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Memo

MEMO


TO                         :    ALL Medical Practitioners

FROM                   :    The Medical Board of Trinidad and Tobago

SUBJECT              :    Sick Leave Certificates and other matters which
                                   have ethical and legal implications

DATE                     :   16th April 2003


Having regard to a number of enquires, Medical Practitioners are
advised of the following:

SICK LEAVE CERTIFICATION
  1. A Certificate for Sick leave may be issued in circumstances where a Doctor/Patient
    relationship exists and where it is determined that a condition/disease exists which‚
    in the interest of the patient‚ will be better served by absence from work and /or the
    physical/health welfare of the community or other persons in the workplace is
    threatened.


  2. It is within the right of the employer to (where some suspicion exists or otherwise)
    question‚ seek more information or (after proof of fraudulent certification) even
    deny the employee the application for sick leave. It is also within the right of the
    employer‚ in questionable circumstances‚ to seek a further opinion where
    warranted.


  3. Where there is some evidence that the validity of sick leave certificate is in
    question, it is within the right of the employer to enter a complaint to the Medical
    Board of Trinidad and Tobago for further inquiry.


  4. The foregoing notwithstanding‚ in certain circumstances‚ a case may be made out
    (in a Court of Law) for fraud against either or both parties. ( The conduct of an
    inquiry by the Board into a matter of this nature is not contingent on a finding of
    guilt in a court of law but rather is to be conducted as an independent inquiry by
    the Medical Board of Trinidad and Tobago).


  5. The issue of a false sick leave certificate is in breach of the Medical Board Act
    (Section 24  [5]  [c]).   It is therefore  illegal to issue a sick leave certificate
    inconsistent with the requirements of paragraph 1 above.


  6. Furthermore‚ the Medical Board Act (Section 24  [5]   [c]) specifies that a medical
    practitioner shall be deemed to be guilty of infamous or disgraceful conduct who
    knowingly gives a false sick leave certificate.   Such conduct therefore is unethical
    conduct
    .


  7. Where there is proof that a medical practitioner has knowingly issued a false sick
    leave certificate‚  such practitioner will be liable to the sanctions as provided for
    under Section 24 [2] of the Medical Board Act namely:


    • Censure or reprimand
    • Suspension for a period not exceeding two years; or
    • Erasure from the Register/revocation of his/her temporary licence as the case
      may be.


  8. Where after due enquiry the practitioner has been deemed guilty of infamous or
    disgraceful conduct‚  such finding will form part of the permanent records of the
    member/ licensee (and will of necessity have to be part of the information that will
    be included in a letter of good standing - which may be required by other
    registration or professional bodies etc.).


  9. The issue of a false sick leave certificate has been deemed to be serious
    professional misconduct
    by the court.


  10. Where a medical practitioner seeks to extract from another practitioner a sick leave
    certificate in circumstances where the conditions are not fulfilled‚ such practitioner
    requesting the certificate could be deemed guilty of infamous or disgraceful
    conduct under Section 24 [5] [i] of the Medical Board Act and be subject to the
    sanctions of Section 24 [2] of the said Act.




  11. ABONDONMENT‚   NEGLIGENCE   AND   GROSS
    NEGLIGENCE


  12. Medical Practitioners are strongly advised that every effort should be made to
    ensure - to best of their ability that medically challenged persons are not
    disadvantaged in any way or their health status compromised.


  13. Practitioners are further advised to be circumspect in their actions which can
    conceivably lead to allegations of either (i) abandonment of patients as provided
    for in the Medical Board Act (section 24 [5] [b] ) or (ii) of ( medical)negligence.
    Even more seriously‚in given circumstances‚ some actions can be deemed to be
    those of gross medical negligence or manslaughter .


  14. These guidelines are issued by the Council of the Medical Board of Trinidad and
    Tobago with a view to guiding and assisting Medical Practitioners in the interest of
    their own professional safety and holds itself available to offer further guidance and
    advice.


  15. Members are also urged to seek‚ and should avail themselves of advice from the
    Medical Protection Society.


  16. In the interest of ethical practice.