CODE OF PROFESSIONAL CONDUCT 2019

FOREWORD

The members of the medical profession are required to abide by the Code of
Professional Conduct of the Malaysian Medical Council. Consonant with the motto of
the Council “Safeguarding Patients, Guiding Doctors”, the objective of the Code is to
ensure propriety in professional practice by medical practitioners and prevention of
abuse of professional privileges.

This edition of the Code, which has been adopted by the Malaysian Medical
Council at its 388th meeting, has been revised from the 1987 Code and new sections
relevant to the current state of development of ethical professional care have been
added.

It also makes reference to the statutory implications of practice and disciplinary

procedures as defined in the Medical Act 1971 (Amended 2012) and Regulations
2017.

I urge all medical practitioners to familiarise with the revised 2019 edition of the
Code and abide by it.

Tan Sri Dato’ Seri Dr. Noor Hisham bin Abdullah

PSM, PJN, SPMS, SPMP, DPMP, SSAP, SSNS, DMPN, KMN, MD
President
Malaysian Medical Council

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 The effective date of this
Code of Professional Conduct 2019
is on the
23rd day of February, 2021.

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 CONTENTS

INTRODUCTION

PART I POWERS OF THE MALAYSIAN MEDICAL COUNCIL

Disciplinary Jurisdiction of the Council

Meaning of Serious Professional Misconduct
Convictions in a Court of Law

PART II FORMS OF SERIOUS PROFESSIONAL MISCONDUCT

1. Neglect or Disregard of Professional Responsibilities

1.1 Responsibilities for Standard of Medical Care to Patients

1.2 The Practitioner and Requests for Consultation
1.3 The Practitioner and his Practice
1.4 Consent for Medical Examination and Treatment
1.5 Confidentiality
1.6 Improper Delegation of Medical Duties
1.6.1 Employment of Unqualified or Unregistered
Persons
1.6.2 Covering
1.6.3 Association with Unqualified or Unregistered
Persons
1.7 Partnership with Unqualified or Unregistered Persons
1.8 Medical Research
1.9 The Practitioner and the Pharmaceutical/Medical
Equipment Industry
1.10 The Practitioner and Third-Party Administrators (TPA)
1.11 The Practitioner and Practice of Traditional and
Complementary Medicine
1.12 Professional Fees

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 1.13 Expert Testimony in Court
1.14 End of Life Professional Management

2. Abuse of Professional Privileges and Skills

2.1 Abuse of Privileges Conferred by Law

2.1.1 Prescribing of Drugs
2.1.2 Dangerous Drugs
2.1.3 Sale of Poisons
2.1.4 Certificates, Notifications, Reports, etc.
2.1.4.1 Medical Sick Certificates
2.1.4.2 Patient Medical Records and Clinical
Notes
2.1.4.3 Denial of Disclosure of Medical
Records
2.1.5 Medical reports

2.2 Abuse of Privileges Conferred by Custom

2.2.1 Abuse of Trust
2.2.2 Abuse of Confidence
2.2.3 Undue Influence
2.2.4 Personal Relationship between Practitioners
and Patients
2.2.5 Practitioners Inability or Fitness to Practice
2.2.6 Medical Errors and Incident Reporting
2.2.7 Chaperone

3. Conduct Derogatory to the Reputation of the Medical

Profession

3.1 Respect for Human Life

3.2 Personal Behaviour

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 3.2.1 Personal Misuse or Abuse of Alcohol and Drugs
3.2.2 Dishonesty: Improper Financial Transactions
3.2.3 Fee Splitting or Kick-back Arrangements
3.2.4 Indecency and Violence
3.3 A Colleague’s Incompetence to Practice
3.4 The Practitioner and Commercial Undertakings
3.5 Plagiarism

4. Advertising, Canvassing and Related Professional Offences

4.1 Advertising and Canvassing
4.2 Dissemination of Information
4.3 Professional Calling Cards, Letterheads, Name Plates,
Signboards, Banners, etc.

PART III DISCIPLINARY PROCEDURES

APPENDICES
I Declaration of Geneva
II Professional Calling Cards, Letterheads, Rubber Stamps
III Signboards
IV Name Plates/Door Plates
V 24-Hour Clinics

Acknowledgement
References and Further Reading
Malaysian Medical Council Guidelines and Related Publications

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 INTRODUCTION

THE CODE OF PROFESSIONAL CONDUCT

AND GUIDELINES IN RELATION TO THE MEDICAL ACT

The practice of Medicine is an ancient profession and the community has great
expectations of its practitioners and places great trust in them. The relationship
between practitioners and patients is privileged, and it is on this basis that practitioners
gain access to the most intimate emotions and secrets of patients in the course of
management of their illness. Without this privilege and trust it would be impossible to
practice medicine and the profession expects a high standard of professional and
personal conduct from its members. These are embodied in various Codes of Medical
Professional Ethics, which vary in detail from country to country, but all place the health
and welfare of the individual and the family under the care of a practitioner of the
foremost importance.

The Malaysian Medical Council is composed of peers in the medical profession,

and is established under the Medical Act 1971 (Amended 2012).

The Code of Professional Conduct, issued under the authority of the Malaysian
Medical Council, provides the yardstick for the conduct and behaviour of registered
medical practitioners in their clinical practices and in all areas of professional activity.
To complement the Code, and to provide additional explanations on the many topics
in the Code, the Council has documents on Good Medical Practice and Confidentiality,
and other Guidelines, as well as periodic directives, and these should be read in
conjunction with the Code. The Code and the guidelines discuss, not ideal behaviour,
but the minimum standards of conduct expected of a registered medical practitioner
and assessed by the Malaysian Medical Council.

The Medical Act 1971 (Amended 2012) is the legislation relating to the
registration of medical practitioners and the practice of Medicine, and with the Medical
Regulations 2017 to the Act, empower these objectives, to deal with all disciplinary
matters involving registered medical practitioners. The statutes underpinning the Code

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of Professional Conduct make it an offence punishable, after due process of inquiry,
when there are transgressions of the expected norms of practice.

By publishing this Code, it is the desire of the Malaysian Medical Council that
no practitioner will have committed professional misconduct on grounds of ignorance
of the expected standards of professional conduct in this country.

It is important that all registered medical practitioners should obtain a copy of

the Code of Professional Conduct and all related guidelines. The Council expects all
registered medical practitioners to familiarise themselves with this Code and
Guidelines and direct any enquiries to the Chief Executive Officer of the Council.
Medical practitioners may also wish to consult the Ethics Committees of the Malaysian
Medical Association, the Academy of Medicine of Malaysia and other medical
professional organisations on matters in which they need clarifications.

Explanatory Notes:

a. Where reference has been made to one gender, it should be read as applicable to both genders.

b. The words “must, should and may” are used throughout the Code. To appreciate the level of
importance and usage of these nodal verbs, the following guidelines are provided:

i. “Must” is used to indicate the overriding duty and the principles that must be upheld;

ii. “Should” is used to indicate advice on the best practice and what is strongly
encouraged. Failure to comply with the advice, depending on the circumstances in
which the breach has occurred, may be actionable; and

iii. “May” indicates an optional course of action which is permissible within the obligations
laid down in the Code.

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 PART I

POWERS OF THE MALAYSIAN MEDICAL COUNCIL

Section 4A of the Medical Act 1971 (Amended 2012)

4A. (1) The Council shall have the power to do all things expedient or
reasonably necessary for or incidental to the carrying out of its
functions under this Act.

(2) Without prejudice to the generality of subsection (1), the powers of

the Council shall include power to –

a. ensure that the provisions of this Act and the regulations

are administered, enforced, given effect to, carried out
and complied with;
b. regulate the standards of practice of registered medical
practitioners;
c. regulate the professional conduct and ethics of
registered medical practitioners;
d. approve or refuse any application for registration or
certification in accordance with this Act or regulations;
e. determine any fees or fines payable;
f. issue certificates;
g. borrow or raise money from time to time by bank
overdraft or otherwise for any of the purposes specified
in this section; a n d
h. recognize and accredit medical qualifications based
upon the recommendation of the Joint Technical
Committee establish under Malaysian Qualifications
Agency Act 2007 [Act 679] for the purpose of
registration.

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 DISCIPLINARY JURISDICTION OF THE COUNCIL

Disciplinary jurisdiction over registered medical practitioners is conferred upon

the Malaysian Medical Council by Section 29 of the Medical Act 1971 (Amended 2012)
which reads as follows:

1. The Council shall have disciplinary jurisdiction over all persons registered under
this Act.

2. The Council may exercise disciplinary jurisdiction over any registered person
who –
a. has been convicted in Malaysia or elsewhere of any offence punishable
with imprisonment (whether in itself only or in addition to or in lieu of a
fine);
aa. has had his qualification withdrawn or cancelled by the awarding
authority through which it was acquired or by which it was awarded;
b. was alleged to have committed serious professional misconduct as
stipulated in the Code of Professional Conduct and any other guidelines
and directives issued by the Council;
c. has obtained registration by fraud or misrepresentation;
d. was not at the time of his registration entitled to be registered; or
e. has since been removed from the register of medical practitioners
maintained in any place outside Malaysia.

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 THE MEANING OF SERIOUS PROFESSIONAL MISCONDUCT

The Malaysian Medical Council attests to the principle that ‘serious professional
misconduct’ means a failure to meet the minimum standards of professional medical
practice as set out in the Code of Professional Conduct, guidelines and directives
issued by the Council, as stated under Disciplinary Jurisdiction of the Council in
Section 29 (2)(b) of Medical Act 1971 (Amended 2012).

The Council endorses the definition of serious professional misconduct laid out
by the Privy Council (Lord Clyde in Roylance v General Medical Council [1999] 3 WLR
541, [1999] Lloyd's Rep Med 139), as follows:

“Misconduct is a word of general effect, involving some act or

omission which falls short of what would be proper in the circumstances.
The standard of propriety may often be found by reference to the rules
and standards ordinarily required to be followed by a medical practitioner
in the particular circumstances. The misconduct is qualified in two
respects. First, it is qualified by the word "professional" which links the
misconduct to the profession of medicine. Secondly, the misconduct is
qualified by the word "serious". It is not any professional misconduct
which will qualify. The professional misconduct must be serious.”

“It is not simply misconduct in the carrying out of medical work

which may qualify as professional misconduct. But there must be a link
with the profession of medicine. Precisely what that link may be and how
it may occur is a matter of circumstances. The closest link is where the
practitioner is actually engaged on his practice with a patient…”

“But certain behaviour may constitute professional misconduct

even although it does not occur within the actual course of the carrying
on of the person's professional practice, such as the abuse of a patient's
confidence or the making of some dishonest private financial gain.”

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 “But that definition is clearly not, and was not intended to be,
exhaustive or comprehensive. To take the point a stage further, serious
professional misconduct may arise where the conduct is quite removed
from the practice of medicine, but is of a sufficiently immoral or
outrageous or disgraceful character.”

Degrees of concurrent acts of moral turpitude, dishonesty, or incompetence

may determine the severity of punishment.

CONVICTIONS IN A COURT OF LAW

In considering convictions the Council is bound to accept the determination of

any court of law as conclusive evidence that the practitioner was guilty of the offence
of which he was convicted. Practitioners who face a criminal charge should remember
this if they are advised to plead guilty, or not to appeal against a conviction merely to
avoid publicity or a severe sentence. It is not open to a practitioner who has been
convicted of an offence to argue during inquiry before the Disciplinary Board that he
was in fact innocent.

It is therefore unwise for a practitioner to plead guilty in a court of law to a charge

to which he believes that he has a defence. In all such instances, the advice of a legal
counsel should be sought.

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 PART II

FORMS OF SERIOUS PROFESSIONAL MISCONDUCT

This part mentions certain kinds of criminal offences and of serious professional
misconduct which have in the past led to disciplinary proceedings or which in the
opinion of the Council could give rise to such proceedings. It does not pretend to be a
complete code of professional ethics, or to specify all criminal offences or forms of
professional misconduct which may lead to disciplinary action. To do this would be
impossible, because from time to time with changing circumstances, the Council's
attention is drawn to new forms of professional misconduct.

Any abuse by a practitioner of any of the privileges and opportunities afforded

to him or any grave dereliction of professional duty or serious breach of medical ethics
may give rise to a charge of serious professional misconduct. In discharging their
respective duties, the Preliminary Investigation Committee and the Disciplinary Board
and the Council must proceed as quasi-judicial bodies. Only after considering the
evidence in each case can the Council determine the gravity of a conviction or decide
whether a practitioner's behaviour amounts to serious professional misconduct.

In the following paragraphs areas of professional conduct and personal

behaviour which need to be considered have been grouped under four main headings.

1. Neglect or Disregard of Professional Responsibilities

2. Abuse of Professional Privileges and Skills
3. Conduct Derogatory to the Reputation of the Medical Profession
4. Advertising, Canvassing and Related Professional Offences

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1. NEGLECT OR DISREGARD OF PROFESSIONAL RESPONSIBILITIES

1.1 Responsibility for Standards of Medical Care to Patients

In pursuance of its primary duty to protect the public, the Council may
institute disciplinary proceedings when a practitioner appears seriously
to have disregarded or neglected his professional duties to his patients.

The public is entitled to expect that a registered medical practitioner will

provide and maintain a good standard of medical care. This includes:
a. conscientious assessment of the history, symptoms and
signs of a patient's condition;
b. sufficiently thorough professional attention, examination
and where necessary, diagnostic investigation;
c. competent and considerate professional management;
d. appropriate and prompt action upon evidence suggesting
the existence of a condition requiring urgent medical
intervention; and
e. readiness, where the circumstances so warrant, to consult,
or refer the patient to appropriate professional colleagues.

A comparable standard of practice is to be expected from medical

practitioners whose contributions to a patient’s care are indirect, for
example those in pathology and radiological specialties.

Apart from a practitioner's personal responsibility to his patients,

practitioners who undertake to manage, or to direct or to perform clinical
work for organisations offering private medical services should satisfy
themselves that those organisations provide adequate clinical and
therapeutic facilities for the services offered.

The Council is not ordinarily concerned with errors in diagnosis or

treatment, or with the kind of matters which give rise to action in the civil
courts for negligence, unless the practitioner's conduct in the case has

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 involved such a disregard of the standard of care that he should have
provided to his patients or such a neglect of his professional duties as to
raise a question of serious professional misconduct.

A question of serious professional misconduct may also arise from a

complaint or information about the conduct of a practitioner which
suggests that he has endangered the welfare of the patient by persisting
in independent practice of a branch of medicine in which he does not
have the appropriate knowledge and skill and has not acquired the
experience which is necessary.

1.2 The Practitioner and Requests for Consultation

1.2.1 In conformity with his own sense of responsibility, a medical

practitioner should arrange consultation with a colleague
whenever the patient or the patient's next of kin desire it, provided
the best interests of the patient are so served. It is always better
to suggest a second opinion in all doubtful or difficult or anxious
cases.

It should be remembered that a practitioner suffers no loss of

dignity or prestige in referring a patient to a colleague whose
opinion and expertise could contribute to the better care of the
patient.

1.2.2 The primary practitioner, who is the practitioner first seeing the
patient, or the practitioner to whom care of the patient has been
transferred, may manage the patient himself or may refer the
patient to another practitioner or specialist, called the referred
practitioner. The primary practitioner should advise the patient
accordingly, but he should not refuse to refer to a registered
medical practitioner selected by the patient or next of kin.

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1.2.3 The arrangements for consultation should be made or initiated by
the primary practitioner, and should be followed up with a referral
letter and relevant results of laboratory, imaging and any other
investigations.

He should acquaint his patient of the approximate expenses

which may be involved in specialist consultations and
examination.

1.2.4 It is the duty of the referred practitioner to avoid any word or action
which might affect the confidence of the patient in the primary
practitioner. Similarly, the primary practitioner should carefully
avoid any remark or suggestion which may seem to disparage the
skill or judgment of the referred practitioner.

1.2.5 The referred practitioner must not attempt to secure for himself
the care of the patient seen for consultation. At the end of
consultation or further management where mutually agreed upon
specifically between the primary practitioner and the referred
practitioner, the patient must be returned to the primary
practitioner with a report including results of investigations and
advice on further care of the patient.

Similarly, a primary practitioner who had received the patient on

transfer must provide feedback in the form of a written status
report to the doctor who had earlier transferred the patient to him.

1.2.6 The referred practitioner is normally obliged when circumstances

permit, to consult the primary practitioner before other consultants
are called in.
1.2.7 In instances when the patient requests the referred practitioner to
take over further management, the primary practitioner should
accept the right of choice by the patient amicably.

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1.3 The Practitioner and his Practice
Partners, Assistants and Locum Tenentes.

There is an ethical obligation on a practitioner not to damage the practice

of a colleague or employer with whom he has been in professional
association. Actions such as setting up a practice close to the
practitioner’s previous clinic, procuring medical records of patients
previously treated by him, inducing such patients to transfer to his new
clinic, or any other similar actions may be deemed unethical.

In employing locum tenentes, the practitioner must ensure that the

person is fully registered with the Medical Council and has a valid Annual
Practising Certificate.

1.4 Consent for Medical Examination and Treatment

Obtaining valid consent is an important component of a sound doctor-

patient relationship. For the consent to be valid, it should satisfy the
requirements of informed consent. It must be given freely and voluntarily,
and not induced by fraud or deceit. It must be obtained in a language
which the person understands, or with the help of an interpreter. The
patient or person giving consent must have the legal capacity and
soundness of mind, and must be aware of the implications of undergoing
the proposed procedure. The procedure must be explained together with
alternative procedures and the known complications. The patient or
person giving consent must be given sufficient opportunity to seek
further explanations.

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1.5 Confidentiality

A registered medical practitioner is responsible for the confidential

information obtained from a patient. The practitioner must ensure that
the information is effectively protected against improper disclosure when
it is transmitted, received, stored, or disposed of.

A practitioner may release confidential information in strict accordance

with the patient’s written consent, or the consent of a person properly
authorized to act on the patient’s behalf. When such permission is
granted, the practitioner should only disclose such relevant confidential
information for a specific purpose. Release of confidential information is
sometimes a statutory requirement, and the patient must be informed of
such disclosure.

1.6 Improper Delegation of Medical Duties

1.6.1 Employment of Unqualified or Unregistered Persons

The employment by a registered practitioner in his professional

practice, of persons not qualified or registered under the Medical
Act 1971, and the permitting of such unqualified or unregistered
person to attend, treat or perform operations upon patients in
respect of matters requiring professional discretion or skill, or
providing certificates of any kind is, in the opinion of the Council,
in its nature fraudulent and dangerous to the public. Any
registered practitioner who shall be proved to the satisfaction of
the Council to have so employed an unqualified or unregistered
person will be liable to disciplinary punishment.

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1.6.2 Covering

Any registered practitioner who by his presence, countenance,

advice, assistance, or cooperation, knowingly enables an
unqualified or unregistered person, whether described as an
assistant or otherwise, to attend, treat, or perform any invasive or
other medical procedures upon a patient in respect of any matter
requiring professional discretion or skill, to issue or procure the
issue of any certificate, notification, report, or other document of
a kindred character, or otherwise to engage in professional
practice as if the said person were duly qualified and registered,
will be liable, on proof of the facts to the satisfaction of the Council,
to disciplinary punishment.

1.6.3 Association with Unqualified or Unregistered Persons

Any registered medical practitioner who assists an unqualified or

unregistered person to attend, treat, or perform any invasive or
other medical procedure upon any other person in respect of
matters requiring professional discretion or skill, will be liable on
proof of the facts to the satisfaction of the Council to disciplinary
punishments.

The foregoing part of this paragraph does not purport to restrict

the proper training and instruction of bona fide medical students,
or the legitimate employment of midwives, medical assistants,
nurses, dispensers, and skilled mechanical or technical
assistants, under the immediate personal supervision of a
registered medical practitioner.

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1.7 Partnership with Unqualified or Unregistered Persons

Any registered practitioner who knowingly forms a professional

partnership with an unqualified or unregistered person, will be liable on
proof of the facts satisfactory to Council, to disciplinary punishment.

1.8 Medical Research

In the scientific application of medical research carried out on a human

being, it is the duty of the practitioner to remain the protector of the life
and health of that person on whom biomedical research is being carried
out.

1.8.1 In any research on human beings, each potential subject must be

adequately informed of the aims, methods, anticipated benefits
and potential hazards of the study and the discomfort it may
entail. He or she should be informed that he or she is at liberty to
abstain from participation at any time. The practitioner should
then obtain the subject's freely-given informed consent,
preferably in writing.

1.8.2 The practitioner can combine medical research with professional

care, the objective being the acquisition of new medical
knowledge, only to the extent that medical research is justified by
its potential diagnostic or therapeutic value for the patient.

1.8.3 A medical practitioner should use great caution in divulging

discoveries or new techniques or treatment through non-
professional channels.

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 1.8.4 The results of any research on human subjects should not be
suppressed whether adverse or favourable.

1.8.5 In any research involving human subjects, the approval of the

relevant institutional ethics committee and/or the Medical
Research and Ethics Committee (MREC) of the Ministry of Health
should be obtained prior to commencement.

1.9. The Practitioner and the Pharmaceutical/Medical Equipment Industry

The medical profession and the pharmaceutical industry have common

interests in the research and development of new drugs of therapeutic
value.

1.9.1 A prescribing practitioner should not only choose but also be seen
to be choosing the drug or appliance which, in his independent
professional judgment, and having due regard to affordability,
should best serve the medical interests of his patient.
Practitioners should therefore avoid accepting any pecuniary or
material inducement which might compromise, or be regarded by
others as likely to compromise, the independent exercise of their
professional judgment in prescribing matters.

1.9.2 It is improper for an individual practitioner to accept from a

pharmaceutical firm, medical equipment industry, and other
related services, monetary gifts or loans or expensive items of
equipment for his personal use. However, the payment made by
such firm for professional work or consultation on contract by an
independent medical practitioner is permitted.

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 1.9.3 No objection can, however, be taken to grants of money or
equipment by firms to institutions such as hospitals, health care
centres and university departments, when they are donated
specifically for purposes of research or patient care.

1.9.4 A practitioner may design instruments, equipment or related

products to be used in healthcare for the diagnosis, prevention,
monitoring or treatment of illnesses or handicaps. Such products
must be approved and registered with the Medical Devices
Authority of Ministry of Health as required by the Medical Devices
Act 2012 (Act 737) before being made available for use by
healthcare providers, including the practitioner himself.

1.9.5 A practitioner may receive appropriate travel grants andhospitality

from pharmaceutical or medical instrument/equipmentcompanies
for conferences or educational meetings, for purposes of
educational and personal professional advancement, provided
that such funding should not be more than what he may be
spending if he went on his own expenses.

1.10 The Practitioner and Third-Party Administrators (TPA)

The practitioner must ensure that in his association with any third-party
administrator or payer (TPA/TPP), insurance firm, or managed care
organisation (MCO), his professional practice must not violate the Code
of Professional Conduct and MMC Guidelines. The practitioner must
ensure that there is no conflict of interest in the provision of care for his
patient, and any form of incentives, limitations, control or contractual
restrictions which may impact or influence the standard or duty of care
to the patient must be avoided. At all times, patient-doctor confidentiality
must be preserved, and specific consent must be obtained from the

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 patient before release of information on illness, investigation results and
management to an employer or to a third party.

1.11 The Practitioner and the Practice of Traditional and Complementary

Medicine

The practitioner should not prescribe or promote traditional health

supplements or traditional medications, or practise traditional treatment
methods, unless such products or practices are evidence based.

1.12 Professional Fees

The practitioner should avoid any conflict with the patient on the
professional fees charged by him after treatment, or for any medical
report, and should provide the patient with written information on
estimated charges and the basis for them before treatment is
commenced or report provided.

The improper or unreasonable or unjustified demand or acceptance of

professional fees from patients contrary to the relevant schedules and
provisions must be avoided.

1.13 Expert Testimony in Court

A practitioner may be requested or required to provide expert opinion in

court, and such opinion must be unbiased and honest and bereft of
conflict of interest, and confined to the practitioner’s area of expertise.

It is unethical for a practitioner to demand a percentage of the costs or

damages awarded by the court and to make the attendance fees
contingent upon the favourable outcome of a matter in which he appears
as an expert.

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1.14 End of Life Professional Management

A practitioner’s primary responsibility in the care and treatment of any

patient is to take measures in the best interest of the patient. Any
decision by a practitioner to prolong life through life support or other
measures, or to terminate such support, must be made in the
practitioner’s best professional judgment, in consultation with colleagues
and the next of kin.

A practitioner must not be involved in euthanasia and/or assist in suicide

of patients.

A practitioner may be confronted with a Living will (or Advance Medical

Directive) (AMD) which is a written statement detailing a person's
desires regarding future medical treatment in circumstances in which he
is no longer able to express informed consent. The circumstances may
be imminent death, terminal illness, or severe and irreversible
conditions. Any decision by the practitioner, to comply with or not to
comply with the AMD, must be made in consultation with relatives and
next-of-kin of the patient.

2. ABUSE OF PROFESSIONAL PRIVILEGES AND SKILLS

2.1 Abuse of Privileges Conferred by Law

2.1.1 Prescribing of Drugs

The prescription of controlled drugs is reserved to members of the

medical profession and of certain other professions, and the
prescribing of such drugs is subject to statutory restrictions.

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 The Council regards as serious professional misconduct the
prescription or supply of drugs including drugs of dependence
otherwise than in the course of bona fide treatment. A practitioner
may be convicted of offences against the laws which control
drugs.

A practitioner must not prescribe such drugs in order to gratify his

own addiction or the addiction of other persons.

2.1.2. Dangerous Drugs

The contravention by a registered practitioner of the provisions of

the Dangerous Drugs Act 1952 and the Regulations made
thereunder may be the subject of criminal proceedings, and any
conviction resulting therefrom may be dealt with as such by the
Council in exercise of their powers under the Medical Act 1971
(Amended 2012). But any contravention of the Act or Regulations,
involving an abuse of the privileges conferred thereunder upon
registered practitioners, whether such contravention has been the
subject of criminal proceedings or not, will be subjected to
disciplinary punishment.

2.1.3 Sale of Poisons

The employment for his own profit and under cover of his own
qualifications, by any registered practitioner who keeps a medical
hall, open shop, or other place in which scheduled poisons or
preparations containing scheduled poisons are sold to the public,
of assistants who are left in charge but are not legally qualified to
sell scheduled poisons to the public, is in the opinion of the
Council a practice professionally discreditable and fraught with
danger to the public, and any registered practitioner who is proved
to the satisfaction of the Council to have so offended will be liable
to disciplinary punishment.

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2.1.4 Certificates, Notifications, Reports, etc.

2.1.4.1 Registered practitioners are in certain cases bound by

law to give, or may from time to time be called upon or
requested to give particulars, notifications, reports and
other documents of a kindred character, signed by
them in their professional capacity, for subsequent use
either in the Courts or for administrative purposes.

Practitioners should exercise the most scrupulous care

in issuing such documents, especially in relation to any
statement that a patient has been examined on a
particular date.

2.1.4.2 Medical sick certificates are issued by practitioners for

guidance on employment by the employer. The issuing
of medical sick certificates without proper examination
of patients, pre-signing of such certificates, failure to
keep proper records in patient’s notes, back-dating for
unacceptable reasons, or issuance of sick certificates
for lengthy durations without interim examination even
for chronic illnesses, and such related matters, is
serious professional misconduct. The stating of the
diagnosis of the illness on the medical sick certificate is
permissible only with the consent of the patient.
Medical sick certificates should be signed by the
practitioner and his name and MMC registration
numbers stamped, with the date of issue clearly
indicated.

Backdating of medical sick certificates, which is defined

as the issuance of a medical sick certificate on a date
after the consultation or treatment, is allowed onlyunder
special circumstances when the practitioner has

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 treated the patient and is aware of his medical
condition, and the practitioner must accept
responsibility for his actions in this respect.

2.1.4.3 Electronic medical sick certificates must satisfy all the

requirements of issuance as well as ensure security
and restricted accessibility.

2.1.4.4 Any registered practitioner who shall be proved to the

satisfaction of the Council to have signed or given
under his name and authority any such certificate,
notification, report or document of a kindred character,
which is untrue, misleading or improper, will be liable to
disciplinary punishment.

2.1.4.5 Patient’s Medical Records and Clinical Notes

A medical record is the documented personal and
confidential information, whether written or electronic,
of the patient. Besides the patient’s personal details, it
also contains the practitioner’s personal findings on the
examination and management of his illness. The
records must be kept in safe and secure custody at all
times. The records may be requested for by the patient
and demanded by the courts of law.

A practitioner must avoid the erasing, obliterating,

tampering or altering of previously made entries in the
clinical records, as these may be interpreted as
attempts to cover up management errors or adverse
events.

26
 2.1.4.6 Denial of Disclosure of Medical Records

A medical practitioner may, on grounds other than the

absence of written consent from a patient or legal next-
of-kin or guardian, deny disclosure of the contents of
the Medical Record, if in his considered opinion, the
contents if released may be detrimental or disparaging
to the patient, or any other individual, or liable to cause
serious harm to the patient’s mental or physical health
or endanger his life. The practitioner may also deny
disclosure particularly if the patient is deceased. In
such instances, the practitioner is required to justify his
decision to deny disclosure.

2.1.5. Medical Reports

Medical Reports are documents prepared by a medical

practitioner on a patient based on factual information found in the
Medical Records.

A medical practitioner may be required to provide comprehensive

medical reports when requested by patients or by the legal next
of kin, in the case of minors or persons under disability, or by the
employer with the specific consent by the patient. Any refusal or
undue or unexplained delay in providing such report, or
withholding of such report on the grounds of non-payment of
hospital charges or professional fees, is unethical.

2.2. Abuse of Privileges Conferred by Custom

2.2.1 Abuse of Trust

Patients grant practitioners privileged access to their homes and

confidences and some patients are liable to become emotionally

27
 dependent upon the practitioner. Good medical practice depends
upon maintenance of trust between practitioners and patients and
their families, and the understanding by both that proper
professional relationships will be strictly observed. In this situation
practitioners must exercise great care and discretion in order not
to damage this crucial relationship. Any action by a practitioner
which breaches this trust may raise the question of serious
professional misconduct.

2.2.2 Abuse of Confidence

A practitioner must not improperly disclose information which he

obtained in confidence from or about a patient.

2.2.3 Undue Influence

A practitioner must not exert improper influence upon a patient to

lend him money or to obtain gifts or to alter the patient's will in his
favour.

2.2.4 Personal Relationships between Practitioners and Patients

A practitioner must not enter into an emotional or sexual

relationship, or any act which may be interpreted as sexual
harassment with a patient (or with a member of a patient's family)
which disrupts that patient's family life or otherwise damages, or
causes distress to, the patient or his or her family.

2.2.5 Practitioner’s Inability or Fitness to Practice

A medical practitioner who is unable to perform his professional

duties to the best level, thereby endangering patients, has an
ethical obligation to inform his senior colleague about his
problems, and may voluntarily cease practising.

28
2.2.6 Medical Errors and Incident Reporting

A medical practitioner who commits errors in the course of

management of his patient must avoid concealing them from the
patient or those in authority and must record such events in the
patient records/notes. It is unethical for the practitioner not to be
truthful and honest in such an event.

2.2.7 Chaperone

A medical practitioner must ensure when consulting or examining

a patient, particularly of the opposite sex to have the presence of
a chaperone with visual and aural contact, within the consultation
room or bedside. This is for the protection of the practitioner and
the patient, and to ensure that the patient is comfortable and not
embarrassed by any appropriate physical examination.

A request by a patient that no chaperone be present must be

documented in the medical record or notes and signed by the
patient. However, the practitioner should request the chaperone
to be in an adjoining area in case assistance is needed.

29
3. CONDUCT DEROGATORY TO THE REPUTATION OF THE MEDICAL
PROFESSION

The medical practitioner is expected at all times to observe proper standards of

personal behaviour in keeping with the dignity of the profession.

3.1 Respect for Human Life

The utmost respect for human life should be maintained even under
threat, and no use should be made of any medical knowledge contrary
to the laws of humanity.

The practitioner must not countenance, condone or participate in the

practice of torture or other forms of cruel, inhuman or degrading
procedures, whatever the offence of which the victim of such procedures
is suspected, accused or guilty, and whatever the victim's beliefs or
motives, and in all situations, including armed conflict and civil strife. The
practitioner must not provide any premises, instruments, substances or
knowledge to facilitate the practice of torture or other forms of cruel,
inhuman or degrading treatment or to diminish the ability of the victim to
resist such treatment.

A practitioner engaged in a prison or in places of detention must provide

professional care in the interest and well-being of the inmates.

3.2 Personal Behaviour

The public reputation of the medical profession requires that every

member should observe proper standards of personal behaviour, not
only in his professional activities but at all times. This is the reason why
the conviction of a practitioner for a criminal offence may lead to
disciplinary proceedings even if the offence is not directly connected with
the practitioner's profession.

30
3.2.1 Personal Misuse or Abuse of Alcohol or Drugs

A practitioner’s conviction for drunkenness or drug abuse or other

offences (driving a vehicle when under the influence of alcohol or
drugs) indicate habits which are discreditable to the profession
and may lead to an inquiry by the Council.

A practitioner who treats patients or performs other professional

duties while he is under the influence of alcohol or drugs, or who
is unable to perform his professional duties because he is under
the influence of alcohol or drugs is liable to disciplinary
proceedings.

3.2.2 Dishonesty: Improper Financial Transactions

A practitioner is liable to disciplinary proceedings if he is convicted

of criminal deception (obtaining money or goods by false
pretences), forgery, fraud, theft or any other offence involving
dishonesty.

A practitioner must not commit dishonest acts in the course of his

professional practice or against his patients or colleagues. Such
acts, if reported to the Council, may result in disciplinary
proceedings.

A practitioner must not prescribe or dispense drugs or appliances

for improper motives. A practitioner's motivation may be regarded
as improper if he has prescribed a drug or appliance purely for his
financial benefit or if he has prescribed a product manufactured
or marketed by an organisation from which he has accepted an
improper inducement.

31
 3.2.3 Fee Splitting or Kick-back Arrangement

A practitioner must not practise fee-splitting or any form of kick

back arrangement as an inducement to refer or to receive a
patient from another practitioner, institution, organisation or
individual. The premise for referral must be quality of care.

However, fee sharing where two or more practitioners are in

partnership or where one practitioner is assistant to or acting for
the other is permissible.

3.2.4 Indecency and Violence

Any conviction for assault or indecency would render a

practitioner liable to disciplinary proceedings, and may be
regarded with particular gravity if the offence was committed in
the course of a practitioner's professional duties or against his
patients or colleagues.

A practitioner must treat colleagues and staff with due respect and
dignity at all times and avoid any act, verbal or physical, which
may cause harm or injury, or which may be interpreted as
harassment, including gender-related, aggressive pressuring or
intimidating behaviour.

3.3 A Colleague’s Incompetence to Practice

Where a practitioner becomes aware of a colleague's incompetence to

practice, whether by reason of taking drugs or by physical or mental
incapacity, or has a medical condition which may pose a risk to his
patient, or repeated acts of poor standard of patient care, then it is the
practitioner’s ethical responsibility even without the need to obtain his
consent to draw this to the attention of a higher authority who is in a
position to act appropriately.

32
 If the practitioner is treating a colleague who is physically or mentally
impaired to the extent that patients have been harmed or are at imminent
risk of harm, the practitioner must first counsel the colleague to self-
report, failing which the practitioner must report the colleague to the
relevant authorities even without his consent, in which case the
practitioner’s obligation to patient confidentiality shall be waived.

3.4 The Practitioner and Commercial Undertakings

The practitioner is the trustee for the patient and accordingly must avoid
any situation in which there is a conflict of interest with the patient.

A practitioner must not associate himself with commerce in such a way

as to let it influence, or appear to influence, his attitude towards the
treatment of his patients.

The association of a practitioner with any commercial enterprise

engaged in the manufacture or sale of any substance which is claimed
to be of value in the prevention or treatment of disease but is unproven
or of an undisclosed nature or composition will be considered as serious
professional misconduct

A practitioner has a duty to declare an interest before participating in any

discussion which could lead to the purchase by a public or private
authority of goods or services in which he, or a member of his immediate
family, has a direct or indirect pecuniary interest. Non-disclosure of such
information may amount to serious professional misconduct.

Where the practitioner has a financial interest in any facility to which he

refers patients for diagnostics tests, for procedures or for inpatient care,
he must disclose his interest in the institution to the patient.

33
 3.5 Plagiarism

Plagiarism is the wrongful appropriation, close imitation or purloining and

publication of another author’s language, thoughts, ideas or
expressions, without authorisation, and representation of that author’s
work as one’s own, as by not crediting the original author.

A medical practitioner who commits plagiarism, in whatever degree,

extent or form as stated above, or in any related manner, may have
conducted an act derogatory to the reputation of the medical profession.

4. ADVERTISING, CANVASSING AND RELATED PROFESSIONAL

OFFENCES

The medical profession in this country has long accepted the convention that
doctors should refrain from self-advertisement. In the Council's opinion self-
advertisement is not only incompatible with the principles which should govern
relations between members of a profession but could be a source of danger to
the public. A practitioner successful at achieving publicity may not be the most
appropriate doctor for a patient to consult. In extreme cases advertising may
raise illusory hopes of a cure.

4.1 Advertising and Canvassing

A registered medical practitioner must not act contrary to accepted

ethical norms and to the public interest, and in a manner which is
discreditable to the profession of medicine. Such acts include but are not
limited to –
i. Advertising, whether directly or indirectly, for the purpose of
obtaining patients;
ii. Advertising, whether directly or indirectly, for the purpose of
promoting one’s own professional advantage;

34
 iii. Procuring, or sanctioning or acquiescing in the publication of
notices commending or directing attention to the practitioner’s
professional skill, knowledge, services or qualification for the
purposes set out in (i) and (ii) above;
iv. Procuring, or sanctioning or acquiescing in the publication of
notices deprecating the skill, knowledge, services or qualification
of other practitioners for the purposes set out in (i) or (ii) above;
v. Being associated with, or employed by, those who procure or
sanction advertising as described in (i) or (ii) above;
vi. Being associated with, or employed by, those who procure or
sanction the publication of notices as described in (iii) or (iv)
above;
vii. Canvassing, or engaging any agent or canvasser, for the purpose
of obtaining patients;
viii. Sanctioning the act of canvassing or employment of any agent or
canvasser, for the purpose of obtaining patient;
ix. Being a party to, abetting, condoning, being associated with or
employed by those who sanction the act of canvassing or employ
any agent or canvasser for the purpose of obtaining patients e.g.
private hospitals, clinics and other medical institutions.

4.2 Dissemination of Information

The Council recognises that the profession has a duty to disseminate

information about advances in medical sciences, healthcare products
and therapeutics provided it is done in an ethical manner.

Specifically, registered medical practitioners should be aware of the

following matters when disseminating such information, which may
amount to self-advertisement and/or may be unethical, depending on the
circumstances.

4.2.1 Practitioners may have their name, qualifications and primary

place of practice stated in articles, literary contributions and

35
 publications for the lay public. However, practitioners should take
every effort to ensure that such publications do not contain
laudatory editorial references to the practitioner’s professional
status or experience.

4.2.2 While photographs of the practitioner in connection with articles

or contributions in the media (including social media) are
permitted, photographs of patients (whether full or in part) must
not be used.

4.2.3 Where a publication has arisen as a result of research on any

instrument or drug provided by a commercial firm, this should be
stated in the publication, together with a disclaimer/statement
regarding any financial interest of the author(s) with the firm.
Similarly, if the practitioner presents a lecture/talk which involves
a commercial product, this should be declared, as well as any
affiliation or financial interest the practitioner may have with the
commercial firm in question.

4.2.4 Practitioners may be in a position to educate their colleagues or

present some new method of treatment or innovation to other
practitioners. In such cases, talks or presentations must be
organised only through professional bodies, medical educational
institutions or registered healthcare facilities.

4.2.5 Interviews with the media on subjects relating to disease and their
treatment should be avoided by a medical practitioner engaged in
active medical or surgical practice, except through an association
or authorised organisation. An authorised organisation or
institution is defined as any bona fide college, medical
educational institution, medical professional body or society.

36
4.3 Professional Calling Cards, Letterheads, Name Plates, Signboards,
Banners etc.

4.3.1. A practitioner may carry calling cards but he should not distribute
calling cards with the purpose of soliciting patients.

4.3.2. The information permitted on professional calling cards,

letterheads and rubber stamps is contained in Appendix II.

4.3.3. A signboard for the purpose of assisting patients to locate a

practitioner is permissible provided it conforms to the limits laid
down by the Council as contained in Appendix III.

4.3.4. Name plates and doorplates should conform with the limits laid
down by the Council as contained in Appendix IV.

4.3.5. 24-Hour Clinics should conform with the requirements laid down
by the Council as contained in Appendix V.

4.3.6. A temporary banner to announce the opening of a new healthcare

facility must satisfy local government requirements. The banner
is only permitted to be displayed at the entrance to the premise
and must not contain the name, photograph or particulars of any
registered medical practitioner.

4.3.7. A billboard (also called a hoarding) promoting any healthcare

facility must satisfy local government requirements and must not
contain the name, photograph or particulars of any registered
medical practitioner.

37
 PART III

DISCIPLINARY PROCEDURES
Medical Act 1971 (Amended 2012)
and
Medical Regulations 2017

Disciplinary Panel

In accordance with Regulations 34 to 42, 44 and 45 of Medical Regulations

2017 –

34. (1) A Disciplinary Panel shall be established from which members

of the Preliminary Investigation Committee and
Disciplinary Board shall be drawn.

(2) The Disciplinary Panel shall consist of the following

members who shall be appointed by the Council:

(a) Council members;

(b) fully registered medical practitioners of at least ten
years of good standing with current annual
practising certificates; and
(c) any person other than in paragraph (a) or (b).

(3) The members of the Disciplinary Panel shall hold office for
a term not exceeding three years and may be eligible for
reappointment.

(4) The Council may, at any time, revoke the appointment of

any member of the Disciplinary Panel.

38
 Preliminary Investigation Committee

35. (1) The Preliminary Investigation Committee shall consist of not

more than five members selected from the Disciplinary
Panel.

(2) The function of the Preliminary Investigation Committee is

to conduct a preliminary investigation into complaints or
information touching on any disciplinary matter to
determine whether or not there shall be an inquiry.

(3) The quorum of the Preliminary Investigation Committee

shall be three.

Disciplinary Board

36. (1) The Disciplinary Board shall consist of the following members
who shall be selected from the DisciplinaryPanel:

(a) at least three members of the Council;

(b) three fully registered medical practitioners of atleast
ten years of good standing with current annual
practising certificates; and
(c) any other person than in paragraph (a) or (b).

(2) The function of the Disciplinary Board is to conduct an

inquiry on any complaint or information touching on any
disciplinary matter received against any medical
practitioner.

(3) The quorum of Disciplinary Board shall be five.

39
 Provisions relating
to Preliminary Investigation Committee
or Disciplinary Board

37. (1) The Council shall appoint a fully registered medical

practitioner from among members of the Preliminary
Investigation Committee or the Disciplinary Board, as the
case may be, to be the chairman of the respective
committees.

(2) The chairman shall preside at all meetings of the

Preliminary Investigation Committee or the Disciplinary
Board, as the case may be.

(3) In the absence of the chairman, the most senior fully

registered medical practitioner present at the meeting of
such Preliminary Investigation Committee or the
Disciplinary Board, as the case may be, shall preside the
meeting.

(4) The decision of the Preliminary Investigation Committee or

the Disciplinary Board, as the case may be, shall be made
by a majority of votes.

(5) In the event of equality of votes, the chairman, or in his

absence, the person chairing the meeting shall have a
casting vote in addition to his deliberative vote.

(6) The Preliminary Investigation Committee or the

Disciplinary Board shall determine its own procedure.

40
(7) No act done or proceedings taken by the Preliminary
Investigation Committee or the Disciplinary Board, as the
case may be, shall be invalid on the ground of –

(a) any vacancy in the membership of, or any defect in

the constitution of the Preliminary Investigation
Committee or the Disciplinary Board; or
(b) any omission, defect or irregularity not affecting the
merits of the case.

(8) A member of the Preliminary Investigation Committee or

the Disciplinary Board shall, subject to such conditions as
may be specified in his instrument of appointment, unless
he sooner resigns, hold office for a term not exceeding
three years and is eligible for reappointment.

(9) The Council may, at any time, revoke the appointment of

any member of the Preliminary Investigation Committee if
such person is found by the Council to be no longer a fit
and proper person to carry out the functions under sub
regulation (1).

(10) A member of the Preliminary Investigation Committee may

at any time resign his office by giving a notice in writing to
the Council and a copy of the notice to the committee.

(11) The Council may appoint any person it thinks fit to fill the
vacancy for the remainder of the term vacated by a
member.

41
 Complaint against Registered Medical Practitioner

38. (1) Any complaint or information pertaining to any registered

medical practitioner shall be made in writing and
addressed to the Council.

(2) The Council shall submit the complaint or information

received to the Preliminary Investigation Committee.

(3) The quorum of the Preliminary Investigation Committee

shall be three.

In order to carry out this specific role, the Council has established a Complaint
Management Committee (“CMC”), comprising of three (3) members of the Council.
These three (3) members of the CMC will hold office as members of this Committee
for a period of one (1) year, unless otherwise decided by the Council.

The CMC will sit as and when required to scrutinize complaints/information received
by the Council against RMPs and to forward the same to one of the Preliminary
Investigation Committees (PIC) set up under Regulation 35 of the Medical Regulations
2017.

The CMC is required to ensure that the complaint/information complies with the
requirements of Regulation 38(1) before such complaint/information is forwarded to a
PIC:

(a) the complaint / information must be in writing; and

(b) the complaint / information must be against an RMP.

42
 Summary Dismissal of Complaint

39. (1) The Preliminary Investigation Committee may recommendto

the Council to summarily dismiss any complaint or
information if it is satisfied –

(a) the name and address of the complainant is

unknown or untraceable;
(b) even if the facts were true, the facts do not
constitute a disciplinary matter; or
(c) there is reason to doubt the truth of the complaint
or information.

(2) The Preliminary Investigation Committee may, before

recommending any summary dismissal, require the
complainant to make a statutory declaration of the facts
alleged by him.

(3) The Preliminary Investigation Committee shall provide

reasons for such recommendation in sub-regulation (1).

Procedure of Investigation

40. (1) Where the Preliminary Investigation Committee has reason

to believe that the complaint or information isprobably true,
the Preliminary Investigation Committeeshall –
(a) notify the registered medical practitioner concerned
of the receipt of a complaint or information with
regard to him;

43
 (b) forward a copy of the complaint or information and
any supporting statutory declaration and document
received to the registered medical practitioner
concerned;
(c) require the registered medical practitioner
concerned to submit a reply to the complaint or
information within thirty days from the receipt of the
notification; and
(d) request from the registered medical practitioner
concerned for clarification or further documents to
be provided within the period of fourteen days from
the receipt of the request.

(2) Upon considering the reply and clarification, if any, by the

registered medical practitioner concerned, the Preliminary
Investigation Committee may recommend to the Council –
(a) no further action shall be taken on the complaint or
information received; or
(b) the complaint or information received shall be
forwarded to the Disciplinary Board for an inquiry to
be held.

(3) If at the close of the investigation, the Preliminary

Investigation Committee finds that there are serious
grounds to support the allegation against the registered
medical practitioner concerned, the Preliminary
Investigation Committee may recommend to the Council
to appoint a member of the Disciplinary Panel who was not
involved with the investigation as the complainant if –

(a) the actual complainant withdraws the complaint or

information; or

44
 (b) the actual complainant is not contactable by the
Preliminary Investigation Committee.

Recommendation and Record of Investigation

41. (1) The recommendation and record of investigation by the

Preliminary Investigation Committee shall be preparedand
forwarded to the Council within thirty days from the close
of investigation.

(2) The Council may, upon considering the recommendation

of the Preliminary Investigation Committee, for reasons to
be recorded –
(a) summarily dismiss the complaint or information; or
(b) forward the complaint or information together with
the recommendation of the Preliminary
Investigation Committee to the Disciplinary Board
for an inquiry.

45
 Inquiry by Disciplinary Board

42. (1) Upon receipt of the complaint or information together with the
recommendation of the Preliminary Inquiry Committee,the
Disciplinary Board –
(a) may issue an interim order to the registered medical
practitioner concerned in accordance with section
29A of the Act;
(b) shall, by a written order, require the attendance of
the complainant and any person appears to be
acquainted with the circumstances of the complaint
or information, before the Disciplinary Board on a
date, time and place to be specified in the order;
and
(c) shall notify the registered medical practitioner
concerned –
(i) the date, time and place at which the inquiry
into the complaint or information shall be
held; and
(ii) his rights to be present with or without
counsel at the inquiry.

(2) The Disciplinary Board shall convene the inquiry on the

date, time and place specified in the order and shall
proceed to inquire into the allegation made against the
registered medical practitioner concerned even if he is not
present.

(3) The Disciplinary Board shall examine the complainant and

any person in support of the allegation.

46
(4) The complainant and any person referred to in sub-
regulation (3) may be cross-examined by the registered
medical practitioner concerned and further be re-
examined by the Disciplinary Board if necessary.

(5) The Disciplinary Board shall record all statements made

by the complainant and person examined.

(6) For the purposes of the inquiry, the Disciplinary Board may
require the complainant or the registered medical
practitioner concerned –
(a) to produce any material with regard to the inquiry
by the Disciplinary Board and to make copies of
such material; or
(b) to attend at a specified time and place to give
evidence and to produce any book, document,
paper or other record.

(7) After taking the statements of the complainant and the

persons referred to in sub-regulation (3), the Disciplinary
Board shall –
(a) if the Disciplinary Board finds that there are not
sufficient grounds to support the allegation,
recommend to the Council that no further action
shall be taken on the registered medical practitioner
concerned; or
(b) if the Disciplinary Board finds that there are
sufficient grounds to support the allegation, frame a
charge against the registered medical practitioner
concerned and explain to him that he is at liberty to
state his defence on the charge framed against him
and call witnesses in support of his defence.

47
 (8) If the registered medical practitioner concerned after being
informed of his rights elects not to make a statement or call
any witnesses in support of his defence, the Disciplinary
Board may recommend to the Council to find such
registered medical practitioner concerned guilty of the
offence charged against him.

(9) If the registered medical practitioner concerned elects to

make his defence before the Disciplinary Board, his
statement and the statements of his witnesses, if any, shall
be recorded and the Disciplinary Board may cross
examine him and his witnesses on their statements.

Recommendation by Disciplinary Board

44. (1) After considering the statement of the registered medical

practitioner concerned and his witnesses, if any, together
with the evaluation report of the Fitness to Practise
Committee, if any, the Disciplinary Board shall –
(a) if the Disciplinary Board finds that there are no
sufficient grounds to support the charge,
recommend to the Council that no further action
shall be taken on the registered medical practitioner
concerned; or
(b) if the Disciplinary Board finds the registered
medical practitioner concerned guilty of the charge,
the Disciplinary Board shall inform the registered
medical practitioner concerned of its finding and the
reasons for its decision.

48
 (2) The Disciplinary Board shall request such registered medical
practitioner concerned to make any plea in mitigation and
after hearing such plea, if any, recommend to the Council
any of the punishments under section 30 of the Act.

Decision of Council

45. (1) The Council may, upon considering the records of the inquiry
and recommendation of the Disciplinary Board, forreasons
to be recorded –
(a) accept the recommendation of the Disciplinary
Board and impose the punishment;
(b) direct the Disciplinary Board to reconvene the
meeting and inquire further into the complaint or
information;
(c) direct that a new Disciplinary Board be constituted
and conduct an inquiry into the complaint or
information;
(d) direct that the charge be dismissed if the Council
finds that no case has been made out against the
registered medical practitioner concerned;
(e) reject the recommendation of the Disciplinary
Board and makes its decision; or
(f) give such other direction as the Council thinks fit.

(2) The Council shall inform the registered medical

practitioner concerned of the decision made under sub-
regulation (2).

(3) The Council shall have the right to publish in the media the
conclusion of any inquiry done.

49
 Appeal against Orders of the Council

In accordance with Section 31 of the Medical Act 1971 (Amended 2012) –

31. (1) Any person who is aggrieved by any order made in respectof
him by the Council in the exercise of its disciplinary
jurisdiction may appeal to the High Court, and the High
Court may thereupon affirm, reverse or vary the order
appealed against or may give such direction in the matter
as it thinks proper; the cost of the appeal shall be in the
discretion of the High Court.

(2) (Deleted by Act A1443).

(3) The practice in relation to any such appeal shall be subject

to the rules of court applicable in the High Court:

Provided that the High Court shall not have power to hear
any appeal against an order made under Section 30
unless notice of such appeal was given within one month
of the service of the order in the prescribed manner.

50
 Interim Orders

In accordance with Section 29A of the Medical Act 1971 (Amended 2012) –

29A. (1) Where upon due inquiry into any complaint or information
referred to it, a Disciplinary Board is satisfied that it is
necessary for the protection of the members of the public
or it is otherwise in the public interest, or it is in the interest
of a registered medical practitioner for his registration to
be suspended or to be made subject to conditions, the
Board may make an order –
(a) that his registration in the appropriate register be
suspended for such period not exceeding twelve
months as may be specified in the order (referred
to in this Part as an interim suspension order); or
(b) that his registration be continued on hiscompliance,
during such period not exceeding twelve months as
may be specified in the order, of such requirement
as the Disciplinary Board thinks fit to impose
(referred to in this Part as an order for interim
restricted registration).

(2) The Registrar shall immediately serve a notification of the

order under subsection (1) on the registered medical
practitioner.

(3) Subject to subsection (1), where a Disciplinary Board has

made an order under this section, the Disciplinary Board
or another Disciplinary Board appointed in its place –

51
 (a) shall review it within a period of six months
beginning on the date on which the order wasmade,
and shall thereafter, for so long as the order
continues in force, further review it before the end
of a period of three months beginning on the date
of the decision of the immediately preceding review;
and
(b) may review it where new evidence relevant to the
order has become available after the making of the
order.

(4) Where an interim suspension order or an order for interim

restricted registration has been made under this section in
relation to any person, the Disciplinary Board that made
the order or another Disciplinary Board appointed in its
place under subsection (3) may –
(a) revoke the order or revoke any condition imposed
by the order;
(b) make an order varying any condition imposed by
the order;
(c) if satisfied that to do so is necessary for the
protection of members of the public or is otherwise
in the public interest, or is in the interest of the
registered medical practitioner concerned, or that
the registered medical practitioner has not complied
with any requirement imposed as a condition of his
registration in the order for interim restricted
registration, replace that order with the interim
suspension order having effect for the remainder of
the former; or

52
 (d) if satisfied that the public interest or the interest of
the registered medical practitioner concerned
would be more adequately served by an order for
interim restricted registration, replace the interim
suspension with an order for interim restricted
registration having effect for the remainder of the
period of the former.

(5) The Registrar shall immediately serve a notification of the

decision under subsection (4) on the registered medical
practitioner.

(6) The Disciplinary Board may apply to the President for an

order made under subsection (1) to be extended, and may
apply again for further extension.

(7) On such an application, the President may extend (or

further extend) for up to six months the period for which
the order has effect.

(8) An interim suspension order or an order for interim

restricted registration shall be in force until –
(a) the end of the period specified in the order or, if
extended under subsection (7), in the order
extending it; or
(b) the date on which proceedings are concluded,
whichever is the earlier.

(9) While a person’s registration in the Register is suspended

by virtue of an interim suspension order, he shall not be
regarded as being registered notwithstanding that his
name still appears in the Register.

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 (10) Immediately upon the expiry or revocation of the order, the
person’s rights and privileges as a registered medical
practitioner shall be revived from the date of such expiry
or revocation, provided that he has complied with all the
terms of the order.

(11) Any registered medical practitioner who is aggrieved by

the decision of the Disciplinary Board or President under
this section may appeal in writing to the Minister.

(12) The Minister may confirm, reverse or vary the decision of

Disciplinary Board or President.

(13) The Minister’s decision on any appeal under subsection

(11) shall be final and binding.

Fitness to Practise Committee

In accordance with Regulation 43 of the Medical Regulations 2017 –

43. (1) During the course of the inquiry, if the Disciplinary Board found
that the registered medical practitioner concerned is
professionally incompetent or his fitness to practise is
impaired by physical or mental disability, the Disciplinary
Board may refer the registered medical practitioner
concerned to the Fitness to Practise Committee for an
evaluation.

(2) The Fitness to Practise Committee shall evaluate any

registered medical practitioner referred to in sub-
regulation (1).

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 (3) For the purpose of evaluating the professionalcompetency
or fitness to practise of a registered medical practitioner,
the Fitness to Practise Committee may, by order in writing,
require the attendance of the registered medical
practitioner concerned before the Committee on a date,
time and place to be specified in the order to answerany
question and to produce any required document.

(4) The Fitness to Practice Committee may, upon receipt of

the complaint or information alleging that any registered
medical practitioner is professionally incompetent or his
fitness to practise is impaired by physical or mental
disability, evaluate such registered medical practitioner
concerned.

Restoration of Name to Register

In accordance with Section 31A of the Medical Act 1971 (Amended 2012) –

31A. (1) No person whose name has been struck off from the
Register under paragraph 30(1)(e) shall thereafter be
entitled to be registered as a medical practitioner under the
provision of this Act, but the Council may, if it thinks fit in
any case to do so, on the application of the person
concerned, order that the name of such person be
restored to the Register provided that a period of three
years shall have elapsed since the order was made; and
where the name of a person has been suspended from the
Register under paragraph 30(1)(c), such person shall be
entitled at the expiration of period of suspension, but not
earlier, to apply for the certificate of registration and

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 the annual practising certificate (if the period for which it is
issued is still unexpired) to be returned to him.

(2) An application under subsection (1) shall be made in such

manner or form and accompanied by such documents,
photographs, particulars and fees as may be prescribe.

Appointment of Legal Advisor

In accordance with Regulation 48(1) of the Medical Regulations 2017 –

48. (1) The Council may appoint a legal advisor to assist the Council,
Disciplinary Board or Preliminary Investigation Committee
during any disciplinary proceedings.

(2) The Council may appoint any person who is and has been
an advocate and solicitor for a period of not less than five
years to advise the Council, Disciplinary Board or
Preliminary Investigation Committee on –
(a) all questions of law arise in the course of any
disciplinary proceedings; and
(b) the meaning and construction of all documents
produced during the disciplinary proceedings.

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 Prohibition from Attending Disciplinary Proceedings

In accordance with Regulation 50 of Medical Regulations 2017 –

50. (1) No member of the Council, Disciplinary Board or Preliminary

Investigation Committee shall attend orparticipate in any
meeting of the Council, DisciplinaryBoard or Preliminary
Investigation Committee, as the casemay be, relating to a
disciplinary proceeding if –
(a) he was the complainant;
(b) he is personally acquainted with any relevant fact;
(c) he has appeared or likely to appear before the
Disciplinary Board for the purpose of making any
statement; or
(d) the complainant, the persons appearing before the
Disciplinary Board for the purpose of making any
statement or the registered medical practitioner is a
member of his family or his associate.

(2) For the purposes of this regulation –

“a member of his family”, in relation to a member of the

Council, Disciplinary Board or Preliminary Investigation
Committee, includes –
(a) his spouse;
(b) his parent (including a parent of his spouse);
(c) his child (including an adopted child or stepchild);
(d) his brother or sister (including a brother or sister of
his spouse); or
(e) a spouse of his child, brother or sister; and

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“associate”, in relation to a member of the Council,
Disciplinary Board or Preliminary Investigation Committee,
means –
(a) a practice or company of which the member or any
nominee of his is a partner or employee; or
(b) a partner or employee of the member.

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 APPENDICES

Appendix I – Declaration of Geneva

Adopted initially by the 2nd General Assembly of the World Medical Association,
Geneva, Switzerland, September 1948 and amended on numerous occasions, this
version of the Declaration was finally amended and adopted at the 68th WMA General
Assembly, Chicago, United States, October 2017.

The Physician’s Pledge

As a member of the medical profession:

I solemnly pledge to dedicate my life to the service of humanity;
The health and well-being of my patient will be my first consideration;
I will respect the autonomy and dignity of my patient;
I will maintain the utmost respect for human life;
I will not permit considerations of age, disease or disability, creed, ethnic origin, gender,
nationality, political affiliation, race, sexual orientation, social standing or any other factor to
intervene between my duty and my patient;
I will respect the secrets that are confided in me, even after the patient has died;
I will practise my profession with conscience and dignity and in accordance with good medical
practice;
I will foster the honour and noble traditions of the medical profession;
I will give to my teachers, colleagues, and students the respect and gratitude that is their due;
I will share my medical knowledge for the benefit of the patient and the advancement of
healthcare;
I will attend to my own health, well-being, and abilities in order to provide care of the highest
standard;
I will not use my medical knowledge to violate human rights and civil liberties, even under
threat;
I make these promises solemnly, freely, and upon my honour.

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 Appendix II – Professional Calling Cards, Letterheads and Rubber Stamps

The calling card, letterheads and rubber stamps should only contain the name
of the practitioner, registrable professional qualifications, recognised State and
National awards, home address and telephone number(s), practice address(es) and
telephone number(s). Adjunct academic appointments should be listed only during the
period it is officially relevant and removed when such appointments lapse. Rubber
stamps used in Medical Sick Certificates and other similar certificates should also
include the MMC Registration Number.

Appendix III – Signboards

1. The rules, regulations and stipulations on signboards by the local state

authorities, are to be complied with.

2. The Council stipulates the following limits to signboards for registered

practitioners –
a. There shall not be more than two (2) signboards to indicate the identity
of the medical clinic or practice.
b. They shall not be floodlit or illuminated.

3. The total combined area of the signboard or signboards (if two (2) signboards
are used) should not exceed 5.574 sq. metres (60 sg. ft.) This includesletterings
fixed or painted on walls or any other backing where the perimeter enclosing
the letterings should not exceed 5.574 sq. metres (60 sq. ft.) in total.

4. Clinics may actually require more than one signboard and these should be
restricted to a maximum of two provided the total combined areas of the two
signboards do not exceed 5.574 sq. metres (60 sq. ft).

5. A signboard should serve to provide guidance and information about a clinic. It

should not be a means for soliciting patients.

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6. Signboards may be illuminated in a style that is appropriate for a medical
practice.

7. Where signs are painted on walls, the perimeter of the lettering should not
enclose an area in excess of those specified above.

8. When the practice is within a commercial complex, there is no objection to the

clinic name appearing in the general directory signboard in the lobby.

9. The use of the Red Crescent on any private medical premise is a contravention
of the Geneva Convention and is illegal.

10. The use of directional signboard/s with the word “Clinic” and an arrow pointing
in the direction of the clinic leading from the main road is permissible if it
conforms to local government regulations. The name of the clinic may appear
in such a directional signboard, which should be within 1km on the main roads
before approaching the clinic in either direction.

Appendix IV – Names Plates/Doorplates

1. Nameplates should be plain and should not exceed 930.25 sq. cm. (1 sq. ft.) in
dimension.

2. The name plates may bear the following –

a. the practitioner's name;
b. his registrable qualifications in small letters;
c. titles may be included; and
d. official crests and logos, e.g. WHO, red crescent, are not allowed.

3. A separate doorplate not exceeding 929 sq. cm. (1 sq. ft.) is permitted to
indicate his consultation hours.

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4. Where it is considered necessary for an assistant to have his own nameplate
the normal rules relating to plates continue to apply.

5. Visiting practitioners may have their nameplates, provided the day(s) and
hour(s) of practice are stated.

6. Nameplates of practitioners who do not practise in the clinic are not permitted
to be exhibited.

Appendix V – 24-Hour Clinic

1. No additional signboard is permitted.

2. Notification of the availability of 24-hour service should be on the doorplate

pertaining to consultation hours or on the existing clinic signboard.

3. Qualified and registered practitioners should be available at all times and his
availability should be within a reasonable period of time not exceeding thirty
(30) minutes.

4. A practitioner may not operate more than one 24-hour clinic at the same time.

5. In the event that an emergency arises requiring the practitioner to be called

away, the clinic should do one of the following –
a. not to accept any new patients until the practitioner is back in the clinic;
or
b. inform intending patients that the practitioner is not available.

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Acknowledgement

MMC acknowledges the approval granted by the Singapore Medical Council and
Medical Board of Australia for inclusion of parts from Ethical Code and Code of
Conduct, respectively.

References and Further Reading

1. Medical Act 1971 (Amended 2012), Medical Regulations 2017

2. WMA Declaration of Helsinki Revised 2017
3. Medical Board of Australia: Code of Conduct for Doctors in Australia, 2011
4. Singapore Medical Council: Ethical Code and Ethical Guidelines 2016
5. Privy Council (Lord Clyde in Roylance v General Medical Council [1999] 3 WLR
541, [1999] Lloyd's Rep Med 139).
6. General Medical Council, Professional Conduct and Discipline: Fitness to
Practice, London: GMC, 1985
7. Medical Research and Ethics Committee (MREC) Ministry of Health Malaysia
2002
8. Medical Devices Act 2012 www.mdbgov.my
9. Code of Conduct of the Pharmaceutical Association of Malaysia S.11 and S11.2
10. Sale of Drugs Act 1952
11. Control of Drugs and Cosmetics Regulations sections 2,7 and 9, 1984

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Malaysian Medical Council Guidelines and Related Publications

1. Good Medical Practice, 2019

2. Confidentiality, 2011
3. Consent, 2016
4. Expert Witness, 2019
5. Brain Death, 2006
6. Clinical Trials and Biomedical Research, 2006
7. Dissemination of Information by the Medical Profession, 2006
8. Medical Records and Medical Reports, 2006
9. Organ Transplantation, 2006
10. Relationship between Doctors and the Healthcare Industry, 2019
11. Audio and Visual Recordings, 2018
12. HIV & Blood-borne Virus Infections,2011
13. Management of Impaired Registered Medical Practitioners, 2010
14. Plagiarism, 2017
15. Position on Managed Care Practice, 2012

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