The Medical Council yesterday stood by its controversial and much-criticised recent announcement that doctors could reject non-emergency cases, saying the wording had caused misunderstanding.

"It never says doctors can simply reject [non-emergency] patients," said Dr Somsak Lohlekha, president of the council. "Read on and you will see the phrase 'for the sake of patients'.

"This means the doctor is required to refer the patient to someone else who could take better care of that patient," he said.

Most importantly, Somsak said, the provision did not allow doctors to reject patients in emergency cases and it was definitely the sole responsibility of the doctor to find another doctor to whom the patient could be referred.

Furthermore, the provision did not apply, for example, in cases where there was only one doctor available at a hospital in a remote area, he said.

"This [announcement] cannot be revoked. It's the principles we've drafted over four years and we will not just change it because some people do not agree with it.

"It's impossible to have all people agree with this… there has never been anything documented that received total agreement from all sides," Somsak said.

He said the council would reword the announcement so that it was clearly understood and would explain it to the general public.

Somsak said that in any case medical professionals also had the basic right as citizens to reject a patient under the Article 50 of the 1997 Constitution, which guarantees the liberty to engage in an enterprise or an occupation and to undertake fair and free competition.

"I didn't want to say this because Thai society could not accept this fact," he said. "This is rather shocking because it's not something we Thais are familiar with."

Preeyanunt Lorsermvattana, head of the Thai Iatrogenic Network, called the Medical Council's decision "ridiculous".

"We're not going to do anything more [to protest the announcement]," she said. "They're making fools of themselves in the public eye."

Arthit Khwankhom

The Nation