Dr. Suzanne Crowe:

I warmly thank the committee for this opportunity to address it today. I am the president of the Medical Council, the statutory body responsible for the regulation of doctors in Ireland. The key objective of the council is to protect the interests of members of the general public in their interactions with registered medical practitioners while also supporting these doctors. The council protects the public by promoting and ensuring high standards of education, training, conduct and competence among doctors who are registered with the Medical Council. The Medical Council maintains the register of medical practitioners, that is, the register of all doctors who are legally permitted to undertake medical work in Ireland. The council also sets the standards for medical education and training in Ireland. It oversees lifelong learning and skills development throughout doctors' professional careers through its professional competence requirements. It is charged with promoting good medical practice. The Medical Council is also where the public may make a complaint against a doctor.

The Medical Council’s remit is set out in the Medical Practitioners Act 2007, as amended, and other relevant legislation. As part of its role, and to support doctors to meet these high standards, the Medical Council produces guidance on matters related to professional conduct, ethics and aspects of practice.

In November of last year, the Medical Council published the ninth edition of its Guide to Professional Conduct and Ethics for Registered Medical Practitioners.

The guide seeks to support doctors by providing principles–based guidance on how to best work in partnership with patients. It covers a wide range of topics and scenarios likely to arise over the course of their professional careers. The guide is also useful for patients as it clarifies the standards of care they should expect from their doctor.

This guide came into effect on 1 January, replacing the eighth edition. In preparation for the drafting of the ninth edition of the guide to professional conduct and ethics, a comprehensive public consultation took place, as well as a targeted round-table consultation with representative stakeholders. All feedback received was utilised to inform the drafting of sections and paragraphs in the ninth edition of the guide.

As with previous editions, and as mentioned, the guide seeks to support doctors by providing principles-based guidance on how to best work in partnership with patients. I hope many of the members have a copy of the guide in front of them. It includes some instructions on how it should be used. It is important that no one section is read in isolation but that the guide is read completely. As outlined in the introduction, the guide outlines general principles that we are expected to adhere to and observe as well as more specific guidance on identified aspects of practice. It is not, however, a legal code. It does not aim to address every clinical and non-clinical situation that arises in practice. However, understanding and applying these principles will assist doctors to safely navigate situations that arise in professional interactions.

The guide also outlines that doctors have a duty to comply with the laws and regulations pertaining to their practice. Their practice and conduct will also be informed by professional, clinical and organisational policies and guidelines. Furthermore, as stated in the guide, the guidance should be read in conjunction with all relevant policy and legal developments during its period of application.

When drafting the ninth edition, the committee considered existing and newly enacted legislation and how it applies to the protection of the public from medical regulatory and legal perspectives. It is important to point out at this juncture that the Medical Council does not have a position on the topic of assisted dying. It is the direct work of the committee to consider and make recommendations for legislative and policy change relating to a statutory right to assist a person to end his or her life, and a statutory right to receive such assistance. It may also be of benefit to the committee to address some recent commentary relating to one of the changes in the new edition of the guide. A number of paragraphs in the eighth edition were edited, merged or removed following the consultation and drafting. One such paragraph in the eighth edition does not appear in the ninth edition, namely, the phrase, "You must not take part in the deliberate killing of a patient". This removal has been misinterpreted by some. The guide states that the medical profession must comply with and operate within the law. As per legislation, it is illegal for all individuals, including doctors, to take part in the deliberate killing of a patient or to assist a person to end his or her life. The removal of this paragraph was not the Medical Council taking a stance or paving the way for any possible future change and should not be interpreted in this way. The removal of this sentence does not diminish the law.

In more broader terms relating to the guide, there is a detailed section on conscientious objection. Paragraph 42 details how a doctor may refuse to provide or to participate in a lawful procedure, treatment or form of care which conflicts with a doctor's moral values. I have provided the committee with the text of the conscientious objection and end-of-life care sections of the guide, in addition to a full copy of the guide.

In conclusion, I will paraphrase the guide by saying that doctors hold a privileged position of trust in society. To maintain this trust, they are expected to demonstrate professionalism through application of the required skills and knowledge and adherence to high standards of professional conduct and ethics.

The guide to professional conduct and ethics outlines the values and principles that underpin professionalism and good medical practice in the interests of patients and the broader population. It specifies how these values and principles apply in various aspects of a doctor's professional practice, for example, with patients, in practice settings, in the broader community and with colleagues.

Patients are individuals with diverse needs. The guide acknowledges their right to be treated with dignity and respect and to participate in decisions about their treatment and care. Given the constantly evolving healthcare environment, the council intends, over the next year and beyond, to issue additional guidance on a range of different areas. With the evolving nature of the practice of medicine and the delivery of healthcare in Ireland, the council will be regularly reviewing what additional support and guidance practitioners may require to supplement the guidance already available in the guide and to align with national health policy developments. I again thank the committee and Chair for the invitation to attend today.