The code of conduct
Good medical practice: a code of conduct for doctors in Australia, issued by the Medical Board of Australia, sets the standard against which doctors' conduct is judged. Its sections cover professionalism, good care, working with patients, a respectful culture, working with colleagues and the healthcare system, patient safety, maintaining performance, professional behaviour, doctors' health, teaching and research.
Code issued 1 October 2020. Check the Medical Board of Australia website for the current version.
Consent
- Consent must be voluntary, informed and given by a person with capacity, for the specific treatment.
- Australian law requires doctors to warn of material risks: risks a reasonable person in the patient's position would consider significant, or that this patient would, if the doctor knows or should know (Rogers v Whitaker, 1992).
- Explain the alternatives, including no treatment, and give the patient time and the chance to ask questions.
- In an emergency where the patient cannot consent, treatment necessary to save life or prevent serious harm can proceed.
Capacity, minors and substitute decisions
| Situation | Key principle |
|---|---|
| Adult with capacity | Can refuse any treatment, even if the decision seems unwise |
| Adult without capacity | Follow a valid advance care directive, or obtain consent from the legally authorised substitute decision-maker under state or territory law |
| Mature minor | A young person who understands the nature and consequences of the treatment can consent (Gillick principle); assess each decision |
| Younger child | Parents or guardians consent, in the child's best interests |
Capacity is decision-specific: a patient can lack capacity for one complex decision but have it for another. Assess understanding, retention, weighing and communication.
Confidentiality and privacy
Patient information is confidential and protected by the Privacy Act 1988 and state laws. Disclosure without consent is allowed only in limited situations:
- Where required by law, such as notifiable diseases, court orders and mandatory reporting.
- Where there is a serious threat to the life, health or safety of the patient or others.
- With the patient's consent, including implied consent for sharing within the treating team.
Be careful with families, employers, police and insurers: confirm what the patient has agreed to before sharing.
Mandatory reporting and notifications
| Duty | What triggers it |
|---|---|
| Child abuse and neglect | Reasonable grounds to suspect a child is at risk of significant harm; required of doctors in every state and territory, with differences in detail |
| Notifiable diseases | Listed conditions reported to public health units, such as tuberculosis, measles and many sexually transmitted infections |
| Practitioner conduct (mandatory notification to Ahpra) | A reasonable belief that another practitioner has practised while intoxicated, engaged in sexual misconduct, placed the public at substantial risk of harm through impairment, or significantly departed from accepted standards |
| Treating a practitioner-patient | A higher threshold applies: notify if there is a substantial risk of harm to the public, or for sexual misconduct; Western Australia has a broader exemption |
| Fitness to drive | Advise the patient of their duty to notify the licensing authority; in some states doctors may notify when there is a risk to the public |
Open disclosure and professional behaviour
- Open disclosure: when something goes wrong, acknowledge it, apologise, explain what happened as far as is known and what will be done, and keep the patient informed (Australian Open Disclosure Framework).
- Professional boundaries: never use your position to pursue a sexual or exploitative relationship with a patient or someone close to them.
- Conflicts of interest: declare them, and do not accept gifts that could influence prescribing or referral.
- Treating yourself, family or friends: avoid it, except in emergencies or for minor problems.
- Social media: confidentiality and professional standards apply online.
- Doctors' health: have your own GP and seek help early.
End of life and advance care planning
Advance care planning, advance care directives and substitute decision-makers are governed by state and territory law. Voluntary assisted dying is legal in every state and in the ACT, under different eligibility rules and processes; a doctor may conscientiously object but must not obstruct access to information. Check the law in your jurisdiction.
Ethics in exam questions
- Spot the ethical question inside a clinical stem: a 15-year-old requesting contraception, a patient refusing surgery, a colleague smelling of alcohol.
- Choose the option that protects the patient while respecting autonomy.
- Remember the order: talk to the patient first, then escalate if risk continues.
- Prefer documented, transparent actions over informal ones.
See clinical reasoning mistakes in the AMC MCQ for how ethics questions are disguised, and cultural safety for the related code obligations.
Common questions
What is a material risk in Australian consent law?
From Rogers v Whitaker: a risk a reasonable person in the patient's position would consider significant, or one the doctor knows or should know this particular patient would consider significant.
Can a 15-year-old consent to treatment in Australia?
Yes, if they have sufficient understanding and maturity to understand the treatment and its consequences, under the mature minor (Gillick) principle. Assess each decision.
When must a doctor make a mandatory notification to Ahpra?
When they reasonably believe another practitioner has practised while intoxicated, engaged in sexual misconduct, placed the public at substantial risk through impairment, or significantly departed from accepted standards. A higher threshold applies to treating practitioners.
Is voluntary assisted dying legal in Australia?
It is legal in every state and in the ACT, with different rules in each. Check the law where you practise.