Private settlements do not erase misconduct in disciplinary cases: medical tribunal

ISLAMABAD: The medical tribunal in Islamabad has ruled that a private settlement between a complainant and a medical practitioner does not end disciplinary liability arising from professional misconduct, while upholding findings against a doctor who carried out a high-risk obstetric surgery without recognised specialisation in obstetrics and gynaecology.

The judgement, authored by tribunal chairman Safdar Saleem Shahid, came in an appeal against disciplinary action taken by the Pakistan Medical and Dental Council (PMDC) against a male practitioner. The tribunal partly modified the penalty by cutting the suspension of the doctor’s licence from three years to one year in light of mitigating circumstances, but it maintained the finding of professional misconduct.

In its ruling, the tribunal reaffirmed that doctors must work strictly within the limits of their recognised qualifications, training and professional competence. It held that the practitioner had failed to ensure documented informed consent on the possibility of hysterectomy before performing the procedure.

Misconduct distinct from negligence

A key aspect of the judgement is its distinction between professional negligence and professional misconduct. The tribunal observed that negligence generally relates to a breach of the standard of medical care resulting in harm, whereas professional misconduct covers violations of the ethical, statutory and regulatory duties governing the profession. It said such misconduct can justify disciplinary action even when actual physical injury has not been conclusively established.

The tribunal further held that PMDC disciplinary proceedings are regulatory in character and are meant to protect professional standards, patient rights and public confidence in healthcare institutions. On that basis, it rejected the argument that a later compromise between the parties should nullify the proceedings, holding that regulatory bodies perform a statutory function that goes beyond the interests of an individual complainant.

Consent and patient rights

The judgement stressed that informed consent is a substantive legal and ethical requirement rather than a mere administrative step. It said patients are entitled to adequate information about the nature of a proposed procedure, foreseeable risks, available alternatives and potential consequences before making treatment decisions affecting bodily autonomy and reproductive rights.

The tribunal also addressed broader concerns about patient safety at the facility where the procedure was performed. Referring to findings recorded by the Punjab Healthcare Commission, it noted shortcomings related to licensing requirements, maintenance of medical records, the availability of appropriately qualified staff and compliance with healthcare standards.

Institutional failures highlighted

The tribunal observed that unsafe healthcare outcomes may result not only from individual lapses but also from systemic institutional failures. It cautioned that healthcare facilities cannot be allowed to let practitioners undertake specialised procedures without proper credentialing, supervision and compliance with regulatory requirements.

In its concluding directions, the tribunal called on regulators to strengthen credentialing systems, improve enforcement of informed consent protocols, ensure maintenance and preservation of medical records, and enhance inspection mechanisms. The judgement is expected to serve as an important precedent in professional disciplinary jurisprudence.