Dec 08 2013

MEDICAL ETHICS

IMAMaharashtraState.org @ 8:44 pm

CODE OF MEDICAL ETHICS 2002
Indian Medical Council

(Professional Conduct, Etiquette and Ethics) Regulations, 2002

(Published in Part III, Section 4 of the Gazette of India, dated 6th April, 2002)

MEDICAL COUNCIL OF INDIA

NOTIFICATION

New Delhi, dated 11th March, 2002

No. MCI-211(2)/2001/Registration. In exercise of the powers conferred under section 20A read
with section 33(m) of the Indian Medical Council Act, 1956 (102 of 1956), the Medical Council of
India, with the previous approval of the Central Government, hereby makes the following
regulations relating to the Professional Conduct, Etiquette and Ethics for registered medical
practitioners, namely:-

Short Title and Commencement: (1) These Regulations may be called the Indian Medical
Council (Professional conduct, Etiquette and Ethics) Regulations, 2002. (2)They shall come into
force on the date of their publication in the Official Gazette.

CHAPTER I

1. CODE OF MEDICAL ETHICS

A. Declaration: Each applicant, at the time of making an application for registration under the
provisions of the Act, shall be provided a copy of the declaration and shall submit a duly signed
Declaration as provided in Appendix 1. The applicant shall also certify that he/she had read and
agreed to abide by the same.

B. Duties and responsibilities of the Physician in general:

1.1 Character of Physician (Doctors with qualification of MBBS or MBBS with post graduate
degree/ diploma or with equivalent qualification in any medical discipline):

1.1.1 A physician shall uphold the dignity and honour of his profession.

1.1.2 The prime object of the medical profession is to render service to humanity; reward or
financial gain is a subordinate consideration. Who- so-ever chooses his profession, assumes the
obligation to conduct himself in accordance with its ideals. A physician should be an upright
man, instructed in the art of healings. He shall keep himself pure in character and be diligent in
caring for the sick; he should be modest, sober, patient, prompt in discharging his duty without
anxiety; conducting himself with propriety in his profession and in all the actions of his life.

1.1.3 No person other than a doctor having qualification recognised by Medical Council of India
and registered with Medical Council of India/State Medical Council (s) is allowed to practice
Modern system of Medicine or Surgery. A person obtaining qualification in any other system of
Medicine is not allowed to practice Modern system of Medicine in any form.

1.2 Maintaining good medical practice:

1.2.1 The Principal objective of the medical profession is to render service to humanity with full
respect for the dignity of profession and man. Physicians should merit the confidence of patients
entrusted to their care, rendering to each a full measure of service and devotion. Physicians
should try continuously to improve medical knowledge and skills and should make available to
their patients and colleagues the benefits of their professional attainments. The physician should
practice methods of healing founded on scientific basis and should not associate professionally
with anyone who violates this principle. The honoured ideals of the medical profession imply that
the responsibilities of the physician extend not only to individuals but also to society.
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1.2.2 Membership in Medical Society: For the advancement of his profession, a physician should
affiliate with associations and societies of allopathic medical professions and involve actively in
the functioning of such bodies.

1.2.3 A Physician should participate in professional meetings as part of Continuing Medical
Education programmes, for at least 30 hours every five years, organized by reputed professional
academic bodies or any other authorized organisations. The compliance of this requirement
shall be informed regularly to Medical Council of India or the State Medical Councils as the case
may be.

1.3 Maintenance of medical records:

1.3.1 Every physician shall maintain the medical records pertaining to his / her indoor patients
for a period of 3 years from the date of commencement of the treatment in a standard proforma
laid down by the Medical Council of India and attached as Appendix 3.

1.3.2. If any request is made for medical records either by the patients / authorised attendant or
legal authorities involved, the same may be duly acknowledged and documents shall be issued
within the period of 72 hours.

1.3.3 A Registered medical practitioner shall maintain a Register of Medical Certificates giving
full details of certificates issued. When issuing a medical certificate he / she shall always enter
the identification marks of the patient and keep a copy of the certificate. He / She shall not omit
to record the signature and/or thumb mark, address and at least one identification mark of the
patient on the medical certificates or report. The medical certificate shall be prepared as in
Appendix 2.

1.3.4 Efforts shall be made to computerize medical records for quick retrieval.

1.4 Display of registration numbers:

1.4.1 Every physician shall display the registration number accorded to him by the State Medical
Council / Medical Council of India in his clinic and in all his prescriptions, certificates, money
receipts given to his patients.

1.4.2 Physicians shall display as suffix to their names only recognized medical degrees or such
certificates/diplomas and memberships/honours which confer professional knowledge or
recognizes any exemplary qualification/achievements.

1.5 Use of Generic names of drugs: Every physician should, as far as possible, prescribe
drugs with generic names and he / she shall ensure that there is a rational prescription and use
of drugs.

1.6 Highest Quality Assurance in patient care: Every physician should aid in safeguarding the
profession against admission to it of those who are deficient in moral character or education.
Physician shall not employ in connection with his professional practice any attendant who is
neither registered nor enlisted under the Medical Acts in force and shall not permit such persons
to attend, treat or perform operations upon patients wherever professional discretion or skill is
required.

1.7 Exposure of Unethical Conduct: A Physician should expose, without fear or favour,
incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession.

1.8 Payment of Professional Services: The physician, engaged in the practice of medicine
shall give priority to the interests of patients. The personal financial interests of a physician
should not conflict with the medical interests of patients. A physician should announce his fees
before rendering service and not after the operation or treatment is under way. Remuneration
received for such services should be in the form and amount specifically announced to the
patient at the time the service is rendered. It is unethical to enter into a contract of “no cure no
payment”. Physician rendering service on behalf of the state shall refrain from anticipating or
accepting any consideration.
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1.9 Evasion of Legal Restrictions: The physician shall observe the laws of the country in
regulating the practice of medicine and shall also not assist others to evade such laws. He
should be cooperative in observance and enforcement of sanitary laws and regulations in the
interest of public health. A physician should observe the provisions of the State Acts like Drugs
and Cosmetics Act, 1940; Pharmacy Act, 1948; Narcotic Drugs and Psychotropic substances
Act, 1985; Medical Termination of Pregnancy Act, 1971; Transplantation of Human Organ Act,
1994; Mental Health Act, 1987; Environmental Protection Act, 1986; Pre–natal Sex
Determination Test Act, 1994; Drugs and Magic Remedies (Objectionable Advertisement) Act,
1954; Persons with Disabilities (Equal Opportunities and Full Participation) Act, 1995 and Bio –
Medical Waste (Management and Handling) Rules, 1998 and such other Acts, Rules,
Regulations made by the Central/State Governments or local Administrative Bodies or any other
relevant Act relating to the protection and promotion of public health.

CHAPTER 2

2. DUTIES OF PHYSICIANS TO THEIR PATIENTS

2.1 Obligations to the Sick

2.1.1 Though a physician is not bound to treat each and every person asking his services, he
should not only be ever ready to respond to the calls of the sick and the injured, but should be
mindful of the high character of his mission and the responsibility he discharges in the course of
his professional duties. In his treatment, he should never forget that the health and the lives of
those entrusted to his care depend on his skill and attention. A physician should endeavour to
add to the comfort of the sick by making his visits at the hour indicated to the patients. A
physician advising a patient to seek service of another physician is acceptable, however, in case
of emergency a physician must treat the patient. No physician shall arbitrarily refuse treatment to
a patient. However for good reason, when a patient is suffering from an ailment which is not
within the range of experience of the treating physician, the physician may refuse treatment and
refer the patient to another physician.

2.1.2 Medical practitioner having any incapacity detrimental to the patient or which can affect his
performance vis-à-vis the patient is not permitted to practice his profession

2.2 Patience, Delicacy and Secrecy : Patience and delicacy should characterize the physician.
Confidences concerning individual or domestic life entrusted by patients to a physician and
defects in the disposition or character of patients observed during medical attendance should
never be revealed unless their revelation is required by the laws of the State. Sometimes,
however, a physician must determine whether his duty to society requires him to employ
knowledge, obtained through confidence as a physician, to protect a healthy person against a
communicable disease to which he is about to be exposed. In such instance, the physician
should act as he would wish another to act toward one of his own family in like circumstances.

2.3 Prognosis: The physician should neither exaggerate nor minimize the gravity of a patient?s
condition. He should ensure himself that the patient, his relatives or his responsible friends have
such knowledge of the patient?s condition as will serve the best interests of the patient and the
family.

2.4 The Patient must not be neglected: A physician is free to choose whom he will serve. He
should, however, respond to any request for his assistance in an emergency. Once having
undertaken a case, the physician should not neglect the patient, nor should he withdraw from
the case without giving adequate notice to the patient and his family. Provisionally or fully
registered medical practitioner shall not willfully commit an act of negligence that may deprive
his patient or patients from necessary medical care.

2.5 Engagement for an Obstetric case: When a physician who has been engaged to attend an
obstetric case is absent and another is sent for and delivery accomplished, the acting physician
is entitled to his professional fees, but should secure the patient?s consent to resign on the
arrival of the physician engaged.

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CHAPTER 3

3. DUTIES OF PHYSICIAN IN CONSULTATION

3.1 Unnecessary consultations should be avoided:

3.1.1 However in case of serious illness and in doubtful or difficult conditions, the physician
should request consultation, but under any circumstances such consultation should be justifiable
and in the interest of the patient only and not for any other consideration.

3.1.2 Consulting pathologists /radiologists or asking for any other diagnostic Lab investigation
should be done judiciously and not in a routine manner.

3.2 Consultation for Patient’s Benefit: In every consultation, the benefit to the patient is of
foremost importance. All physicians engaged in the case should be frank with the patient and his
attendants.

3.3 Punctuality in Consultation: Utmost punctuality should be observed by a physician in
making themselves available for consultations.

3.4 Statement to Patient after Consultation:

3.4.1 All statements to the patient or his representatives should take place in the presence of the
consulting physicians, except as otherwise agreed. The disclosure of the opinion to the patient
or his relatives or friends shall rest with the medical attendant.

3.4.2 Differences of opinion should not be divulged unnecessarily but when there is
irreconcilable difference of opinion the circumstances should be frankly and impartially explained
to the patient or his relatives or friends. It would be opened to them to seek further advice as
they so desire.

3.5 Treatment after Consultation: No decision should restrain the attending physician from
making such subsequent variations in the treatment if any unexpected change occurs, but at the
next consultation, reasons for the variations should be discussed/ explained. The same
privilege, with its obligations, belongs to the consultant when sent for in an emergency during
the absence of attending physician. The attending physician may prescribe medicine at any time
for the patient, whereas the consultant may prescribe only in case of emergency or as an expert
when called for.

3.6 Patients Referred to Specialists: When a patient is referred to a specialist by the attending
physician, a case summary of the patient should be given to the specialist, who should
communicate his opinion in writing to the attending physician.

3.7 Fees and other charges:

3.7.1 A physician shall clearly display his fees and other charges on the board of his chamber
and/or the hospitals he is visiting. Prescription should also make clear if the Physician himself
dispensed any medicine.

3.7.2 A physician shall write his name and designation in full along with registration particulars in
his prescription letter head.

Note: In Government hospital where the patient–load is heavy, the name of the prescribing
doctor must be written below his/her signature.

CHAPTER 4

4. RESPONSIBILITIES OF PHYSICIANS TO EACH OTHER

4.1 Dependence of Physicians on each other : A physician should consider it as a pleasure
and privilege to render gratuitous service to all physicians and their immediate family
dependants. 5

4.2 Conduct in consultation : In consultations, no insincerity, rivalry or envy should be
indulged in. All due respect should be observed towards the physician in-charge of the case and
no statement or remark be made, which would impair the confidence reposed in him. For this
purpose no discussion should be carried on in the presence of the patient or his representatives.

4.3 Consultant not to take charge of the case: When a physician has been called for
consultation, the Consultant should normally not take charge of the case, especially on the
solicitation of the patient or friends. The Consultant shall not criticize the referring physician. He /
she shall discuss the diagnosis treatment plan with the referring physician.

4.4 Appointment of Substitute: Whenever a physician requests another physician to attend his
patients during his temporary absence from his practice, professional courtesy requires the
acceptance of such appointment only when he has the capacity to discharge the additional
responsibility along with his / her other duties. The physician acting under such an appointment
should give the utmost consideration to the interests and reputation of the absent physician and
all such patients should be restored to the care of the latter upon his/her return.

4.5 Visiting another Physician’s Case: When it becomes the duty of a physician occupying an
official position to see and report upon an illness or injury, he should communicate to the
physician in attendance so as to give him an option of being present. The medical officer /
physician occupying an official position should avoid remarks upon the diagnosis or the
treatment that has been adopted.

CHAPTER 5

5 DUTIES OF PHYSICIAN TO THE PUBLIC AND TO THE PARAMEDICAL PROFESSION

5.1 Physicians as Citizens: Physicians, as good citizens, possessed of special training should
disseminate advice on public health issues. They should play their part in enforcing the laws of
the community and in sustaining the institutions that advance the interests of humanity. They
should particularly co-operate with the authorities in the administration of sanitary/public health
laws and regulations.

5.2 Public and Community Health: Physicians, especially those engaged in public health work,
should enlighten the public concerning quarantine regulations and measures for the prevention
of epidemic and communicable diseases. At all times the physician should notify the constituted
public health authorities of every case of communicable disease under his care, in accordance
with the laws, rules and regulations of the health authorities. When an epidemic occurs a
physician should not abandon his duty for fear of contracting the disease himself.

5.3 Pharmacists / Nurses: Physicians should recognize and promote the practice of different
paramedical services such as, pharmacy and nursing as professions and should seek their
cooperation wherever required.

CHAPTER 6

6. UNETHICAL ACTS : A physician shall not aid or abet or commit any of the following acts
which shall be construed as unethical –

6.1 Advertising:

6.1.1 Soliciting of patients directly or indirectly, by a physician, by a group of physicians or by
institutions or organisations is unethical. A physician shall not make use of him / her (or his / her
name) as subject of any form or manner of advertising or publicity through any mode either
alone or in conjunction with others which is of such a character as to invite attention to him or to
his professional position, skill, qualification, achievements, attainments, specialities,
appointments, associations, affiliations or honours and/or of such character as would ordinarily
result in his self aggrandizement. A physician shall not give to any person, whether for
compensation or otherwise, any approval, recommendation, endorsement, certificate, report or 6
statement with respect of any drug, medicine, nostrum remedy, surgical, or therapeutic article,
apparatus or appliance or any commercial product or article with respect of any property, quality
or use thereof or any test, demonstration or trial thereof, for use in connection with his name,
signature, or photograph in any form or manner of advertising through any mode nor shall he
boast of cases, operations, cures or remedies or permit the publication of report thereof through
any mode. A medical practitioner is however permitted to make a formal announcement in press
regarding the following:
(1) On starting practice.
(2) On change of type of practice.
(3) On changing address.
(4) On temporary absence from duty.
(5) On resumption of another practice.
(6) On succeeding to another practice.
(7) Public declaration of charges.

6.1.2 Printing of self photograph, or any such material of publicity in the letter head or on sign
board of the consulting room or any such clinical establishment shall be regarded as acts of self
advertisement and unethical conduct on the part of the physician. However, printing of sketches,
diagrams, picture of human system shall not be treated as unethical.

6.2 Patent and Copy rights: A physician may patent surgical instruments, appliances and
medicine or Copyright applications, methods and procedures. However, it shall be unethical if
the benefits of such patents or copyrights are not made available in situations where the interest
of large population is involved.

6.3 Running an open shop (Dispensing of Drugs and Appliances by Physicians): – A
physician should not run an open shop for sale of medicine for dispensing prescriptions
prescribed by doctors other than himself or for sale of medical or surgical appliances. It is not
unethical for a physician to prescribe or supply drugs, remedies or appliances as long as there is
no exploitation of the patient. Drugs prescribed by a physician or brought from the market for a
patient should explicitly state the proprietary formulae as well as generic name of the drug.

6.4 Rebates and Commission:

6.4.1 A physician shall not give, solicit, or receive nor shall he offer to give solicit or receive, any
gift, gratuity, commission or bonus in consideration of or return for the referring, recommending
or procuring of any patient for medical, surgical or other treatment. A physician shall not directly
or indirectly, participate in or be a party to act of division, transfe rence, assignment,
subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment.

6.4.2 Provisions of para 6.4.1 shall apply with equal force to the referring, recommending or
procuring by a physician or any person, specimen or material for diagnostic purposes or other
study / work. Nothing in this section, however, shall prohibit payment of salaries by a qualified
physician to other duly qualified person rendering medical care under his supervision.

6.5 Secret Remedies: The prescribing or dispensing by a physician of secret remedial agents of
which he does not know the composition, or the manufacture or promotion of their use is
unethical and as such prohibited. All the drugs prescribed by a physician should always carry a
proprietary formula and clear name.

6.6 Human Rights: The physician shall not aid or abet torture nor shall he be a party to either
infliction of mental or physical trauma or concealment of torture inflicted by some other person or
agency in clear violation of human rights.

6.7 Euthanasia: Practicing euthanasia shall constitute unethical conduct. However on specific
occasion, the question of withdrawing supporting devices to sustain cardio-pulmonary function
even after brain death, shall be decided only by a team of doctors and not merely by the treating
physician alone. A team of doctors shall declare withdrawal of support system. Such team shall
consist of the doctor in charge of the patient, Chief Medical Officer / Medical Officer in charge of
the hospital and a doctor nominated by the in-charge of the hospital from the hospital staff or in
accordance with the provisions of the Transplantation of Human Organ Act, 1994.
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The Clause No. 6.8, as under, is included in terms of Notification published on
14.12.2009 in Gazette of India & the same is also enclosed as Annexure – I.

“6.8 Code of conduct for doctors and professional association of doctors in their
relationship with pharmaceutical and allied health sector industry.

6.8.1 In dealing with Pharmaceutical and allied health sector industry, a medical
practitioner shall follow and adhere to the stipulations given below:-

a) Gifts: A medical practitioner shall not receive any gift from any pharmaceutical
or allied health care industry and their sales people or representatives.

b) Travel facilities: A medical practitioner shall not accept any travel facility inside
the country or outside, including rail, air, ship , cruise tickets, paid vacations etc.
from any pharmaceutical or allied healthcare industry or their representatives for
self and family members for vacation or for attending conferences, seminars,
workshops, CME programme etc as a delegate.

c) Hospitality: A medical practitioner shall not accept individually any hospitality
like hotel accommodation for self and family members under any pretext.

d) Cash or monetary grants: A medical practitioner shall not receive any cash or
monetary grants from any pharmaceutical and allied healthcare industry for
individual purpose in individual capacity under any pretext. Funding for medical
research, study etc. can only be received through approved institutions by
modalities laid down by law / rules / guidelines adopted by such approved
institutions, in a transparent manner. It shall always be fully disclosed.

e) Medical Research: A medical practitioner may carry out, participate in, work in
research projects funded by pharmaceutical and allied healthcare industries. A
medical practitioner is obliged to know that the fulfillment of the following items (i)
to (vii) will be an imperative for undertaking any research assignment / project
funded by industry – for being proper and ethical. Thus, in accepting such a
position a medical practitioner shall:-

(i) Ensure that the particular research proposal(s) has the due permission from the
competent concerned authorities.

(ii) Ensure that such a research project(s) has the clearance of national/ state /
institutional ethics committees / bodies.

(iii) Ensure that it fulfils all the legal requirements prescribed for medical research.

(iv) Ensure that the source and amount of funding is publicly disclosed at the
beginning itself.

(v) Ensure that proper care and facilities are provided to human volunteers, if they
are necessary for the research project(s).

(vi) Ensure that undue animal experimentations are not done and when these are
necessary they are done in a scientific and a humane way.

(vii) Ensure that while accepting such an assignment a medical practitioner shall
have the freedom to publish the results of the research in the greater interest of the
society by inserting such a clause in the MoU or any other document / agreement
for any such assignment.

f) Maintaining Professional Autonomy: In dealing with pharmaceutical and allied
healthcare industry a medical practitioner shall always ensure that there shall
never be any compromise either with his / her own professional autonomy and / or
with the autonomy and freedom of the medical institution. 8

g) Affiliation: A medical practitioner may work for pharmaceutical and allied
healthcare industries in advisory capacities, as consultants, as researchers, as
treating doctors or in any other professional capacity. In doing so, a medical
practitioner shall always:

(i) Ensure that his professional integrity and freedom are maintained.
(ii) Ensure that patients interest are not compromised in any way.
(iii) Ensure that such affiliations are within the law.
(iv) Ensure that such affiliations / employments are fully transparent and disclosed.

h) Endorsement: A medical practitioner shall not endorse any drug or product of
the industry publically. Any study conducted on the efficacy or otherwise of such
products shall be presented to and / or through appropriate scientific bodies or
published in appropriate scientific journals in a proper way”.

CHAPTER 7

7. MISCONDUCT : The following acts of commission or omission on the part of a physician
shall constitute professional misconduct rendering him/her liable for disciplinary action

7.1 Violation of the Regulations: If he/she commits any violation of these Regulations.

7.2 If he/she does not maintain the medical records of his/her indoor patients for a period of
three years as per regulation 1.3 and refuses to provide the same within 72 hours when the
patient or his/her authorised representative makes a request for it as per the regulation 1.3.2.

7.3 If he/she does not display the registration number accorded to him/her by the State Medical
Council or the Medical Council of India in his clinic, prescriptions and certificates etc. issued by
him or violates the provisions of regulation 1.4.2.

7.4 Adultery or Improper Conduct: Abuse of professional position by committing adultery or
improper conduct with a patient or by maintaining an improper association with a patient will
render a Physician liable for disciplinary action as provided under the Indian Medical Council
Act, 1956 or the concerned State Medical Council Act.

7.5 Conviction by Court of Law: Conviction by a Court of Law for offences involving moral
turpitude / Criminal acts.

7.6 Sex Determination Tests: On no account sex determination test shall be undertaken with
the intent to terminate the life of a female foetus developing in her mother?s womb, unless there
are other absolute indications for termination of pregnancy as specified in the Medical
Termination of Pregnancy Act, 1971. Any act of termination of pregnancy of normal female
foetus amounting to female foeticide shall be regarded as professional misconduct on the part of
the physician leading to penal erasure besides rendering him liable to criminal proceedings as
per the provisions of this Act.

7.7 Signing Professional Certificates, Reports and other Documents: Registered medical
practitioners are in certain cases bound by law to give, or may from time to time be called upon
or requested to give certificates, notification, reports and other documents of similar character
signed by them in their professional capacity for subsequent use in the courts or for
administrative purposes etc. Such documents, among others, include the ones given at
Appendix –4. Any registered practitioner who is shown to have signed or given under his name
and authority any such certificate, notification, report or document of a similar character which is
untrue, misleading or improper, is liable to have his name deleted from the Register.

7.8 A registered medical practitioner shall not contravene the provisions of the Drugs and
Cosmetics Act and regulations made there under. Accordingly,

a) Prescribing steroids/ psychotropic drugs when there is no absolute medical
indication;
b) Selling Schedule „H? & „L? drugs and poisons to the public except to his patient; 9
in contravention of the above provisions shall constitute gross professional
misconduct on the part of the physician.

7.9 Performing or enabling unqualified person to perform an abortion or any illegal operation for
which there is no medical, surgical or psychological indication.

7.10 A registered medical practitioner shall not issue certificates of efficiency in modern
medicine to unqualified or non-medical person.

(Note: The foregoing does not restrict the proper training and instruction of bonafide
students, midwives, dispensers, surgical attendants, or skilled mechanical and technical
assistants and therapy assistants under the personal supervision of physicians.)

7.11 A physician should not contribute to the lay press articles and give interviews regarding
diseases and treatments which may have the effect of advertising himself or soliciting practices;
but is open to write to the lay press under his own name on matters of public health, hygienic
living or to deliver public lectures, give talks on the radio/TV/internet chat for the same purpose
and send announcement of the same to lay press.

7.12 An institution run by a physician for a particular purpose such as a maternity home, nursing
home, private hospital, rehabilitation centre or any type of training institution etc. may be
advertised in the lay press, but such advertisements should not contain anything more than the
name of the institution, type of patients admitted, type of training and other facilities offered and
the fees.

7.13 It is improper for a physician to use an unusually large sign board and write on it anything
other than his name, qualifications obtained from a University or a statutory body, titles and
name of his speciality, registration number including the name of the State Medical Council
under which registered. The same should be the contents of his prescription papers. It is
improper to affix a sign-board on a chemist?s shop or in places where he does not reside or
work.

7.14 The registered medical practitioner shall not disclose the secrets of a patient that have
been learnt in the exercise of his / her profession except –
i) in a court of law under orders of the Presiding Judge;
ii) in circumstances where there is a serious and identified risk to a specific person
and / or community; and
iii) notifiable diseases.

In case of communicable / notifiable diseases, concerned public health authorities should be
informed immediately.

7.15 The registered medical practitioner shall not refuse on religious grounds alone to give
assistance in or conduct of sterility, birth control, circumcision and medical termination of
Pregnancy when there is medical indication, unless the medical practitioner feels himself/herself
incompetent to do so.

7.16 Before performing an operation the physician should obtain in writing the consent from the
husband or wife, parent or guardian in the case of minor, or the patient himself as the case may
be. In an operation which may result in sterility the consent of both husband and wife is needed.

7.17 A registered medical practitioner shall not publish photographs or case reports of his / her
patients without their permission, in any medical or other journal in a manner by which their
identity could be made out. If the identity is not to be disclosed, the consent is not needed.

7.18 In the case of running of a nursing home by a physician and employing assistants to help
him / her, the ultimate responsibility rests on the physician.

7.19 A Physician shall not use touts or agents for procuring patients.

7.20 A Physician shall not claim to be specialist unless he has a special qualification in that
branch. 10

7.21 No act of invitro fertilization or artificial insemination shall be undertaken without the
informed consent of the female patient and her spouse as well as the donor. Such consent shall
be obtained in writing only after the patient is provided, at her own level of comprehension, with
sufficient information about the purpose, methods, risks, inconveniences, disappointments of the
procedure and possible risks and hazards.

7.22 Research: Clinical drug trials or other research involving patients or volunteers as per the
guidelines of ICMR can be undertaken, provided ethical considerations are borne in mind.
Violation of existing ICMR guidelines in this regard shall constitute misconduct. Consent taken
from the patient for trial of drug or therapy which is not as per the guidelines shall also be
construed as misconduct.

The following Clause No. 7.23 & 7.24 are deleted in terms of Notification published
on 22.02.2003 in Gazette of India & the same is also enclosed as Annexure – II.

7.23 If a physician posted in rural area is found absent on more than two occasions during
inspection by the Head of the District Health Authority or the Chairman, Zila Parishad, the same
shall be construed as a misconduct if it is recommended to the Medical Council of India/State
Medical Council by the State Government for action under these Regulations.

7.24 If a physician posted in a medical college/institution both as teaching faculty or otherwise
shall remain in hospital/college during the assigned duty hours. If they are found absent on more
than two occasions during this period, the same shall be construed as a misconduct if it is
certified by the Principal/Medical Superintendent and forwarded through the State Government
to Medical Council of India/State Medical Council for action under these Regulations.

CHAPTER 8

8. PUNISHMENT AND DISCIPLINARY ACTION

8.1 It must be clearly understood that the instances of offences and of Professional misconduct
which are given above do not constitute and are not intended to constitute a complete list of the
infamous acts which calls for disciplinary action, and that by issuing this notice the Medical
Council of India and or State Medical Councils are in no way precluded from considering and
dealing with any other form of professional misconduct on the part of a registered practitioner.
Circumstances may and do arise from time to time in relation to which there may occur
questions of professional misconduct which do not come within any of these categories. Every
care should be taken that the code is not violated in letter or spirit. In such instances as in all
others, the Medical Council of India and/or State Medical Councils have to consider and decide
upon the facts brought before the Medical Council of India and/or State Medical Councils.

8.2 It is made clear that any complaint with regard to professional misconduct can be brought
before the appropriate Medical Council for Disciplinary action. Upon receipt of any complaint of
professional misconduct, the appropriate Medical Council would hold an enquiry and give
opportunity to the registered medical practitioner to be heard in person or by pleader. If the
medical practitioner is found to be guilty of committing professional misconduct, the appropriate
Medical Council may award such punishment as deemed necessary or may direct the removal
altogether or for a specified period, from the register of the name of the delinquent registered
practitioner. Deletion from the Register shall be widely publicized in local press as well as in the
publications of different Medical Associations/ Societies/Bodies.

8.3 In case the punishment of removal from the register is for a limited period, the appropriate
Council may also direct that the name so removed shall be restored in the register after the
expiry of the period for which the name was ordered to be removed.

8.4 Decision on complaint against delinquent physician shall be taken within a time limit of 6
months.

8.5 During the pendency of the complaint the appropriate Council may restrain the physician
from performing the procedure or practice which is under scrutiny.
11
8.6 Professional incompetence shall be judged by peer group as per guidelines prescribed by
Medical Council of India.

8.7 The following Clause No. 8.7 & 8.8 are included in terms of Notification published on
27.05.2004 in Gazette of India & the same is also enclosed as Annexure – III.

“8.7 Where either on a request or otherwise the Medical Council of India is informed that
any complaint against a delinquent physician has not been decided by a State Medical
Council within a period of six months from the date of receipt of complaint by it and
further the MCI has reason to believe that there is no justified reason for not deciding the
complaint within the said prescribed period, the Medical Council of India may-

(i) Impress upon the concerned State Medical council to conclude and decide the
complaint within a time bound schedule;
(ii) May decide to withdraw the said complaint pending with the concerned State Medical
Council straightaway or after the expiry of the period which had been stipulated by the
MCI in accordance with para(i) above, to itself and refer the same to the Ethical
Committee of the Council for its expeditious disposal in a period of not more than six
months from the receipt of the complaint in the office of the Medical Council of India.”

“8.8 Any person aggrieved by the decision of the State Medical Council on any complaint
against a delinquent physician, shall have the right to file an appeal to the MCI within a
period of 60 days from the date of receipt of the order passed by the said Medical
Council:

Provided that the MCI may, if it is satisfied that the appellant was prevented by sufficient
cause from presenting the appeal within the aforesaid period of 60 days, allow it to be
presented within a further period of 60 days.
12
APPENDIX – 1

A. DECLARATION

At the time of registration, each applicant shall be given a copy of the following declaration by
the Registrar concerned and the applicant shall read and agree to abide by the same:

1) I solemnly pledge myself to consecrate my life to service of humanity.

2) Even under threat, I will not use my medical knowledge contrary to the laws of
Humanity.

3) I will maintain the utmost respect for human life from the time of conception.

4) I will not permit considerations of religion, nationality, race, party politics or social
standing to intervene between my duty and my patient.

5) I will practice my profession with conscience and dignity.

6) The health of my patient will be my first consideration.

7) I will respect the secrets which are confined in me.

8) I will give to my teachers the respect and gratitude which is their due.

9) I will maintain by all means in my power, the honour and noble traditions of
medical profession.

10) I will treat my colleagues with all respect and dignity.

11) I shall abide by the code of medical ethics as enunciated in the Indian Medical
Council (Professional Conduct, Etiquette and Ethics) Regulations 2002.

I make these promises solemnly, freely and upon my honour.

Signature ………………………………………………
Name ………………………………………………………
Place ………………………………………………………
Address………………………………………………
……………………… ………………………
……………………… ………………………
Date …………………

13
APPENDIX – 2

1. FORM OF CERTIFICATE RECOMMENDED FOR LEAVE OR EXTENSION OR
COMMUNICATION OF LEAVE AND FOR FITNESS

Signature of patient
or thumb impression ___________________________________________

To be filled in by the applicant in the presence of the Government Medical Attendant, or Medical
Practitioner.

Identification marks:-

1. __________________________

2. __________________________

I, Dr. _____________________________________ after careful examination of the case certify
hereby that _______________ whose signature is given above is suffering from
__________________ and I consider that a period of absence from duty of
____________________ with effect from __________________ is absolutely necessary for the
restoration of his health.

I, Dr. ________________________ after careful examination of the case certify hereby that
______________________ on restoration of health is now fit to join service.

Place ___________________ Signature of Medical attendant.

Date ________________ Registration No. ___________________

(Medical Council of India / State Medical
Council of …………..…. State)

Note:- The nature and probable duration of the illness should also be specified . This certificate
must be accompanied by a brief resume of the case giving the nature of the illness, it s
symptoms, causes and duration.

14
APPENDIX-3

FORMAT FOR MEDICAL RECORD
(see regulation 3.1)

Name of the patient :

Age :

Sex :

Address :

Occupation :

Date of 1st visit :

Clinical note (summary) of the case :

Prov. : Diagnosis :

Investigations advised with reports :

Diagnosis after investigation :

Advice :

Follow up :

Date: Observations:

Signature in full ………………………….

Name of Treating Physician

15

APPENDIX –4

LIST OF CERTIFICATES, REPORTS, NOTIFICATIONS ETC. ISSUED BY DOCTORS FOR
THE PURPOSES OF VARIOUS ACTS / ADMINISTRATIVE REQUIREMENTS

a) Under the acts relating to birth, death or disposal of the dead.

b) Under the Acts relating to Lunacy and Mental Deficiency and under the Mental illness Act
and the rules made thereunder.

c) Under the Vaccination Acts and the regulations made thereunder.

d) Under the Factory Acts and the regulations made thereunder.

e) Under the Education Acts.

f) Under the Public Health Acts and the orders made thereunder.

g) Under the Workmen?s Compensation Act and Persons with Disability Act.

h) Under the Acts and orders relating to the notification of infectious diseases.

i) Under the Employee?s State Insurance Act.

j) In connection with sick benefit insurance and friendly societies.

k) Under the Merchant Shipping Act.

l) For procuring / issuing of passports.

m) For excusing attendance in courts of Justice, in public services, in public offices or in
ordinary employment.

n) In connection with Civil and Military matters.

o) In connection with matters under the control of Department of Pensions.

p) In connection with quarantine rules.

q) For procuring driving licence.

*************************************************

Foot Note: The Principal Regulations namely, “Indian Medical Council (Professional Conduct,
Etiquette and Ethics) Regulations, 2002” were published in Part – III, Section (4) of
the Gazette of India on the 6th April, 2002, and amended vide MCI notifications
dated 22/02/2003, 26/05/2004 & 14.12.2009.

 

 

 

Dear Drs

We invite your valuable suggestions, and recommendations on the above MCI code of medical Ethics.

 

 

KINDLY GIVE YOUR VALUABLE INPUTS SO AS TO FORMULATE GUIDELINE FOR FURTHER PLAN OF ACTION.

 

1-Define clear cut what constitutes advertising violations & soliciting of patients-DOS & DONTS-

2-Foreign trips-pharmaceutical companies claiming overseas conference-prior permission from MMC ?

3-On paper consultant or director of pharmaceutical companies & getting payment.

4-Sponsorships of medical events-printing of products on conference brochures.

5- Cut practice-professional fees/referral charges.

6- Display of Registration  cert in clinic-writing of registration no on letterhead-

Affix only MCI/MMC recognized degrees-

7- Prescriptions-Legible writing, Generic drugs.

8- Once again put all details of code of conduct on IMA/MMC  website in bold title .

 

9- Publish this in papers with appeal to all drs,ima branches,public to visit IMA website & to follow strictly code of ethics.

 

10- “Patient Grievance Cell”- by medical associations, hospitals, etc

 PLEASE EMAIL YOUR SUGGESTIONS TO

imamsmumbai@yahoo.co.in

 

DR DILIP SARDA                                    DR JAYESH LELE

PRESIDENT                                                HON STATE SECRETARY

IMA MAHARASHTRA

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