MOH to clarify taking of 'informed consent' by doctors and review SMC disciplinary process

According to Senior Minister of State Edwin Tong, the Ministry of Health will set up a working group to "review the legal position, as well as the practical aspects of taking such consent - what it entails and what the standards are - with a view to
According to Senior Minister of State Edwin Tong, the Ministry of Health will set up a working group to "review the legal position, as well as the practical aspects of taking such consent - what it entails and what the standards are - with a view to providing appropriate guidance for doctors". ST PHOTO: GAVIN FOO

SINGAPORE - The Ministry of Health will conduct a "thorough review" of what comprises sufficient information for a patient to give informed consent on treatment options, Senior Minister of State Edwin Tong said on Saturday (March 2).

The ministry will set up a working group to "review the legal position, as well as the practical aspects of taking such consent - what it entails and what the standards are - with a view to providing appropriate guidance for doctors", he said.

He was speaking at a a ceremony where 350 doctors affirmed the Physician's Pledge to have a duty of care to their patients.

Informed consent means what a patient must know - the benefits and risks associated with various treatment options - for him to give the green light to a particular treatment.

The ministry will consult doctors both in public and private practice as part of the review.

"But let me be clear - this is not about going soft on or compromising on patient safety,"Mr Tong said.

"Acting in the patient's best interests is non-negotiable and remains paramount. What we do not want to have is the practice of defensive medicine, and, as I have explained, being clear on informed consent helps both doctor and patient."

His remarks followed the unprecedented move by the Health Ministry to get the High Court to review a judgment of the Singapore Medical Council.

The SMC's disciplinary tribunal had fined orthopaedic surgeon Lim Lian Arn the maximum $100,000 for not telling a patient of possible complications from a commonly used steroid injection.

The tribunal's decision caused an uproar within the medical profession because most doctors who prescribe that steroid jab usually do not tell patients of the side effects, which are both rare and transient.

 
 

Doctors feared that the tribunal's judgment would set a precedent for the amount of information that they would need to share with patients and lead to the practice of defensive medicine.

More than 5,000 people have signed an appeal, started by another doctor, Dr Tho Kam San, to share their concerns with Health Minister Gan Kim Yong. The subject was also raised in Parliament.

On Saturday, Mr Tong said the ministry will also do a "very comprehensive" review of the medical regulatory landscape which is overseen by the SMC.

This will include how complaints and appeals are filed, the composition and decision making processes of the various Complaints Committees and Disciplinary Tribunals, the issue of expert evidence and sentencing guidelines.

"This is timely, as we seek to constantly improve on the appropriate regulation of the medical profession," he said.

"The SMC and its processes must have, and must be able to maintain, the confidence and trust of medical professionals, patients and the general public."