Theme: Professional Ethics

General Duties of a Clinical Psychologist

Given below are some of the duties of a clinical psychologist:

Advertising Services

A clinical psychologist should not:

  • Solicit any person with disabilities, directly or indirectly. This includes advertisements, circulars, hand-bills etc. However, clinical psychologists can formally announce through the press about starting/resumption of practice, change of practice, change of address, winding up of practice, and temporary absence from practice.(( Regulation 3, The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))
  • Display qualifications on the sign board, letter head pad, prescription slip, visiting card, certificate, report and other documents that carry the psychologist’s signature. The Registration Certificate should also be fixed in the place of practice, in a clearly visible manner.(( Regulation 8, The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))
  • Not undertake practice in any field other than the psychologist’s field of specialization.(( Regulation 11(k), The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))

Fee and Payment

Clinical psychologists should not charge an exorbitant fee. Also, a psychologist should not enter into a deal of ‘No payment, no cure’.(( Regulation 9, The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))

Details of Patients

Clinical psychologists should maintain a register of the details of patients, prescriptions issued, fees charged etc.(( Regulation 13, The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))

Moreover, clinical psychologists have the duty to maintain confidentiality. This includes keeping the information about their patient’s mental health, mental healthcare treatment, and physical healthcare confidential.(( Section 23, Mental Health Act, 2017))

Treatment and Care of Patients

A clinical psychologist should undertake rehabilitation or treatment of people with disabilities at regular and required intervals, or the proper time.(( Regulation 11(h), The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998)) However, they should not:

  • Exaggerate the course of disease or the gravity of the condition of any person with disability.(( Regulation 10, The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))
  • Indulge in any indecent activity or have any improper relations.(( Regulation 11(b) and 11(c)The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))
  • Make use of harsh and rough language with any person with disability.(( Regulation 11(d), The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))
  • Take undue advantage of the condition of a person with disability.(( Regulation 11(f), The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))
  • Intentionally and knowingly neglect any person with disability.(( Regulation 11(i), The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))
  • Avail or attempt to avail any benefit meant for people with disability.(( Regulation 11(j), The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))

Violation of these duties will qualify as misconduct and can make a psychologist liable to disciplinary proceedings by the Rehabilitation Council of India.(( Regulation 15, The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998))

Complaining against a Clinical Psychologist

You can complain to multiple forums regarding the misconduct of clinical psychologists. The violation of any of the general duties of a psychologist can be grounds to take action against them.(( Regulation 15, The Rehabilitation Council of India (Standards of Professional Conduct, Etiquette, and Code of Ethics for Rehabilitation Professionals) Regulations, 1998)) Some of the forums include:

Rehabilitation Council of India

The Rehabilitation Council of India is the forum that oversees the work of a clinical psychologist. You can lodge a complaint against a professional on the ground of ‘Professional Misconduct’. The Council can order the removal of a psychologist’s name from the register of Rehabilitation Professionals (permanently or for a specified period of time), if found guilty. (( Section 21, The Rehabilitation Council of India Act, 1992))

State Commissioner of Disability/ Chief Commissioners of Disabilities

If you are a person with a disability who was treated by a clinical psychologist who violated their duties/ethics, you have the option to complain to the State Commissioner of Disability or Chief Commissioner of Disabilities, Government of India. You can find the list of State Commissioners here.

Mental Health Review Board/State Mental Health Boards

You can approach three main authorities if you have been treated by a clinical psychologist at a mental health establishment for mental health issues:

  • Central Mental Health Authority – It is the central authority under the law, which has functions including registering all mental health establishments under the Central Government, maintaining a register of all mental health establishments in the country, developing quality/service norms for mental health establishments under the Central Government, supervising all mental health establishments under the Central Government, receiving complaints about deficiencies in provision of services, etc.
  • State Mental Health Authority – It is the authority at the state level which has functions including registration of mental health establishments in the State, developing quality/service norms for mental health establishments in the State, supervising all mental health establishments in the State , receiving complaints about deficiencies in provision of services, etc.
  • Mental Health Review Board – It is the authority at the district level under the law, which has functions to register, review, alter, modify or cancel an advance directive, to appoint a nominated representative, to adjudicate complaints regarding deficiencies in care, etc.

As of now, the authorities, particularly the Central Mental Health Authority and the Mental Health Review Boards are functioning. However, some States, such as Delhi, Kerala, etc. have constituted the State Mental Health Authority. You should seek information about the functioning of these authorities from your respective State.

Who is a Medical Practitioner or Doctor?

A Medical Practitioner is a professional who practices medicine through the study, diagnosis, prognosis, and treatment of any disease or injury or other impairments. As per Indian law, a registered medical practitioner is a person whose name is found in the State Medical Register of any State, and who possesses the required medical qualifications.(( Section 21, Indian Medical Council Act, 1956))

However, a Physician is a Doctor with qualification of MBBS, or MBBS with post graduate degree/ diploma, or with equivalent qualification in any medical discipline. Only a doctor having a qualification recognized by the Medical Council of India and registered with the Medical Council of India/State Medical Council(s) can practice the  modern system of Medicine or Surgery.(( Regulation 1.1.3, Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002))

Qualifications

Doctors are registered medical practitioners under the law if they:

  • Hold recognized medical qualifications granted by Universities or Medical Institutions listed in the Indian Medical Council Act.(( Section 2(h), Indian Medical Council Act, 1956)) A list of recognized universities can be found here.
  • Hold recognized medical qualifications granted by certain other Medical Institutions, also listed in the Act. A list of these institutions can be found here.
  • Enrolled with the State Medical Register(( Section 15, Indian Medical Council Act, 1956))
    or the Indian Medical Register,(( Section 21, Indian Medical Council Act, 1956)) and have received a registration number.

If the medical degree is from a foreign university degree, an Indian citizen possessing primary medical qualifications awarded by a foreign medical institution must clear a screening test,(( Section 13(4A), Indian Medical Council Act, 1956)) in order to be registered with either the Medical Council of India or State Medical Council. Further, you can find a list of  recognized foreign universities here.(( Second Schedule, Indian Medical Council Act, 1956))

Duties of a Medical Professional or Doctor

A doctor should uphold the dignity and honor of their profession,(( Regulation 1.1.1, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002)) and their prime objective should be to render service to humanity.(( Regulation 1.1.2, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002)) Further, doctors should be upright, modest, sober, patient, prompt and conduct themselves with propriety in their profession.(( Regulation 1.1.2, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002)) Legal regulations provide a comprehensive list of a doctor’s general duties, which are:

Maintaining a good practice

Doctors should:(( Regulation 1.2, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

  • Take care of each patient and provide proper service and devotion.
  • Try continuously to improve medical knowledge and skills. They should also use this knowledge to benefit both patients and other colleagues.
  • Practice methods of healing founded on a scientific basis. A doctor should not associate professionally with anyone who violates this principle.(( Regulation 1.2.1, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

Maintaining medical records of patients

  • Maintaining medical records:(( Regulation 1.3, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
    • Doctors should maintain medical records of patients for a period of 3 years from the commencement of treatment.(( Regulation 1.3.1, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
    • Upon a request by the patient, or authorised attendant, or legal authorities, such medical records shall be produced within 72 hours.(( Regulation 1.3.2, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
    • A medical practitioner has to  maintain a register of all the medical certificates issued by them. The identification marks of the patient, along with the signature or thumb impression of the patient shall be collected. The practitioner has to keep a copy of the same.(( Regulation 1.3.3, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
    • Efforts have to be made to digitalize the records.(( Regulation 1.3.4, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

General Duties of a Doctor

A doctor has some general duties apart from the ones give above including:

  • Displaying registration numbers.(( Regulation 1.4, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002)) Upon registration, the State Medical Council gives the doctor a registration number. This should be displayed in all the prescriptions, certificates, money receipts given to the patients.(( Regulation 1.4.1, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Use of generic names of drugs.(( Regulation 1.5, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002)) The Generic Name of a drug refers to its chemical name, or the chemical makeup of the drug, rather than the assigned brand name.
  • Highest quality assurance in patient care.(( Regulation 1.6, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002)) Further doctors should:
    • Aid in safeguarding the profession against the admission of people who don’t have the appropriate education or don’t have the proper moral character.
    • Not employ anyone for a professional practice who is neither registered or enlisted under any of the medical laws. For example, if a doctor is hiring a nurse, it should be someone who is a registered nurse, qualified to practice medicine.
  • Exposing unethical conduct of other members of the profession.(( Regulation 1.7, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Doctors should announce their fees before rendering service. For instance, personal financial interests of a doctor should not conflict with the patient’s medical interests.(( Regulation 1.8, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Observing the laws of the country and not helping others in evading the same.(( Regulation 1.9, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

Duties towards patients

Although doctors are not bound to treat every patient that comes up to them, they should always be ready to respond to calls from the sick and injured. A doctor can advise the patient to go to another doctor, but must treat patients in times of emergencies. No doctor should arbitrarily refuse to treat their patient.(( Regulation 2.1.1, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

A doctor should be patient, delicate, and must honor the privacy of the patient.(( Regulation 2.2, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002)) While explaining the condition of a patient, the doctor should neither exaggerate nor minimize the gravity of the patient’s condition.(( Regulation 2.3, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

The patient must not be neglected. Once the doctor has undertaken a case, they should not neglect the patient or withdraw from the case without giving adequate notice to the patient and the patient’s family. Further, doctors should not deliberately commit acts of negligence that may deprive a patient from necessary medical care.(( Regulation 2.4, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

If your doctor fails in any or all of these duties, you can complain against them in the appropriate forum.

Misconduct by a Doctor/Medical Professional

As per the law, violation of any of the doctor’s duties will qualify as ‘misconduct’ and can result in disciplinary action being taken against a doctor. Further, some other acts also qualify as ‘misconduct’ and can be complained against, like:

Improper or fraudulent activities

  • Committing adultery or improper conduct with a patient, or maintaining an improper association with a patient by abusing one’s professional position.(( Regulation 7.4, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Conviction by a court for offences involving moral turpitude*/criminal acts.(( Regulation 7.5, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Undertaking sex determination with the purpose of aborting a female foetus.(( Regulation 7.6, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Signing or giving any certificate, report, or similar document which is untrue, misleading, or improper.(( Regulation 7.7, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Performing or enabling unqualified persons to perform an abortion or any illegal operation for which there is no medical, surgical or psychological reason.(( Regulation 7.9, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

Confidentiality of patient information

  • Contributing to press articles and giving interviews regarding diseases and treatments which may have the effect of advertising or soliciting practices. However, medical practitioners are free to write to the press under their own name on matters of public health and hygienic living. They can also deliver public lectures and talks under their own name, and announce the same in the press.(( Regulation 7.11, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Disclosing the secrets of a patient that have been learnt in the exercise of their profession. However, disclosure is allowed:
    • in a court of law under orders of the presiding judicial officer;
    • in circumstances where there is a serious and identified risk to a specific person and /or community; and
    • in case of notifiable diseases.(( Regulation 7.14, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Publishing photographs or case reports of patients without their permission. For instance, a doctor cannot publish the patients identity in any medical or other journal in a manner. However, if the identity is not disclosed, the consent is not needed.(( Regulation 7.17, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

Refusing patient treatments

  • Refusing only on religious grounds to give assistance in or conduct of sterility*, birth control, circumcision and medical termination of pregnancy when there is medical reason to do so. However, practitioners may refuse to do so if they believe that they are incompetent for the same.(( Regulation 7.15, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

Conducting operations or treatments

  • Conducting operations without obtaining written consent from the husband or wife, parent or guardian in the case of a minor, or the patients themselves. Additionally, consent of both husband and wife is required in operations that result in sterility. (( Regulation 7.16, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))
  • Conducting in vitro fertilization or artificial insemination without the informed consent of the female patient, her spouse and the donor. However, the female patient should give written consent. Providing sufficient information about purpose, methods, risks, inconveniences, disappointments of the procedure and possible risks and hazards is also a duty of a doctor. (( Regulation 7.21, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

Further, this is not a complete and exhaustive list of all kinds of professional misconduct. Circumstances that are not mentioned above may also qualify as professional misconduct and the responsible medical council can take action on the same.(( Regulation 8.1, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

Complaining against a Medical Professional

You can file any complaint with regard to professional misconduct to the State Medical Council or Medical Council of India for disciplinary action.(( Regulation 8.2, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002)) The list of all the State Medical Councils in India can be found here.

Procedure to complain

If the State Medical Council has not decided upon a complaint for over six months, the complainant can approach the Medical Council of India (MCI). Additionally, the MCI has the power to withdraw the case from the State Council and transfer it to themselves.(( Regulation 8.7, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

If a person is not satisfied by the decision of a State Medical Council, they may go to the MCI to challenge the decision within 60 days from receiving the order by the Council. However, if 60 days have passed, then the MCI may or may not accept the complaint of the aggrieved person.(( Regulation 8.8, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

Punishment 

Once a complaint is received, the relevant Medical Council will hear the practitioner. Further, if the person is found guilty, the punishment will be determined by the Council. For instance, it can direct the name of the practitioner to be removed from the corresponding register altogether, or for a specified time period. This means that the practitioner will not be able to practice for that period.(( Regulation 8.2, Indian Medical Council (Professional Conduct, Etiquette, and Ethics) Regulations, 2002))

Who is an Architect?

An architect is a person who designs buildings and advises in their construction. Indian law recognises an architect when their name and other personal details have been provided in the Register of Architects maintained by the Council of Architecture.  Once their name is listed in the Register of Architects, they are allowed to pursue his profession. Thus, a name entry in this register works as a proof of a qualified architect. There are certain ways to get a name registered, depending on the foreign or Indian qualification one may possess.(( Article 25(a), Architects Act, 1972))

  • For Indian qualification, a Bachelor Degree of Architecture awarded by Indian Universities, National Diploma in Architecture, Degree of Bachelor of Architecture (B. Arch.) awarded by the Indian Institute of Technology (IIT), Membership of the Indian Institute of Architects, etc., will be considered as a qualification.(( Schedule, Architects Act, https://www.coa.gov.in/index1.php?lang=1&level=2&sublinkid=121&lid=135))
  • For foreign qualifications recognized by the Indian government, different degrees from various countries such as UK, Australia, Germany, Switzerland, etc., are accepted. The list can be accessed here.
  • An Indian citizen who has no qualification certificate can get registered if they have been engaged in the profession for at least five years, after which Central government can consider their application for registration.(( Article 25(b), Architects Act, 1972))
  • A person can also get registered if they possess any other recognised qualification under the legal rules which may be made by the Central government under the Architects Act.(( Article 25(c), Architects Act, 1972))

Complaining against an Architect

A person can complain about an architect’s conduct if the architect does not exhibit fairness and impartiality in a work assigned, or is caught taking commission or any such inducements, or any other forms of professional misconduct. You can complain to the Council of Architecture.

Council of Architecture

The Council of Architecture is a statutory body constituted by the Government of India under the provisions of the Architects Act, 1972, enacted by the Parliament of India. The Council of Architecture is charged with the responsibility to regulate the education and practice of professional architects throughout India, besides maintaining the register of architects. Further, it oversees architectural standards periodically by way of conducting inspections through Committees of Experts.

Process of complaint and penalties against an architect

Any violation of the duties of an architect will be considered as professional misconduct and will attract disciplinary action. Additionally, the Council can take any of the three actions listed below after an inquiry:

  1. Reprimand the said architect
  2. Suspend their practice as an architect
  3. Remove their name from the register of architects(( Section 30, Architects Act, 1972))

You can find a format of a complaint here. A committee constituted by the Central Government looks into all complaints against architects and inquiries relating to misconduct of architects. (( Rule 35(1), Council of Architecture Rules, 1973))

Further, in case you come across any unregistered person who is impersonating someone, posing, misrepresenting or misusing the title of ‘Architect’, you can file a complaint against such person(s) along with relevant supporting documents online at the Complaint form available on the Council’s website.

Duties of an Architect

Architects have several duties by which they have to practice their profession. This includes maintaining etiquette, following architectural guidelines for buildings etc.

General Duties of an Architect

  • Provide the employees and associates with a suitable working environment, compensate them fairly and facilitate their professional development.(( Regulation 2(1)(xix), Architects (Professional Conduct) Regulations, 1989))
  • Every partner shall ensure that when an architect enters into a partnership agreement with one or more architects, the firm also complies with the provisions of the sub-regulation.(( Regulation 2(2), Architects (Professional Conduct) Regulations, 1989))
  • Ensure that their professional activities do not conflict with their general responsibility to contribute to the quality of the environment and future welfare of society.(( Regulation 2(1)(i), Architects (Professional Conduct) Regulations, 1989))
  • Compete fairly(( Regulation 2(1)(xi), Architects (Professional Conduct) Regulations, 1989)) and maintain a high standard of integrity.(( Regulation 2(1)(viii), Architects (Professional Conduct) Regulations, 1989))

Architect’s duties towards clients

  • Inform the client of the conditions of engagement and scale of charges, and agree that these conditions shall be the basis of the appointment.(( Regulation 2(1)(iv), Architects (Professional Conduct) Regulations, 1989))
  • Not give or take discounts, commissions, gifts or other inducements for the introduction of clients or of work.(( Regulation 2(1)(vi), Architects (Professional Conduct) Regulations, 1989))
  • Act with fairness and impartiality when administering a building contract.(( Regulation 2(1)(vii), Architects (Professional Conduct) Regulations, 1989))

Architect’s duties towards the profession

Some of the architect’s duties to the profession are not to:

  • Sub-commission an architect’s work to another architect. However, this can happen if the client agrees to it.(( Regulation 2(1)(v), Architects (Professional Conduct) Regulations, 1989))
  • Attempt to supercede or replace another architect.(( Regulation 2(1)(xiii), Architects (Professional Conduct) Regulations, 1989))
  • Attempt to obtain, offer to undertake or accept a commission for which they know another architect has been selected or employed, until they have evidence that the selection, employment or agreement has been terminated. Additionally, they have to give the previous architect written notice.(( Regulation 2(1)(xv), Architects (Professional Conduct) Regulations, 1989))
  • Advertise professional services. An architect should not allow their name to be included in advertisements or used for other publicity.(( Regulation 2(1)(xxv), Architects (Professional Conduct) Regulations, 1989))