ETHICS OF THE MEDICAL PROFESSION REGULATIONS

SUBSIDIARY LEGISLATION 464.17

ETHICS OF THE MEDICAL PROFESSION

REGULATIONS

18th November, 2008

LEGAL NOTICE 303 of 2008, as amended by Legal Notice 249 of 2025.

(1) The title of these regulations is the Ethics of the

Medical Profession Regulations.

(2) The scope of these regulations is to inform the practitioners

of the particulars of the professional and ethical standards adopted

by the Council and of certain forms of conduct which may be held

by the Council to constitute misconduct in a professional respect.

Amended by

L.N. 249 of 2025.

(Regulation 22)

ETHICS OF MEDICAL PRACTITIONERS

1. (a) The Medical profession occupies a position of trust in society. A

doctor’s calling is to serve humanity under all conditions. Members of

the profession have built up a tradition of placing the needs of the

patient above all else.

(b) On admission to the medical field every new member not only succeeds

to benefit of its special place in society, but also takes upon himself the

duty of maintaining this high position. The justification for the freedom

of medicine lies in the hands of those who practise it.

2. In all matters bearing on faith or morals the catholic member of the

profession shall abide by the tenets of the Roman Catholic Apostolic Religion in

terms of article 2 of the Constitution.

3. The attention of members of the medical profession is drawn to the General

Notice issued by the Medical Council for the guidance of member s of the

professions upon which it exercises disciplinary jurisdiction.

4. In addition to the requirements of the Medical Council, there are customs

and ethical rules which are observed by the profession as a code of conduct. The

endless number of situations that might and do arise in the course of professional life

cannot be all specifically covered by any set of rules. The following rulings are

accepted as covering the major and the more common features of professional life

and will serve to illustrate the principles of behaviour. These principles can and

should be applied to such other problems and situations as may arise.

5. A doctor shall by his conduct and in all matters set a high standard.

6. A doctor in the pursuit of his profession must not allow himself to be

influenced by motives of profit.

7. A doctor shall neither instigate nor condone any advertisement relating to

his professional status of work. (Also see circular MC/435/93 of 1.10.1993 relating

to the publication of announcements about career and academic achievements.)

8. A doctor shall not accept conditions of service which do not ensure his

professional independence. (Also see circular MC/145/93 of 22.2.1993 on

safeguarding professional independence.)

9. A doctor shall not in any circumstances do, authorise to be done or condone

anything that would weaken the physical or mental resistance of a human being,

except for the prevention and treatment of disease.

10. A doctor must always bear in mind the importance of preserving human life

from the time of conception until death.

11. (a) A doctor shall not hesitate to propose or to accept consultation with a

professional colleague when, for any reason, this appears to be desirable

in the interest of the patient. The attendance of a consulting practitioner

shall cease when t he consultation is conclude d, u nless another

appointment is arranged by the medical attendant.

(b) When a consultant sees a patient in his rooms at the request of his

medical attendant, it is his duty to write to the latter stating his opinion

on the case and the mode of treatment which he thinks should be

adopted.

(c) Whenever an irreconcilable difference of opinion between practitioners

occurs, the circumstances should be frankly and impartially explained

to the patient or his relatives either by the consultant or by the medical

attendant in the presence of the former.

(d) When it becomes the duty of a practitioner occupying an official

position to see and report on a case of illness or injury, he should

communicate with the patient and inform him that he is entitled to ask

his practitioner to be present during the examination. The practitioner

who is officially reviewing the case shall scrupulously avoid any

interference with, or remarks on, the treatment or diagnosis that has

been adopted. (Also see circulars MC/145/93 of 22.3.1993 and MC/180/

99 of October 1999 on clarifying the procedure to be adopted during

such visits.)

12. (a) A medical practitioner shall not voluntarily disclose without the consent

of the patient, preferably to be given in writing, any information,

including any certification, which he has obtained in the course of his

professional relationship with the patient. An exception to this rule may

only be made in terms of the requirements of local laws.

(b) The Council may investigate any conviction under this provision and if it

deems necessary, the said Council shall initiate disciplinary proceedings

before the Disciplinary Committee in accordance with the Disciplinary

Proceedings Regulations.

13. (a) When the medical practitioner is requested to attend a patient who is

already under the care of another practitioner, where the case is not one

of emergency, he shall decline to do so except in consultation with the

practitioner in attendance or in cases where the consultation is not

agreed to, until the practitioner in attendance has been informed,

preferably in writing, that his services are no longer desired.

(b) A medical practitioner who has been called upon in an emergency to

visit a patient who, under ordinary circumstances, would have been

attended to by another practitioner, shall, after the emergency has been

provided for, retire in favour of the ordinary medical attendant but shall

still be entitled to charge the patient for his services.

(c) When a practitioner is consulted in his own office, it shall not be

necessary for him to enquire whether the patient is under the care of

another practitioner.

14. It is desirable that the family doctor be present during operations and in that

case he shall charge a fee for his attendance. If he assists, his fee shall be included in

the fee for the operation and the patient or his family will be informed accordingly.

15. A medical practitioner shall not circulate professional cards to chemists or

opticians; nor should he have any salary or commission or any other arrangement

with a chemist or optician; he shall not have any financial interest either directly or

indirectly in a local chemist’s shop.

16. In respect of -

(a) untrue certification or report;

(b) covering and association with unqualified or unlicensed persons;

(c) contravention of the Dangerous Drugs Ordinance (Cap. 101) and

regulations made thereunder;

(d) advertising, canvassing, lectures, broadcasting, etc.,

the attention of members of the medical profession is drawn to the General Notice

mentioned in paragraph 3 hereof issued by the Medical Council and published in the

Government Gazette of the 23rd June, 1981, with amendments as published in the

Government Gazette of the 27th January, 1984.

For the purposes these regulations

"the Act" means the Health Care Professions Act;

"practitioner" means a medical practitioner or dental surgeon

registered under the Act;

"the registers" means any of the registers mentioned in articles

11 and 12 of the Act.

(Regulation 22)

ETHICS OF DENTAL PRACTITIONERS

1. The attention of members of the dental profession is drawn to the General

Notice issued by the Medical Council for the guidance of member s of the

professions upon which it exercises disciplinary jurisdiction, published in the

Government Gazette of the 23rd June, 1981, with amendments as published in the

Government Gazette of the 27th January, 1984.

2. In respect of -

(a) abuse of a professional relationship;

(b) convictions;

(c) untrue certification and reports;

(d) advertising, canvassing, broadcasting, etc.;

(e) contravention of the Dangerous Drugs Ordinance (Cap. 101) and

regulations made thereunder;

(f)

covering;

(g) commissions;

(h) dichotomy;

(i)

undercutting; and

(j)

professional secrecy,

the attention of members of the dental profession is drawn to the General Notice

issued by the Medical Council and mentioned in paragraph 1 hereof.

3. Wherever the word "practitioner" is used in this Notice, it means a dental

surgeon or a dentist.

4. (a) A practitioner shall not hesitate to propose or to accept consultation

with a professional colleague when, for any reason whatsoever, such

consultation appears to be desirable in the interest of the patient. The

attendance of a consulting practitioner shall cease when the consultation

is concluded unless another appointment is arranged by the attending

practitioner.

(b) When a practitioner sees a patient in his rooms at the request of his

medical attendant or of another practitioner, it shall be his duty to write

to the latter stating his opinion on the case and the mode of treatment he

thinks should be adopted.

(c) Any difference of opinion should not be divulged unnecessarily; but

when there is an irreconcilable difference of opinion, the circumstances

should be frankly and impartially explained to the patient’s relatives. It

would then be open to them or to him to seek further advice, either

preferably in consultation with the person who is already in attendance

or with the medical attendant or practitioner only.

(d) When it becomes the duty of a practitioner occupying an official

position to see and report on a case of illness or injury, such practitioner

should communicate with the patient informing him that he is entitled to

ask his practitioner to be present during the examination. The

practitioner who is seeing the case officially shall scrupulously avoid

interference with, or remarks on, the treatment or diagnosis that has

been adopted.

5. A practitioner must not disclose voluntarily, without the consent of the

patient,preferably in writing, information, including certification which he has

obtained in the course of his professional relationship with the patient. Exception to

this rule is made only by the requirements of the local laws.

6. (a) When a practitioner is requested to attend to a patient who is already

under the care of another practitioner and where the case is not an

emergency, he shall decline to do so, except in consultation with the

practitioner in attendance, or in case the consultation is not agreed to,

until the practitioner in attendance has been informed, preferably in

writing, that his services are no longer required.

(b) A practitioner called in an emergency to visit a patient, who under

ordinary circumstances would have been attended to by another

practitioner, shall, when the emergency has been provided for, retire in

favour of the ordinary practitioner, but shall still be entitled to charge

the patient for his services.

(c) When a practitioner is consulted at his own office, it shall not be

necessary for him to enquire whether the patient is under the care of

another practitioner, but if that fact shall transpire, the interest of the

patient for courtesy may require that the practitioner or medical

attendant be informed of the consultation and its results.

7. (a) No practitioner shall accept a commission or consideration for the

introduction of a patient to a consultant, to a private hospital or other

institution, or to a medical practitioner, chemist, nurse, midwife or other

person or company and he shall not pay a consideration for the

introduction of patients to himself.

(b) A practitioner shall not participate in any division of sharing of fees of

which the patient is not aware, excluding a normal dental clinic

partnership, and this shall apply to consultations between practitioners

or medical practitioners.

8. A practitioner shall neither instigate nor condone any advertisement relative

to his professional status or work.

9. The professional conduct of a dental practitioner is guided by principles

essentially similar to those adopted by the medical profession and the relations

between a medical practitioner and a dental practitioner shall be subject to the same

considerations.

The Council may investigate those convictions for criminal

offences committed by any practitioners within the medical profession

other than those specifically mentioned in the Act and if it deems it

necessary, the said Council shall initiate disciplinary proceedings

before the Disciplinary Committee in accordance with the Disciplinary

Proceedings Regulations.

The following offences shall be deemed to be offences

which may entail erasure from the registers or any other

disciplinary action

(a) acts of immorality, indecency or dishonesty or any

other act involving the abuse of a professional

relationship;

(b) treating or attending to patients while the practitioner

is under the influence of any drink or drugs;

(c) driving or being in charge of a motor vehicle when

under the influence of drink or drugs, or being found

drunk, or being drunk and disorderly or incapable of

properly looking after oneself;

(d) forgery, fraud, embezzlement and cognate offences;

(e) gross or prolonged neglect of duties and disregard of

personal responsibilities to patients, clients and the

public;

(f)

dealing in the commerce of drugs, medicinals and

other remedies by medical practitioners, dental

surgeons and veterinary surgeons.

(1) No practitioner shall for the purpose of being engaged

by patients or of promoting his own professional advantage

ETHICS OF THE MEDICAL PROFESSION

(a) advertise or canvass directly or indirectly,

(b) employ or is professionally associated with anyone

who so advertises or canvasses,

(c) procure or acquiesce in the publication of notices

commending or drawing attention to his own

professional skill, knowledge, qualifications or

services or depreciating those of other practitioners.

(2) Any practitioner who is found guilty of any of the offences

referred to in sub-regulation (1) shall be liable to disciplinary

action.

(3) The provision of factual information about the services

offered by a practitioner to patients shall not be deemed to be

contrary to the provisions of this regulation.

The factual information referred to in the preceding

regulation shall -

(a) be demonstrably true in all respects;

(b) not be misleading, vulgar or sensational;

(c) seek to maintain the decorum and dignity of the

profession;

(d) not contain any testimonial or endorsement of clinical

skills;

(e) not claim that any one doctor is superior to others, nor

contain any endorsement for any particular doctor;

(f)

avoid aggressive forms of competitive persuasion,

such as those that prevail in commerce and industry;

(g) be honest and never exploit a patient’s vulnerability or

lack of medical knowledge;

(h) be presented discreetly so as to facilitate informed

decision making.

(1)

Practitioners shall not -

(a) publicly endorse any particular commercial product or

service;

(b) publicly associate themselves with any product, such

as a tobacco product, which clearly affects health

adversely since such action may give an inappropriate

message to the public;

(c) overtly and publicly endorse advertisements for

health-related services, such as nursing homes and

private clinics.

(2) When a practitioner becomes publicly associated with a

particular commercial product or service, the practitioner shall

ensure that endorsement is not inadvertently stated or implied.

(3) In the case of practitioners who have any kind of financial

or other involvement, directly or indirectly, with any organisation,

they shall exercise due diligence to ensure any advertising

conforms with these guidelines and avoid involvement in

promoting the services of the organisation.

(1) Signs exhibited in connection with a practice should

not exceed what is reasonably necessary to indicate to those who

are seeking the practice, the location and of the premises and

entrance thereto.

(2) The name of every practitioner regularly attending patients

should be shown at the premises where he practises his profession

by means of a professional plate. The name of persons other than

practitioners, employed in the practice, need not appear on such

signs.

(3) The sign shall not indicate that a practitioner is in regular

attendance at a practice when he is not. The professional plate of a

former practitioner shall be retained for one year only if the name

on the plate is preceded by the word "late" or "formerly".

(4) In those cases where the practice is carried on in a private

house -

(a) the entrance thereto may be illuminated by means of a

small lamp; and

(b) there should be no lettering other than the number or

the name of the house.

(5) If a practice is carried out in an office block or business

centre -

(a) the professional plate may conform with others in the

same place;

(b) no hanging sign or illuminated box shall be allowed;

(c) daylight, flashing or neon signs are not permissible.

(6) The professional plate, letterheads used in professional

practice and any notice appearing in any medium accessible to the

public, may include the practitioner’s name, qualifications, degrees

and special qualifications registred with the Medical Council and

any other diploma or degree granted by universities, colleges or

other recognised professional bodies and a title describing the type

of practice.

(7) All qualifications should appear in the usual abbreviated

manner, as approved by the institution awarding them, but the

names of hospitals where one has studied or held appointments

shall not appear on a nameplate.

(8)

(a) The word "consultant" may only be used by persons

who hold or have held such an appointment.

(b) The word "specialist" may only be used by persons

who have completed their specialist training and are

listed as such in the Specialist Register held by the

Medical Council.

(9) The nameplate may also give an indication of the hours of

attendance, provided that neither the plate nor the lettering are

unnecessarily large or brightly coloured. The exhibition of notices

describing the nature of treatment provided is not allowed.

(10) A practitioner shall be responsible for all signs, plates and

notices which are directly or indirectly related with his practice and

which are situated in the public part of the pharmacy or premises.

(11) The words "clinic", "surgery", "dental surgery", "office" or

"consulting rooms" shall only be used to describe the place where a

practice is carried out.

It shall be the duty of every practitioner to ensure that the

windows and doors of his surgery and waiting rooms are adequately

screened from public view unless such waiting or consulting rooms

are situated within a pharmacy.

(1) While practitioners may be involved in publishing, it

shall however be ensured that there is no improper or undue

advertising.

(2) In granting interviews to the media, practitioners shall

assume full responsibility for anything appearing in print or

broadcast as a result thereof and a practitioner involved in public

activities should be particularly careful to ensure that no publicity

is given to his practice.

Practitioners may participate in the presentation and

discussion of medical, quasi-medical, dental or veterinary topics in

newspapers or on radio or television, however the information

given shall not in any way remark any unique or outstanding

qualities or any greater experience in a particular field and

practitioners shall maintain anonymity especially in circumstances

where the practitioner refers to his personal management of

individual clinical matters.

(1) Entries in telephone directories, including classified

lists -

(a) shall be in normal type;

(b) shall include the practitioner’s name and address;

(c) may include his qualifications, degrees or special post-

graduate diplomas;

(d) may have an indication of his type of practice.

(2) No other special entries are allowed nor should an entry

appear which does not include the practitioner’s name and address.

(1) Communications to patients -

(a) shall be sent in sealed envelopes; and

(b) shall not draw attention to the professional skill of any

practitioner.

(2) Recall cards should be sent only with the prior written

agreement of the patients to whom they are addressed.

(3) Communication with patients should be clear and effective

and in such a manner that the patient understands fully and clearly

what is being said.

(1) A practitioner shall not call upon or communicate with

any person who is not already a patient of his practice with a view

to providing advice or treatment unless he has been expressly

requested to do so by the person himself or by another person

authorised to do so on his behalf.

(2) A practitioner may, however, on acquiring a practice notify

persons whom he is reasonably entitled to assume to be patients of

that practice.

A practitioner shall not enter into any arrangements by

which patients are referred to him by non qualified persons, nor

should he pay any commission or grant any special discount to any

person or organisation other than according to the provisions of

these regulations.

A practitioner may be deemed to be involved in canvassing

if, without the consent of the administrator of the institutions

providing professional services, he attempts to induce persons to

contact him for treatment or advice.

Any practitioner who signs and issues any certificate,

report or other document containing statements which he knows, or

ought to know, to be untrue, misleading or otherwise improper,

shall be liable to have his name erased from the register.

(1) No practitioner shall enable an unqualified person to

exercise his profession, attend in any manner to any matter

requiring professional knowledge and skill, issue or procure the

issue of any professional document or otherwise act as if he were

duly qualified or registered.

(2) The preceding sub-regulation shall not apply when the

practitioner is supervising over any person so employed and retains

personal responsibility for the professional services rendered in the

case of

(a) the training of medical, dental or any bona fide

students, or

(b) the legitimate employment of nurses, midwives,

physiotherapists and other persons trained to perform

specialised functions relevant to different professions.

Every practitioner shall abide by the obligations set out by

t he D a ng e r o u s D r u g s Or di n a n c e a n d a n y r e g u l a t i o n s m a d e

thereunder. Any breach of the provisions thereof shall render the

practitioner liable to his name being erased from the register.

It shall be the duty of practitioners to comply with the laws

of Malta.

(1) Practitioners shall neither circulate professional cards

through each other nor pay any commission or allow any discount

or any other arrangement with each other or with any proprietor of

a business concern.

(2) A practitioner may not accept a commission for the

introduction of a patient or a client to a consultant, to a private

hospital or other institution, or to a medical practitioner, or to a

dental surgeon or dentist, to a veterinary surgeon, apothecary,

nurse, midwife or any other person or company.

Practitioners shall not participate in any division or sharing

of fees of which the patient or the client is not aware.

(1) It shall be unlawful for any practitioner to charge a fee

less than that established in the official tariff of fees unless he is

satisfied that the patient does not have sufficient means to pay such

fee.

(2) In special cases bills exceeding thirty euro may be

decreased by not more than ten per cent.

Every practitioner shall abide by the relevant provisions of

the Laws of Malta and by the code of ethical standards for the

general guidance of the profession in Schedules A and B.

Any change of address and of surgery hours may be

communicated to patients by a suitable notice being placed in the

waiting room and may also be announced for not more than three

times through the press provided such announcements are made in

normal type.

(1) When a practitioner has reason to believe that a patient

is suffering from a condition arising from, or in connection with,

dental treatment, it is the duty of the practitioner concerned to

recommend to the patient to permit him to communicate with a

dental practitioner.

(2) In those cases where the patient refuses this proposal, the

practitioner may give such treatment as may be necessary to deal

with the emergency condition.

(3) The practitioner shall not refer the patient to a second

dental practitioner unless he obtains from the patient permission to

disclose this fact to the first dental practitioner.

(4)

(a) In those cases where a patient is not being followed by

a dental practitioner, it is acceptable, following the

specific request of the patient, for the medical

practitioner to indicate the name of a dental

practitioner without indicating the treatment which he

considers should be given by the dental practitioner.

(b) The medical practitioner may, with the permission of

the patient, communicate with the dental practitioner

and if the medical practitioner requires a further

medical or dental opinion, a pathological or

radiological report from a third party, or a reference to

a hospital, he shall inform the dental practitioner

concerned of the proposed action and of the

subsequent outcome.

(5) When treating a patient, a dental practitioner may select an

anaesthetist to ssist him, but if the anaesthetist is not the patient’s

own medical practitioner no objection should be made to the

patient inviting his own medical practitioner to be present. Where

the patient is under medical care the dental practitioner may be

expected to inform the patient’s medical practitioner of any

proposed operation requiring an anaesthetic.