Transcript
Code of Medical Deontology of the Romanian College of Physicians
CHAPTER I
Fundamental principles of physicians’ practice
Article 1 - The purpose and role of the medical profession
the doctor’s whole professional activity is dedicated exclusively to protecting life, physical and mental health and
human being.
Article 2 - Non-discrimination
Professional performance and overall activity of the physician will exercise, respectively take place, without any
discrimination, including the one regarding health status or patient’s chances of healing.
Article 3 - Respecting the human dignity
in all situations, medical performance, in any form or way it is held, will be in strict compliance with human dignity
as a fundamental value of the professional body.
ARTICLE 4 - Primacy of benefit and good human interest
in all decisions having medical character, the doctor will need to ensure that the concern and good human
interest prevail over the benefit of society or science.
Article 5 - Mandatory professional standards and conduct of physicians
The doctor should make all efforts and ensure that any medical intervention that he performs or professional
decision that he takes, should respect the rules and professional obligations and rules of conduct of that specific
case.
Article 6 - Professional Independence
The doctor is obliged to dwell and to defend their professional independence, any determination or decision of
the medical professional for economic or administrative reasons being prohibited.
ARTICLE 7 - The nature of doctor-patient relationship
Doctor patient relationship will be an exclusively professional one and will be build on its respect for human
dignity, understanding and compassion for suffering.
ARTICLE 8 - Obligation of means diligence
The doctor will devote all his knowledge and skills for the patient’s best interest and will do all due diligence to
ensure that the decision taken is correct and the patient gets maximum benefit in relation to specific conditions,
so that his health should not suffer .
Article 9 - The principle of professional specialization
except some cases of vital emergency, the doctor is acting according to his/her specialty, competencies and
practice skills he/she has.
Article 10 - Respect towards colleagues
Throughout his/her entire activity, the doctor will respect his colleagues, refraining to denigrate or bring criticism
on their professional work.
CHAPTER II Consent
Article 11 - Granting and withdrawal of consent
(1) No intervention within the health system can be made until the target person has given his free and informed
consent.
(2) Under the same conditions, consent can be withdrawn at any time by the target person.
(3) The provisions on consent withdrawal are valid in terms of the expressed consent under the law, by a person
or institution other than the target person.
Article 12 - Consent for minors
(1) Where, by law, a minor is unable to consent to an intervention, it cannot be made without the consent of his
representative, authorization given by an authority or other persons or bodies designated by law.
(2) The doctor, depending on age and maturity of the child and his only strict interest, may take into account the
minor’s opinions.
ARTICLE 13 - Consent of persons without the capacity to consent
Where, by law, an adult does not have – because of a mental disability, illness or similar reason – the capacity to
consent to an intervention, this cannot be made without the consent of a representative or without the consent of
an authority or a person or agency appointed by law.
Article 14 - Person’s prior and proper information
(1) The doctor will ask for and receive consent only if, in advance, the respective person or the one entitled to
give consent as to medical intervention received adequate information about the purpose and nature of
intervention, and the consequences and risks predictable and generally accepted by the medical society.
(2) If possible, the doctor will monitor the information to be appropriate and related to the person who is to
manifest the consent.
Article 15 - The lack of consent in emergency situations
Where, because of an emergency, you cannot get proper consent, it is allowed to proceed immediately to any
intervention that is essential from the medical point of view, to the best interest of that person’s health.
Article 16 - Implied consent
In the interest of the patient are valid and will be taken into consideration any prior authorizations and wishes
regarding medical intervention by a patient who, when found in front of a new intervention, not having a state of
health which allows him/her to express his/her will, or if, through its nature, the medical act has a specific
sequence and repeatability.
CHAPTER III Confidentiality and access to health data
Article 17 - Confidentiality
The doctor will keep professional secrecy and act in accordance with the legal right of each individual to respect
of his/her privacy in terms of information abut the state of health.
Article 18 The scope of the obligation related to the professional secrecy
(1) The obligation of doctor’s professional secrecy is opposable including his/her family members
(2) Physician’s obligation to professional secrecy persists after the person ceased to be his patient or has died.
ARTICLE 19 - Transmission of data regarding a person’s health
The doctor, at the request of the person concerned, will inform the respective person or the person designated by
it about any information he/she holds on the state of health of the person concerned.
Article 20 Exceptions to the rule of professional secrecy
Exceptions from the right of everyone to respect his/her privacy in terms of health information are only those
expressly provided by the law.
CHAPTER IV
General rules of behavior in the medical activity
Article 21 – Professional and ethical behavior
(1) The physician should be a model of professional and ethical behavior, being always concerned with
increasing his professional and moral level, the authority and prestige of the medical profession.
(2) Professional behavior involves, without limitation, the doctor’s constant and continuous concern for finding by
any means, including through forms of medical education, the latest medical findings, methods and techniques
that are learned and approved by the medical community.
Article 22 - Unethical facts and acts
The following acts are contrary to fundamental principles of the profession of doctor, in particular:
a) the practice of euthanasia and eugenics;
b) except as provided by law or professional rules, denial of medical services;
c) abandonment of a patient without ensuring that it was taken over by another medical facility or by another
doctor or that he/she has the appropriate conditions for the situation and his/her state of health
d) use of diagnostic or treatment methods scientifically unsubstantiated or unsupported by the medical
community, having risks for the patient;
e) except in vital emergencies, practicing the medical profession in conditions that could compromise the
professional act or could affect the quality of medical care;
f) issuing a medical document of convenience or to obtain an unlawful or immoral use;
g) issuing a medical document for which the doctor has no professional competence:
h) attracting customers taking advantage of the position held or by onerous promises and contrary to the
advertisement rules of health activities;
i) using, submitting, or leaving the impression of having other professional titles, skills or specialties, which are
false;
j) violation of fundamental principles of the practice of the profession of doctor.
Article 23 - Violations of professional independence
The following documents constitute a serious interference with the independent character of the medical
profession:
a) except as provided by law and previously notifying the professional bodies, association or collaboration, in any
form or manner, direct or indirect, between a doctor and a person who produces or distributes drugs;
b) advertising, in any way, for medicines, medical devices or medical products;
c) engage directly or indirectly, in the distribution of drugs, medical devices, medical devices or other health
products;
d) infringement of the transparency principle in relation to producers and distributors of medicines and medical
products;
e) receive donations as gifts in cash or in objects or other advantages, which makes them lose symbolic value
and influence the medical act, from one of the entities referred to in subparagraph. a)-c).
Article 24 - Unmediated nature of doctor-patient relationship
Unless objectively exceptional circumstances and impossible to remove, any medical decision will be based
primarily on personal and unmediated examination of the patient by that physician.
Article 25 - Limits of the professional commitment
(1) In any case, the medical professional commitment can not exceed the professional competence, technical
capacity and equipment of the office or health unit or the facilities affected, including by agreement or strong
collaboration with other health units.
(2) If your doctor has sufficient knowledge or experience to provide appropriate care, it will require a check or
appropriate in the circumstances would lead to such a patient to consult another medical facility. The same will
apply if the technical equipment and material unit in which the consultation or medical intervention is not
adequate consultation, diagnosis or medical intervention.
Article 26 - Clear diligence
The doctor who responded to a request of medical nature will ensure that the person has fully understood the
prescription, recommendation or any other requirements of that doctor as well as to the fact that the patient is,
where appropriate, taken by another medical facility or in supervision of another professional in the field.
Article 27 - Working with other professionals
In cases when the patient was taken or directed to another specialist, the doctor will work with the latter,
informing him of any medical data or information about that person and informing him of any other matter related
to his/her state of health.
Article 28 - Consultation Team
Where necessary, the doctor, having the patient’s consent or, where applicable, the consent of the authorized
person/institution, shall request the opinion of one or more doctors, which can be consulted for taking appropriate
measures for the best interest of the patient.
Article 29 - Reporting decision-making
(1) for a consultation organized by the treating physician under the provisions of art. 27, making and
communicating the final decision belongs to the doctor who organized the consultation.
(2) If the opinion of most doctors participating in a consultation organized in accordance with art. 27 differs from
that of the doctor who organized the consultation, the patient or, where appropriate, the institution or the
authorized person will be informed.
Article 30 - Right to a second medical opinion
In all cases the doctor will observe the patient’s right to obtain a second medical opinion.
Article 31 - Remote Medical Act
Remote medical investigation or intervention in any existing forms and procedures, is allowed only if the patient is
directly assisted by his doctor, and purpose of the investigation and the procedures that the patient undergoes is
to help the doctor determine the diagnosis, to establish treatment or take any other action necessary to complete
the medical care or medical intervention in case of operations. Emergencies are excepted.
Article 32 - Completion of the assumed obligation
(1) Doctor will ensure that the patient understands the nature and extent of doctor-patient relationship, that
he/she has a correct expectation of regarding the results of medical services and the healthcare services that
he/she is going to receive.
(2) Once the physician-patient understanding is settled, the doctor is bound to carry out all assumed obligations
as they result from the agreement between parties or the habits and customs of the medical profession.
Article 33 - Denial of medical services
(1) Refusing medical assistance may occur strictly by law or if by the person’s request to the doctor he asks for
such acts that may blunt professional independence, his image of harm his moral values or his request is
inconsistent with the fundamental principles of medical practice, with the social purpose and role of medical
profession.
(2) in all cases, the doctor will explain to the respective person the reasons behind his refusal and will ensure that
through the denial of health services, the health and life of the person in question are not endangered, and if the
refusal is based on violation of the doctor’s moral convictions will guide the person to another colleague or other
medical facility.
CHAPTER V – Activities related to medical care
Article 34 - Legality and accuracy of the content of medical documents
The doctor will issue to the entitled persons only documents permitted by law and show medical reality as it
results from medical data and information held legally by the doctor as a result of having exercised the profession
regarding that person.
Article 35 - Compliance of the medical document with the medical specialty
(1) Medical documents related to the patient’s health care, issued by the physician after personal exercise of the
profession, will be issued within the extent of physician’s specialty and professional competencies.
(2) Any medical activity will be recorded in appropriate documents of registration activity.
Article 36 - Obligations related to public health
(1) The doctor has the professional and legal obligation to care for the rules of hygiene and prevention. For this
purpose, whenever he has the opportunity and if necessary, he will inform those persons about their duty towards
themselves and to the community and collectivity.
(2) The physician has the moral obligation to notify the competent authorities about any situation that is causing
danger to public health.
Article 37 - Reporting misconduct
(1) The doctor who has knowledge of facts which in his opinion, may constitute professional misconduct, will
inform the other doctor, responsible for that conduct, through a medical letter.
(2) If the error is not corrected or he appreciates that all appropriate measures have not been taken in that
situation, the doctor will thoroughly inform the professional body and, except as provided by law, will disclose
data only after the professional body has ruled on the matter.
ARTICLE 38 - Primacy of conciliation
in dispute or difference in any professional situation, before any public approach is mandatory conciliation in the
professional body.
Article 39 - The obligation of mutual support and loyalty
In all situations and circumstances related to the exercise of professional duties, doctors will support each other
and act with loyalty to one another. Obligation regarding support and loyalty also continues towards professional
body and its organs.
CHAPTER VI – medical research
Article 40 - The principle of legality and ethics of medical research
Any medical research will be conducted in strict compliance with the fundamental principles of the profession of
doctor, in full respect to human beings and species and respecting the strict conditions set by law and
professional rules.
Article 41 - Research on human beings
Research on humans is exceptional, and can be made only if, cumulatively, the following conditions are met:
a) there is no alternative to research on humans, of comparable efficacy;
b) risks that the person can expose are not disproportionate to the potential benefits of research;
c) research project was approved by the court or competent authority after having been subject to independent
review of its scientific relevance, including an objective assessment of the importance of research and a
multidisciplinary review of the acceptability on the ethical plan;
d) the person on whom research is done is informed of his rights and the guarantees provided by law for his
protection;
e) consent has been given expressly, specifically and was recorded in writing. This consent can be withdrawn
freely, at any time.
ARTICLE 42 - Research on the person without capacity to consent
No medical research can be carried out on a person without capacity to consent unless the following conditions
are met:
a) the conditions referred to in art. 41, points. a)-d);
b) research results have the potential to produce real and direct benefits to their health;
c) research cannot be performed with comparable efficacy on individuals capable of giving consent;
d) the necessary authorization provided for in art. 41, points. c) was specifically given also in writing;
e) the person has no objections.
ARTICLE 43 - Doctor’s diligence
The doctor is obliged to make all due diligence and to persist in order to clarify all the facts when involved in a
medical research. If necessary, to fully clarify, the doctor is obliged to seek support from the medical professional
bodies.
ARTICLE 44 - Intervention on the person
No person may be subject to experiments, tests, samples, treatments or other interventions for research
purposes except as expressly and exhaustively provided by law.
Article 45 - Removal and transplantation of organs, tissues and human cells from living donors
(1) Collection and transplantation of organs, tissues and human cells from living donors are made only in cases
provided by law, by written, free, prior and express consent, and only after that person was informed in advance
about the risks of intervention. In all cases, until removal, the donor may retract the given consent.
(2) Unless expressly provided by law, it s prohibited the removal of organs, tissues and cells of human origin from
minor persons and alive persons, but who lack judgment because of a mental disability, a severe mental disorder
or another similar reason.
Article 46 - Removal of organs, tissues and cells from deceased persons
Removal of organs, tissues and cells, having therapeutic or scientific purposes, from deceased persons are
made only as provided by law, by written consent, expressed during the life of the deceased or, failing that, by
written free, prior and express agreement, given in the following order : by the surviving spouse, parents,
offspring or, finally, relatives up to the forth degree collateral in line.
Article 47 - Limitations of medical research
The following activities in the field of medical research are contrary to the purpose and role of the medical
profession:
a) any medical intervention on genetic characteristics that are intended to change a person’s lineage. Exceptions
are conditions that require treatment and prevention of genetic diseases, in which they will obtain all appropriate
approvals:
b) any intervention seeking to create a human being genetically identical to another human being alive or dead;
c) creation of human embryos for research purposes;
d) any interference which might determine the sex of the future child. Exceptions are situations where,
objectively, it is necessary to determine sex in order to avoid a serious hereditary diseases related to baby’s sex;
e) examination of genetic characteristics of a person for purposes other than strictly medical and legal conditions
and procedures;
f) any action that would follow and would determine the selection of persons or would affect the human species;
g) participation or involvement in an activity of identifying a person based on his genetic fingerprints other than in
a civil or criminal proceedings or for strictly medical or scientific research, both made strictly according to law;
h) participation in any acts which might give property values to a human body, its elements or products, except as
expressly provided by law.
CHAPTER VII – Advertising of medical activities
Article 48 - Purpose of advertising
(1) Advertising forms to practice is intended to provide public information on their activities.
(2) Advertising must be truthful, not misleading, to observe professional secrecy and be done with dignity and
prudence.
(3) Whatever means of advertising used, all laudatory or comparative claims and all claims concerning the
identity of patients are prohibited.
(4) The means of advertising forms to practice cannot be used as advertising to acquire customers.
Article 49 - Means of advertising
(1) forms of exercising the medical profession can use one or more means of advertising, namely:
a) placing a firm;
b) advertising notices under the provisions of this code of medical ethics;
c) advertisements and endorsements in directories and phone books;
d) invitations, brochures and notices of conferences, colloquia, etc., and specialized training;
e) professional correspondence and business cards;
f) Internet address.
(2) The following means of advertisement are forbidden:
a) providing services through personal presentation or by an intermediate at the domicile or residence of a
person or in a public place;
b) proposed personalized services performed by a form of exercise of profession, without been requested
previously in this respect, whether it is done or not for recruitment of patients;
c) providing medical consultations conducted on any physical means, and by any other means of mass
communication, including radio or television broadcasts, except those approved by the Romanian College of
Physicians or other bodies accredited for this purpose.
(3) In his/her appearances in the media, the doctor will be able to present diagnostic and treatment procedures,
specific medical techniques or other methods and means of investigation, but cannot use this opportunity to
boost himself or for any other company involved in the production of drugs or medical devices.
Article 50 - The company billboard
(1) The company billboard shall have maximum dimensions of 40 x 80 cm and will be located at the entrance of
the building and / or the shape of the premises to practice and has its main or secondary professional office or
desk.
(2) Company billboard includes the following information:
a) Romanian College of Physicians;
b) the territorial structure of the Romanian College of Physicians;
c) name of practice of the profession;
d) references to identify the office (floor, apartment);
e) references to professional titles, academic, scientific, medical specialties and competencies;
f) references to its main and secondary office.
Article 51 - Advertising through media
(1) Forms of practice of the profession may publish notices in the small or big advertising.
(2) Notices published in professional directories refer to the activity of the forms to practice medicine, name and
main skills and qualifications through which doctors practice, as well as the work program.
Article 52 - Correspondence
(1) Correspondence of the form of practice of the profession may include:
a) telephone number, fax, Internet and e-mail address ;
b) the main office and, where appropriate, secondary office and / or other job;
c) medical specialties and competencies;
d) the academic, scientific or professional titles;
e) the logo of the respective form to practice.
(2) Professional business cards of the doctor working in the respective form of exercise of the profession may
include information permitted, and quality of the doctor to practice.
ARTICLE 53 - Website
(1) Doctors and forms of practice of the profession can have a website that may include information of work and
other advertising allowed.
(2) The content and layout of the Internet address shall respect the dignity and honor of the profession and
professional secrecy
(3) Web page cannot contain any character insertion having advertising character or mention of a product or
service, different from the activities that the doctor has the right to provide or that form of practicing the
profession.
(4) web page cannot contain links to other addresses whose contents would be contrary to the essential
principles of the medical profession.
(5) To achieve the requirements specified in par. (4), doctor or the form to practice the profession who owns the
website must provide regular visits and evaluation of their pages and of the pages that are allowed access by the
connections made through their address and should have them immediately disposed where content and form
are contrary to essential principles of medical profession.
CHAPTER VIII – Conducting the proceedings
ARTICLE 54 – Swiftness
(1) Research and analysis of any complaints regarding a potential violation of the provisions of this code of ethics
are promptly made by persons appointed to research the deed or by those who were required data related to the
settlement of the complaint being required to act on the best effort, not delaying or extending the
accomplishments of the attributions, including disclosure of the required data.
(2) in the application of data and information necessary to settle the disciplinary proceedings, it will be indicate
the date by which data communication or information requested is to be made.
Article 55 - Presumption of innocence
(1) Research and analysis of any complaint will be made with account of and respecting the doctor’s presumption
of innocence.
(2) The persons appointed to research the complaint or members of the discipline committee will act with tact and
moderation, not to prejudge or to issue any personal views and in no sense a solution during the solving of the
referral.
Article 56 - Impartiality
(1) The person designated to research the complaint or members of the discipline committee which has / have
any personal interest in any way, or has / have family ties with the doctor under investigation or the person
making the complaint , will inform the President of the committee, who will decide, as appropriate, to maintain or
replace the person.
(2) The provisions of paragraph (1) apply also if conflict situations exist.
(3) No person involved in disciplinary investigation or settlement will not make public statements on that case
until its final resolution.
ARTICLE 57 - Written Contradictoriality
(1) The committee of discipline will persist in getting a written position of each party involved in the disciplinary
case.
(2) Oral contradictoriality will run only if it is strictly necessary to solve a case, not being able to hear the case
otherwise. In this case, the presiding judge will act with tact and understanding, being prohibited from directly
addressing the parties involved or issuing of judgments or opinions about the case by the members of the
committee.
Article 58 - Expertise
(1) according to the cause subject to research, the discipline committee may require specialized expertise from
reputable specialist physicians.
(2) The provisions of art. 55 shall apply in respect of experts as well.
Article 59 - Conduct of hearings
(1) Upon the cause subject to settlement, members of the discipline committee will address the persons subject
to hearing, exclusively through the chairperson or requesting him permission and only to ask the person useful
and relevant questions, dealing with the cause.
(2) During the hearing members of the discipline committee are forbidden to issue personal opinions or
assessments of any kind. If necessary, the chairperson may
intervene and restore the decent setting the hearings, including suspending the meeting.
CHAPTER IX – Final
Article 60 – Application of the Code of medical ethics
Unless more favorable situations, acts committed before the entry into force of this medical code of ethics will be
subject to the provisions of the former code.
Article 61 - Entry into force
This medical code of ethics enters into force within 30 days of its publication in the Official Gazette of Romania,
Part I.
