SMC must consider wider implications of its rulings

Doctors, like everyone else, cannot be expected to always be free from error.
Doctors, like everyone else, cannot be expected to always be free from error. PHOTO: ST FILE

It is good that the Singapore Medical Council (SMC) has taken seriously the concerns of more than 4,000 people who signed a petition seeking clarification on informed consent (SMC: Doctors not expected to inform patients of all possible complications; Jan 31).

Their statement that doctors are not expected to inform patients of all possible complications goes some way towards allaying doctors' fears. However, they failed to provide clear objective guidelines on how much information qualifies as valid informed consent.

The explanation for the harsh sentence is unsatisfactory.

To put this into perspective, SMRT was fined $400,000 in February 2017 for safety lapses leading to an accident that killed two people near Pasir Ris MRT station the previous year (SMRT fined $400k over fatal accident; March 1, 2017).

The punishment meted out to Dr Lim Lian Arn was not for causing harm or for poor treatment. It was for the simple error of inadequate documentation on one particular occasion.

Doctors, like everyone else, cannot be expected to always be free from error. Yet, the SMC's harsh sentencing suggests that this is exactly what is required.

It is a standard that is humanly impossible to maintain in a field as complex as medicine.

Facing harsh punishments for what most see as minor offences will make all doctors practise in a climate of fear.

It is unrealistic to expect doctors not to practise defensive medicine in such a climate of capricious punitive action for the least error. This will result in increasing costs of medical care.

I urge the SMC to seriously consider the wider implications of its rulings and the direction it is pushing medical practice towards.

I sincerely hope these concerns are taken seriously in formulating the new sentencing guidelines for doctors.

Andrew Yam (Dr)

A version of this article appeared in the print edition of The Straits Times on February 05, 2019, with the headline 'SMC must consider wider implications of its rulings'. Print Edition | Subscribe