Health Minister clarifies his veto of Medical Council's decision on doctors treating Thaksin

Public Health Minister Somsak Thepsuthin has clarified his position regarding the veto of the Medical Council’s decision to penalize three doctors who treated Thaksin Shinawatra, the former Prime Minister, during his stay at Police General Hospital while being detained as a prisoner, as ordered by the court.

On Thursday (June 12), a statement from Somsak to Dr Somsri Phaosawat, the President of the Medical Council, was released, with the following details:

"Under the authority of Section 25 of the Medical Profession Act 1975, the Minister of Public Health, as the Special President of the Medical Council, has the direct responsibility to provide an opinion on the Medical Council’s decision. The Medical Council is a key mechanism in upholding the ethics of the medical profession, which is crucial for maintaining public trust in healthcare in Thailand.

Medical ethics are not just regulations but the core values of the profession, reflecting the responsibility doctors have for the lives and dignity of their patients. They must be based on four principles: respecting the patient’s will, maximizing benefit, avoiding harm, and acting justly.

Therefore, the decision to give an opinion on the penalty for the doctors must be carried out carefully, sensitively, and with true fairness. It should not be driven by public pressure but must be based on facts, intent, and the context of their actions with integrity.

I used all the information and facts obtained from the investigation carried out by the Ad Hoc Investigation Subcommittee, chaired by Dr Amorn Leelarasamee, which diligently investigated the matter for five months and five days.

The findings of the Ad Hoc Investigation Subcommittee are as follows:

• Dr Watchai Mingbanjerdsuk – Recommended dropping the charges.
• Dr Ruamthip Suphanan – Recommended a light penalty of a "warning and admonishment".
• Pol Lt Gen Dr Sopnarush Singhajaru – Recommended "probation".
• Pol Lt Gen Dr Taweesilp Wetchavitarn – Concluded there was "no ethical wrongdoing".

Even though it later became apparent that when the matter was considered by the screening committee and the Medical Council in its final review, the decision was "reversed" from the initial investigation findings. The punishment was escalated, including a suspension of the medical license for several months, which is a significantly different interpretation. Additionally, there were no new facts that differed from the initial investigation.

What particularly concerns me, and cannot be overlooked, is why the Medical Council did not agree with the findings of the investigation subcommittee.

In the absence of new evidence or compelling reasons, such a significant change in the final decision raises doubts about whether there were any motivations beyond the facts and professional principles involved in the decision-making process.

During the review process, I made two requests for further information regarding the ethics subcommittee's evaluation. However, the Medical Council deemed that the documents provided were “sufficient.” From my perspective, withholding such important information could be detrimental to fair judgment and comprehensive decision-making today.

In this vote, I expect that all members casting their votes are not those with vested interests but individuals who can maintain neutrality.

I would like to emphasize once again that my proposal to halt this decision is not based on personal opinions or superficial judgments, but rather on a thorough and detailed consideration of the facts. However, since my view differs from that of the Medical Council meeting, this has led to today's meeting, where I invite everyone to reconsider the matter with the utmost caution.

I would like to clarify the reasons for vetoing the decision as follows:

In the case of Dr Watchai (the first defendant), who was accused of providing inaccurate medical information, the Medical Council carefully considered the issue and ruled to dismiss the charges.

Upon reviewing all the documents and facts, I believe the decision aligns with the principles of justice and is fair to all parties, and I agree with the Medical Council's decision.

In the case of Dr Ruamthip (the second defendant), who was accused of incorrectly issuing a referral for a prisoner, which allowed the prisoner to be sent for medical treatment outside the prison and was seen as a failure to uphold professional standards:

However, issuing a referral during the pre-examination process is a standard practice in prisons, as prisons are not hospitals, and not every medical specialty is available. This procedure ensures readiness for cases requiring specialized medical care.

In this case, the doctor only allowed the referral to be used as requested by the on-duty nurse in an emergency situation, without making the final decision to send the prisoner, which is the authority of the prison commander.

Dr Ruamthip's actions were within the scope of medical practice, and there was no intent to commit any ethical violations, so the decision should not be considered a breach of ethics.

In the case of Dr Sopnarush (the third defendant), who was accused of providing inaccurate medical information during an interview with a journalist about the condition of a patient at the Police General Hospital, which was interpreted as misleading the public about the patient's condition: 

The fact is, Dr Sopnarush never stated the patient was in a "critical" condition. The phrases "blood pressure still high" and "the condition is still concerning" were simply explanations of the patient's state at the time, not misleading information, and were consistent with the medical records. 

As the hospital administrator (not the attending physician), responding to a journalist's inquiry without prior notice was part of his duty to provide information transparently. Interpreting his statements as an ethical violation is unfair and should not be grounds for disciplinary action.

In the case of Dr Taweesilp (the fourth defendant), who was accused of writing an incorrect medical opinion that allowed a prisoner to stay in the hospital, which was interpreted as providing inaccurate information: 

The punishment of Dr Taweesilp occurred because there was a disagreement over medical opinions. Disagreement between doctors is a natural part of medical decision-making. Investigations revealed that Dr Taweesilp's medical opinion was not false; the disciplinary action arose from differing medical views.

The holistic approach to patient care may lead to differing opinions and should not be considered a factual inaccuracy.

Even the Ad Hoc Investigation Subcommittee, chaired by Dr Amorn Leelarasamee, previously concluded that the case involving Dr Taweesilp should not be considered a violation. This judgment is reasonable and justifiable.”

Furthermore, during his meeting with the Medical Council today, Somsak also presented the Supreme Administrative Court’s ruling, which addressed a case where an official was unable to make an administrative decision.

The ruling brought up by Somsak in the meeting concerns the issue of neutrality. The Supreme Administrative Court ruled that when an official, who is the chairman of a disciplinary investigation committee, participates in the meeting to vote on the disciplinary penalty for the person under investigation, it undermines the neutrality of the administrative decision-making process. This constitutes a serious violation as defined under Section 16 of the Administrative Procedure Act B.E. 2539 (1996).