Other hospital-wide processes need urgent reviewing

A harsh punishment in this case will make doctors only more cautious when family members make genuine requests.
A harsh punishment in this case will make doctors only more cautious when family members make genuine requests.PHOTO: ST FILE

We are glad the Ministry of Health (MOH) is appointing a committee to review the disciplinary process for doctors.

The recent case (NUH doc fined for sharing patient's info, March 7) reinforces yet again the pressing need for this.

This case clearly demonstrates the disparity between the disciplinary tribunal's decision and adequate consideration of the challenges that doctors face in their daily clinical work.

While we agree with the finding that the doctor fell short of maintaining the patient's medical confidentiality, we feel that the fine is excessive and is not commensurate with the reasons for lapse in verification procedure.

Unfortunately, no consideration was given to the fact that the doctor was wilfully and deliberately misled by a close relative with an agenda that was not in the interest of the patient.

Also, insufficient consideration was given to the mitigating factor that the doctor's actions were done in good faith and with good intention, in the midst of a heavy case load.

Furthermore, in this instance, the patient has a history of depression, and the doctor may not have been able to verify the identity of the husband with her, without risk of aggravating her symptoms.

We can list many examples of daily occurrences where a doctor acts in his patient's best interests and in good faith, to assist family members in seemingly minor matters.

A harsh punishment in this case will make doctors only more cautious when family members make genuine requests.

We are deeply concerned that the severity of the punishment will have the ultimate outcome of doctors being driven to practise defensive medicine.

This episode brings up issues of identity authentication, and how measures taken to assure the identity of relatives without failure may be self-defeating, if they destroy or erode trust in the patient-doctor relationship.

We also hope that the Singapore Medical Council and MOH will urgently review hospital-wide processes and provide guidelines and training in:

• Consent procedure

•Culpability of institution versus individuals

•Verification procedure to maintain medical confidentiality

There is an urgent need for this in view of the recurrence of the severity of fines imposed on doctors for mistakes honestly made as they strive to give the best medical attention to their patients.

Lee Yik Voon (Dr)

President

Singapore Medical Association