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MALAYSIAN SOCIETY FOR
COMPLEMENTARY THERAPIES
CODE
OF ETHICS
RULE ONE
MEMBERS SHALL AT ALL TIMES CONDUCT
THEMSELVES IN AN HONOURABLE
MANNER IN THEIR
RELATIONS WITH
THEIR PATIENTS,
THE PUBLIC, AND WITH
OTHER MEMBERS
OF THE SOCIETY.
1. Membersí
Obligations to their Patients
The
relationship between a
complimentary medical practitioner and
his or
her patient
is that of
a professional
with a
client. The patient
puts complete trust in practitionerís integrity and it is the duty of
Members not to abuse this trust in any way. Proper moral conduct must
always be paramount in Membersí relationship with patients. Members must
act with consideration concerning fees and justification for treatment.
Members
must take care when explaining the procedures and treatment which they
propose to administer, and should recognize the patientís right to
refuse treatment or ignore advice. Treatment
of a patient is legally permitted only with his or her expressed or
implied consent, the law regards as
an assault even the touching of one person by another without the former's
consent. It is unacceptable
to solicit a patient by any means to accept treatment when he or she has
not specifically requested it.
For
the purposes of the ìcomplementary medical treatmentî of a minor they
should obtain the consent of the parent or guardian of all patients under
the age of 18.
When
the consent of the parent or guardian cannot be obtained, members are
warned that they may, in legal terms, be committing as assault on the
patient.
Members
must take care to see that their practices are managed with due diligence,
in particular, delegation of professional duties should be made only in favour
of those qualified to accept them.
It
is the duty of the Member if he or she is away from the practice for any
length of time to ensure that adequate arrangements are made to enable
patients to receive treatment.
Members
have an implicit duty, within the law, to keep all information concerning,
and views formed about, patients entirely confidential between the Member
and the patients concerned. This
same level of confidence must be
maintained by assistants and receptionists when these are employed.
Even the fact of a patientís attendance at a Memberís practice
should be considered confidential, and should not be disclosed to a third
party without the patientís consent.
Members
are warned not to assume that details of a wifeís or husbandís case
should be freely discussed with the other.
The above ruling applies to all parties including next of kin and
Members sh
ould never allow a third person to be present unless with the
express consent of the patient.
Disclosure
of any confidential information to a third person is only in order when
all the following requirements are met.
Disclosure is in the patientís interests
It is done with the patientís knowledge and consent except
when the patient is not in a condition to give this and a third person is
in a position to be responsible for the patientís interests.
There is a real need
for such information to be imparted, such as when a Member considers a
case should be referred to a colleague.
The
only exception to this
principal confidentiality are:
When the law requires the information to divulged (see
below, Memberís Obligations to the Public).
When for reasons relating to the
condition or treatment of a patient it is undesirable to seek his
consent, but is in the patientís own interest that confidentiality
should be broken.
When the Member reasonably considers that his or her duty to
society at large takes precedence.
When it is in the interests of the complementary medical
training, or research approved by the Council, but then only with the
patientís informed consent.
Members
must ensure that they keep clear and comprehensive records of the
treatment they administer to patients.
2.
Memberís Obligations to the Public
B.1.
Disclosure of Information
Disclosure
of communications between members and their patients may be required by
Courts of Law. If
Members receive requests for the disclosure of confidential
information, they should first refer the matter to the Council for advice.
If a Member is asked in a Court of Law to disclose information
which he or she considers confidential, the Member should ask the Court to
take into consideration his or her reasons for not wishing to divulge the
information requested, i.e. on the grounds of professional secrecy.
If the Court nevertheless overrules this contention and requires
disclosure of the information, the Member may be in contempt of court by
refusing to disclose it. It
is by no means certain that complementary medical practitioner would be
afforded the same rights generally given to registered medical
practitioners regarding the withholding of confidential information on the
grounds of professional secrecy. In
serious cases, such withholding of information might be construed as an
attempt to obstruct the course of justice.
In cases where sensitive information is given to a practitioner,
especially regarding activities of a criminal nature, Members are strongly
advised to take legal advice and to consult the Council before deciding
how best to proceed.
When
in doubt concerning any matters that have legal implications, a Member
would be wise to consult the Council.
B.2
Use of the Titleí Doctorí
No
Member may use the title ëDoctorí either directly or indirectly in
such a way as to imply that he or she is a registered medical
practitioner, unless this be the case.
However, when a member has been conferred the titleí Doctor of
Complementary Medicineí by the Society, he/she shall be so entitled to
use the honorific.
Examples
of direct use by a Member would be using the title on a nameplate or
notepaper, or in a directory or simply by referring to himself or herle="mso-spacerun: yes"> registered medical
practitioner.
An
example or direct use would be to permit a person to refer to the Member
as a registered medical practitioner without correcting him or her. The
misuse of the title ëDoctorí will
be construed by the Council as misleading the public.
In
their relations overseas, members should follow the custom(s) of
professions of similar status
3.
Membersí Obligations to other Practitioners
It
is against the interests of the Society to have distrust or dispute
between Members. Members
shall at all times conduct themselves in an honourable manner in their
relations with other practitioners
C.1.
Transfer of a Patient
Action
taken by a Member to persuade the patient of another practitioner or of
his principal (if he or she is employed as an assistant), or of a clinic
in which he or she may be working, to patronize him or her is in all
circumstances unethical and contravenes this Code of Ethics. In
consequence it is advisable that Members should apply a clear and proper
procedure when exchanging or referring patients or dealing with the
patients of other practitioners.
When
a Member treats a patient of another practitioner (referred by the other
or not) due to holidays, illness, or any other reason, the Member shall
consider himself or herself to be under an obligation to encourage the
patient to return to the original practitioner as soon as that
practitioner can accept them back for treatment, and to inform the
original practitioner as to which patients have been treated and the
treatment that has been given. In the same way, when a patient attends a
second practitioner because the original practitioner has for any reason
neglected to refer them advice on where to go, the obligation on the
second practitioner still remains the same.
An exception to this may be if the original practitioner indicates
that he or she wishes otherwise.
In
all cases the decision whether or not to return to the original
practitioner rest solely with the patient and no attempt must be made by
either practitioner to persuade the patient to remain with, or to return
to, him or her. Any such attempt would, amount to soliciting the patient
to accept treatment when he or she had not specifically requested it and
would therefore be construed as unethical conduct.
If a patient decides against returning to the original
practitioner, the second practitioner should ask the patient to inform the
original practitioner in writing or should do this himself.
Where
a patient transfers to
another practitioner for any reason, eg: change of location, all possible
help should be afforded to the second practitioner if requested. The
Council would not wish to lay down specific rules as to what information
about the patient should be forwarded to the second practitioner. The
determining factor should be interests of the patient, and his or her
consent to pass on information by them in confidence should always be
obtained.
If
a patient chooses for personal reasons to transfer to another practitioner
without the knowledge or recommendation of the original practitioner, it
would be advisable as a matter of courtesy for the second practitioner to
inform the original practitioner before making any further arrangements,
so that any relevant information may be exchanged.
C.2
Denigration
No
matter how justified a practitioner may feel in holding critical view of a
colleagueís competence or behaviour, it is unprofessional and would be
considered unethical that he or she should communicate such an opinion to
a third party. Not only might such criticisms be unjustified or
slanderous, but it is contrary to good complementary medical practitioner
practice that the confidence of the public should be undermined because of
personally held views.
A
Member to whom criticisms of a colleagueís competence are communicated,
whether he or she be a member of the Society or not, should at all times
act with discretion and should himself express no opinion. An exception to
this is when a Member needs to refer a complaint to the Council.
RULE
TWO
MEMBERS
SHALL AT ALL TIMES ABIDE BY THE ADVERTISING CODES LAID DOWN BY THE COUNCIL
OF THE SOCIETY.
The
following principles will be
applied by the Professional Ethics Committee
in relation to advertisements by Members and Fellows of the Society
(hereinafter referred to as ëMembersí). The principles are explained
and amplified in the Explanatory Guidelines.
The Explanatory Guidelines will be
adapted in the light of practical experience.
1.
Advertising, both in form and content, shall be appropriate to the
interest of the patient.
2.
Advertising, both in the form and content, shall be appropriate to
the standing of the profession of complementary medicine and to the
standing of the profession generally.
3.
Advertising shall not contain claims of superiority, specialism or
curability and any claims made shall be capable of substantiation.
4.
Advertising shall not denigrate other Members of the profession or
other professions.
5.
Advertising shall not be false, fraudulent, misleading, deceptive,
self laudatory, extravagant or sensational.
6.
Advertising shall comply both with legal requirements and with the
Malaysian Code of
Advertising Practice, and other relevant codes (if any).
EXPLANATORY
GUIDELINES
A.
Interest of Patient
1.
The prime task of a complementary medical practitioner, as of any
member of the medical
and paramedical professions, is to relieve suffering.
The interests of the patient,
and of the prospective patient, as in all other are paramount at all times
in matters concerning advertising as in all other matters.
2.
Advertisements shall recognize that many patients, particularly
those who are anxious for
themselves or for their dependants, or who are in pain, may be vulnerable
to advertising encouraging them to seek treatment which, in their
particular condition, may be inappropriate or unnecessary
3.
Advertising shall not play on patientís anxiety or create
unjustified expectations as to the form or length of the treatment or its prospects
for relieving the condition concerned.
4.
The relationship between complementary medical practitioner and the
patient is one of
trust and it is essential that advertising shall be of such nature
that the trust of the patient is not abused
and his lack of knowledge of either his condition or complimentary
medicine is not exploited.
B.
Appropriate to the Profession
1.
The public expects high standards of propriety, integrity and behaviour
from the professions. Accordingly
advertising shall give members of the public the information which they
need for their confidence in complimentary medicine and in the said
profession.
2.
Advertising shall not be of a kind which could reasonably be
regarded as likely to bring the
profession into disrepute.
3.
Practices should be identified by professional name plates or signs
of a size, colour and form appropriate to the nature of the area and to
the location of the practice and bearing the names, qualifications of the
complimentary medical practitioner practicing at the premises.
The names should be of those Members regularly in attendance;
details of former practitioner should be removed within a reasonable
period of time.
4.
Non-complimentary medical qualifications and titles may be shown in
connection with a Memberís practice such as degrees from bona-fide
academic institutions, statutory designations of medical or paramedical
qualifications awarded by
established and generally recognized professional bodies of reputation and
standing. This title 'Doctor', or its
abbreviation, may not be used in any connection with the Memberís
practice unless the holder is a medical practitioner or holds a doctorate
from a recognized University or Polytechnic and it is used in a form or
manner which does not reasonably lead patients to believe that the holder
is a Doctor of Medicine, and unless has been conferred the title ìDoctor
of Complimentary Medicineî by the Society.
5.
Where fees are
quoted in
advertisement the
fees and charges
for both
the initial
consultation, subsequent
treatment sessions and likely prescription costs shall be stated.
A clear indication of exactly what is included within the fees
quoted shall also be given. (eg. Whether prescriptions, if appropriate,
are included within the initial consultation fee). If service tax is
payable, this should be stated and the free quoted should be inclusive of
service tax. Any arrangements
for the discounting of fees shall be limited to specific groups or classes
of patient and not be related to the treatment of particular conditions or
be offered in the form of vouchers, incentives or similar schemes.
6.
Advertising through unsolicited canvassing, by door to door or
postal distribution, telephone or personal visits is prohibited.
7.
Essential practice information, consisting of names and
qualifications, address and telephone numbers, hours of business and
arrangements for emergency cover and special facilities such as car
parking and crËches, and information about complementary medicine itself
may be distributed to medical and bona-fide paramedical practitioners,
dispensing chemists and non-commercial points of contact such as
libraries, information centres and citizensí advice bureaux. Members may
also circulate information about complementary medicine and their practice
to those holding formal appointments as medical or personnel officers of
commercial concerns in reasonable geographical proximity to the Memberís
practice.
8.
Members are responsible for ensuring that their advertisements
appear in surroundings which
are appropriate to professional advertisements.
9.
Where advertising takes place in joint advertisements with
practitioners of other therapies,
Members shall take reasonable steps to ensure that those other
practitioner are members of recognized professional bodies whose standards
of practice and behaviour are equivalent to those of the Society and that
the professional advertisement are clearly
separated from advertisements for commercial or leisure activities.
C.
Claims
1.
Principle 3 is a specific application of Principles 1 and 2.
2.
Claims of superiority in advertisements are inappropriate in the case of
complementary medicine because they almost certainly incapable of proof,
are liable to be misunderstood by patient and are inappropriate to a
profession.
3.
There are no recognized specialist qualifications in complimentary
medicine, hence none shall be claimed in advertisements.
4.
Advertisements which expressly or implicitly claims to cure
conditions, as distinct from relieving symptoms, is prohibited.
D.
Denigration
1.
The interests of the patient and of the profession require that any
denigration of a professional colleague, or member of another medical or
paramedical profession, whether directly or by implication, is prohibited.
E.
Broadcasts, Lectures, Articles etc.
Members
are advised to consult the Council before participating in any form of
publicity in the press, or on television or radio because:
1.
There is a risk that such participation might constitute
advertising,
2.
There may be difficulties which can be avoided only by means of expert
advice. When asked
for comment by a newspaper, Members should realize that they have little
or no control
over the published form and content, nor is there any certainty that they
will be quoted in full, or in
the context they intend. Similar
dangers exist in edited television or in the radio programs.
3.
If not properly informed on the subject matter, a contributor could be
responsible for the
publication of incorrect information and thus be the cause of
misleading information reaching the public.
The Council and every member must take all steps to ensure the
publicity originating from them
is seemly and proper, and does not in any way damage the public image of
the profession or the Societyís interests.
F.
Information Leaflets, Literature etc.
F.1.
The circulation of literature intended to educate and inform the
public about the work of the complementary medicine, the scope of his
services etc, is perfectly acceptable.
The
following rules apply:
1.
Any reference to an individual Member must be confined to his or
her name, designator letters,
address and telephone number.
2.
The literature offered should be of a strictly professional style
and format.
3.
The literature should be distributed to members of the public only
at their express wish eg. Leaflets may be left in the reception area of
the practice or posted at the request of an interested individual.
In addition, the Council may authorize the distribution of
informational literature at exhibitions, seminars etc, in which the
Society is participating.
F.2.
Members may publish books, pamphlets and articles of an informative
nature about Complementary
medicine and other subjects relevant
to it. Such publications must however be scientific or educational
value, and must avoid matters that might be considered to be in the nature
of excessive personal advertising.
The
Council considers that proper consultation over the publicity of any sort
is of paramount importance. This will not only help to avoid the pitfalls and
difficulties outlined above, but will certainly be of great assistance to
the member involved in publicity and make it easier to deal successfully
with it.
Advertising
and relations with the media are subjects of continuous review and
discussion, not only among complementary medical practitioner but all the
healing professions. It is therefore not possible to outline all the situations
and eventualities that may arise. A
Member in doubt as to any of the above matters should clarify his or her
position in advance with the Council.
G.
Commercial Activity
Members
shall not use their membership qualification
s in the commercialisation
of any product or remedy or in connection with any retail or commercial
establishment.
RULE
THREE
MEMBERS
SHALL COMPLY AT ALL TIMES WITH THE REQUIREMENTS OF THE CODE OF PRACTICE.
Any
Member who fails to meet the
requirements of the Code of Practice may be held to be in breach of the
Code of Ethics and may be subject to disciplinary measures on the grounds
of professional misconduct (see Rule six, Section B.2).
RULE
FOUR
MEMBERS
SHALL NOT GIVE FORMAL COURSES OF
INSTRUCTION IN THE PRACTICE OF COMPLIMENTARY MEDICINE WITHOUT THE APPROVAL
OF THE COUNCIL OF THE SOCIETY.
A.
Lecturing to medical and paramedical groups and the public, in order that
they may better
understand the work of the qualified complementary medical
practitioner, the scope of his or her services and overall role is
perfectly acceptable. The permitted
scope of lecturing is largely as a matter of common sense in interpreting
these guidelines. However such
lectures should be strictly informational and should not be promoted or
constructed as being a ëtrainingí in the theories or techniques of
complimentary medicine.
B.
The training of the individual or individuals by a Member in the
techniques of Complimentary
medicine without the express consent of the Council of the Society is
strictly forbidden. The only
exceptions to this rule are :-
1.
Where the training is done by
a Member under the auspices of a teaching establishment
approved by the Council of the Society.
2.
Where the Member is training other fully qualified practitioners of complementary medicine and the contents of
the course have been vetted and approved by the Council, and completion of
the course does not lead to any ëqualificationsí, ídegreesí,
certificatesí etc, apart from certificates of attendance, except where
these have been approved by the Council.
3.
The above rules do not preclude the participation of students of
complementary medicine teaching establishments approved by the Council as
observers, and in so far as they are qualified, as assistants in a
Memberís practice. Whenever
students are permitted to participate in the work of the Member must
ensure that:
3.1.
The teaching establishment where the individual studies has been
consulted and permission obtained.
3.2.
Where case taking is observed or confidential information is
discussed, by the consent of the patient is always obtained before
allowing the student access to this.
RULE
FIVE
IT
IS REQUIRED THAT MEMBERS APPLY THE FOREGOING CODE TO ALL THEIR
PROFESSIONAL ACTIVITIES.
A.
Membership of other professional Organizations
Members
of the Society may belong to other Organizations whose ethical standards
may differ from those of the Society.
Such Members must accept that their dual membership does not give
them any immunity from the consequences
of contravening the regulations of the Society whether contained in its
Constitutions and Regulations, this Code of Ethics or any rules,
memoranda, recommendations or advice issued by the Council for the conduct
of the Members.
B.
Members on the Register Practicing with Non-Member
Any
Member who has a non-member of the Society practicing
with him or her, or allows a non-member to practise at the same
time premises is warned of the risk of misleading patients di
rectly,
indirectly or by default, so as to believe that such as individual giving
treatment is a Member of the Society. Furthermore, the fact that such non-member(s)
are practicing with him or her, be they complementary medical practitioner
or members of the other professions, does not in any way alter application
of this Code of Ethics to the activities of the Member concerned.
This infraction call render a Member liable to disciplinary action.
RULE
SIX
INFRINGEMENT
OF THE ETHICAL CODE RENDERS MEMBERS LIABLE TO DISCIPLINARY ACTION
WITH SUBSEQUENT LOSS OF PRIVILEGES AND BENEFITS OF THE SOCIETY.
Professional
Misconduct
A.
General
A.1.
Examination of complaints
Members
may be assured that all allegations made against them by individuals,
whether patients or other members, will be carefully examined by the
Ethics Committee under the procedure
outlined below. Only
following such an examination might a further hearing take place
under the procedure laid down by the Council, at which it is possible,
inter alia for a members to be expelled.
The Ethics Committee acts impartially and its decisions depend
solely on the facts and circumstances of each case.
A.2.
Complaints Procedure
Complaints
against a Member are always investigated by the Council, provided
such complaints are put in writing. The
procedure is then that the Member is informed in writing of the complaint.
The complainantís letter is acknowledged, and in all cases a copy
of their letter is sent to the Member concerned.
A request for an explanation is made to the Member asking
for a detailed explanation of their side of the matter, supported
by documentary evidence when appropriate.
A complaint against a Member can only be upheld if the Member is
clearly shown to be in breach of Ethical Code, and in all other matters it
is up to the complainant, if still aggrieved, to seek redress through a
Civil Action. See Appendix
Two- Disciplinary Procedure.
A.3.
Guidance
If
any Member requires advice on a Professional or ethical problem, he or she
may consult the Council, who will refer him or her to the appropriate
person or committee for advice. If
the Council considers that giving advice may conflict with its judicial
functions, it may refer him or her to an independent adviser.
A.4.
Convictions
Members
should be aware that the Ethics Committee is obliged to accept the
findings of the Court of Law, and is not able to re-open the investigation
of facts which lead to a
conviction. The Ethics
Committee will consider only the seriousness of the conviction and any
surrounding circumstances in mitigation.
Members should therefore treat with caution any encouragement to
plead guilty to an offence and should take legal advice where possible.
B.
Proscribed Conduct
B.1
Interpretation
It
is reiterated that the
interpretation of ëProscribed Conductí which is provided in this Code
of Ethics for the purposes of the disciplinary procedure, is not
exhaustive and is intended as guidance only.
B.2
Examples of Proscribed Conduct
Any
Member who:-
1.
brings the profession into disrepute be his or her personal behaviour,
eg.
Being convicted of
drunkenness, drug abuse or an offence of dishonesty
2.
fails properly to care for a patient or neglects his or her
practice, eg. By failing to conform
with the standards laid down by the Code of Practice, or Local Authority
by-laws , or by infringing the guidelines in this Code of Ethics as to,
example, delegation of duties; or
3.
abuses of his or her position of
trust as a complementary medical practitioner
eg.
by breaching a patientís
confidence, or by using undue influence to obtain gifts or other benefits
from a patient,
shall
render himself of herself liable to disciplinary procedures.
C.
Personal Relations between Complementary Medical Practitioner and
their Patients
C.1.
Certain behaviour may render a Member liable to prosecution under
Criminal Law.
Even it there is no prosecution such behaviour is likely to be
treated as serious professional misconduct.
C.2.
The Council is concerned mainly with the possible abuse of a complementary
Medical practitionerís
position of trust. Thus, the
abuse of professional visits to a
patientís home or the abuse of knowledge gained in professional
confidence to pursue a personal relationship with either
the patient or a member of his or her family, is viewed as
unethical.
C.3.
It is possible for patients to cause embarrassment and worry by forcing
their attention
on a practitioner. The
Council reiterates that all allegations of
professional misconduct
are examined most carefully.
D.
Professional Standards
A
Member in addition renders himself or herself liable to disciplinary
procedures for any breach of This Code, as for example, if he or she:
1.
Conducts himself or herself unethically in relation to another
practitioner, eg. in relation to the transfer of a patient, or by
denigrating the reputation of the practitioner or
2.
Infringes the guidelines in this Code of Ethics as to advertising,
or otherwise conducts himself or herself in a manner calculated to attract
patients, or to promote his or her own professional attainments.
IN
CONCLUSION
It
is finally reiterated that no document can cover all eventualities, and it
is yet again
emphasized that if in doubt the Council should be consulted.
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