The Malaysian Medical Council’s (MMC) guideline states: “Generally, no procedure, examination, surgery, or treatment may be undertaken on a patient without the consent of the patient, if he or she is a competent person.”
My experience unfortunately proves the MMC isn’t capable of upholding its own guideline.
In 2023, a gynaecologist at a private hospital conducted a painful pap smear and a transvaginal ultrasound probe on me when I went to explore Hormone Replacement Therapy (HRT).
The doctor had not mentioned doing either procedure, both of which involve inserting objects into a woman’s body, before I was in the examination chair. She only said she needed to examine me for dryness.
Having never had an examination for dryness, I assumed the severe pain and discomfort I felt during the procedures were part of that examination.
I only discovered what the doctor had done after the nurse informed me outside the clinic, and I was slapped with a bill totalling more than RM700.
Angry and in shock, I complained immediately to the hospital before leaving. The hospital advised me to have my pap smear specimen destroyed, which I agreed to as I had not consented to the procedure.
I demanded a refund and asked the hospital what it would do to prevent the doctor treating another patient in the same way.
I also complained to the Ministry of Health (MOH) and the MMC. The MMC charged the doctor. The hearing for her defence was held on April 28, 2025.
As a result of my complaints, I have official letters in which the doctor:
- Admits I “may not have been adequately informed”, and that the procedures were conducted based merely on an “impression” of consent. During cross-examination at the MMC hearing, the doctor agreed that “under the impression” meant an assumption I had agreed without explicit confirmation from me.
- Takes “full responsibility” that I did not have a “complete understanding of the procedure”.
- Apologises for “not explaining the details” of the procedure.
- Concedes she “did not receive explicit consent” before performing the procedure.
Despite the doctor’s written admissions, the MMC found the doctor “not guilty” of Rule 4.4.2 of its Good Medical Practice guidelines under which the doctor was charged.
One of the grounds for its verdict was that both procedures “were medically necessary components of the standard pre-assessment for HRT”. The MMC declared the doctor’s actions were in “good faith”.
The MMC also claimed I “seemed to understand the necessity of the examination” and hadn’t objected to them. The grounds for its “not guilty” verdict lack understanding about what consent is and is spurious.
Consent is permission to do something or an agreement for something to happen. Key to consent is that a patient must be informed and understand what they are giving consent for.
I don’t dispute that both procedures are necessary before a patient can begin HRT. My complaint is that the doctor did not inform me and did not get my consent before performing them.
Official letters from the hospital provide ample evidence that was in fact the case.
Additionally, how could I have understood the necessity of the examination or objected to them if by the doctor’s own admission, I hadn’t been “adequately informed”?
When I submitted this complaint to the MMC two years ago, I was warned it would be pointless. The MMC has an unfortunate reputation of protecting doctors. The evidence in my case reinforces that reputation.
Indeed, what is evident is that in the grounds for its verdict, the MMC refers only to the doctor’s claims during the defence hearing and ignores the evidence provided in my testimony and in the hospital’s official letters.
This verdict renders meaningless the MMC’s own best practice guidelines and sets a troubling precedent for the profession. In doing that, the MMC fails in its mission to safeguard patients and guide doctors.
The author lives in Selangor.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
