This post is mirrored at Gigamole Diaries..
The President of the Singapore Medical Association was prodded out of the kinda slumbering organization to respond to the 'akan datang' move to appoint non-medical people (chiefly their nemesis, lawyers) to Chair the Singapore Medical Council.
I think it is a rather unconvincing response, almost like he doesn't quite believe it himself. Which really underscores the passivity of the profession at the moment. Same for the Singapore Medical Council.
I do however agree with Dr Chong's last point: '...what medical ethics really needs is more moral courage and leadership so that public interest can be better served.' How true. But what has the SMC done that can truly be said to have shown moral courage and leadership? So far it's been hiding behind the law, and only taking to task those who have obviously flouted the 'law'.
12 comments:
Gigamole wrote:
"So far it's been hiding behind the law, and only taking to task those who have obviously flouted the 'law'."
I suggest Gigamole peruses the more recent SMC annual reports, in particular the proceedings of disciplinary cases.
The facts do not substantiate his claim that SMC only disciplines those who get up to criminal activity.
"... only taking to task those who have obviously flouted the 'law'."
Are you suggesting then that the SMA or SMC actively 'hunt' errant doctors down?
I am not sure that a system that makes doctors whistle-blower/plaintiff, investigator, prosecutor, judge/jury, and executioner is a system that instils confidence in doctors who are not part of the powers that be.
A direct quote from the SMA President's Forum letter:
"The move to allow lawyers to chair DTs [ disciplinary tribunals ] will bring about a technical convergence of law and medical ethics, with DT proceedings probably becoming more legalistic, and a slow deterioration in the higher standards of medical ethics, which is against public interest."
My reaction comes in 2 parts - 1) sounds like a backhanded insult, and 2) Huh?
"My reaction comes in 2 parts - 1) sounds like a backhanded insult, and 2) Huh?"
:)
Actually on re-reading my post in the light of day, I find that I may have been somewhat hasty in what I wrote, and was quite horrified that it actually sounds kinda offensive. Even to me.(Shamefacedly admit it, yeah, I am guilty). Didn't mean to be... not to SMA President nor the SMC. Methinks they are doing their best. So my unreserved apologies.
When I started blogging, I made it a point to be focused on ideas rather than people, and made it a principle not to be personal or offensive. I kinda lapsed.
My intention really was to put an alternative perspective on the table and to provoke a debate on the issue rather than to have everyone close ranks and chorus a rejection of the possibility of a lay person chairing the SMC. And I think there are actually currently not a lot of good reasons why it should never be that way. And there's certainly quite a bit of public perception that more transparency is needed and more assurance that the profession is capable of self regulation.
Simple question you have to ask yourself:
Do you want the standard of care to be determined by a lawyer or doctor.
If we go down the road of having a lawyer chair the DC to determine what is acceptable medical care, then I guess all of us will have to practice defensive medicine from now on...
If on the other hand, we return to having a senior clinician chair the DC, then Bolam still holds and as long as we practice what is acceptable to our peers, we will be OK. IF we cross the line and do what is not acceptable to the profession, we will be punished as we rightly deserve.
That is what the whole issue boils down to. I am sure that is not what the authorities intended but unfortunately, that is what is likely to happen....
Actually, gigamole, I was reacting to the SMA President's remarks, not yours. :)
Anyway, today's online Forum has a rebuttal. Think Dr. Chong will develop a migraine soon, if he hasn't gotten one already.
Yeah, I know. Don't worry. I was just amused at your dig at his letter. :)
Don't mind my little bit of self flagellation.
"Do you want the standard of care to be determined by a lawyer or doctor.
If we go down the road of having a lawyer chair the DC to determine what is acceptable medical care, then I guess all of us will have to practice defensive medicine from now on..."
Paul, I am not so sure I agree with that extrapolation. Afterall it's not as if you are replacing the whole DT with lawyers, and that suddenly you are devoid of professional inputs. I think the reality is that as frat members are not very likely to be very objective in judging frat sibs (let alone senior frat members who might have been our teachers, professional colleagues, friends, golf/drinking kakis etc). I would actually think that having a non-medical chair would actually improve the deliberations and move it to a more objective plane.
Then in the same reasoning you would recommend to have a non-legal chair to improve the deliberations of the DT for lawyers and move it to a more objective plane? Ironically we seem pretty comfortable for 1 SC or a retired judge (and no lay persons) to be in the DT for complaints against lawyers. No lay persons.
http://www.asiaone.com/News/AsiaOne%2BNews/Singapore/Story/A1Story20071206-39957.html
Gigamole,
1. Would you support the appointment of a doctor or engineer, to chair the Law Society's disciplinary tribunals?
2. Your claim of "fraternity" behaviour remains unproven -- can you substantiate it?
1. I would.
Law's DT seems also not defensible. I was pointed this website :
http://www.asiaone.com/News/AsiaOne%2BNews/Singapore/Story/A1Story20071206-39957.html
Kinda like Lord of the Rings don't you think? No fellowship here though :):
One Ring to rule them all, One Ring to find them,
One Ring to bring them all and in the darkness bind them ...
2. Admittedly can't prove. How to prove this kind of thing? I am referring to a public perception, which to me is pretty reasonable expectation. It may be that it is the profession's duty to prove it wrong.
In law/criminal/civil courts, the legal system is such that it appoints 1 (or 3) judge(s) and these r deemed the best-trained pple to adjudicate legal matters. But when we talk abt professional self-regulatory tribunals, we should not hold the same mindset that the judge/snr lawyer must also the best person to chair and lead a committee that safeguards public interests or professional ethics. Would anyone disagree?
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