PROFESSIONAL CODE OF

ETHICS AND DISCIPLINE:

FITNESS TO PRACTICE

“Promoting Quality Healthcare and Safeguarding

the Public is our Prime Concern”

2014
1.0 PREFACE

The Code of Conduct was last reviewed by the Council in 1995. Though most of the
provisions of the 1995 edition are relevant to date, it is necessary that these are updated
or indeed rephrased - in order to reinforce their relevance in the health profession. It is
in this context that this update is hereby made. As a consequence, the Code of Conduct
has been changed to Code of Ethics.

It is further recognised that the preparation of such a document by necessity, requires a

wider consultation and input particularly by individuals and professional associations
whose members will be directly affected by its content. Therefore, views at individual
level and as a professional grouping are encouraged in order to enrich and broaden its
applicability across all professions covered by the Act.

Part I of this Code of Ethics describes the statutory basis and machinery of the Council’s
jurisdiction in cases of professional misconduct and criminal offences. Part II deals
with various forms of misconduct that may lead to proceedings by the Disciplinary
Committee. Part III contains specific advice in certain areas of professional conduct.
Part IV describes the statutory basis and machinery of the Council’s jurisdiction in
relation to practitioners whose fitness to practice is adversely impaired by their physical
or mental illness.

This Code of Ethics applies to all health practitioners whose call to practice requires them
to register under the Health Professions Act No. 24 of 2009. As at 1st June, 2014 , there
were more than thirty (30) health Professions registrable under the Act. However, the
Act allows for emerging health professions to be registered after the recommendation
by the Council to the Minister of Health.

The Code of Ethics covers professional conduct of all the registered health professionals
apart from nurses who are covered under a different Act. The Code of Ethics further
covers all practitioners employed in the public and private sector including those in
faith based organisations (Mission health institutions).

It should be noted that this Code of Ethics outlines basic principles of professional
practice across the board. It is not a substitute for the specific Code of Ethics for the
various health professions registered by the Council. Codes of Ethics are “profession
specific” rather than generic. It is therefore, encouraged that as a matter of urgency,
individual health associations prepare and submit to the Council, their individual Codes
of Ethics in support of the implementation of the Health Professions Act No. 24 of
2009. These should be profession focused based on their scope of practice. It is always
important to remember that good professional practice is a prelude to the attainment of
a good reputation at individual level, improves patient/client outcome and contributes
to national development.

professional code of ethics and discipline: fitness to practice, 2014 i

Table of Contents

1.0 Preface.............................................................................................................................................i

3.0 Definition of terms.............................................................................................................................iii

4.0 The disciplinary processes of the council..................................................................................1

5.0 Professional misconduct which may lead to disciplinary proceedings....................2

5.1 Neglect or disregard by the health practitioner of his/her professional

responsibilities to his/her patients and clients under his/her care and
treatment.................................................................................................................................................2

5.2 Abuse of professional privileges or skills................................................................................4

5.3 Personal behaviour or conduct of the health practitioner derogatory to the

reputation of the profession ..........................................................................................................6

5.4 Improper advertising..........................................................................................................................8

5.5 Disparagement of professional colleagues............................................................................11

5.6 Ethical considerations on stigmatising conditions which disadvantage the

patient or Client...................................................................................................................................11

5.7 Participating in or conducting clinical or other health related research not

approved by the relevant ethics committee..........................................................................11

5.8 Relationships between the health professionals and the associated

industries...............................................................................................................................................12

5.9 Continuing professional development and supervision..................................................13

6.0 Fitness to practice...............................................................................................................................13

professional code of ethics and discipline: fitness to practice, 2014

3.0 DEFINITION OF TERMS

“Associated Industries” means commercial firms which manufacture or market

medicines, diagnostics, therapeutic agents or appliances.

“Council” means the Health Professions Council of Zambia as created under the Health
Professions Act No. 24 of 2009 of the Laws of Zambia..

“Conviction” means determination of an offence by a Court of Law in Zambia. A

conviction in itself gives the Disciplinary Committee jurisdiction even if the offence
did not involve professional misconduct. The Committee is however particularly
concerned with convictions for offences which affect a practitioner’s fitness to practice.
In considering convictions, the Council is bound to accept the Court ruling.

The phrase “Infamous Conduct in a Professional Respect” was defined in 1894 by Lord
Justice Lopes in the United Kingdom as follows:-

“If a medical man in pursuit of profession has done something with regard to it which
will be - reasonably regarded as disgraceful or dishonourable by his professional
brethren of good repute and competency, then it is open to say, that he has been guilty
of infamous conduct or professional misconduct in a professional respect.”

In another judgement delivered in 1930, Lord Scrutton stated -as below:- “Infamous
conduct in a professional respect means no more than serious misconduct judged
according to the rules, written or unwritten, governing the professional.”

In upholding the phrases in quote, the Health Professions Council of Zambia (HPCZ)
considers significant, that peers of proven good repute and competency should be
involved in the disciplinary processes of fellow peers.

“Controlled Medicines” means shall have the interpretation as defined in the Medicines
and Allied Substances Act No. 3 of 2013.

“Health Practitioner” means a person registered as a health practitioner in accordance

with the Health Professions Act No. 24 of 2009 of the Laws of Zambia.

“Informed Consent” means giving sufficient information in a way that patients can
understand, to enable them exercise their right to make informed decisions about their
care.

professional code of ethics and discipline: fitness to practice, 2014 iii

PART I

4.0 THE DISCIPLINARY PROCESSES OF THE COUNCIL

4.1 Statutory Provisions

Disciplinary powers are conferred on the Council by the Health Professions Act No. 24
of 2009 which established the Council and the Registers. The Council’s jurisdiction in
relation to professional misconduct and criminal offences is regulated by Sections 31
and 61 of the Health Professions Act No. 24 of 2009 and the Disciplinary Proceedings
(Rules). The Act under Section 31 (1) and (2) and Section 61 provides as follows:

4.2 Section 31

(1). A person shall not:-

(a) make or cause to be made an unauthorised entry, alteration or erasure in the

Register or a certified copy of an entry in the Register or a certificate of registration
or other certificate issued under this Act;
(b) impersonate or use the title of a registered health practitioner while not registered
as such under this Act;
(c) procure, or attempt to procure, registration under this Act, by fraud, false
representation or the concealment of a material fact;
(d) forge a certificate of registration or other certificate issued under this Act; or
(e) undertake to provide health care services in excess of the scope of practice
permitted for the registered health profession.

(2) A person, who contravenes subsection (1), commits an offence and is liable, upon
conviction, to a fine not exceeding seven hundred thousand penalty units or
imprisonment for a period not exceeding seven years, or both.

4.3 Section 61

A health practitioner commits professional misconduct if the health practitioner : -

(a) contravenes the provisions of this Act;

(b) unlawfully discloses or uses to the health practitioner’s advantage any information
acquired in the health practitioner’s practice;
(c) engages in conduct that is dishonest, fraudulent or deceitful;
(d) commits an offence under any other law;
(e) engages in any conduct that is prejudicial to the health profession or is likely to
bring it into disrepute; or
(f) breaches the Code of Ethics or encourages another health practitioner to breach
or disregard the principles of the Code of Ethics.

1 professional code of ethics and discipline: fitness to practice, 2014

PART II

5.0 PROFESSIONAL MISCONDUCT WHICH MAY LEAD TO DISCIPLINARY

PROCEEDINGS

In this Code of Ethics, professional misconduct offences which have in the past led to
disciplinary proceedings or which in the opinion of the Court could give rise to such
proceedings have been listed. However, this is not a complete set of offences. To do this
would be impossible, because from time to time and with changing circumstances, the
Council’s attention is drawn to new forms of professional misconduct.

It is important to note that any abuse by a health practitioner of any of the privileges
and opportunities afforded to the health practitioner or any grave dereliction of
professional conduct or serious breach of professional ethics may give rise to a charge
of professional misconduct.

Professional misconduct and personal behaviour which is of professional concern has

been grouped under the following headings:-

5.1 Neglect or disregard by the health practitioner of his/her professional

responsibilities to patients and clients under his/her care and treatment;
5.2 Abuse of professional privileges or skills;
5.3 Personal behaviour or conduct of the health practitioner derogatory to the
reputation of the health profession;
5.4 Improper Advertising;
5.5 Disparagement of professional colleagues;
5.6 Ethical considerations on stigmatising conditions which disadvantage the
patient or client;
5.7 Participation in or conducting clinical or other health research not approved
by the relevant Ethics Committee; and
5.8 Improper relationships between the health professionals and the Associated
Industries.
5.9 Continuing Professional Development and Supervision

5.1 Neglect or disregard by the health practitioner of his/her

professionalresponsibilities to his/her patients and clients under his/her care
and treatment;

(a) Responsibility to maintain standards of health care provision

Treatment, care and welfare of the patient or client should take into account the
patient’s/client’s needs, preference and confidentiality. Patients/clients should not be
discriminated on grounds of age, gender, marital status, education, medical condition,
national or ethnic origin, physical or mental disability, political affiliation, tribe, race,
religion or social status.

professional code of ethics and discipline: fitness to practice, 2014 2

Patients are entitled to access quality health care from health practitioners. -These
include:

(i) conscientious assessment of the history, symptoms and signs of the patient’s
or client’s condition;
(ii) thorough professional attention, examination and, where necessary,
diagnostic investigation;
(iii) competent and considerate professional management;
(iv) appropriate and prompt action upon evidence suggesting the existence of a
condition requiring urgent professional intervention;
(v) readiness, where the circumstances so warrant, to consult appropriate
professional colleagues; and

(b) Delegation of health care duties

(i) A health practitioner must at all times be mindful of his/her limitations

and the competences of his/her peer, and where necessary, recommend
additional service or opinion as long as this is in the interest of the patient or
client.

(ii) A health practitioner who delegates treatment or other procedures must be

satisfied that the person to whom he/she is delegating the duties is competent
to carry them out. It is important that the health practitioner should retain
ultimate responsibility for the management of the patient or client because
only the health practitioner has received the necessary training to undertake
this responsibility.

(iii) A health practitioner should not delegate professional duties to unqualified

person if such duties require the health practitioner’s personal knowledge
and skills.

(iv) A health practitioner who delegates the duties of signing certificates or

prescriptions must ensure that the person the health practitioner has
delegated such duties to is duly registered under the Health Professions Act. .

(c) Maintenance of standards

A health practitioner shall ;

(i) maintain basic equipment or appropriate standards of hygiene in the health

practitioner’s practice as directed by the Council;
(ii) conduct relevant investigations on a patient/client or, where necessary,
arrange for such investigations to be conducted by another health
practitioner;
(iii) assess a patient’s/client’s condition from such patient’s/client’s medical
history or clinical signs and where in doubt, to consult with, or to refer such
patient/client to another health practitioner;
(iv) keep, in English, clear and accurate records of clinical findings, decisions
made, treatment prescribed and advice given to patients or clients;

3 professional code of ethics and discipline: fitness to practice, 2014

 (v) allocate available resources to the promotion of good medical practice and
the maintenance of such health practitioner’s professional competence;
(vi) meet the standards of professional practice that are generally regarded as
appropriate by professional peers, locally or internationally;
(vii) Maintain high standards of probity in financial matters and ensure that
there are adequate systems to maintain and monitor good practice in
financial dealings;

A health practitioner shall not;

(i) Intervene in a patient’s/client’s treatment or treating a patient/client

without obtaining adequate informed consent from the patient/client
except in an emergency;
(ii) Perform, except in an emergency, a professional act for which the health
practitioner is inadequately trained or is insufficiently experienced or
which is not within such health practitioner’s professional competence;
(iii) perform, except in an emergency, a professional act under improper
conditions or in inappropriate surroundings;
(iv) Give advice or information to a patient/client or patient’s/client’s relative
in an unprofessional manner or offering unnecessary professional service
to a patient/client for a health practitioner’s direct or indirect personal
gain;
(v) Issue a false or inaccurate medical report;
(vi) Accept a commission from a person or another health practitioner in
return for the purchase, sale or supply of any goods, substances or materials
used by the health practitioner in the conduct of the health practitioner’s
professional practice;
(vii) Share fees with any person or health practitioner who has not taken
a commensurate part in providing the services for which those fees are
charged;
(viii) Charge or receive fees for services not personally rendered except for
services rendered by another health practitioner with whom such health
practitioner is associated as a partner, shareholder in a company or locum
tenens;
(ix) Wilfully neglect , abandon or refuse to attend to a patient/client entrusted
into a health practitioner’s professional care to such an extent that the
neglect or refusal is not in the best interest of the patient/client;
(x) Discriminate in the management of patients/clients based on the
patient’s/client’s lifestyle, culture, beliefs, race, sex, sexuality, disability,
age, ethnicity, social or economic status.

5.2 Abuse of professional privileges or skills

(a) Abuse of privileges conferred by law; misuse of professional skills

A health practitioner must undertake to discharge his/her professional duties

diligently and in a manner that best considers the welfare of the patient/client.

professional code of ethics and discipline: fitness to practice, 2014 4

(i) Prescribing and supply of controlled medicines

 The prescribing and supply of controlled medicines is reserved to members

of the health profession and certain other authorised professionals. The
prescribing and supply of such medicines is subject to statutory restrictions.
It is professional misconduct to prescribe or supply controlled medicines
other than in the course of bona fide treatment. Any practitioner who
contravenes any provisions of the following Acts, shall commit professional
misconduct;
 The Medicines and Allied Substances Act of the Laws of Zambia-; and
 The Narcotic and Psychotropic Drugs Act of the Laws of Zambia.

(ii) Medical Certificates

A health practitioner’s signature is required by statute on certificates for a variety

of purposes on the presumption that the truth of any statement which a health
practitioner may certify can be accepted without question. A health practitioner is
accordingly expected to exercise care in issuing certificates and similar documents,
and he/she should not certify statements which he/she has not taken appropriate
steps to verify.

A health practitioner who, in a professional capacity, signs any certificate or similar

document containing statements which are untrue, misleading or otherwise
improper shall be liable to disciplinary proceedings.

(iii) Termination of Pregnancy

Termination of pregnancy is regulated under the Termination of Pregnancy Act CAP

304 - of the Laws of Zambia. A conviction under this Act in circumstances which
contravenes the Act in itself shall afford a ground for disciplinary proceedings.

(b) Abuse of privileges in personal circumstances

As health practitioner must practice the art and science of his/her profession
conscientiously. A health practitioner must avoid a patient/client relationship
which could impair professional judgement especially, in the areas of familial, social,
financial, business or close personal relationship.

Patients or clients grant health practitioners privileged access to their homes

and confidences, and some become emotionally dependent upon their health
practitioners. Good professional practice depends upon the maintenance of trust
between the health practitioners and the patients or clients and their families,
and the understanding by both that a proper professional relationship will be
strictly observed. In this situation, health practitioners must exercise great care and
discretion not to damage this crucial relationship and trust. Any action by a health
practitioner which breaches this trust will constitute professional misconduct.

5 professional code of ethics and discipline: fitness to practice, 2014

Three particular areas identified in which this trust may be breached;

(i) Improperly disclose information which he/she obtained in confidence from

or about a patient or client;
(ii) Exerting improper influence upon a patient or client to lend him/her money
or given other favours;
(iii) Entering into an emotional and/or sexual relationship with a patient/client
or with a member of a patient’s/client’s family which disrupts the patient’s/
client’s family life or otherwise damages, or causes distress to the patient/
client or the patient’s family.

It should be noted that the Council is not concerned with personal relationships
between the health practitioner and other persons but only with the personal
relationships established between the health practitioner and the patient or the close
relatives of the patient. The Council considers it professional misconduct for a health
practitioner who uses his/her professional position in order to pursue or advance a
personal relationship of an emotional or sexual nature with a patient or close relative
of a patient.

The Council is also aware that health practitioners are sometimes caused undue
anxiety by unsolicited declarations of affection by patients or clients or threats that
a complaint will be made on the grounds of a relationship which existed only in the
patient or client’s imagination. All complaints received by the Council are screened
most carefully and action is taken only when the evidence collected is sufficient to
warrant disciplinary proceedings.

The health practitioner has a duty to avoid any action which might disturb the
confidence of the patient/client in any health practitioner or in the health profession
as a whole. The professional relationship between the health practitioner and his/
her patient/client depends on trust and the assumption that the health practitioner
will act in the best interests of the patient/client. Patients deserve full respect in all
areas of their personality (physical, psychological, spiritual, financial, and social) and
the health practitioner should aim at rehabilitating them to their full state of human
dignity.

Acts of indecency or dishonesty or other acts involving abuse of professional privileges

will render the health practitioner liable to disciplinary proceedings for misconduct.

5.3 Personal behaviour or conduct of the health practitioner derogatory to the

reputation of the profession.

A health practitioner should observe proper standards of personal behaviour, not

only in professional activities, but at all times. This is the reason why the conviction
of a health practitioner for any offence may lead to disciplinary proceedings even
if the offence is not directly connected with the health practitioner’s profession. In
particular, four areas of personal behaviour can be identified which may occasion
disciplinary proceedings. These are:- personal misuse of alcohol or substance abuse,
indecent and/or unprofessional dressing, dishonest behaviour or corrupt practices,
and indecent or violent behaviour.

professional code of ethics and discipline: fitness to practice, 2014 6

(a) Personal misuse of alcohol or substance abuse

Convictions for drunkenness or other offences arising from misuse of alcohol or other
substances indicate habits which are discreditable to the profession and may be a source
of danger to the health practitioner’s patients/clients. A health practitioner who treats
or attends to a patient or client, or performs other professional duties while he/she
is under the influence of alcohol or other substances of abuse, is liable to disciplinary
proceedings.

(b) Indecent and/or unprofessional dressing

A health practitioner is expected to be dressed respectably and should be adequately

covered in prescribed uniform or according to the given dress code provided that such
dressing will not be adjudged to be offensive, provoking, revealing private body parts;
sagging trousers, mini-skirts, tight trousers and other similar unprofessional attires.
Indecent and/or unprofessional dressing, which has come to the attention of the
Council, may attract disciplinary action.

(c) Dishonest behaviour or corrupt practices

A health practitioner is required to uphold honest behaviour at all times. A health

practitioner is liable to disciplinary proceedings if he/she:-

(i) is convicted of criminal deception (obtaining money or goods by false

pretences), corruption, forgery, fraud, theft or any other offence involving
dishonesty;
(ii) commits dishonest acts in the course of the health practitioner’s professional
duties or against his patients/clients or colleagues;
(iii) improperly demands or accepts fees from a patient or client in circumstances
contrary to laid down regulations (institutional policies) or if the health
practitioner knowingly and improperly obtains any payment to which he/
she is not entitled;
(iv) issues prescriptions without following prescription procedure .
(v) participates in the manufacturing and supplying of counterfeit or
substandard medicines or medical equipment and allied substances to
persons or institutions.
(vi) practises without a valid practicing licence or practices in an unregistered
health facilities; or in partnership or association with a person not registered
under the Act;
(viii) involves himself/herself in corrupt practices or forgery
(ix) practises under the influence of alcohol or other intoxicating liquor or drug;
or personally misuses alcohol or other drugs.

(c) Indecent or violent behaviour

Health practitioners are expected to behave in ways acceptable for the conduct of their
profession. Indecent or violent behaviour on a patient or client or fellow or colleagues
is regarded as professional misconduct. Any conviction for indecency or assault would
warrant disciplinary proceedings, and would be regarded with particular gravity if the

7 professional code of ethics and discipline: fitness to practice, 2014

offence was committed in the course of the health practitioner’s professional duties.
This includes verbal abuse.

Therefore, a health practitioner shall not:

(i) Display indecent or violent behaviour towards patients/clients or their

relatives or towards professional colleagues;

(ii) Be involved into verbal abuse, assault or battery towards professional

colleagues, patients/clients or their relatives.

(d) Maintaining Professional Confidence

It is a health practitioner’s duty to strictly observe the rule of patient/client confidentiality

by refraining from disclosing voluntarily to any third party information which he/she
has learned directly or indirectly in his/her professional relationship with the patient
or client. The death of the patient or client does not absolve the health practitioner from
the obligation to maintain confidentiality. Divulging information regarding a patient/
client which has come to the practitioner’s knowledge during his/her course of duty is
deemed professional misconduct.

However, the following are exceptions to this principle, if the :

(i) Patient or next of kin or patients legal advisor gives express, informed,
written, or verbal consent. In case of a minor, the written or verbal consent
of a parent or guardian.
(ii) Information is required by law;
(iii) Information regarding a patient or client’s health is given in confidence to
a relative or other appropriate person, in circumstances where the health
practitioner believes it is undesirable on medical grounds to seek the patient
or client’s consent;
(iv) Disclosure is in the public interest
(v) Information may be disclosed for the purpose of a medical or health research
project. In such a case the project should have been approved by a recognised
Ethics Committee appointed for such a purpose and that the participant
consented to the disclosure of such research information.
(vi) In the health practitioner’s opinion, disclosure of confidential information to
a third party is in the best interest of the patient.

5.4 Improper Advertising

Professional conduct in relation to advertising of health services or one’s professional

status is regulated by this Code of Ethics.. This Code of Ethics provides that any level of
advertising must not contain false, inaccurate, misleading or incomplete information
either on the services provided or on the individual professional status and neither
should it be self-promotional.

This part of the Code sets out the reasons why advertising by the health practitioner
may be undesirable and may in some cases be regarded as professional misconduct.

professional code of ethics and discipline: fitness to practice, 2014 8

The following paragraphs highlights various circumstances in which questions of
advertising most commonly arise.

The Council states that health practitioners should refrain from self-promotion,
because the health practitioner who is most successful at achieving publicist may not
be the most appropriate to consult. Furthermore, people with health problems are
often particularly vulnerable to persuasive influence. In such circumstances the use of
promotional advertising is not only the breach of professional Code of Ethics but could
be a source of danger to the public, in extreme cases, raising illusory hopes of a cure.

In order to make an informed choice of a health practitioner to consult, prospective

patients/clients need to have ready access to accurate, comprehensive, well presented
information about the health practitioners in their geographical areas.
The following acts by a health practitioner or a facility on the issuance of notices or
announcements by the health practitioner and health facilities shall be deemed
acceptable forms of advertising:

(a) Posters, fliers and brochures

Notices or announcements in form of posters or sign posts of such health practitioners,

including factual information about their names, profession, qualifications, field of
practice, scope of services available, consulting hours, contact details (phone number,
email) may be distributed for the benefit of the members of the public in their areas.
Such information may be displayed at the health practitioners’ health facility. The
maximum size for the poster or sign post shall not exceed 1.5m x 1m. Within the facility
premises, one poster or sign post shall be displayed at all points of entry.

It is acceptable for health practitioners to inform patients/clients and their colleagues

of their services and practice arrangements provided the material circulated makes no
claim as to the quality of the service of the health practitioner, personal qualities and
level of performance. Such material may be made available for issue individually to
existing patients/clients at the health practitioner’s health facility in form of fliers or
brochures and may be made available to persons about health practitioners’ services
but should not be distributed to un-soliciting persons and should not be released in bulk.

(b) Print and electronic media

The publication of notice in the print or electronic media containing factual information
about the health practitioner’s names, profession, qualifications, registration number,
field of practice, scope of services available, consulting hours, contact details (phone
number, email).

(c) Articles, books and broadcasting

Broadcasting of articles and publishing of books properly indicating the health

practitioner’s name as an author and indicating professional standing. Similarly
health practitioners possessing necessary knowledge and skills may participate in
the presentations and discussions of health topics through the media or before the lay
audiences provided no information about a health practitioner’s professional standing
is presented in such a way as to imply that he/she is the only best or most experienced

9 professional code of ethics and discipline: fitness to practice, 2014

person practicing in that particular field. Any reference to publications by the health
practitioners whether forthcoming or past should be factual.

Health practitioners who regularly write in magazines, journals or newspapers

addressed to the public, articles or columns offering advice on common health conditions
or problems or who are involved in regular service or televisions or radio programmes
dealing with such matters. In such circumstances the practitioner should not take undue
advantage by advertising themselves or colleagues through the programme or article.

(e) General Notices by Practitioners or Health Facilities

The following services shall be acceptable by health practitioners and health facilities:
 The advertising of employment opportunities in relevant professional
journals in daily newspapers.
 The sharing of information between professional colleagues which relates to
services they offer, practice arrangements, details of fees and charges.
 Specialists providing information to professional colleagues informing them
of the services they offer and of their practice arrangements including the
details of fees and charges.

However, the health practitioners shall not:

(i) Advertise the services in manner that both the contents of the advertisement
and method of presentation is incompatible or contrally with acceptable
forms set out in this Code of Ethics.
(ii) Arrange for or agree to any publication or broadcasting of information which
improperly draws attention to the title of professional attainment of a health
practitioner, the quality of services offered, such health practitioners prices,
which would cause persons to believe that the health practitioner has special
abilities when compared with other practitioners;
(iii) Publish material or air a radio programme in a manner likely to attract
patients to the health practitioners’ financial benefits or to encourage patients
to refer themselves directly to such practitioners;
(iv) Personally or through his/her agent use the circulation of such material to
gain advantage over local colleagues or to canvas their patients/clients.
(v) Publish information about a health practitioner’s professional standing in
such a way as to imply that he is the only best or most experienced person
practicing in that particular field.
(vi) Release materials to un-soliciting persons in public places
(vii) Agree to be paid or remunerated based on the number of patients solicited to
the health facility.
(viii) In communication addressed to the lay public, using or permitting the use
of his/her professional qualification as an advertisement for the organisation
or being personally involved in advertising its services.
(ix) Accept any pecuniary, material or any other inducement from
pharmaceutical industry or any other industry which might compromise,
or be regarded as likely to compromise, the independent exercise to their
professional judgement in prescribing matters. However, monetary grants

professional code of ethics and discipline: fitness to practice, 2014 10

 or equipment donated to the health facilities for the benefit of large majority
of the patients may be acceptable provided the facility is not compelled or
induced to procure items from the pharmaceutical industry or any other
industry.

In the event that the case is not clear, the Council shall determine if professional
misconduct was committed.

5.5 Disparagement of professional colleagues

(i) A health practitioner has a duty, where the circumstances so warrant, to

inform the Council about a professional colleague whose behaviour may
have raised a question of professional misconduct, or whose fitness to practise
may be seriously impaired by reason of a physical or mental illness. Similarly,
a health practitioner may also comment on the professional performance of a
colleague in respect of whom the health practitioner acts as a referee.
(ii) It is not acceptable for a health practitioner to disparage, whether directly or
by implication, the professional skill, knowledge, qualifications or services of
any other health practitioner irrespective of whether this may result in his/
her own professional advantage.

Failure to report any un-acceptable conduct of a colleague which the health practitioner
is privileged to be aware of will be considered unprofessional.

5.6 Ethical considerations on stigmatising conditions which disadvantage the patient

or client.

(i) A health practitioner should not refuse to treat or attend to a patient/client

if the condition is within the health practitioner’s competence, solely on the
grounds that the patient/client is or may be - having a stigmatising medical
condition.

(ii) In order to prevent transmission of communicable conditions within the

health care system, a health practitioner must apply stringent precautionary
measures that help to protect and prevent the spread of communicable
diseases between patients/clients and other health care workers; in addition,
a health practitioner must take special care in the disposal of contaminated
materials including sharps.

(iii) A health practitioner shall not conceal his/her own illness which could
endanger patients/clients and professional colleagues.

5.7. Participating in or conducting clinical or other health related research not

approved by the relevant Ethics Committee.

When required to participate in any research involving human participants, a health

practitioner must ensure that there is a written and approved research protocol with
defined lines of scientific supervision from a relevant Ethics Committee. A practitioner
must ensure that Research participants are sufficiently protected and that their

11 professional code of ethics and discipline: fitness to practice, 2014

participation in the research is based on informed consent.

Relative probability of harm and benefits must also be adequately explained to all the
participating human participants including their proxy. A health practitioner shall
ensure :

(i) That the research is approved by established institutional and professional

bodies.
(ii) The protection of the protection of the rights of human study subjects and
to conform to recognised medical norms and guidelines of the profession
related to research.

5.8. Relationships between the health professionals and the Associated Industries

Notwithstanding the beneficial relationship between the health profession and the
Associated Industries in terms of research, and the consequent development of new
drugs or diagnostic equipment of therapeutic value, their production and distribution
for clinical use, the medical practice owes much to the industries for the facilitation of
medical/health research and post graduate education of health practitioners through
financial support from associated industries.

The necessity of advertising and other forms of sales promotion by individual firms
within the associated industries is appreciated to enhance their commercial viability
and provision of relevant information.

A health practitioner should not only choose but shall also be seen to be choosing the
drug, appliance or goods which, in his/her independent professional judgement and
having due regard to economy, will best serve the medical/health interest of his/her
patient/client.

Health practitioners should therefore, avoid accepting any pecuniary or material

inducement which might compromise, or be regarded as likely to compromise, the
independent exercise to their professional judgement in prescribing matters.

The seeking and/or acceptance by health practitioners of unreasonable sums of

money or gifts from commercial firms which manufacture or market medicines or
diagnostic or therapeutic agents or appliances may be regarded as improper. Examples
of inducements which the Council may regard as improper are set out below:

(a) Clinical trials of medicines

It may be improper for a health practitioner to accept per capita or other payments from
a pharmaceutical firm or associated in relation to a research project such as the clinical
trial of a new drug, unless the payment has been specified in a protocol of the project
which has been approved by the relevant national or local Ethics Committee. It may be
improper for a practitioner to accept per capita or other payments under arrangements
for recoding clinical assessments of a licensed medical product, whereby he/she is
asked to report reaction which he/she has observed in patients/clients for whom he/she
has prescribed the drug, unless the payments have been specified in a protocol for the

professional code of ethics and discipline: fitness to practice, 2014 12

project which has been approved by the relevant national or local Ethics Committee.

It is improper for a health practitioner to accept payment in money or kind which could
influence his/her professional assessment of the therapeutic value of a new drug.

(b) Gifts and loans

It may be improper for an individual health practitioner to accept from a associated

industries monetary gifts or loans or expensive items of equipment for his/her personal
use. Exception can, however, be taken to grants of money or equipment by firms to
institutions such as health facilities, training institutions, when they are donated
specifically for the purposes of research.

(c) Acceptance of hospitality

It may be improper for an individual health practitioner or groups of health practitioners

to accept lavish hospitality or travel facilities under the terms of sponsorships of
postgraduate meetings or conferences. However, exception is likely to be taken to
acceptance by an individual health practitioner of a grant which enables him travel to
an international conference or to acceptance, by a group of practitioners who attend
a sponsored postgraduate meeting or conference or hospitality at an appropriate level
which the recipients might normally adopt when paying for themselves.

(5.9) Continuing Professional Development and Supervision

It is expected that health practitioners are kept abreast with the current trends in their
scope of practice. The health practitioners have also an obligation to supervise their
colleagues and mentor students who have been placed under their charge. Therefore, a
health practitioner shall:

i. Upgrade such skills and knowledge as appropriate to the health practitioner’s

scope of practice as required by the Council;
ii. Provide an honest and objective appraisal or assessment of the performance
of any health practitioner under such health practitioner’s supervision or
any student undergoing training under such health practitioner;
iii. Adequately supervise junior health practitioners under their responsibility.

6.0 FITNESS TO PRACTICE

When a health practitioner’s fitness to practice is adversely impaired by reason of a

physical or mental illness in such a way that it imperils patients/clients, embarrasses
professional colleagues or indeed jeopardises professional position, the Disciplinary
Committee may liaise with the Specialist and Impaired Practitioners Committee in
suspending the practitioner’s registration or attach conditions to it after the provisions
of the Disciplinary Proceedings (Rules) have been followed.

This measure shall be undertaken to protect the public and safeguard the reputation of
the profession.

13 professional code of ethics and discipline: fitness to practice, 2014

 0211 221898, 0977702977
Published by:
Health Professions Council of Zambia,

zambia limited
P.O Box 32554,
Dental Training School Premises, Wamulwa Road,
Thornpark, Lusaka.
Tel: (260-1) 236241,
Fax: (260-1) 239317
Email: [email protected]
Website: www.hpcz.org