ADVERTISEMENTS:
A committee comprising of Prof. J. S. Neki, Prof. D.N. Nandi, Prof. A.K. Agarwal, Dr. V.N. Vahia and Dr. J.K. Trivedi, have formed a code of ethics for psychiatrists in India approved by the Indian Psychiatric Society at its Annual Conference, 1989, held at Cuttack.
Preamble:
1. Responsibility:
As a practitioner, the psychiatrist must know that he bears a heavy social responsibility because he not only deals with disturbed human behaviour but also has to contend with intimacies of life. As a scientist he would serve the society through observation, investigation and experimentation, and well planned and ethically carried out research.
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2. Competence:
The maintenance of high standards of professional competence is (the) responsibility of all psychiatrists in the interest of both the public and the profession. Psychiatrists are responsible for their own continuing education and should realize that theirs must be a life-time learning.
As members of the profession they will not violate ethical standards and, when such violation comes to their notice, will take steps to correct it.
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3. Benevolence:
The interest of the patient and his health will stand paramount with them in their professional practices. Personal interests would find but a secondary place. Financial arrangements will never contravene professional standards. Psychiatrists will always safeguard the interests of the patient and the profession.
4. Moral Standards:
They will at all times be responsive to the moral codes and expectations of the community they serve, and will not let their behaviour in anyway malign their profession.
5. Patient Welfare:
They will not treat a case that does not clearly fall within their competence. The patient’s integrity and welfare as also that of the communities in which they work.
They will terminate the clinical or consulting relationship with the patient when it is reasonably clear to them that the patient is no longer benefitting from it.
In case of referral, they will continue to feel responsible for the patient’s welfare until the responsibility has been formally transferred.
6. Confidentiality:
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They will safeguard information about a patient that they have obtained in the course of their clinical work, teaching or research in order to safeguard the patient’s interest and protect him from social stigma, discrimination and harm.
They will treat this as a primary obligation and not reveal unto others any such information unless certain ethical conditions are met, or when there is clear and imminent danger to an individual or society and then only to the appropriate authorities or concerned co- professionals.
Confidentiality of the clinical records will be meticulously guarded and identity of the patients will not be revealed even in scientific communication. No data about a patient shall be ordinarily revealed to any agency without the consent of the patient or his family.
Recommendations:
1. Every person who has attained the age of majority and who does not appear to have lost the ability of reason shall be assumed to be capable of giving consent.
A patient should be taken up for medical evaluation and treatment with his consent. In case a patient, because of his mental illness, is unable to express valid consent, the psychiatrist may undertake to treat him with the consent of a person close to him who appears to be clearly interested in the welfare of the patient. The only exception of treating without consent would be in an emergency situation involving an immediate threat to the life or health of patient or others.
For purposes of research, the consent shall be contained on the lines indicated above after satisfying the following:
a) The consent is entirely voluntary.
b) The patient can withdraw the consent at any stage.
c) Withdrawal of the consent shall not affect the interest of the patient.
2. The decision to hospitalize a patient will essentially rest on the consideration of his welfare and will also take into consideration legal and administrative constraints as well as its social appropriateness.
3. Psychiatric treatment shall be initiated only on clinical considerations and shall be in accordance with scientific knowledge and professional ethics. The patient’s welfare should be the primary factor determining the choice of the treatment modality, should the specific modality not fall within the patient to a competent colleague.
The termination of therapy also shall be determined on clinical consideration. Treatment should not be permitted to continue unjustifiably or for material consideration. All treatment should be humane and never punitive. No psychiatrist shall refuse to treat in an emergency.
4. Gifts and gratifications from patients under treatment should not be accepted.
5. Any kind of sexual advances towards any patient is unethical.
6. In case of doubt or in situations where unconventional treatment procedures are contemplated, a second opinion must be obtained.
7. It is unethical to force a contract upon a patient during treatment.
8. Even when a patient has been referred by a legal or administrative authority or by the employer, welfare of the patient will remain of paramount consideration. The patient should be informed of the purpose for which he is to be examined.
9. Basic human rights of the mentally retarded should not be subjected to unethical abridgement. Due ethical discretion should be exercised when advising such procedures as sterilization.
10. In the interest of the patient and the society, drug abusers who refuse to give consent may be treated with the consent of their relatives. Effort has to be made to motivate them for accepting treatment voluntarily.