Biomedical Law and Ethics

• Date: 01 December 2014
• Published date: 01 December 2014
• Author: Paul TAN LLB (Hons) (National University of Singapore); BCL (Oxon); Advocate and Solicitor (Singapore). Prem Raj PRABAKARAN BEng (Mechanical) (Hons) (National University of Singapore); LLB (Hons) (National University of Singapore); BCL (Oxon); Deputy Senior State Counsel/Deputy Public Prosecutor, Attorney-General's Chambers

Introduction

6.1 The year under review saw a significant decision on professional discipline in Ang Pek San Lawrence v Singapore Medical Council[2015] 1 SLR 436 (Lawrence Ang). In addition, in ACB v Thomson Medical Pte Ltd[2015] 2 SLR 218 (ACB), the High Court considered the public-policy laced issue of whether a claim for the maintenance of a healthy child conceived after a botched in-vitro fertilisation (IVF) procedure should be allowed.

Professional discipline

6.2 In Lawrence Ang, the disciplinary committee (DC) had convicted Ang of professional misconduct under s 45 of the Medical Registration Act (Cap 174, 2004 Rev Ed) for his failure to make arrangements to ensure that a neonatologist would be present at or placed on standby for the delivery of a patient's baby despite the fact that there were certain clinical indicators which, in the DC's view, suggested the need for such arrangements to be made.

6.3 The decision of the Court of Three Judges is significant because it lays down guidelines for the Singapore Medical Council (SMC) in the prosecution of medical professionals. Of these guidelines, three stand out for mention. First, the court reiterated the distinction first articulated in Low Cze Hong v Singapore Medical Council[2008] 3 SLR(R) 612 that s 45 of the Medical Registration Act embodies two limbs of professional misconduct, viz, (a) where there was a deliberate and intentional departure from the standards of medical practice observed or approved by competent and reputable members of the profession; and (b) where there was such serious negligence as to portray the abuse of the privileges of the profession. The court in Lawrence Ang elaborated that each limb entailed different and separate elements of inquiry and that this required disciplinary committees to be conscious as to which limb was being applied. In this case, the court criticised the DC for failing to identify the limb under which it was assessing the conduct of Ang. The court also emphasised that the standard of proof was higher than the civil standard of proof.

6.4 Second, the court made clear that convictions could not rest on generalised and ambiguous standards. In this case, the SMC attempted to justify the DC's decision by reference to good clinical practice. While recognising that the SMC Ethical Code and Ethical Guidelines may have adopted such language, this still required disciplinary committees to articulate what that meant in the specific context and circumstances...