Doctors' Charter?

In her letter to the ST Forum published on 28 Feb, Dr Helen Tan wrote:


"Patients complain about doctors all the time. But is there an avenue for doctors to address their grievances? Who can we complain to?

We need a doctors' charter to look into the rights of doctors."


I didn't write on this topic because I thought it wasn't necessary to have a Charter, since we supposedly have the SMA fighting for us. But this letter in the ST Forum today made me thin about the issue again.


Why do doctors need a charter when they have taken Hippocratic oath?

I FIND it strange that Dr Tan Hui Mien, Helen should call for a doctors' charter ('Need for a doctors' charter', ST Online Forum, Feb 28) when doctors take the Hippocratic oath before they start to practise.

The profession of healing and saving life is different from the work of trading goods. Teaching, for example, is a noble profession that commands high esteem. No teacher would ask for a teachers' charter to look into the rights of teachers.

The relationship between doctor and patient is similar to that between teacher and student. Both professions call for compassion and understanding.

Patients and students always respect doctors and teachers respectively as people of high moral standing. The laws of the country protect both sides. A charter is required only when the laws are not favourable or not adequate for one party.

If a doctor cannot establish a good relationship with his patients, he needs to reflect on what is missing and not what is needed to protect his interests.

Should patients require a charter to look after their interests too?

Paul Chan Poh Hoi


Now that's like asking why women need the Women's Charter when they already have their wedding vows.

Why do we need laws to protect the battered wife when the husband has already promised to love and cherish the wife till death do them part?

Saying: 'If a doctor cannot establish a good relationship with his patients, he needs to reflect on what is missing and not what is needed to protect his interests' is like asking a battered wife to reflect on why she deserves to be beaten. Just as not all husbands are loving and non-violent, not all patients allow a good patient-doctor relationship to be formed between themselves and their doctors.

In any case, nothing in the Hippocratic Oath says the doctor cannot defend himself against unfair accusations from the patient, which was Dr Tan's main worry.

Mr Chan himself had written: A charter is required only when the laws are not favourable or not adequate for one party. I believe it is exactly this sentiment that prompted Dr Tan and others to write to the Forum, and for Dr Tan to call for a Charter.

The reason why there was a need for legislation on domestic relationship is because of the fact that the family relationship has broken down such that we cannot rely solely on traditional sense of obligations and duties to protect all parties in a family. Has the patient-doctor relationship come to that stage?

The legal responsibilities of the doctor to his patients has existed since the first laws of Mesopotamia had been engraved in stone, and malpractice today is a field of its own in legal practice, so I don't think we need further legislation to protect the patients or to detail doctors' obligations.

What we seem to be lacking is the sense and awareness of the patient's duties and obligations. So maybe Mr Chan's idea of a Patients' Charter, in which is spelled out a patient's rights and obligations in a patient-doctor relationship, including what the limitations are on liability on the part of the doctor in case of the patient's non-adherence and non-compliance to treatment, as well as what forms of complaints on a public forum against a doctor may be held as defamatory and not covered under 'special privilege', has its place too.

Will it happen?

I think it will eventually, if we do not address this perceived imbalance in the rights and obligations between patients and doctors felt on the part of the doctors.

Do I want it to happen in my life-time?

Well, let me put it this way: do YOU ever want the Women's Charter to be invoked in YOUR marriage?