The Specialist Forum Volume 13 No 11 November 2013 | Page 49

ETHICS

Protecting electronic records
Electronic records should be regularly backed up and a back-up disk kept
at a secure off-site location. Do not be tempted to keep your computer
back-up drive in a fire-proof safe - if a fire breaks out, it can melt. Instead,
use secure, off-site storage, wherever possible. If you have sprinklers in
areas that house computers that contain electronic copies of medical
records, put waterproof covers on the computers before going home at
night.
Doctors have a professional obligation to ensure that sensitive patient
information is kept secure. Doctors should remember, too, that in the event

of a complaint, clinical negligence claim or disciplinary proceedings, a successful defence will largely depend upon the evidence available in the relevant clinical records. If essential information is inaccurate, indecipherable,
or missing, cases may be lost when otherwise they could have been won.

Further information
• ISO standards for record management.
• Electronic Communications and Transactions Act 2002.
• MPS Booklet, Guide to Keeping Medical Records in South Africa (2011).
• HPCSA, Guidelines on the Keeping of Patient Records (2008).? SF

Ethics for all
The Medical Protection Society’s (MPS) annual Ethics4All events will be
held in Durban and Pretoria on 1 and 2 December respectively. In this
article, Dr Graham Howarth, MPS head of Medical Services (Africa),
briefly discusses some of the key components that make up a professional’s ethical framework.

of dishonesty committed in a desperate, but misguided, attempt to
recover the situation. Honesty, truthfulness and a straightforward, open
approach to patients and others is one of the most precious attributes
of the professional person.

Ethics, values and the law

Respect for patients might seem to be just common sense, rather than
an ethical principle. Such an intuitive response is likely to stem from an
existing ethical sensibility that has already been accepted. It should also
make it very easy to understand that respect for another individual is
not a single concept, but a combination of the principles of autonomy,
fidelity and veracity along with an intention to do no harm.

Ethics is largely about what happens in between those areas where
the law has provided us with clarity and definition - although many ethical principles, such as confidentiality are also enshrined in legislation.
Violating these principles is illegal and unethical. Values, on the other
hand, have nothing to do with legislation, arising from various sources
and in many cases, long before you begin your career, for example fairness, decency, kindness, tolerance and responsibility.

Acting ethically and behaving professionally
Striking a balance between a caring, supportive and patient-centred
approach, the need to make a living and to run a profitable business
in order to achieve this, is not easy to achieve. Striving to act ethically
and professionally at all times will help you to find this elusive balance.

Professionalism
A doctor’s duty of care is an important professional and ethical responsibility, but in general the expectation is one of reasonableness, not of
perfection. This expectation of reasonableness in your actions applies
to standards as well as to specific acts and omissions. The ethical
principle of treating others as one would wish to be treated ourselves is
a useful starting point.

Morality and decency
Behaviour that might be the norm in some walks of life can be viewed
seriously by a regulatory body in a healthcare field such as medicine.
The level of decency and morality displayed in your personal life, and
in broader aspects of your professional and business dealings, is a
pointer of how you might behave in relation to patients in your care.
When it comes to morality and decency there are no half measures for
the healthcare professional.

Honesty
Your professional reputation can often survive an honest mistake or
lapse in judgment, if the response and subsequent actions are open,
honest and transparent. It is far more difficult for personal integrity to
survive a minor transgression if this is then compounded by serial acts

The Specialist Forum | November 2013

Respect

Patient autonomy and consent
Consent requires information to be shared so that a patient feels able
to make a decision for their own benefit, according to their own codes
and values. Patients who feel respected and involved in decisions about
their care and treatment will, in turn, have greater respect and trust for
their healthcare professionals.

Confidentiality
Patient autonomy and their absolute right to confidentiality must be
ensured in almost all but the most exceptional circumstances. Patients
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