Bound by a code of ethics

THE injudicious and irresponsible comments of senior physician and Chairman of the Medical Legal Society, Dr Mike Rogers regarding the Tomlin-Newsome case (South China Morning Post, June 28 and 29) should not go unchallenged.

Before these, or the arguably prudish indignation of one judge, cloud the issue, the facts of the case need to be clarified to determine whether a real problem exists. The main issue here is not adultery, but whether the clinician involved had an affair with a patient.

All health care professionals are bound by a code of ethics; such codes define a set of duties, and correlative patient rights, by which standards of practice are set and evaluated.

Although some of these duties are not enforceable by law, they are accepted rules by which each profession governs itself, to which all practitioners are expected to adhere, and which exist primarily to ensure standards of conduct and patient care.

Clinicians are expected to recognise potential conflicts in practice, and to apply knowledge of these codes, and their professional expertise, to evaluate possible consequences, before deciding how best to act in each situation. It does not require an expert in biomedical ethics to recognise potential conflict when a clinician is the patient's lover.

Possible consequences include less objective clinical judgment, possibly leading to clinical error; frank discrimination against other patients, who may well be deferred if another receives preferential treatment; the clinician's lover being less likely to form an unbiased opinion as to the standard of care being received, or alternative choices of treatment. Such consequences are potentially damaging, contravene basic patient rights, and lower standards of practice. Attractions do occur, and relationships commonly develop, in the workplace.