New Zealand Guidelines and Requirements for Registered Medical Practitioners

Excerpts from relevant publications so the public are aware of the freedoms, responsibilities and laws pertaining to both the practitioner and his/her patient.

Currently, a patient has rights to any treatment with certain conditions, just as a doctor may have the rights to either prescribe or perform (or not) that treatment so long as he/she does so in good faith and in a responsible manner according to guidelines as set out.

When a doctor treats a patient with a non-conventional (non-mainstream, non-orthodox) method or medicine – then the patient must be fully informed of the conventional treatment, whether the risk of not having that conventional treatment puts him/her at increased risk and what might be the expected success.

Written informed consent is required.

Statement on complementary and alternative medicine - NZMC 2011

NZ Medical Council

  1. When complementary and alternative medicines (CAM) have demonstrated benefits for the patient and have minimal risks, and patients have made an informed choice and given their informed consent, Council does not oppose their use.
  2. No person may be found guilty of a disciplinary offence under the Health Practitioners Competence Assurance Act 2003 merely because that person has adopted and practised any theory of medicine or healing if, in doing so, the person has acted honestly and in good faith1.

Medical Practitioners Disciplinary Tribunal

“There is an onus on the practitioner to inform the patient not only of the nature of the alternative treatment offered but also the extent to which that is consistent with conventional theories of medicine and has, or does not have, the support of the majority of practitioners.

The Tribunal recognises that persons who suffer from chronic complaints or conditions for which no simple cure is available are often willing to undergo any treatment which is proffered as a cure. As such, they are more readily exploited.”

In treating patients and in engaging in health promotion, (a doctor) must:

  1. ensure that the treatment is efficacious, safe and cost effective
  2. have current knowledge and skills in your area of practice
  3. be competent in the practices you employ
  4. act honestly and in your patient’s best interests according to the fundamental ethics of the profession
  5. provide sufficient information to allow patients to make informed choices, and to refer to, or consult with, others when patients request it, when you require assistance or when the standard of practice requires it. (Where there is no reason to believe such a referral would expose the patient to harm there is no barrier to making a referral to a CAM practitioner or to utilising a CAM treatment)
  6. not misrepresent information or opinion. Patients must be made aware of the likely effectiveness of a given therapy according to recognised peer-reviewed medical publications, notwithstanding your individual beliefs
  7. obtain informed consent to any proposed treatment.

Doctors as scientists

Doctors have the ability to access, interpret and assimilate new knowledge critically, have strong intellectual skills and grasp of scientific principles, and are capable of effectively managing uncertainty, ambiguity and complexity. They have the capacity to work out solutions from first principles when patterns do not fit, and the ability to work outside guidelines when circumstances demand.
Doctors use scientific tools and techniques, including audit and research, to develop new knowledge.

Doctors as health professionals

Doctors share attributes with many health professionals that include listening and communication skills, the ability to work as part of a team, non-judgmental behaviour, compassion and integrity which combine to merit the trust of patients and whānau (extended family). They have the ability to assess patients’ healthcare needs taking into account personal and social circumstances, culture and beliefs.

Doctors are trained to:

  • Integrate information from a variety of sources in order to make decisions or reach diagnoses.
  • Provide medical and/or surgical interventions, including the prescription of medicines, in both elective and emergency situations.
  • Practise specific clinical skills such as the art of history taking and physical examination.
  • Identify and minimise risk and harm.
  • Identify and advise on appropriate tests, treatment options (including non-intervention) or preventative measures, and explain and discuss any associated risks, benefits and uncertainties.
  • Support patients in understanding their condition and empower them to make informed decisions.
  • Assist patients and whānau to decide when supportive care is preferable to intervention, including in relation to end-of-life decisions..

Consensus Statement on the Role of the Doctor in New Zealand - JNZMA 2011

Key statements

  • Doctors regularly take ultimate responsibility for medical decisions and diagnoses in situations of complexity and uncertainty, drawing on scientific knowledge and principles, clinical experience, and well developed judgement.
  • Doctors accept their ethical responsibilities to act in the best interests of their patients, and the population as a whole, and undertake this in a caring, compassionate, competent, and trustworthy manner.
  • Doctors work in partnership with patients in the delivery of their healthcare and serve as advisors and interpreters in the pursuit of optimal health outcomes using evidence-based medicine and in accordance with available resources.
  • Doctors work effectively as leaders. As members of healthcare teams, doctors recognise and respect skills and attributes of other practitioners.
  • Doctors are advocates for improved population health and health equity for all people.
  • Doctors are committed to the spirit and principles of The Treaty of Waitangi, particularly as it relates to the attainment of health equity for Māori.
  • Doctors have diverse roles, within and outside of the health sector, in the promotion and maintenance of both individual and population health.
  • Doctors accept responsibility for maintaining the high standards of the medical profession to uphold the trust placed in them by patients and the community, and demonstrate this through adherence to relevant declarations including the New Zealand Medical Association Code of Ethics and the Code of Health and Disability Services Consumers Rights.