Medical Board of Trinidad and Tobago Code of Ethics in the Practice
The principle of autonomy upholds the patientís right to selfĖdetermination. An autonomous person has the capacity to think, decide and reason for themselves and is able to act on those thoughts. As medical practitioners we have a duty to respect a patientís autonomy. This principle is central to the concept of informed consent and confidentiality.
Informed ConsentIt is the responsibility of physicians to ensure that patients are adequately informed about their medical condition and management plan. This requires that the physician give the patient all relevant information (risks, potential benefits, and alternative treatment) in a manner that the patient understands.
In the case of the emancipated minor the consent of the parent(s) is not required.
In emergency situations, where the probability of harm from lack of treatment outweighs the probability of harm from treatment itself and the patient is not able to give informed consent, the attending physician may perform the necessary treatment without the prior consent of the patient, once this action is in the best interest of the patient.
In situations where consent is not obtained for procedures such as examination, investigations or treatment, the physician is at risk of prosecution for battery by a court of law (criminal law) or a civil lawsuit for the tort of battery
Capacity and Competence Capacity is a term used to denote the ability to make decisions. It requires understanding the information related to the decision; being able to appreciate the significance of the decision; retain and evaluate the information and communicate the decision. Competence is a legal construct, and capacity is a test of competence.
Diminished Autonomy Special precautions should be put in place to protect patients with impaired capacity or diminished autonomy. At all times however, the principle of respect for personhood requires that the personís views be taken into account. Patients with diminished autonomy include:
A physician has a duty to keep his patientís information confidential. This duty continues until after death, however in certain circumstances, the duty is overridden by considerations of the public interest . These include:
The patientís consent should be sought prior to sharing medical information.