Philippine Society of Nephrology

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Contents

Introduction

In order to strengthen and maintain the ethical and professional standards of the practice of nephrology in the country, the Philippine Society of Nephrology prepared this code of ethics to guide the nephrologists in the conduct of his/her profession towards his/her patients, colleagues, allied professionals and community.

General Principles

All physicians practicing the subspecialty of nephrology must be certified as nephrologists by the Philippine Society of Nephrology and as internists/pediatrician by the Philippine College of Physicians/ Philippine Pediatric Society. The Golden Rule and Primum Non Nocere shall be the guiding principles and should be upheld by the nephrologists at all times. Service to humanity is the primary objective of the practice of nephrology; regardless of race, creed, political affiliations, religious belief and financial gains. Nephrologists have the duty to constantly update his/her scientific knowledge in the field of nephrology and share it with colleagues, students, allied professionals and the community. The general ethical principles governing a group of nephrologists, clinics and dialysis centers are exactly the same as it applies to the individual nephrology practitioner. The Nephrologist's professional conduct in private and public shall always be in keeping with the honorable traditions of the medical profession s embodied in the Hippocratic Oath, the International Code of Ethics, the Codes of Ethics of the Philippine Medical Association, and the Philippine College of Physicians/ Philippine Pediatric Society. This Code of Ethics will serve as a guideline for the things nephrologists think, say and do while serving the patients, as well as a guideline for his/ her relationship towards colleagues, allied professionals and community.

DUTIES TO PATIENTS

  • The Nephrologist should see to it that the best interests of the patients are served, bearing in mind that their relationship is an implied contract of trust and confidence, thus the rules of privileged communication shall not be violated except when required by law or for the greater interest of the public.
  • The Nephrologist is under no obligation to accept a patient especially if the case is not within the scope of his/her expertise, except in case of emergency. The patient has the right to choose his/her nephrologists.
  • The Nephrologist shall take into consideration the wishes of the patient as to the method of diagnostic procedures and the treatment to be done, after explaining the risks and benefits, possible consequences if refused by the patient, as well as the immediate and long term financial costs. The nephrologists shall secure free and informed consent for the proposed management agreed upon.
  • The Nephrologist shall inform the patient of the nature of his/her illness and the prognosis thereof if possible.

Referral or consultations to other specialists should always be sought with the consent of the patient in difficult and problematic cases with the purpose of giving the best service.

  • The Nephrologist shall not engage in, nor encourage the selling and purchase of human organs for transplant purposes. Organs from live donors shall be secured only with free informed consent.
  • The Nephrologist shall not prescribe, dispense, manufacture or provide secret remedies for use in any manner and/or boast of radical cure or exhibit testimonial successes in their use without good scientific basis.

Professional fees or honoraria of nephrologists shall be commensurate with the services rendered as well as the ability of the patient to pay, with due consideration to the difficulty/seriousness of the case, the experience and expertise of the nephrologists, and the prevailing fees in the community/hospital. The Code of Ethics of the Philippine College of Physicians/ Philippine Pediatric Society, the Nuremberg/ Helsinki Codes, and good clinical practice must be adhered to in all researches using human subjects.

DUTIES TO COLLEAGUES

The Golden Rule should always be the guiding principle and should be upheld at all times. Relationships among colleagues should always be of mutual respect and cooperation with the end goal, which is, the patient's welfare.

  • The Nephrologist should assist a colleague in the management of a patient when assistance is called for or solicited, in the interests of the patient's welfare, for opinion, co-management and for transfer of service.
  • Nephrologists should willingly give free medical service to active medical practitioners as well as his immediate dependents.

It is unethical to indulge in fee splitting, to receive commissions, referral fees and rebate or whatever term it may be called, to solicit patients and professional services given by diagnostic clinics and dialysis centers.

DUTIES TO THE COMMUNITY

  • Nephrologists shall assist the judicial authorities when called upon for the administration of justice, as long as the rule on privileged communication is not violated.

The Nephrologist should not advertise nor employ propaganda schemes with the purpose of enticing patients.

  • The Nephrologist should warn the public of false pretensions, frauds, and quacks, for these practices will cause injury to the health of the patients.
  • The Nephrologist may participate in civic actions or mercy missions anytime if the need arises.

RELATIONSHIP WITH PARAMEDICAL, PHARMACEUTICAL AND TECHNICAL INDUSTRY

  • The Nephrologist should cooperate with and safeguard the interests, reputation and dignity of individuals in the paramedical fields as long as they do not violate their respective ethics.
  • The Nephrologist shall not allow technical and pharmaceutical industries to use his/her name in the promotion of equipment, drugs and other medical products for commercial purposes except in scientifically approved journals supported by scientific studies or researches.
  • The Nephrologist should not receive nor solicit monetary/ financial support or any personal services for self-serving ends.
  • The Nephrologist's practice pattern should not be influenced by his/her relationship with the pharmaceutical industry.

GROUP PRACTICE

  • The Nephrologist can and may join a group practice with other medical specialists as long as the professional ethics of each subspecialty is observed at all time.

Professional fees may be collected as a group or individually, depending upon the agreement of both parties and patients.

Patients should be fully informed about the capabilities and expertise of the members of the group, the clinics or the dialysis center.

IMPLEMENTING PROVISIONS AND SANCTIONS

This Code of Ethics shall be published in the nephrology journal or distributed to each member of the Philippine Society of Nephrology upon approval by the board of directors of the society. Violation of any provisions of the code shall constitute unethical practice and shall be held as ground for sanctions from the association (namely: to reprimand, suspend or expel). The Code of Medical Ethics of the Philippine Medical Association, Philippine College of Physicians and the Philippine Pediatric Society will cover events or provisions not included in this Code.

This Code of Medical Ethics can be amended anytime by the Board of Directors of the Philippine Society of Nephrology on the recommendation of the Committee on Ethics.

History

In 1971, a group of young nephrologists fresh from their specialty training abroad founded a society that was to spearhead the development of renal care throughout the country, the Philippine Society of Nephrology (PSN).

The founding members were Dr. Filoteo Alano, President; Dr. Hilario Esguerra II, Vice President; Dr. Libertad Nazareno-Rosales, Secretary-Treasurer; and Dr. Ophelia Completo-Buot, Dr. Aurora Padolina-Perez, Dr. Ruben Basilio, Dr. Benjamin Atanacio, Dr. Adriano dela Paz, Dr. Elsa Jacinto, Dr. Cecilia Talusan and Dr. Antonio Talusan, Board Members.

The PSN hosted its first national scientific convention on May 25, 1974 with then Secretary of Health, Dr. Clemente Gatmaitan, Sr., as keynote speaker. Conventions were thereafter held every 2 years with distinguished speakers from all over the world. In 1985 however, due to the growing number of nephrologists and physicians involved in caring for patients with kidney disease, the conventions were held annually providing continuing quality medical education.

The Philippine Journal of Nephrology (PJN), which is the official scientific publication of the society began in 1986 with Dr. Filoteo Alano as editor-in-chief . The PJN is published regularly and serves as the avenue for local scientific research papers in the specialty.

As the number of specialists in nephrology grew the PSN realized the need for standardizing the quality of subspecialty training. Thus the society organized its Specialty Board (PSN-SB) and Training Program Accreditation Board (PSN-TPAB) in 1982. The PSN-SB is tasked with evaluating qualified graduates of subspecialty training programs for certification as a diplomate and their elevation to fellow, the society signifying peer acceptance. The PSN-TPAB is responsible for accrediting the subspecialty training programs of various hospitals throughout the country. All these in an effort to achieve the highest standards in the practice of nephrology and to ensure that training programs remain current and well-rounded in developing renal physicians with a strong academic orientation and interest in doing research while maintaining humane and compassionate patient care.

In 1990 the PSN spread its wings to cover the Southern Philippines with the formation of the Visayas-Mindanao Chapter. The Officers were Dr. Ophelia C. Buot, President; Dr. Vivina Chiu, Vice-President for Visayas; and Dr. Josefino Ramos, Vice-President for Mindanao. The following year the chapter successfully hosted the annual convention held in Cebu.

In 1991, the Society became actively involved in the Preventive Nephrology Program of the National Kidney Institute with Drs. F. Alano and I. Gueco leading this ambitious nationwide project of screening public school children for early signs of renal disease.

In 1995, the pediatric nephrologists of the society founded their own organization, the Philippine Pediatric Nephrology Society of the Philippines (PNSP) which is under the umbrella of the PSN. Through this endeavor the unique and highly specialized needs of the pediatric renal disease population may be more adequately addressed.

It was also in 1995, that the Kidney Biopsy Registry and Renal Disease Registry projects were conceived. The Society undertook these projects to be able to come out with objective data on the major renal diseases and the status of dialysis and renal transplantation in the country. These projects were spearheaded by Dr. Romina Danguilan and Dr. Benita Padilla and they have been presenting the annual registry reports. Presently the renal registry project has become a joint effort of the Department of Health, National Kidney & Transplant Institute and the PSN.

Starting 1997, the Society saw the need for additional Continuing Medical Education activities and closer interaction among its growing membership, thus regular Nephrology Fora were held about five to six times a year in various accredited nephrology training institutions. Regular Midyear meetings were also initiated in the month of November and held in Cebu (1997), Puerto Princesa (1998) and Boracay (1999).

The Society started to accept Associate Members in 1998 to enable it to expand its membership to include Nephrology fellows in training and other doctors interested in the practice of Nephrology.

In 1999, the membership approved the Mission and Vision Statement which will guide the PSN in all its activities for the coming years. During the last PSN annual convention in April 2000, the International Society of Nephrology sponsored a symposium on Tropical Nephrology through its COMGAN (Committee for the Global Advancement of Nephrology) Project.

In 2002, Dra. Rosales spearheaded the revision of the organiztional chart of the Society. It was also in this year that PSN took a lead in celebrating Kidney Month, which was previously led by the National Kidney and Transplant Institute. Launching of public awareness program and lay fora at different provinces were held.

Starting 2003, the PSN was given a mandate to accredit free standing dialysis centers. In relation to this, a workshop on quality assurance in cooperation with DOH and Philhealth were conducted. The workshop results set the tone for the quality assurance of free standing dialysis centers. Reimbursement of Philhealth for peritoneal dialysis patients was also proposed by the society to help the patients unload their financial burdens.

In the same year 2003, the Philipine Association for Renal Health (PAReH), was organized. This is an organization which is compose of kidney patients and individuals involve in renal care. This aims to establish in the country a unified support program to its member and to all Filipinos, through regular awareness and education campaign. It has been registered with the Security and Exchange Commission with the official website ilovemykidney.com.

It was also in the same year 2003 that, the International Diabetes Federation and the International Society of Nephrology involved the PSN here in our country on a global campaign on increasing awareness of the importance of screening for microalbuminuria in people with Type 2 diabetes. The worldwide Microalbuminuria Screening Day was held last Sept 13 among patients with Type 2 DM in several hospitals.

The Philippines also hosted the 14th Asian Colloquim last November 2003 which was held at Shangri-la Hotel.

Currently, the society has continued to expand with a present membership of 294 doctors, consisting of 105 Nephrology Fellows, 116 Diplomates, 73 Associate members all over the country who are providing patients with kidney disease the best in renal care.

Vision

The Philippine Society of Nephrology, Inc. is a cohesive body that ensures adherence to the highest standards of excellence in training and research in the field of Nephrology. It commits itself to train, regulate, and support its members to enable them to be globally competitive, ethical, excellent and compassionate.

It is a dynamic partner of Medical and Professional Societies, and a foremost source of knowledge and information. The PSN, Inc. serves as a liaison between its members and various support and regulatory institutions.

The society is committed to the highest quality care for patients as it leads renal related public health programs, especially those that are relevant to the Filipino people.

Mission

The Philippine Society of Nephrology, Inc. promotes and disseminates current knowledge and information in Nephrology. It provides guidelines in the delivery of nephrologic care, and ensures the strict implementation of these guidelines. Through accreditation, it enforces global training and research standards.

The society provides information on members needs and problems, as well as expertise and recommendations for policy formulation regarding renal disease. It shall initiate, recommend, promote, and coordinate public health programs geared towards awareness, prevention, and treatment of renal disease.

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