College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology

Ethics For Pathologists

College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology

Ethics form the basis of all meaningful and acceptable human activities. They indeed are the only feature which distinguish humans from animals. They are of exceptional importance for those who practice Medicine .Pathology and Pathologists being a distinct specialty of Medicine often face issues which are peculiar to their specialty. They therefore need a code of their own. College of Pathologists Pakistan, on its establishment, recognized the importance of a Code of Ethics for Pathologists. Indeed the standing Committee on Ethics was the first standing committee established by the College. .Some people thought that it was a futile exercise in view of prevailing conditions in our country. However it was decided that a bottom line has to be drawn for all to know and follow. The committee was reconstituted on the start of the new term of the President It has now finalized its recommendations in the form of Ethics for Pathologists. It is a fairly comprehensive document. The Code of Ethics comprising fifteen articles is the core. It attempts to cover all aspects of the professional life of a pathologist. It must however be understood that these are only principles. They do not cover specific situations. The conduct expected of a Pathologist in the light of these principles is given separately. The enforcement procedures are also outlined. Ethics are not static. They keep on evolving. We will be mindful of any changes which might be required in future. We are grateful to all members of both standing committees for their efforts in compiling this unique document. This is perhaps the first attempt in the country for a specialty to provide a code of ethics for its members, It is hoped that pathologists would provide lead to others in this vital area also.

Manzoor Ahmad President January 7, 2011

College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology

Contents

Preamble Mission Statement Code of Ethics Appendix I Conduct of a Pathologist

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Appendix II Role of Standing Committee on Ethics Appendix III Definitions AppendixIV Standing Committee on Ethics 2010 AppendixV College Committees

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College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology

Code of Ethics
PREAMBLE: Pathology is the basis of modern medicine. It is the very foundation of good patient management; hence its own health and strength is of utmost importance. Human beings are the supreme creature on earth. Their position is not due to physical strength of their body or even because of their high mental capabilities. It is due to their unique values based on high morals and ethics. A highly intelligent but corrupt mind can lead to worst disasters. A sound mind ,a healthy body and suitable ethical environment should be the requirements for the practice of pathology. The onus lies on pathologists themselves to create conditions which satisfy these requirements. , In view of the important role played by ethics in conduct of a pathologist, College of Pathologists Pakistan decided to formulate the Ethics Code for the practice of Pathology in all its dimensions and horizons. The Standing Committee on Ethics was assigned the task to develop and implement the code.

College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology

MISSION STATEMENT: The College of Pathologists Pakistan (CPP) is an ethical and moral organization to serve the best interests of the discipline of Pathology. It values the moral and ethical values as the most sacred and the most precious asset of the organization. CPP will observe the highest possible ethical and moral standards in all its policies, decisions and day to day work. With this solid foundations and highest intellect guidance CPP will Insha Allah serve as the most significant motivating institution to promote the healthy growth of Pathology and pathologists. This will be beneficial to all other disciplines of Medicine as well as to the patients. OBJECTIVES: College of Pathologists Pakistan and all Fellows and Members will be committed to the highest standards of ethical conduct. These standards are non-negotiable. will Insha Allah create an open , healthy and intimidation free environment for active and enthusiastic contributions by its members toward development of discipline of Pathology. will adhere to the strict criteria of justice and merit and will not allow underhand and unethical manipulations to cater for the likes and dislikes of individuals. would serve as an example of honesty ,integrity and uprightness for all pathologists in the country to follow. will abide by the established codes of ethics that pertain to the medical profession. . This Code of Ethics is designed to protect and enhance the reputation and integrity of Pathology and Pathologists in Pakistan. However, while it can provide answers and guidance on many issues, it is not exhaustive. It does however represent CPPs standards and states its expectation that all Pathologists will address situations from a framework of the highest levels of personal and professional integrity.

College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology

CODE OF ETHICS

College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology

CODE OF ETHICS 1.Applicability of Code of Ethics

1.1.The code of ethics will be binding on the CPP and all its Fellows/Members. All Members and Fellows will sign a pledge to this effect 1.2.It will be notified and will be made available to all pathologists and others on the College website /College office. Any changes ,when made, will be incorporated 1.3 It can be complied by all pathologists, not part of the College, as a guideline for appropriate conduct.

. 2.No Rights Created 2.1This Code is a statement of certain fundamental principles, policies and procedures that govern the College, its personnel as well as pathologists in general. It is not intended to and does not create any rights in any employee, customer, supplier, competitor, shareholder or any other person or entity 3. INTEGRITY

3.1Personal and Professional integrity is the most important and crucial requirement if a credible and ethical Pathology service has to be provided for our patients. 3.2.CPP and all pathologists will promote values of Truth , Accuracy and Accountability in their professional and personal dealings. 3.3.Accuracy of all information will be ensured. Any attempt to conceal , fabricate, falsify or misrepresent is not permissible.

College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology 4. ACCOUNTABILITY 4.1Self and organizational accountability are paramount elements for constant improvement, growth and Quality Assurance. Muslims are committed to instill the highest zeal, sprit and confidence guided by the superb ethical and moral guidelines as enshrined in Quran-e-Majeed and the Sunnah of the Prophet (PBUH). Similarly those who practice other faiths have their own set of high values which they follow.

4.2We are responsible for all our professional acts to all those who have placed faith in Pathology and CPP. They comprise not only our Members and Fellows but also lay public, physicians ,donors and our patients. We must also remember that we are answerable above all to Allah Talah for our every act. 4.3 It will be ensured that mechanisms are devised to monitor and promote good management of all available financial and manpower resources at the disposal of CPP or as individual pathologists. 4.4All local and national laws and regulations that govern the practice of medicine in the country will be followed faithfully 5.CONFLICTS OF INTEREST 5.1 No judgment on any professional activity should be compromised or seen to be compromised by personal or financial considerations. All decisions should solely be made in the interest of the patient. 5.2 All known or potential conflicts of interest in any matter would be disclosed to stakeholders.

College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology 6.ADVERTISING 6.1It is sometimes necessary to disseminate information to public about pathology and its role in patient care. It, however, would not be used to project personal or business interests. 6.2The advertising in print /electronic media would conform to the high standard expected of a physician. It would be confined to announcements about start, cessation, change in practice or address. 6.3Nameplates, Signboards and business cards would not be large/flashy or misleading. 6.4 In case of any doubt, opinion of the Ethics Committee will be sought. 7.FUND RAISING AND COMMERCIAL INTERESTS 7.1 Our aim is serving humanity and welfare of the patient through better diagnosis and disease management. Any selfish interest will be subordinated to this goal.. Pathologists and industry have common interest in provision of suitable and affordable products for patient welfare. They need to work closely to attain this end.We strongly endorse the following positions.

7.2.Coercive practices for fund raising are not permitted. kickbacks, fee splitting, commissions, gratifications, both giving and receiving are forbidden,

7.3.A Pathologist would be expected to select products and equipment for purchase for their institutions by employing independent and impartial judgment. 7.4They should not accept any financial support, equipment or gifts for personal use from. the supply firm

College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology 8.PROFESSIONAL RELATIONSHIP 8.1 All patients as well as colleagues will be accorded respect and consideration at all times. 8.2 Any criticism of a colleague would be within limits of decency and never in front of a patient. 8.3 Diversity will be encouraged in all activities 8.4 No tolerance would be shown for any form of discrimination or harassment based on race language, color creed , religion, gender or financial standing 9 .PRIVACY AND CONFIDENTIALITY 9.1There is implicit understanding that any information divulged by or about a patient will not be communicated in an unauthorized manner. We should therefore 9.2Maintain the confidentiality of all personal, medical and treatment information 9.3.If any such Information is to be revealed, it must be with consent of the patient or his authorized representative. 9.4.Such disclosure would however be permissible for fulfilling legal requirements or for the benefit of the patient 9.5.Disclosure should not be beyond what is required 9.6.College Fellows/Members must also maintain the confidentiality of among other things: all non-public information regarding CPP, its business, donors, stakeholders, programs, and projects. 9.7The laboratory reports and records of the patient should only be released to a third party by written consent of patient/authorized representative or if required by Law. 10. INFORMED CONSENT 10.1 In great majority of cases within purview of a pathologist, written informed consent may not be required in all cases. The patient reporting for test in a lab would indicate implied consent. However when invasive procedures like bone marrow aspiration/biopsy,Fine needle aspirations are involved, the patient will be fully explained the procedure and its implication

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College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology

11.SECOND CONSULTATION 11.1.The well being of the patient is of paramount importance. A pathologist will therefore willingly secure a second opinion from professional colleagues about any issue if he himself does not feel confidant. 11.2. He will also be expected to provide all material under his possession or control for such opinion if a request is made by the referring physician, the patient or a court of law. 11.3.While giving second opinion, care would be exercised not to affect the reputation of the original consultant nor any attempt would be made to secure any business or personal advantage. 12. RESEARCH AND PUBLICATIONS 12.1.It is the duty of the Pathologist to provide protection to the life and well being of any human subject included in the research project. 12.2.Aanimals and other living objects will also be treated in a humane manner strictly according to established standards. 12.3.All subjects will be informed about the aims, methodology and possible hazards if any. 12.4.The subjects would be afforded opportunity to withdraw from the project if they so desire. 12.5.The result of research whether favourable or not will not be suppressed. 12.6.It would not be appropriate to use name for a project or publication in a manner which is disproportionate to its contribution. 12.7. It would guide students and clinicians toward proper scientific and unbiased diagnostic and research methodologies aiming at improvement in overall scientific knowledge and its proper use. 12.8 Plagiarism in any form is unacceptable 13.RESPECT FOR PATIENTS, LABORATORY SPECIMENS AND TISSUE 13.1All pathologists and staff working for them would ensure that all laboratory samples, tissue and all human and animal remains are treated with due respect at all times

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College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology 14. USE OF PATHOLOGY 14.1The use of Pathology and all its specialties is dedicated for the welfare of patients and of all mankind only. Its employment for any other purpose which could cause harm is not permissible. 15.ADHERENCE TO CODE OF ETHICS FOR PHYSICIANS 15.1 CPP,.its Fellows and Members will also comply with any code of ethics for medical profession approved by the College

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College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology

APPENDIX-I Conduct of a Pathologist

In the light of above general principles and guidelines,the following conduct is expected from a Pathologist 1) 2) 3) 4) 5) He or she will be upright and honest in all affairs Will not engage in any immoral and unethical practice of pathology or medicine Will choose the most appropriate equipment and reagents based on merit Will not accept bribe in any form and kind Will try to stop all unethical practices and corruption

6) Will not engage in kickbacks and commissions in luring the tests for his or her private laboratory. 7) 8) 9) Will not use the hospital laboratory for promotion of his/her private practice Will not give a false impression about his qualifications Will not use students and other subordinates to promote his/her private practice

10) Will not hire under qualified personnel at his/her laboratory 11) Will not compromise the standards of the laboratory; public or private 12) Will observe the highest possible Total Quality Management System 13) Will safeguard the interest of the patients 14) Will not encourage unnecessary and costly tests 15) Will treat patients as human beings with due respect and honor 16) Will not remain silent or indifferent seeing wrongs in medical and pathology practice

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College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology 17) Will speak up for the truth and for the ethical values and resist all wrong doings 18) Will not hide the true witness 19) Will not engage in any form of nepotism and favoritism 20) Will not pass or fail students on recommendations , personal and institutional biases 21) Will not leak out questions, papers or give other hints to favor certain candidates 22) Will do his/her utmost to be punctual, dutiful, careful and honest while performing duties 23) Will not resist in seeking second opinions by the patients 24) Will not ridicule or intimidate the fellow colleagues 25) Will not accept any gift from students or their friends and relatives 26) Will be enthusiastic in promoting genuine research and teaching 27) Will constantly try to gain new knowledge and sharpen skills 28) Will try to do frequent self accountability 29) Will be helpful to the colleagues in terms of consultation, opinions and all positive considerations 30) Will be respectful to all seniors and juniors 31) Will not sabotage the systems by conniving and concealments 32) Will not include his/her name in a research or paper in which he/she has not contributed quite significantly 33) Will help students in their research and work, keeping their best interest in view. :

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College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology APPENDIX-II

ROLE OF STANDING COMMITTEE ON ETHICS: 1. The Committee would comprise pathologists ,physician and non physicians of known high integrity 2.. College Council will refer policy issues which require examination from the ethical stand point to the Committee for its recommendations . 3..The Committee would make suitable recommendations to ensure that the College and its Members/Fellows function on solid ethical and moral grounds in all its aspects i.e. administration, education, examination, research, elections and all other functions 4..The Committee will examine cases of individuals or institutions in conflict with code of ethics referred by the College ,Member/Fellow, any individual or institution. 5. The Committee on referral of any breach of the Code of Ethics would carry out necessary and appropriate inquiries providing right of hearing to the accused party. It will give recommendations to the Council for appropriate actions and penalties, if any . 6.The committee will be guided in its deliberations and recommendations by the following guidelines. 6.1. It would not let quackery and unscientific methods contaminate the pure research 6.2. It would not allow greed orientation and corruption seep in the disciplines of Pathology 6.5... It would safeguard the human rights and not let them be subjected to un-informed/dangerous or unsafe procedures and practices. 6.6. The Committee will safeguard the animals and plants rights by promoting ethical values in laboratory procedures and environment

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College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology APPENDIX-III DEFINITIONS.In this Code unless there is anything repugnant in the subject or context,(a) (b) (c)

College means the College of Pathologists Pakistan Council means the Council of the College of Pathologists Pakistan Committee means a committee established by the College under the prescribed rules.

(d) (e) (f) (g) (h)

Executive Committee means Executive Committee of the College Fellow means a Fellow of the College. Government means the Government of Pakistan. Laboratory means a pathology laboratory as recognized by the College Pathologist means a qualified physician who has successfully completed a training course in specialties or sub-specialties of Pathology as recognized by the College from time to time, as the case may be.

(i)

Pathology means the discipline including all its specialties and subspecialties as recognized by the College from time to time, as the case may be.

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(j)

Specialty means a sub discipline of Pathology as recognized by the College from time to time, as the case may be.

(k) (l) (m)

Prescribed means prescribed by College rules. President means the President of the College. Physician means a medical graduate holding MBBS degree or its equivalent as recognized by the Pakistan Medical and Dental Council established under the (XXXII of 1962). Medical and Dental Council Ordinance, 1962

College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology APPENDIX-IV 17

Standing Committee on Ethics (2010) Terms of Reference The Committee will formulate an ethics code for the pathologists. This will cover all aspects of work of a pathologist including ethical issues in the practice of the specialty. The Committee will also be responsible enforcement of the code as well as prescribe suitable action against violators. Members 1.Prof. Anwar Ali Akhund Professor of Pathology Peoples Medical College for Girls Nawab Shah Sindh 2. Prof. Athar Saeed Dil Professor of Pathology Frontier Medical College Abbottabad 3.Dr. Muhammad Fayyaz Department of Radiology Pakistan Institute of Medical Sciences Islamabad 4. Prof Anwar ul Haque (Chair) Professor of Pathology Pakistan Institute of Medical Sciences, Islamabad. 5.Dr. Muhammad Iqbal Khan Islamic International Medical College. Islamabad. 6.Dr. Lubna Naseem Department of Pathology Pakistan Institute of Medical Sciences Islamabad 7.Mr. Rana Naveed. GEO News Islamabad 8.Mr Wahajus Siraj Chief Executive Nayatel Broadband Islamabad

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College of Pathologists Pakistan

Promoting Education ,Good Laboratory Practices and Research in Pathology APPENDIX-V College Committees The attainment of College objectives and its work is planned to be channeled through College Committees. They will be influential in formulating College Policies on various issues. Their role would be advisory to the President. The relevant Bye Laws are as under. Chapter -7: 7.1 Committees and Commissions College council may establish Committees and Commissions to inquire and recommend policies or course of action for any issue within purview of the College, to conduct examinations, manage financial or administrative affairs for any other purpose to run the affairs of the College. The Chairpersons and Members will be appointed by the President. They will ordinarily be Fellows/Members of good standing: The President, however, is authorized to appoint a member from outside the College. The Committees and Commissions will formulate their own rules for conduct of business, which will be approved by the Council. The President will fix the duration in which the Committee/ Commission will finalize the report or function. In case where extension is required, Council will be approached for the approval. The Committee/ Commissions will cease to exist, 03 months after the President who appointed them leaves the office, unless the incoming President renews their mandate. The Council will make financial allocations for the work assigned as required. The Committees/ Commissions will make financial report to the treasurer as often as required by the Council. Final report will submitted within three months of completion of the task assigned.

7.2. 7.3. 7.4. 7.5.

7.6.

7.7. 7.8.

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7.9.

President will formulate and communicate to the Committee/Commissions terms of reference for any work which is to be under taken by them.

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