Tuesday, June 23, 2009

Disciplinary tribunals are not law courts -....errrmmmm..... so what's the point?

The President of the Singapore Medical Association was prodded out of the kinda slumbering organization to respond to the 'akan datang' move to appoint non-medical people (chiefly their nemesis, lawyers) to Chair the Singapore Medical Council.

I think it is a rather unconvincing response, almost like he doesn't quite believe it himself. Which really underscores the passivity of the profession at the moment. Same for the Singapore Medical Council.

I do however agree with Dr Chong's last point: '...what medical ethics really needs is more moral courage and leadership so that public interest can be better served.' How true. But what has the SMC done that can truly be said to have shown moral courage and leadership? So far it's been hiding behind the law, and only taking to task those who have obviously flouted the 'law'.

If that's all the SMC cares to do, we may as well have a lawyer to Chair, instead of a doctor pretending to be a lawyer.


Disciplinary tribunals are not law courts

I REFER to the letter by Mr M. Lukshumayeh last Saturday, 'SMC post: Don't get emotional, docs'. The writer has failed to understand the objectives of the Singapore Medical Council's (SMC's) disciplinary tribunals (DTs) and has mistaken the DTs for a law court.

The law courts are responsible for interpreting the law and for enforcing punishment when the law is broken. However, whatever is not prohibited by law remains legal and permissible, but may still be unethical. This is where professional tribunals like SMC's DTs come in.

The law cannot spell out everything but sets an absolute minimum for all to observe, while ethics and professionalism demand higher levels of conduct and behaviour than just obeying the law. This is the essence of professionalism and ethics, be it for doctors or other professions.

As such, SMC's objective is to uphold high standards of professional conduct and ethical behaviour among doctors.

Furthermore, the Singapore Medical Association (SMA) does not object to lay people or lawyers in DTs. Lay people bring with them their own valuable expertise and viewpoints. Lawyers ensure that procedural matters pertaining to principles of fairness and natural justice are not overlooked, which is why lawyers are already present now at SMC disciplinary hearings. But having a lawyer or ex-judge chair a DT may bring about long-term consequences that do not serve public or patient interest, even if the move appears superficially rational.

That is because the role of the DT is to ascertain if professional misconduct has occurred in areas which the law is silent on. Legal training, on the other hand, is aimed at understanding if the law has been broken. The two are very different.

The move to allow lawyers to chair DTs will bring about a technical convergence of law and medical ethics, with DT proceedings probably becoming more legalistic, and a slow deterioration in the higher standards of medical ethics, which is against public interest.

Perhaps it is by the same reasoning that lawyers do not sit on the DTs of other professions in Singapore. Higher standards of medical ethics are not achieved by making DT proceedings more legalistic or having more lawyers if DT proceedings are conducted in a fair manner.

Instead, while it may be expedient to get lawyers to chair SMC's DTs now, what medical ethics really needs is more moral courage and leadership so that public interest can be better served.

Dr Chong Yeh Woei
50th Council
Singapore Medical Association


sparkle said...


You show your ignorance in your blog.
Better read up before you blog such comments again.

There were lots of responses to the ST which went unpublished - you go and think why.

Lukshumayeh was a lawyer struck off the Bar and he gets press in bigger font on ST???????


gigamole said...


I actually have absolutely no idea what you are talking about.

Actually on re-reading my post in the light of day, I find that I may have been somewhat hasty in what I wrote, and was quite horrified that it actually sounds kinda offensive. Even to me.(Shamefacedly admit it, yeah, I am guilty). Didn't mean to be... not to SMA President nor the SMC. Methinks they are doing their best. So my unreserved apologies.

When I started blogging, I made it a point to be focused on ideas rather than people, and made it a principle not to be personal or offensive. I kinda lapsed.

My intention really was to put an alternative perspective on the table and to provoke a debate on the issue rather than to have all the doctors close ranks and chorus a rejection of the possibility of a lay person chairing the SMC. And I think there are actually currently not a lot of good reasons why it should never be that way. And there's certainly quite a bit of public perception that more transparency is needed and more assurance that the profession is capable of self regulation.

Would a lawyer necessarily be worse than a doctor in that position? I don't think so.

Krukenburg said...

Why do we say that "medical professionals, being a tight-knit group, will lack the courage to adequately discipline their colleagues", yet on the other hand, we seem pretty comfortable for 1 SC or a retired judge (and no lay persons) to be in the DT for complaints against lawyers? No lay persons.

gigamole said...

Totally agree with you, Krukenburg...

But I don't know too much about DTs for other professions. In my mind what is good for the goose must be equally good for the gander. So let this perhaps prod the public into re-examining the way other tribunals function.

Krukenburg said...

Neither do i...but i chanced upon this: http://www.asiaone.com/News/AsiaOne%2BNews/Singapore/Story/A1Story20071206-39957.html

gigamole said...

I suppose compared to the number of judges required for the death penalty the death penalty, the DT won't need more than one.

I think it means either lawyers have an exceptional ability to make error free judgments, or that the number of errant lawyers far exceed those of the medical profession.

Krukenburg said...

In law/criminal/civil courts, the legal system is such that it appoints 1 (or 3) judge(s) and these r deemed the best-trained pple to adjudicate legal matters. But when we talk abt professional self-regulatory tribunals, we should not hold the same mindset that the judge/snr lawyer must also the best person to chair and lead a committe to safeguard public interests or professional ethics. Would you agree?

gigamole said...

Absolutely. Thanks for point it out. I wasn't aware how law DTs were organized, and quite horrified to find out.