncil and such statement
shall consist of the follo$in% .
1i3 all necessary particulars concernin% the parties and the date and place of
investi%ation, the nature of the evidence adduced before the ommittee
and such other matters of a li5e nature as the ommittee shall thin5
proper4
1ii3 a summary of the facts of the matter in dispute as found by the
ommittee to have been proved; and
1iii3 a statement of the inferences 1if any3 material to the issues in dispute
dra$n by the ommittee from such facts4
(II) IN ALL CASES OF APPEAL EITHER
1i3 a resolution that the ouncil of the Association uphold the decision of the
ommittee and dismiss the appeal, or
1ii3 a resolution in one of the forms set out in sub(para%raph 1I3 1i3, 1ii3, 1iii3,
1iv3, 1v3, 1vii3, 1viii3 and 1i!3 and in addition one of the follo$in% resolutions .
1a3 that the appeal be allo$ed, or
1b3 that the appeal be dismissed, or
1c3 that the decision of the ommittee be modified accordin%ly4
RULE 7
A copy of the Resolution of the ommittee adopted under Rule B shall be sent by the
)onorary /eneral Secretary of the Association to the complainant and the respondent
and to the )onorary /eneral Secretary of such Franch 1if any3 as the ommittee shall
resolve to be directly concerned for the confidential information of the members of the
E!ecutive ommittee of such Franch as the ommittee shall resolve4
122
RULE >
Save $here the ommittee has adopted a Resolution in terms of Rule B 1I3 1i!3 if a
medical practitioner shall ma5e amends or e!press re%ret in $ritin% to the satisfaction of
the Ethics ommittee, it shall be competent for the ommittee subse&uently by
Resolution to rescind any Resolution passed under Rule B and to pass such further
Resolution 1if any3 as may appear to them appropriate in all the circumstances4
RULE ?
The Resolution of the ommittee upon a case, other than a case $here the ommittee
has adopted a Resolution in terms of Rule B 1I3, 1vii3, 1viii3 or 1i!3 shall be final unless
ne$ facts shall subse&uently be brou%ht for$ard $hich, in the opinion of the ommittee,
7ustify the case bein% reopened4 In a case $here the ommittee has adopted a
Resolution in terms of Rule B 1I3 1vii3, 1viii3 or 1i!3 such Resolution shall be final unless
the case is referred bac5 to the ommittee by the ouncil and upon any reference bac5
by the ouncil, it shall be open to the ommittee to rescind such Resolution and to pass
such further Resolution 1if any3 as may appear to them appropriate in all the
circumstances4
RULE 10
1i3 In any case, $here the ommittee has adopted a Resolution in terms of Rule B 1I3
1vii3, 1viii3 or 1i!3, the )onorary /eneral Secretary of the Association shall
communicate in $ritin% $ith the respondent and the )onorary Secretary of the
Franch of $hich the respondent is a member informin% them of the date on $hich
the Resolution $ill be considered by the ouncil and invitin% them to submit prior to
such date for the confidential information of the ouncil4
1a3 In the case of the respondent, any representation $hich he desires to
place before the ouncil; and
1b3 In the case of the )onorary Secretary of a Franch, any report $hich the
E!ecutive ommittee of the Franch shall resolve to place before the
123
ouncil in miti%ation of the conduct of the respondent $hich report may
refer to the character and status of the respondent and any other matter
$hich such Franch ommittee consider $ould further its purpose4
1ii3 Such communication from the )onorary /eneral Secretary of the Association shall
$herever reasonably practicable be sent so as to %ive both to the respondent and
to the )onorary Secretary of the Franch not less than t$enty(one days6 notice and
$here an unreasonable delay $ould be caused by delayin% the consideration of the
matter until a later meetin% of the ouncil4
1iii3 Any representation sent by the respondent and any report adopted by the E!ecutive
ommittee of a Franch and submitted by the )onorary Secretary of such Franch
under this Rule shall be communicated to the members of the ouncil and of the
Ethics ommittee only4
RULE 11
After a case has been referred to the Ethics ommittee for investi%ation, if either party
shall ma5e any report or complaint or institute any proceedin%s based on the matter in
dispute or anythin% in any $ay connected there$ith, $hether to any criminal or civil court
or any body havin% statutory or other po$ers of discipline over either party $hile the
matter is under consideration by the Ethics ommittee or the ouncil, the ommittee or
the ouncil, as the case may be, may, at its discretion, ad7ourn or refuse to proceed $ith
the investi%ation of the case4
RULE 12
1i3 If any member of the Ethics ommittee shall have ta5en part in the previous
investi%ation into any case, he shall be debarred from ta5in% part in the
consideration of such case as a member of the ouncil of the Association, but he
shall not be debarred from %ivin% evidence as to facts if called upon to do so4
1ii3 If any member of the Ethics ommittee be personally concerned in a case or be
principal or partner or assistant of any person so concerned, or have other$ise any
124
personal interest in or special 5no$led%e of the case, he shall, before the
consideration by the Ethics ommittee of any report or recommendation thereon,
disclose such interest to the ommittee and, if so decided by the ommittee, he
shall retire from the meetin% durin% such consideration, but he shall not be
debarred from %ivin% evidence as to facts if called upon to do so4
1iii3 9here the hairman of the Ethics ommittee is debarred from ta5in% part in the
consideration of a case under 1i3 or 1ii3 above, the ommittee shall appoint one of
its members to act as hairman for the purpose of the case4
RULE 19
1i3 In every case in $hich the Ethics ommittee shall, after due investi%ation in
accordance $ith these Rules, have passed a Resolution declarin% that in the
opinion of the ommittee, the conduct of any medical practitioner, $hether by
contravention of the Rules and Resolutions of a Franch, or other$ise, has been 1or
is3 detrimental to the honour and interests of medical profession or of the
Association, it shall be the duty of the )onorary /eneral Secretary of the
Association, it shall be the duty of the )onorary /eneral Secretary of the
Association, if the ommittee shall so resolve, to cause such Resolution to be
brou%ht directly to the 5no$led%e of every member of the Franch in the area of
$hich such practitioner resides, and every member of such other Franches as
hereto, $hich 'otice it shall be the duty of the )onorary /eneral Secretary of the
Association to authenticate by his si%nature4 In the case of a 'otice of $hich
copies are made by a mechanical process, it shall suffice if the si%nature of the
Secretary appears on the ori%inal 'otice and is copied as part thereof4
1ii3 In any case in $hich the Ethics ommittee shall, at the time of, or subse&uently to,
the adoption of a Resolution of the nature contemplated by para%raph 1i3 of this
Rule, have also resolved that, in the opinion of the ommittee, it is desirable that
such Resolution shall be brou%ht officially to the notice of any specified Franches of
the Association, it shall be the duty of the )onorary /eneral Secretary of the
Association to transmit copies of the said Resolution to the )onorary Secretaries of
the Franches so specified, $hose duty it shall be to brin% such Resolution in a
proper manner to the notice of the Members of the Franch4
125
1iii3 In any case in $hich the ommittee has adopted a Resolution in terms of Rule A 1I3
1viii3, no Resolution of the nature contemplated by para%raphs 1i3 or 1ii3 of this Rule
shall be adopted by the ommittee until after the consideration by the ommittee of
the report of the )onorary /eneral Secretary under Rule B 1I3 1viii3 and in any case
in $hich 'otices have been sent by the )onorary /eneral Secretary under
para%raphs 1i3 or 1ii3 of this Rule and in $hich the ommittee subse&uently rescinds
its Resolution under Rule @, it shall be the duty of the )onorary /eneral Secretary
to send to the recipients of the 'otice so sent a further notice of such rescission
and to ta5e all reasonable steps to ensure that such further notice is received by all
recipients of such ori%inal 'otice4
126
FORM OF NOTICE REFERRED TO IN PARAGRAPH (&)
A7 MALAYSIAN MEDICAL ASSOCIATION
1Private and onfidential3
NOTICE
In pursuance of Rule 2- of the Rules of the Ethics ommittee of the Association relatin%
to omplaints re%ardin% Professional onduct, 'otice is hereby %iven that a meetin% of
the ommittee, held at 444444444444444444444444444444444444444444444 on the4444444444444day
of444444444444444444444444a Resolution in the follo$in% terms $as duly passed .
8That, in the opinion of the ommittee, the conduct of4444444444444444444444has been 1or is3
detrimental to the honour and interests of the medical profession and+or to the honour
and interests of the Association in that he
has44444444444444444444444444444444444444444444444444444444444444444448
Si%ned in pursuance of the Rules of the Ethics ommittee of the Malaysian Medical
Association relatin% to the complaints re%ardin% Professional onduct4
)onorary /eneral Secretary
Malaysian Medical Association
127
RULE 14
1i3 All notices or communication re&uired by these Rules to be served on or sent to any
person may in the case of a Member of the Association be served or sent either by
personal delivery or by Re%istered Post in a prepaid letter addressed to such
member at his address appearin% in the Re%ister of Members of the Association
and in the case of a person $ho is not a member be served or sent either by
personal delivery or by bein% sent throu%h the post in a prepaid letter addressed to
such person at his last 5no$n address4 Any notice or communication if served by
post shall be deemed to have been served on the day follo$in% that on $hich the
letter is posted 1unless such day follo$in% is a Sunday or other day on $hich no
postal delivery is made, in $hich event the notice or communication shall be
deemed to have been served on the day on $hich a postal delivery shall ne!t be
made3 and in provin% service, it shall be sufficient to prove that the letter $as
properly addressed and put into the Post Office4
1ii3 The Ethics ommittee may appoint Ethics Sub(ommittee in each of the Franches
and dele%ate all or some of its functions to these Sub(ommittees, $hich shall deal
$ith all ethical complaints that arise $ithin the Franch4 9here an ethical complaint
affects members in more than one Franch, it shall be referred to the Ethics
ommittee of the Association4 In all ethical matters comin% under the Ethics Sub(
ommittee, $here the rules of the Ethics ommittee or The ode refer to the
Ethics ommittee, this shall be read as referrin% to the Ethics Sub(ommittee4
Each Ethics Sub(ommittee shall consist of the Franch hairman $ho shall be
hairman of the Sub(ommittee, the Franch Secretary, $ho shall be the Secretary
of the Sub(ommittee, and three other members $ho shall be appointed by the
Ethics ommittee4
The Rules of the Ethics ommittee shall %enerally apply to the Ethics Sub(
ommittee4
128
129