Download presentation
Presentation is loading. Please wait.
Published byMaryann York Modified over 9 years ago
1
Whistle-blowing: the curse of the Black Pearl Dr Phoebe-Anne Mainland MA (Medical Law & Ethics) FANZCA FHKCA FACLM
2
Declaration Chinese University of Hong Kong Alfred Health Alfred Health Ethics Committee MDA National
3
Ethics and reporting colleagues Voluntary and mandatory notification of health professionals Does codifying address problems of voluntary reporting? Ethical & moral approach to aberrant behavior
4
Whistleblowing Reporting behavior or an action that fails to conform to standards of law or morality
5
July 2010 Australian Health Practitioner Regulation Agency AHPRA National organization for registration & accreditation of 10 health professions Including doctors
6
The Act Health Practitioner Regulation National Law Act Requires of registered HP ‘Mandatory Notification’ of other HP Whose professional practice has placed the public at risk of substantial harm Notifiable conduct
7
Notifiable conduct Practised the practitioner’s profession while intoxicated by alcohol or drugs; or Engaged in sexual misconduct in connection with the practice of the practitioner’s profession; or Placed the public at risk of substantial harm in the practitioner’s practice of the profession because the practitioner has an impairment; or Placed the public at risk of harm because the practitioner has practised the profession in a way that constitutes a significant departure from accepted professional standards.
8
Previously Moral & ethical reasons to report conduct that could place a patient at harm Principalism Virtues Codes of ethics
9
Principalism Beauchamp & Childress Autonomy Beneficence Non-maleficence Justice
10
Virtues Honesty Integrity Respectfulness Compassion Tolerance Patience Diligence Professionalism Collaborativity Humility ANZCA Code of Professional Conduct
11
http://www.wma.net/
12
A PHYSICIAN SHALL Deal honestly with patients and colleagues, and report to the appropriate authorities those physicians who practice unethically or incompetently or who engage in fraud or deception. WMA International Code of Medical Ethics
13
Other health professions Not all had codes of ethics or practice
14
A PHYSICIAN SHALL Deal honestly with patients and colleagues, and report to the appropriate authorities those physicians who practice unethically or incompetently or who engage in fraud or deception. WMA International Code of Medical Ethics
15
A PHYSICIAN SHALL Deal honestly with patients and colleagues, and report to the appropriate authorities those physicians who practice unethically or incompetently or who engage in fraud or deception. WMA International Code of Medical Ethics
16
Doctors have a long history of codes of ethics Advance for other health professions
17
Why did Australia codify? Perceived failure of voluntary notification
18
Jayant Patel, Bundaberg Hospital
20
How did this occur? Failure of appointment system to identify problem practitioner Exposure by media After Google search Failure of attempts by colleagues to be heard Failure of voluntary reporting
21
Problems of Voluntary Reporting Not reported Reported Whistleblower Subject Profession Public Process
22
Not reported Harm to the patient Harm to standard of health care Lack of trust of professions by society Undermining professionalism
23
Whistleblower Whistleblower protection legislation ‘Grassing on mates’ Discredited Personal life dredged
25
Subject Professional and personal life upset Mud sticks Indignation of being investigated Refusal to accept
27
Profession Destabilize the profession Destabilize team
28
Public Blame, accusations, accountability Suspicion of profession
29
Process How to report, to whom? Conflicts of interests of institution/employer Consequences of reporting Transparency Mandate of those making judgments
30
Will codifying address these problems? Cross professional reporting Recognize team Other professions in better position to observe Empowering, as requirement & pathway is unambiguous
31
Not reporting Opposite problem Overwhelming reports Vexatious notifications
32
Whistleblower Same issue of ‘disloyalty’ Justification ‘I had to’ Protection for vexatious reports Detrimental to relationships
33
Subject No progress for subject Harrowing even if exonerated Denial Denial after investigation Lack of insight Unchangeable
34
Accusation cascade Confronts sense of self Professionally Personally Defensive Mistrust Abandonment Destructive to self Counterproductive
35
Subject No progress for subject Harrowing even if exonerated Denial Further problems No warnings No performance management No remedial intervention Discourage HP own health care Conflicts with other ethical duties
36
A PHYSICIAN SHALL Act in the patient’s best interest when providing medical care. Behave towards colleagues as he/she would have them behave to him/her. WMA International Code of Medical Ethics
37
Process Suspicion for both voluntary & mandatory notification Lack of confidence worse No solution to Unknown consequences of reporting Lack of transparency Mandate of authority
38
Bottom line There will be outliers of performance Need to protect patients Responsibility to look after colleagues Is mandatory notification necessary?
39
Ethical and moral values Reinforce principles & virtues Role models, leadership & example Curriculum and ongoing professional development ‘Normalize’ peer review, self audit Reflection, awareness, insight Whistleblowing unnecessary
40
Ethical and moral values Transparency of process Acceptance of reviewers Engage professionals in appointment What is the ‘appropriate authority’?
41
‘…if Dr Patel had been working in a major tertiary hospital, any sub-standard performance would have been "very evident.” ’
42
The MVSA Audit
43
Support Subject Whistleblower Profession Public
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.