Dr. John Duddy:

I wish to respond to a couple of questions from Deputy Billy Kelleher about the ethical or moral obligation on doctors to go to managers or administrators when they have concerns. The Medical Council’s guide to professional ethical practice places an obligation on doctors to do this when they have patient safety concerns about how a service is being provided. That said, it leads to the Deputy’s next question in the sense that there is no obligation on the administrator or manager to do anything about it when these concerns are raised. That can create a difficulty for many doctors.

The other interesting thing about the Medical Council guidelines is that if a doctor is in a managerial position, there are ethical obligations placed on him or her to ensure patient safety and provide safe patient care. A different standard is applied to managers who are doctors and managers who are not doctors because the former are at risk of being reported to their regulator if they are in a management position and a patient safety incident occurs. That is of concern. Our members have put forward motions at meetings to support the introduction of ethical obligations for health care managers to be accountable and have a duty similar to managers who are doctors.