Ethical aspects for the rules and procedures for issuing medical certificates

Writing a medical certificate can be a complicated part of medical practice. A doctor is expected to sign a variety of medical certificates that range in purpose from confirming sickness to certifying death. Medical certificates are legal documents based on clear and relevant evidence and should be written promptly, honestly, accurately, and objectively. Medical certificates may have financial implications for the patient or recipient through benefits, employment, or compensation payments, and a failure to complete a certificate appropriately may have a negative impact on the patient, the patient’s family, or the receiving organization. For example, a doctor who certifies a patient to undertake work when he or she is unfit may place the patient or the patient’s colleagues or the organization at risk. Society places a great deal of trust in doctors. This article attempts to propose ethical considerations based on the findings of two guides: the “Guide for writing medical certificates” prepared by the Korean Medical Association and the “Statement on medical certification” prepared by the Medical Council of New Zealand. The authors discuss some suggestions for guidance in medical certification to protect each individual involved and to promote good medical practice. The structured step table and self-check list provided may be of assistance.