Medical Ethics Code: an Analysis from Ethical-Disciplinary Cases Against Medical Professionals within the Specialty of Psychiatry

Abstract

Objective: To identify the nature of infractions committed by doctors working within the field of psychiatry, between 2010 and 2016, from the scope of appeals within ethical-disciplinary cases judged at the Plenary Tribunal of the Federal Medical Council, based on the medical ethics code, and to list some elements that make it possible to outline the professional profile of those involved. Method: This was a document-based investigation in the form of a retrospective and descriptive study. Data were gathered using the Federal Medical Council (CFM) database and from consultation of judgments issued by the Plenary Body of the Medical Ethics Tribunal (TSEM), of the CFM. The investigation used a sample consisting of 206 appeals and 19 referrals, totaling 224 appeals by doctors who underwent trials. We took into account cases judged between April 13, 2010 and August 3, 2016. Three databases were used in the investigation: cases (224); doctors facing charges (191) and cases/penalties (146). Based on the records of the 191 doctors charged, the ethical-disciplinary cases of seven doctors working in psychiatry were analyzed specifically for the present study, whether or not they had a specialist title. Characterization of infractions committed encompassed references to the articles of the medical ethics code most frequently infringed in the field of psychiatry, along with a survey of the motives for these infractions and some characteristics relating to these professionals’ profile. Results: Among the findings from this investigation, infractions of the articles of the medical ethics code can be highlighted, such as article 30 “[...] Use of the profession to corrupt customs and to commit or favor crime [...]” and article 40 “[...] Taking advantage of situations arising from the doctor-patient relationship to obtain physical, emotional, financial or any other advantage [...]”. The professional profile of those involved in these cases was also shown: the average age was 49.8 years, and all of these professionals were male. The mean length of time since graduation among the psychiatrists with appeals to the plenary body of the TSEM was 31.28 years at the time of judgment. The punishment handed down most frequently was to strike these professionals off the register, reaching the percentage of 42.9%. Among the five professionals with specialist titles, four complemented their studies with specializations, after the episode that originated the ethics charges.  Conclusion: The data gathered showed that the professionals were punished for irregularities in the sphere of ethics, including issues going beyond technical and/or scientific competence. This makes it possible to highlight that punishments proportional to the seriousness of the infraction act were applied, along with the importance of bioethics in medical training and the need for specialization, from the results of the judgments on ethical-professional cases before the plenary body of the TSEM.