A panel headed by Justice Judith Prakash yesterday issued sentencing guidelines to help the medical profession "arrive at fair and consistent sentencing decisions", said the Singapore Medical Council (SMC).
The committee was one of two set up last year to improve the SMC's disciplinary process. It comprised four lawyers, six doctors and a representative each from the ministries of health and law. The other committee was to speed up disciplinary processes.
The SMC as medical watchdog metes out punishment to errant doctors. Its disciplinary tribunals (DTs) usually comprise two doctors and one lay person or legally trained person.
Explaining the need to review the process, Health Minister Gan Kim Yong told Parliament in April last year that there had been some unfair penalties from the DTs.
"Some sentences are not commensurate with the circumstances of the case," he said.
"Despite their best efforts, some DTs are too lax while others are too draconian, and the SMC has had to appeal to the court against the sentences meted out."
A number of DT judgments had been overturned by the Court of Three Judges on appeal.
The 54-page guidelines explain when tribunals need to mete out more severe penalties and when they should be lighter. It gives some real examples as references.
When a doctor is found guilty by a DT, sentencing options range from counselling, censure and fines, to suspension and striking the doctor's name off the medical register so he can no longer practise.
A doctor is sentenced for wrongdoing in order to:
• Uphold people's faith in doctors
• Protect people's health, safety and well-being
• Act as a general deterrence by making an example of a doctor
• Stop a particular doctor from re-offending. This is particularly applicable for recalcitrant doctors
• Retribution to punish a doctor guilty of misconduct
• Rehabilitation in less serious cases, if the doctor is amenable to reform
Of all the objectives, public interest is paramount, the guide states. It said a sentence might appear excessive given the offence, but might be "warranted from a public interest perspective".
Harm, it said, is not just bodily injury, but also emotional or psychological distress, serious economic harm, increased pre-disposition to certain illnesses, dependence or tolerance of addictive drugs, loss of chance of recuperation, or death.
It said fines should be for minor offences or in addition to another penalty where a doctor had profited from the misconduct. Fines could also be used where a suspension has no impact, for example if the doctor is no longer practising.
A suspension is merited "when the misconduct is serious and unbefitting of a doctor". As it is a serious sanction, it does not recommend a suspension of a nominal period.
Striking a doctor off the medical register is for the most serious cases, such as flagrant abuse of position, if he caused grave harm to patients or society, if the misconduct indicates a serious character defect, or for sexual offences.
An important reason for striking a doctor off is dishonesty - even if the offence does not involve his practice or patients. However, mitigating factors include the extent of the deception, the reasons for it and if actual harm was caused.
The guidelines state that seniority or the eminence of the offender is an aggravating, and not a mitigating, factor.
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