Being part of a professional order is not a right, but a privilege that is subject to ethical regulations and rigorous laws. The medical profession is governed by several statutes, including the Professional Code, the Medical Act and the Code of Ethics of Physicians. The Medical Act specifies what is the practice of medicine and the scope of practice of the physician. According to this law, the role of the doctor is to:
assess and diagnose any health impairment in human beings in interaction with their environment, prevent and treat disease with the aim of maintaining health, restoring health or providing appropriate symptom relief
Acts exclusively reserved for doctors
As a doctor, certain activities are exclusively reserved for you, such as:
- Diagnosing diseases;
- Prescribe diagnostic tests;
- Use invasive diagnostic techniques or those that present a risk of harm;
- Determine medical treatment;
- Prescribing treatments, medications and other substances;
- Carry out pregnancy monitoring and perform deliveries;
- Carry out clinical surveillance of the condition of sick people whose state of health presents risks.
Disciplinary complaint for breach of ethics
As a physician, you are subject to ethical obligations set out in the Professional Code and the Code of Ethics of Physicians. When you are accused of breaching your professional obligations, you may face disciplinary action. The syndic of the Collège des médecins, who is an independent employee within the college, is responsible for protecting the public by ensuring that there is no practice of the profession that is inappropriate or unethical. To do so, the physician may conduct an investigation into a physician, either when requested or on his or her own initiative, if he or she has reasonable grounds to believe that the physician has breached his or her ethical obligations. If he concludes that this is the case, he will file a complaint against the doctor with the Disciplinary Council. The Disciplinary Council is an independent tribunal composed of a chairperson, who is a lawyer appointed by the government, and two physicians appointed by the board of directors of the Collège des médecins. He will have the task of determining the physician’s innocence or guilt and, if necessary, imposing one or more sanctions. Because the practice of medicine is rigorously regulated, we understand that it can be difficult to navigate. At Lambert Lawyers, we are here to support you and defend your rights during disciplinary proceedings brought by the Collège des médecins. Don’t wait to face the charges alone and contact us now for specialized legal assistance in disciplinary law and to be entitled to a solid defense, adapted to your situation.
Duties and obligations of the physician
As a doctor, you are subject to several obligations, some common to all professions, others specific to doctors. It is the violation of one or more of these obligations that will lead the syndic to open an investigation and file a complaint. Thus, you not only have the obligation to comply with the various laws to which you are subject, but to ensure that the people you employ or who perform acts on your behalf also comply with them. As a physician, you are subject to two types of duties: general duties, and duties to the public, the patient, and the profession. We will analyze some of these duties.
General duties
First, as a physician, you have a primary duty to protect and promote the health and well-being of your patients by practising your profession with respect for their life, dignity and liberty. In addition, you must discharge your professional obligations with competence, integrity and loyalty and refrain from the immoderate use of any psychotropic or analogous substance. You also have an active role to play in contributing to the development of the profession and to maintaining and improving the availability and quality of medical services available to the public by collaborating with your colleagues, sharing your knowledge and participating in various training activities in the field. Obviously, you must practice the profession in accordance with science, which means refraining from collaborating with a charlatan. It is also important to use health care resources wisely. Finally, in the event of a civil lawsuit for professional misconduct, you must fully engage your civil liability, and cannot try to dissuade a person from waiving his or her recourse.
Duties and Obligations to the Patient, the Public and the Profession
Quality of the professional relationship
At all times, you must behave in a manner that is beyond reproach to any person with whom you come into contact in the practice of the profession, including any patient, whether physically, mentally or emotionally. Thus, it is important to establish a relationship of mutual trust with your patient, and it will be possible for you to end the professional relationship when this bond of trust is lost. Since it is your duty to practise in an impersonal and impartial manner, you cannot refuse to examine or treat a patient on a discriminatory ground, and you must inform your patient of any personal beliefs that may affect your ability to provide appropriate professional services.
Duty of confidentiality
Maintaining professional secrecy is also necessary to establish a relationship of trust with your patients. This means that, as the patient’s doctor, you must, in particular, in order to preserve professional secrecy:
- Keep confidential what has come to your knowledge in the course of practising the profession, i.e., do not disclose facts or confidences of which you have personal knowledge;
- Refrain from holding or participating, including on social networks, in indiscreet conversations about a patient or the services provided to him or her or revealing that a person has used his or her services;
- Take reasonable measures with respect to persons who collaborate with you to ensure that professional secrecy is preserved;
- Not to use confidential information to the detriment of a patient;
- Refrain from revealing a serious or fatal prognosis to the patient’s family and friends if they forbid you to do so;
There are certain exceptions to professional secrecy. In particular, it can be broken in order to prevent an act of violence, including suicide. If you provide confidential information in this case, you must indicate in the patient’s record the following, among other things:
- The date and time of the communication;
- The identity of the person(s) exposed to the danger and the identity of the person(s) to whom the communication was made;
- The act of violence and the danger identified, as well as its imminence;
- The information provided.
Freedom of choice
As a physician, you must not interfere with the patient’s free choice to consult or have a prescription filled by a colleague, another professional or any other competent person.
Duty to inform
A competent patient has the right, in the name of personal autonomy, to be involved in medical decisions that affect him/her, including the risks involved in his or her decision to accept or refuse treatment or surgery. This is why, before undertaking any examination, treatment or research, you must, except in an emergency, obtain the free and informed consent of your patient, or his or her legal representative. To do this, you have the role, as a doctor, to provide your patient with the necessary information to help them make an informed decision. Thus, it is your duty to give them the relevant explanations so that they can understand the nature, purpose and possible consequences of the examination, investigation, treatment or research you will be carrying out, and to inform them of any serious or fatal prognosis. When the patient wishes to use treatments that are insufficiently recognized by science, you must advise them of the inherent risks and benefits of usual care. Finally, you must inform your patient of an accident or complication that is likely to result or has had significant consequences on his or her state of health or physical integrity.
Duty to follow up
Your duty to your patient does not end after the examination or treatment of the patient, you are also responsible for ensuring the medical follow-up required by his or her state of health, or for ensuring that another person takes care of him/her. If you can no longer follow up with your patient, it is essential to inform them with reasonable notice and to ensure that they can continue to receive the required professional services.
Duty of quality processing
At all times, you must take into account your abilities, your limitations, and the means available to you when you practice medicine. Consequently, if a situation is beyond your competence, you must, in the patient’s interest, consult or refer the patient to a colleague or other competent professional. Thus, you must refrain from practising medicine when the quality of your practice, your actions or the dignity of the profession could be compromised by your condition or certain circumstances.
Science-based processing
At all times, you must practise as a physician in accordance with current medical information. Thus, you must ensure that your research, diagnosis, investigation, examination, and treatment are sufficiently proven and in line with science.
Treatment in the interest of the patient
As a physician, you must refuse to collaborate or participate in any medical act or research activity that would be contrary to the patient’s interest, having regard to his or her health. You must also ensure that the staff accompanying you are qualified and licensed to practice medicine.
Duty of independence and disinterestedness
It is your duty to safeguard your professional independence by avoiding any situation in which you would be in a conflict of interest, especially when such conflicts could affect the loyalty you have towards your patient or the integrity of the patient. For example, you must:
- Refrain from acting as a physician on behalf of a third party in litigation against your patient;
- Refrain from treating yourself or loved ones, such as your spouse or children, except in cases that are clearly not serious;
- Adhere to any agreement or accept any benefit that may influence your professional practice;
- Do not solicit customers.
This duty of professional independence also applies if you are acting as a medical expert in litigation, since your medical report must be objective, impartial and disinterested.
Duty of integrity
This duty is common to all professions: in order to maintain public trust, it is essential that professionals demonstrate honesty and transparency. Thus, as a doctor, you must avoid guaranteeing the effectiveness of a treatment, examination or cure of a disease, in which case you could be sued if this promised result is not obtained. In addition, you must refrain from reproducing in any medical document or transmitting to anyone any information that you know to be incorrect.
Advertising and public statements
Although it is permissible for physicians to advertise, it must be done with integrity and in compliance with the rules imposed. As such, you may not advertise or permit to be made on your behalf any false, misleading or incomplete advertisement or representation to the public or to any person using your services. The information conveyed in a doctor’s advertisement must be factual, accurate and in accordance with science, and must not be directed at vulnerable people.
Accessibility and correction of records
As a professional, you must respect the right of patients 14 years of age and older to have access to their medical documents within 20 days of receiving the request, unless you believe that the disclosure of the documents would cause serious harm to the patient’s health. If applicable, you must, upon written request from the patient, inform the patient in writing of the reasons for the refusal and enter them in the file. In addition, you must, no later than 30 days after receipt of the request, respond to any request made by a patient to correct or delete inaccurate, incomplete, ambiguous, outdated or unsubstantiated information in any document concerning the patient. In the event of a refusal, you must justify your reasons in writing and inform the patient of his or her recourse.
Honorarium
You also have certain obligations related to the fees you receive, which are detailed in the Code of Ethics of Physicians. For example, you must:
- Claim only fees that are justified by the nature and circumstances of the professional services rendered.
- Refrain from claiming fees from anyone for professional activities the cost of which has been or is to be paid by a third party;
- Refrain from claiming fees for professional services not rendered.
Duties towards other professionals and the Collège des médecins
Your duties are not limited to your patients, since you also have certain obligations to your colleagues and to your professional order. Thus, you must demonstrate professionalism in your relations with your colleagues and collaborate with them by assisting them as needed. You may not disparage, abuse trust, wilfully mislead, surprise good faith or use unfair practices, harass, intimidate or threaten your colleagues in any professional relationship. In addition, you must work with the Collège des médecins to help them carry out their mandate to protect the public. This obligation to collaborate manifests itself in several ways, such as:
- Your duty to refrain from pressuring, accepting or offering money or any other benefit, to influence a decision of the College;
- Your duty to report to the College any person authorized to practise medicine whom you believe to be unfit to practise, incompetent, dishonest or who has committed acts in contravention of the provisions of the Professional Code, the Medical Act or the regulations made thereunder.
- Your duty to respond in writing as soon as possible to any correspondence from the College or any person associated with it.
Acts derogating from the dignity of the profession
In order to maintain a relationship of mutual trust with your patients, you must refrain, for the duration of the professional relationship that is established with the person to whom you provide services, from abusing that relationship to have sexual relations with that person, from engaging in abusive acts of a sexual nature or from making abusive comments of a sexual nature, which also constitutes an act derogating from the dignity of the profession. The length of a professional relationship varies from patient to patient and does not always coincide with the end of the service delivery. It is established by taking into account, among other things, the nature of the pathology, the nature of the professional services rendered and their duration, the vulnerability of the person and the probability of having to render professional services to the person again.
Sanctions
If you are found guilty of the offences of which you are accused, the Disciplinary Council will impose one or more of the following sanctions on you:
- A reprimand;
- Temporary or permanent removal from the roll of the order, even if you have ceased to be registered since the date of the offence;
- A fine;
- An obligation to give to any person to whom it is due an amount of money that you hold or should hold for them;
- An obligation to disclose a document or any information contained therein, and an obligation to complete, delete, update or correct any such document or information;
- A revocation of your licence;
- Revocation of your specialist certificate;
- A limitation or suspension of your right to engage in professional activities.
Being the subject of a disciplinary complaint can be a stressful and difficult experience for any physician. We understand the impact this can have on your career and reputation. If you are faced with a disciplinary complaint, do not wait for the situation to escalate. Contact us today for a rigorous defense to protect your rights and continue your practice with peace of mind.