June 21, 2018

UAE: New Code of Ethics and Professional Conduct for Health Professionals

The UAE's Minister of Health and Prevention issued a resolution, approving a Code of Ethics and Professional Conduct for Health Professionals. This new Code, a federal resolution that applies across the UAE, expands upon the expectations of health practitioners outlined in earlier Emirate-specific codes. The conduct expectations, if breached, could seriously impact the licence of the UAE health professional. In this short article, we summarize the key features of the 2017 Code and how it is likely to impact health professionals in the UAE.

Background

In the last few years, there has been a renewed debate about ensuring consistency in medical practices and that a high level of ethical and professional standards is maintained. Providing world-class healthcare is one of the 6 pillars of the UAE's National Agenda in line with Vision 2021

In 2016, a new medical malpractice law was passed in the UAE (the "2016 UAE Medical Malpractice Law"). This contained several provisions, setting out the sort of conduct that could constitute malpractice on the part of the practitioner.

On 25/12/2017 the Minister of Health and Prevention issued a resolution, approving a Code of Ethics and Professional Conduct for Health Professionals (the "2017 Code"). This new 2017 Code has been passed, as a follow up to the 2016 UAE Medical Malpractice Law and expands on the expectations of health practitioners, which if breached could impact the licence of the practitioner. This is a federal resolution which applies across the UAE.

Key provisions of the 2017 Code

The spirit of the 2017 Code is similar to that of the 2016 UAE medical malpractice law.

There is specific focus on health professionals behaving in such a way that the interest and wellbeing of the patient is paramount. The 2017 Code also contains sections on the responsibilities that the professional has towards themselves, their colleagues and society.

We set out the key provisions below:

Responsibilities towards patients

The focus of these provisions contained in Section 1 of the 2017 Code relate to the interest and well-being of the patient. 

Section 1.3 relates to informed consent and that the patient must be given sufficient information, so that consent is without pressure or coercion.

A key focus of the Code is confidentiality of information and that the patient's information will not be disclosed unless consent has been provided or there is a good and compelling reason for disclosure.

Section 1.7 relates to conflicts of interest. The health professional shall avoid excess provision of service and the patient should only be referred for treatment or tests that are necessary.

There is specific mention at Section 1.7.4 of financial benefits received by health professionals for providing a health service or for prescribing a certain drug or product and that this shall be strictly prohibited.

Responsibilities towards oneself

Section 2 sets out the responsibilities that health professionals have towards themselves. They are expected to keep their professional knowledge and skills up to date and to pay attention to their own physical and mental health. Maintaining professionalism is a key feature within this article. This section highlights that the health professional must act with honesty and integrity and not follow any fraudulent or manipulative practices or abuse his/ her professional status in order to obtain a financial benefit.

Responsibility towards colleagues

Section 3 relates to the behavior of health professionals towards their colleagues, including interns.

This section contains provisions that a health professional shall not criticize his/ her colleague in front of a patient and shall make the utmost effort to train and develop their colleagues.

Health professionals should ensure that if they have referred or delegated a case, the new health professional has the right knowledge and skills to provide the required care.

Responsibility towards the society

Section 4 states that health professionals shall act as a role model for members of society, shall be committed to maintain public health and demonstrate truthfulness and honesty.

A health professional shall also have a responsibility to the environment and to use resources in an appropriate way and to safely dispose of waste in an environmentally friendly manner.

What is the impact of the 2017 Code?

Whilst in recent years, state-level health authorities (the DHA and HAAD) have passed codes of conduct that apply within the relevant Emirates, the 2017 Code is a federal law and applicable across all Emirates.

Although it is not clear whether an Emirate-specific code or this federal code will take precedence in the event of a conflict between them, the spirit of the 2017 Code is to enhance the obligations upon a health professional to promote professional practices and is a welcome move. As set out above, providing world-class healthcare is one of the 6 pillars of the UAE's National Agenda in line with Vision 2021 and the introduction of the 2017 Code is in line with that vision.

Health professionals and healthcare providers should be aware of the provisions that seek to clamp down on manipulative or fraudulent practices, where health professionals receive financial benefits for, for example, recommending a certain treatment/surgery or for prescribing a certain drug. This is a widespread practice in this region, where, for example, doctors can be incentivized by the revenue that they bring into their employer. That can encourage bad practices, such as the professional putting his interests above the best interests of the patient and is contrary to the vision of the UAE government in providing a world-class service.

Now that the 2017 Code is in place, we expect to see an increased notification of complaints to the licensing committee. If the licensing committee finds that breaches have occurred, they may issue warnings or suspensions against the health professional. That, in turn may lead to a spike in malpractice complaints by patients.

Whilst breaches of the 2017 Code may not automatically lead to an actual finding of medical malpractice, unprofessional or unethical standards may influence a decision by the regulators, expert committees or the courts on whether malpractice has occurred and whether compensation to a claimant should be awarded.

Impact on Operators: engaging and managing healthcare professionals

Healthcare operators should now consider the implications of the Code for the model under which they engage healthcare professionals as well as the terms and conditions for doing so. It has been historical market practice to incentivize healthcare professionals through a remuneration structure tied into how many procedures they book through the operator as well as the number of patients treated. Effectively, healthcare professionals have been regarded as self-employed consultants with a commoditized practice or portfolio.   

Such an approach has been criticized as commercializing the medical professional and failing to put the patient at the centre of the healthcare industry. The Code is clearly designed to boost confidence in the healthcare industry and to change the culture of the profession in the UAE. 

The following practical tips should be considered by all operators:

  • Review the remuneration structures in place for healthcare professionals to ensure they are compatible with the Code;
  • Ensure the Code is widely known and understood within the operations, providing training as necessary;
  • Ensure that compliance with the Code is a key obligation under the healthcare professionals'' terms of engagement such that breach of the Code can result in disciplinary action and potential dismissal;
  • Review disciplinary procedures in light of the Code; and
  • Place the Code within a wider context and policy of clinical governance

If you have any questions, please do not hesitate to contact Shabnam Karim, Legal Director (shabnam.karim@clydeco.com) who specializes in medical malpractice litigation, Sara Khoja, Partner (sara.khoja@clydeco.com) who specializes in employment law or Wayne Jones, Partner (wayne.jones@clydeco.com) who specializes in insurance matters.