CodeBlue‘s editorial asserting that doctors must follow the law—without exception—may be uncomfortable for some, but discomfort is not a rebuttal.
In fact, the editorial is notable precisely because it states what should be self-evident in any modern health system: when ethical guidance diverges from statutory law, the result is not moral nuance—it is institutional failure.
In biomedical ethics, the relationship between law and ethics is often portrayed as complex. Yet complexity must not be confused with contradiction. Internationally accepted ethical frameworks—from the Belmont Report to the Declaration of Helsinki—do not place clinicians above the law. Rather, they assume compliance with legal standards as a baseline, not an optional constraint.
From a scientific standpoint, medicine operates within structured systems precisely because evidence alone is insufficient to protect patients. Laws exist to ensure consent, transparency, reporting, oversight, and redress—mechanisms that data and clinical judgement alone cannot guarantee.
History is unequivocal on this point. Many of the gravest medical harms—from unethical experimentation to systemic neglect—occurred not because clinicians lacked scientific knowledge, but because institutions allowed professional discretion to operate without legal constraint.
Medicine operates on trust, built on the presumption that practitioners will function within a defined scaffold of regulatory and professional ethics boundaries. This scaffold includes regulations on certification, treatment protocols, and professional conduct.
Ethics committees in research reject studies that bypass regulatory review; why should the practice of medicine be any different? Deviating from it without due process and transparency is the equivalent of publishing research without ethical approval: it invalidates the outcome and destroys credibility.
CodeBlue is correct to argue that an ethical and legal red line has been crossed. The concern is not an isolated lapse by individual clinicians, but a systemic failure involving institutions entrusted with safeguarding professional standards.
When the country’s highest medical ethics authority appears unwilling—or unable—to assert the primacy of the law, it sends a dangerous signal: that professional self-regulation can supersede democratically enacted legal protections.
The situation is made worse when this failure is mirrored across the ecosystem—within the Ministry of Health, private hospitals, professional medical groups, and segments of the medical profession itself. Whether driven by convenience, fear, or collective self-interest, such alignment erodes accountability and normalises illegality.
CodeBlue’s editorial is undoubtedly brave, and bravery is rarely rewarded in real time. Yet journalism, like medicine, has a duty not merely to inform but to protect the public interest.
Our profession’s social contract is built on the premise that we will self-regulate within the law. When that self-regulation fails, and worse, when the governing structures appear complicit, external accountability and public scrutiny become the only correctives.
“Doctors Must Follow The Law. Period” is a statement of scientific integrity.
The authors are consultant paediatricians. Dr Tan is also a bioethicist and clinical ethicist.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
