Code of Medical Ethics and Deontology
Medical deontology is a set of principles and rules that a physician must adhere to during the practice of the profession. The behavior of the physician, even outside the time of professional practice, should be exemplary in accordance with the dignity required by this profession.
Physicians are obliged to recognize the principles and rules contained in this Code.
The physician must recognize the Medical Chamber as a public entity, which represents the common interests of medical professions and regulates their relationships for the benefit of the public.
Every physician, upon registration with the Medical Chamber, must have a complete understanding of the Deontological Code and simultaneously take an oath orally or in writing, vowing to respect it diligently.
Duties and mission of the physician
The fundamental duty is to protect the life and physical and mental health of the individual and alleviate suffering. In his humanitarian mission to protect health, discover and treat diseases, the physician relies on science and his conscience.
Medical assistance
The physician must provide equal medical assistance to everyone, regardless of age, sex, race, nationality, religion, political views, economic status, social position, etc., while respecting human rights and the dignity of each individual. In times of war or disasters, he must immediately engage to offer his help, making himself available to the competent authorities.
Respect for Tradition
The physician must do everything in his power to respect and protect the highest traditions of the medical profession, continuously practicing a high professional standard and appropriate ethical behavior towards the patient, family members, and any other person seeking help.
Limitations on Professional Activity
The physician should never abuse the conditions created by the profession. The physician should not use the position for personal and professional gain.
Emergency Assistance
Regardless of their specialty, physicians should not refuse to intervene anywhere and under any circumstances to provide emergency assistance to anyone in need, seeking specialized assistance if necessary.
Relationships with Colleagues and Staff
During his work, the physician must take care to maintain the good reputation of the medical profession and have proper relationships with colleagues and other medical staff.
Use of Knowledge
The physician should use his knowledge and skills, relying on professional independence, freedom of action, and personal responsibility.
Professional Duties
The physician has a duty to update himself with the latest scientific developments, participate in qualifying activities for his professional advancement. He must make a fair assessment of the patient's condition based on history, clinical signs, and appropriate examinations. When necessary and possible, he should consult with specialists outside or within his specialty and implement consultation orders.
He must assist the public in understanding health issues and contribute to the education and training of other doctors.
PHYSICIAN'S DUTIES TOWARDS THE PATIENT
Relationship with the Patient
The physician must care for the well-being of the patient and his health interests. Their relationship should be based on mutual trust. The free choice of the physician and the medical institution by the patient constitutes the fundamental principle of these relationships.
Professional Competence
The physician must guarantee the patient dedication and professional competence. He must handle diagnostic and therapeutic problems,
dedicating the necessary time to the patient.
He must perform his work without professional and ethical shortcomings, without abusing the patient physically, emotionally, or materially.
Violations in this direction, according to the degree of importance, are punished according to the provisions of Law No. 6815, dated 01.06.2000,
and the Statute of the Order of Physicians.
Approval of Treatment by the Patient
The physician must respect the patient's right to, with free will, accept or refuse the recommended treatment and type of medical assistance. If the patient is unable to give consent and his representative is not present, in emergency medical situations, the physician acts under his responsibility in the best possible interest of the patient.
Duties towards Children, the Elderly, and the Disabled
In the practice of his profession, the physician must engage in caring for children, the elderly, and the disabled, especially when he observes that the family or non-family environment where they live does not sufficiently care for their health.
A physician called to treat a child or minor should try to obtain the consent of parents, relatives, or legal representatives. An exception is made when the case is urgent, and the physician cannot communicate with them.
In case of suspicion of abuse or mistreatment of a child, the physician is obliged to report to the relevant legal authorities.
Patient Information
The physician must inform the patient about the progress of examinations and the type of treatment, provide predictions by making the patient aware of the benefits and risks, to jointly make the right decision for the best treatment.
In case the patient is too young to judge independently or mentally incapacitated, the physician is obliged to make a decision of the family or guardian, and when this is impossible, to act under the responsibility of medical consultation.
The right of the patient to be informed about the results
The patient has the right to know the truth about his illness and to be familiar with all the results of analyses and other medical documents. However, if the physician judges that this disclosure harms the health of the patient, then he is not obliged to inform him about the truth or show him medical documentation.
Informing Family Members
It is the moral duty of the physician to show understanding and empathy with the patient's family and keep them informed about the progress of the patient's condition. This collaboration is in the patient's best interest.
Diagnostic and therapeutic procedures
The physician must propose and perform only those diagnostic procedures that are necessary for the most reliable diagnosis and only that treatment that is in line with established standards of contemporary medical science.
In the treatment of the patient, the physician must be as rational in economic expenses, in accordance with common medical practice.
Unnecessary diagnostic and therapeutic procedures are not allowed, regardless of who will cover the expenses of the patient's treatment.
Avoidance of Family Issues
The physician should not get involved in the patient's personal or family problems and should not try to influence him, except when required by the type of medical treatment.
Preservation of Confidentiality
The data that the physician learns during the performance of his duties are considered medical secrets. With the patient's consent, the physician is obliged to keep it secret even from family members and other persons, even after the patient's death, except in cases where it poses a risk to the health and life of others.
Disclosure of Secrets
The physician has the right to disclose medical secrets of the patient in cases where their concealment jeopardizes the patient's life or is required by a legally recognized authority.
When the physician uses medical data about a patient for publication, he is obliged to ensure that the patient's identity is not revealed.
Assertion of Rights
The physician must strive for his patient to enjoy all social or material rights that legally belong to him.
Any abuse, deception, or falsification of medical documents is punishable by law.
Continuity of Treatment
When the physician will be absent for a certain period, he is obliged to ensure the continuity of medical treatment for his patient by referring him to another physician.
When the physician judges that the conditions for proper treatment of the patient's condition are beyond his professional abilities and knowledge, then he must take measures for the patient to be transferred for treatment to another physician capable of taking on this treatment. The recommendation for the colleague or colleagues should be honest, justifiable, and documented.
Changing the Attending Physician
If the patient, well-informed about his illness and able to make independent decisions, loses faith in the physician, the latter is allowed to discontinue the treatment and recommend medical treatment to another physician or medical institution. This action is also taken in cases where the patient, consciously, behaves improperly, becomes brutal and threatening, except when the patient's condition is momentarily endangered by the disease, and the physician is obliged to help.
Medical Assistance for Prisoners
The physician called or working for an institution where inmates are serving a sentence must not only provide medical assistance but also protect the sick prisoner's rights and dignity. If he is physically or psychologically abused, the physician must inform the legally recognized authorities.
Forced Treatment and Nutrition for the Prisoner
Forced treatment and nutrition are allowed only in cases where the mentally incapacitated prisoner is unable to decide for himself. If an adult, mentally healthy prisoner refuses food, this must be respected by the physician.
The physician is categorically prohibited from participating in violence or torture against the prisoner.
Documentation of Actions
All diagnostic and medical procedures performed by the physician on the patient must be described (recorded) in the relevant medical documents (medical record, visit register, prescriptions, discharge summaries, reports, etc.), which are official administrative, legal, and scientific acts.
Any abuse, deception, or falsification is punishable by law.
Issuing Medical Documents
Upon the request of the patient, family members, or legally recognized authorities, the physician issues or signs certificates, discharge summaries, certificates, and other documents only when he is sure that they are true. These documents are written in the Albanian language, but if necessary, also in foreign languages.
Patients' Complaints
If patients have complaints about care or treatment, they must be given an immediate and appropriate response. The attending physician has professional responsibility to deal constructively and honestly with complaints. If during treatment, the patient has suffered serious harm, regardless of the reason, he must be fully informed about what happened, and if possible, ask him to forgive or, when under 16 years old, ask his family for forgiveness.
Relief of Suffering for the Dying Patient
Relieving suffering and pain is one of the main duties of the physician. This is particularly important during the treatment of a patient who is dying. Regardless of the treatment, the physician must try to offer spiritual care, always respecting the patient's wishes and religious belief. At the same time, the physician must inform the family and friends of the patient about his condition and try to find their cooperation in relieving the patient's suffering.
Not Hastening Death
Hastening the end of life or provoking death is contrary to medical ethics. If the patient is unconscious, without hope of living, the physician must act according to his personal judgment for the best, in accordance with his professional and moral beliefs.
Death of the Patient
When a patient dies, the attending physician must explain to the family the reasons and circumstances of death. They should be informed in detail.
RELATIONSHIPS AMONG PHYSICIANS, TOWARD THE PROFESSION AND INSTITUTIONS
Reciprocal Respect
Relationships among physicians should be based on principles of reciprocal respect. The physician should treat his colleagues with honesty, just as he would want them to treat him. The physician should not belittle his colleagues and make the patient doubt their knowledge and abilities.
Respect for Teachers
The physician must show respect and courtesy towards his teachers for the knowledge, professional skills, and expertise he has gained from them.
Solidarity with Colleagues
If a physician is asked for professional advice or help by a colleague, he must be willing to provide it sincerely and in accordance with his best knowledge. He should show solidarity with colleagues who are subjected to unjust accusations.
Attitude Toward Inappropriate Behavior of Colleagues
If a physician becomes aware of irresponsible behavior by a colleague, which may be related to ethical or medical irregularities, he should not discuss them with the patient, family, or other colleagues, but should discuss them with the relevant authorities of the Order of Physicians.
Mistakes of Collaborators
The physician is obliged to point out the mistakes that may be made by collaborators or other assisting staff, treating them with tact, without compromising the dignity of anyone and never in front of the patient, family, or their friends.
Relationships with the Attending Physician
A physician may treat a patient from another physician, only at the request of this physician, or when requested by the patient. In this case, he must inform the attending physician about diagnostic and therapeutic recommendations and clinical assessments.
Enhancing Professional Skills and Authority
To enhance professional authority, it is the duty of the physician to continuously study and follow the latest developments in his profession so that he can offer patients the highest level of medical treatment.
Professional Reputation and Moral Figure
The physician must maintain the professional reputation and independence and must not allow his name to be used in commercial propaganda for personal gain. He must avoid unearned profit and the inflation of his fame through bragging.
The physician must maintain a clean moral figure by staying away from activities that degrade his personality (alcohol, drugs, and other incompatible with morality).
PHYSICIAN'S ATTITUDE TOWARD HUMAN REPRODUCTION, CLINICAL EXPERIMENTS, AND BIOMEDICAL RESEARCH AND ORGAN TRANSPLANTS
Information on Sexual Issues
In family planning, the physician should mainly protect natural and educational methods and then artificial ones in accordance with medical knowledge and moral views. He is obliged to inform spouses about the consequences and harm of specific contraceptive preparations.
Care for Sexual Health
The physician must take care of the sexual health of the patient, including the promotion of life and personal relationships, counseling, and medical assistance for healthy sexual development, care for reproduction, and sexually transmitted diseases.
Termination of Pregnancy
The physician is prohibited from performing abortions and sterilizations, except in cases provided for by legal acts and medical indications.
Application of Assisted Reproductive Methods
In the treatment of infertility for conceiving children, the physician must be aware that the application of assisted reproductive methods, including in vitro fertilization, requires understanding of the basic knowledge of these methods by both partners. It is the duty of the physician to be familiar with the ethical developments of such methods in line with globally accepted concepts and recognized by law.
Abuse of human embryos for research purposes is unethical, unacceptable, and punishable by law.
Participation in Scientific Research
A physician undertaking preventive, diagnostic, and therapeutic research must present the research plan before a competent and independent commission to assess scientific rigor and ethical acceptability. Care must be taken to inform the individuals involved in the research on the research subject, anticipating possible benefits and harms, and seeking their consent. If obtaining consent is impossible due to the person's condition, it may also be sought from relatives.
The individual involved in research must be clearly informed of their right to interrupt the research. The use of a placebo-controlled study is only allowed when, according to scientific data, the patient can benefit, and harmful effects are safely excluded.
Application of New Methods
The application of new diagnostic, therapeutic, and preventive methods is allowed only after the approval of the project, clinical examination by an independent and competent commission. Adoption, implementation, and promotion of scientifically unverified methods, causing false hopes to patients and their families, constitute a violation of medical ethics.
Reporting of Results
The achieved results must be reported by the researching physician in accordance with the rules of scientific reports during a specialist meeting, and only after a professional opinion is obtained can they be made known to the general public.
Research on Heredity
Scientific research in the field of health and heredity, using appropriate technologies in the genetic materials of human beings, is acceptable for diagnostic purposes (in vitro or in utero prenatal diagnosis of genetic diseases without harming the embryo or mother), for clinical industry purposes (production of drugs, hormones, vaccines, etc.), for scientific purposes in studying DNA sequences in human genomes for the treatment of chromosomal defects.
Transplantation of Organs and Tissues from the Deceased
In the case of brain death, professionally and securely verified within the legal framework of Law No. 8193 dated 6.02.1997 "On organ transplantation," the physician may retain organs, body parts, or tissues that can be used for the treatment of other patients. The physician determining brain death is not allowed to participate in this procedure.
Transplantation of Organs and Tissues from the Living
The removal of organs or tissues from a living, adult, and mentally competent donor is only done when they provide free and written consent, after making the possible consequences known. The removal of an organ when such an action risks the life of the donor is unacceptable.
CONDITIONS OF PROFESSIONAL PRACTICE
Ensuring the Working Environment
In the practice of the profession, the physician must have a suitable environment and the necessary technical means.
In the practice of private practice, the physician must have only one office. The maintenance of a second one can only be done with the authorization of the Regional Council of the Order of Physicians.
Non-Exploitation of Administrative Functions
A physician performing administrative functions or elected to public duties is prohibited from exploiting the position to increase the number of clients and for other benefits.
Acceptance of Gifts and Funding
The physician must not accept material gifts or debts from companies, firms, or individuals trading in medicines and other materials. Financing for conferences, seminars, and congresses is excluded, where the aim is for professional qualification.
Certification
In prescriptions and documents issued, the physician is allowed to write:
- Name, surname, address, telephone number, and consultation hours.
- Qualification and specialization.
- Titles and functions recognized by the Order of Physicians.
- Honorary titles recognized by the Republic of Albania.
Content of the Cabinet Plate
On the sign placed at the entrance of the office, the physician writes the name, surname, recognized titles and specializations, and consultation hours.
When the physician holds a foreign diploma, the country and university issuing the diploma or certificate authorizing the practice of this profession must be specified.
Employment Contract
The practice of medicine in any form, whether in a private or public institution, is done with a written contract specifying the obligations of the parties involved. Any contract project is communicated to the Order of Physicians, which may make remarks within one month.
Employment of Colleagues
A physician who has opened an office is allowed to employ other physicians at his own expense, following licensing rules.
Honorariums
The payment of honorariums is made either directly by the patient or by a specific administration or organization. The physician must provide explanations about the fees or the cost of treatment. Prepayment for the entire treatment that may span multiple sessions is prohibited. When several physicians contribute to an examination or treatment, the fees must be separate and individual.
Association of Physicians
Any association or grouping of physicians must be based on a written contract that respects the independence of each.
Contracts are approved by the Regional Council of the Order of Physicians.
Any agreement or grouping contract, for professional purposes between physicians on one side and other employees such as nurses, pharmacists, etc.,
is sent to the Regional Council of the Order of Physicians, which must be reviewed by the Regional Council within one month.
Right to Strike
The physician has a constitutional right to strike. However, the physician, acting according to science and conscience, is obliged to guarantee emergency and essential assistance services for the patients.
Respect for the Code
It is the duty of all physicians registered with the Order of Physicians to respect the articles of this Code.
Disciplinary Measures
Non-compliance with the articles of this Code does not exempt the physician from the responsibility arising from the non-fulfillment of ethical and deontological duties prescribed in this Code.
Disciplinary measures resulting from the violation of this Code are determined according to the regulations for the Disciplinary Commissions of the Order of Physicians.