• Judgement notes misconduct may warrant disciplinary action even where physical injury is not conclusively established
• Says informed consent legal, ethical obligation, not merely an administrative formality

ISLAMABAD: The medical tribunal in Islamabad held that private settlements between complainants and medical practitioners did not extinguish disciplinary liability arising from professional misconduct.

The judgement expected to serve as an important precedent in professional disciplinary jurisprudence was authored by tribunal chairman Safdar Saleem Shahid, in an appeal challenging disciplinary action taken by the Pakistan Medical and Dental Council (PMDC) against a male medical practitioner.

The doctor had undertaken a high-risk obstetric surgical procedure without recognised specialisation in obstetrics and gynaecology and had failed to ensure documented informed consent regarding the possibility of hysterectomy.

While partially modifying the penalty by reducing the suspension of the practitioner’s licence from three years to one year in view of mitigating circumstances, the tribunal upheld the findings of professional misconduct and reaffirmed the principle that medical practitioners must practice strictly within the limits of their recognised qualifications, training and professional competence.

A significant feature of the judgement is its detailed distinction between professional negligence and professional misconduct. The tribunal observed that while negligence generally concerns breach of the standard of medical care resulting in harm, professional misconduct encompasses violations of ethical, statutory and regulatory obligations governing the medical profession. Such misconduct may warrant disciplinary action even where actual physical injury is not conclusively established.

The tribunal further held that disciplinary proceedings conducted by PMDC were regulatory in nature and intended to safeguard professional standards, patient rights and public confidence in healthcare institutions. Consequently, such proceedings cannot be treated as private disputes capable of being terminated solely through compromise between the parties.

Rejecting the argument that a subsequent settlement should nullify disciplinary proceedings, it observed that regulatory bodies perform a statutory function extending beyond the interests of individual complainants.

The tribunal emphasised that info­rmed consent was a substantive legal and ethical obligation and not merely an administrative formality. Patients are entitled to receive adequate information regarding the nature of a proposed procedure, foreseeable risks, available alternatives and potential consequences before making treatment decisions affecting their bodily autonomy and reproductive rights.

The judgement also addresses the broader institutional dimensions of patient safety. Referring to findings recorded by the Punjab Healthcare Commission, the tribunal noted deficiencies relating to licensing requirements, maintenance of medical records, availability of appropriately qualified staff and compliance with healthcare standards at the facility where the procedure was performed.

The tribunal observed that unsafe healthcare outcomes often arise not only from individual lapses but also from systemic institutional failures. It cautioned that healthcare establishments cannot be permitted to allow practitioners to undertake specialised procedures without appropriate credentialing, supervision and regulatory compliance.

In its concluding directions, the tribunal called upon regulators to strengthen credentialing systems, enforcement of informed consent protocols, maintenance and preservation of medical records, and inspection mechanisms.

Published in Dawn, June 5th, 2026