The Medical
Board’s consultation on its draft revised guidelines Code of Conduct:
Good medical practice – A code of conduct for doctors in Australia (the draft code), concluded last month. The draft code will replace
the current Good medical
practice: A code of conduct for doctors in Australia dated March 2014.
While codes
are an important tool for setting standards about acceptable conduct, we
believe there are many problematic aspects of the draft code. In our submission
to the consultation we highlighted these and called upon the Board to address them
in the final version of the code.
Many clauses in the draft code
are too wordy and confusing, and it is not clear how they would work in
practice. It is as if the draft code
seeks to deal with every possible interaction between a doctor and a patient
and set guidance about how this is to occur. We
believe that the increased length of the code (from 22 to 31 pages) will discourage
doctors from referring to it. Doctors
are already burdened with excessive regulation and bureaucracy and the draft
code does nothing to alleviate this, but appears to add to it.
Of
particular concern to us are the following sections of the code.
The
provisions on culturally safe and respectful practice which are intended to
assist doctors in caring for patients from diverse backgrounds, risk leaving
doctors unsure about whether they should challenge cultural practices where
they conflict with good medical practice. Doctors should not feel constrained
from recommending appropriate treatment to
patients from culturally diverse backgrounds.
The section
of the draft code on professionalism potentially limits doctors’ speech and may
impact on the ability of doctors to comment on issues they believe are
important. The proposed revised code requires a doctor who states a view which
differs from the profession’s “generally accepted views” to make an
acknowledgement of the profession’s view or risk disciplinary action. Determining the profession’s generally
accepted view on an issue may be difficult. In addition, the clause as
currently drafted does not distinguish between clinical, personal or
professional issues. Doctors should be free to express their views without the
threat of regulatory action by the Board.
We believe
that the parts of the draft code which seek to address discrimination, bullying
and sexual harassment in the profession also require review. It is important that
the code is clear that discrimination, bullying and harassment are unacceptable,
but the obligations imposed on individual doctors within this section exceed
existing obligations under current workplace laws.
Additionally, responsibilities on employers and employees for bullying,
discrimination and sexual harassment in the workplace are set out in a range of
state, territory and federal laws and employer policy. This is a
complicated area of the law and disputes are usually adjudicated in specialist
tribunals such as the Fair Work Commission or other discrimination
tribunals. It is not clear how the code will articulate with other forums
that deal with bullying, discrimination and sexual harassment.
We believe
that more work is needed by the Board to address these issues in the final
version of the code. We are hopeful that the revised code will be a useful
guide for practitioners to good medical practice not a hindrance.
More
information
Read Avant’s
submission to the Medical Board dated 16 August 2018.