SINGAPORE: The Ministry of Health (MOH) has asked the Singapore Medical Council (SMC) to review a maximum fine its disciplinary tribunal had imposed on a doctor.
Dr Lim Lian Arn, an orthopaedic surgeon, was fined S$100,000 for failing to obtain informed consent from a patient before giving her an injection.
More than 4,000 doctors had signed a petition over SMC's disciplinary ruling last month, asking the health minister to examine SMC's decision and clarify its stand on the need for doctors to obtain informed consent for minor procedures such as routine injections.
In a statement on Wednesday (Feb 20), MOH said that this decision could lead to the practice of "defensive medicine". It noted questions that have been raised about the liability imposed in the case.
MOH has asked SMC to apply to court to have its decision reviewed, it said in the statement. SMC has already made the application even though the time for appeal has passed.
“Whilst both Dr Lim and the SMC may have accepted the sentence, the decision in this case carries with it much wider professional practice implications and also has an impact on future cases," MOH said.
"MOH is of the view that this decision should be reviewed,” it added.
MOH also said that it will continue to engage with healthcare professionals for greater clarity and balance in medical practice and processes.
Senior Minister of State for Health Lam Pin Min had said in Parliament on Feb 11 that doctors do not need to lay out and get consent from a patient for every side effect or complication of a drug or treatment.
He was addressing questions raised by Members of Parliament regarding Dr Lim's case.
Dr Lam said: “It is wrong to infer that the decision (of the disciplinary tribunal) makes it mandatory for a doctor to lay out and get the consent of a patient for every possible side effect and potential complications of a drug or treatment."
"What a doctor needs to inform a patient about prior to a treatment or procedure continues to depend on the specific facts of the case, including the particular circumstances of the patient," he added.
Dr Lam also revealed that in determining the sentence, the disciplinary tribunal had considered cases submitted by both counsels involving similar conduct, where the sentences had involved fines from S$5,000 to S$10,000 and suspension orders from three to 12 months.
The maximum penalty for such misconduct had been S$10,000 before it was increased to S$100,000 when the Medical Registration Act was last amended in 2010, he said.
Dr Lam acknowledged that many "fair-minded" doctors would think that the penalty imposed on Dr Lim was harsh.
"The concerns are understandable, when considering the facts and circumstances of this case,” he said.