Medical ethics refers to all of the obligations and duties relating to the practice of the medical profession. In other words, physicians have professional obligations that others do not have, and these cannot be ignored.
Physicians have always imposed personal obligations on themselves. But the obligations allowing them to collectively fulfill a social role have changed over time. One way to better understand the nature and scope of these changes is to recall what our profession is. In order to promote health in today’s world, all physicians must have medical expertise and utilize it for the service of others. They are allowed to regulate themselves so that their practice is free of all influences that would run counter to this social role.
In order to protect their professional independence, physicians need associations that promote not only expertise but also the development of personal qualities that have helped to make medicine a profession marked by humanism. “Virtues” such as loyalty, integrity, impartiality and respect for the individual traditionally associated with the medical profession are more necessary now than they ever were. Indeed, many prefer to use the term “professionalism” rather than medical ethics. There is now a whole tide in favor of medical professionalism.
Medical ethics unquestionably occupies an important place in Québec. While not attempting to prove this established fact on a theoretical level, this section will present the historical reasons which explain it. Since the creation of the College of Physicians and Surgeons of the Province of Québec over 150 years ago, all physicians have been obliged to be members of this corporation. Over the years, the College has put in place many mechanisms whereby it could ensure the competence of its members and oversee the conduct of their professional activities in an ever more effective manner.
The Code of ethics of physicians is not a stranger to the success of these interventions. It has always had the force of law in Québec; indeed, it has even been designed to be used for disciplinary purposes. In fact, physicians have progressively included in the Code—so that it could impose penalties—acts that do not meet the public’s expectations for all professionals, namely that they be competent, serve others and discipline themselves. This section will show that from one revised version to the next, the Code has been increasingly precise in defining the obligations of physicians toward patients, the community and the profession.
While the structure and functions of the Collège date back to a time when the professions were poorly understood, they comply with the mandates that have since been entrusted to professional orders: to verify the competence of its members and their aptitude to practice; to maintain their competence and oversee their practice; to examine the reasons for dissatisfaction concerning them, and to conduct inquiries and submit complaints to the Disciplinary Council. The government’s takeover of the health care system and the profound changes that characterized it did not mean the end of professional independence for Québec physicians. On the contrary, the professional system is still considered a vital part of the health care system, and the Collège remains the principal body guaranteeing the quality of care delivered by physicians.
The last section explains why physicians have had to create other associations to defend their interests. Within the Collège, physicians keep an eye on the evolution of obligations allowing them to pursue their social mission, which is to practice quality medicine to protect the public.