as approved on February 26, 2019


The Code of Ethics of the Philippine Society of Nephrology, Inc. was first drafted in 2004, and last revised in 2016, with the provision that it may be amended anytime by the National Board of Trustees of the Philippine Society of Nephrology, upon the recommendation of the Council of Past Presidents. Given the rapid pace of change in the landscape of our society today (political, economic, technological, and sociocultural), and the many challenges that nephrologists face in the various roles that they fill (not just as clinicians, but also as medical directors of dialysis units, owners of dialysis facilities, advisors and consultants for the pharmaceutical industry, academicians, administrators, etc.), the Council of Past Presidents considered it timely to review our Code of Ethics to see if any updates might help to better guide all of us in facing all these challenges and still be able to stay true to our calling, always keeping the interests of our patients and the health and well being of the general public in mind as the highest good, and staying true to our promise and commitment to be in service of this noble end.

The Council of Past Presidents (COPP) undertook a review of our Code of Ethics, ensuring its alignment with the World Medical Assembly International Code of Medical Ethics (WMA Code of Ethics), a document that is particularly significant because of the following considerations:

(1)The Philippines, through the Philippine Medical Association, is a signatory of this globally endorsed document.

(2)The WMA is “the only international organization that seeks to
represent all physicians, regardless of nationality or specialty.”
(Williams, 2015)1

(3)The WMA has “undertaken the role of establishing general
standards in medical ethics that are applicable worldwide”2 , and was the same organization that produced the Declaration of Geneva, which is an update of the Hippocratic Oath, in 1948, and the Declaration of Helsinki in 1964.

(4)The WMA developed the International Code of Medical Ethics in 1949, and has revised it three times since then, in 1968, 1983 and 2006.

This update of the PSN Code of Ethics is the product of a review by the Council of Past Presidents, completed on January 31, 2019, and underwent further revision by the National Board of Trustees on February 26, 2019. This document is the final version of the PSN Code of Ethics as approved by the National Board of Trustees on February 26, 2019. This Code of Ethics will serve as a guideline for the way nephrologists think, speak and act while serving patients, as well as in their relationship with colleagues, allied professionals, and the community. In this document, the term “Nephrologist” pertains to all the various categories of membership in the Philippine Society of Nephrology, Inc., as defined in its constitution and by-laws.

1 Williams, JR. World Medical Association Medical Ethics Manual 3rd Edition, 2015, page 24
2 Ibid


  1. All physicians practicing the subspecialty of nephrology must be certified as nephrologists by the Philippine Society of Nephrology and as internist/pediatrician by the Philippine College of Physicians (PCP)/Philippine Pediatric Society (PPS).
  2. The nephrologist should always endeavour to be guided by ethical principles in their decision making – respectful of human rights, mindful of the benefits as well as the risks and burdens entailed by certain courses of action, and always seeking the highest good of the patient by any decision and course of action taken.
  3. Service to humanity is the primary objective of the practice of nephrology, made available to all patients regardless of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor.
  4. The nephrologist has the duty to constantly update their scientific knowledge in the field of nephrology and share it with colleagues, students, allied professionals and the community.
  5. The nephrologist’s professional conduct in private and public should always be in keeping with the honourable traditions of the medical profession as embodied in the Declaration of Geneva (which is an updated version of the Hippocratic Oath; see end of this document), the World Medical Association International Code of Ethics, the Codes of Ethics of the Philippine Medical Association, the Philippine College of Physicians, the Philippine Pediatric Society and the Professional Regulation Commission.
  6. The nephrologist should seek appropriate care and attention if he/she suffers from mental or physical illness.


  1. The nephrologist should always exercise independent professional judgment and maintain the highest standards of professional conduct.
  2. The nephrologist should be dedicated to providing competent medical service with compassion and respect for human dignity, always having the best interests of the patient as his/her goal, and always proceeding with the assumption that their relationship is an implied contract of trust and confidence.
  3. The nephrologist should respect the patient’s right to confidentiality. The rules of privileged communication should not be violated except when required by law or when there is a real and imminent threat of harm to the patient or to others and this threat can be only removed by a breach of confidentiality. It is ethical to disclose confidential information when the patient consents to it.
  4. The nephrologist is under no obligation to accept a patient, especially if the case is not within the scope of his/her expertise, except in emergency situations when there is no one else who is willing and able to give such care.
  5. The nephrologist must always respect the patient’s right to
    choose his/her nephrologist.
  6. The nephrologist should inform the patient of the nature of
    his/her illness and the prognosis thereof if possible.
  7. The nephrologist should respect a competent patient’s right to accept or refuse treatment. The nephrologist should secure the patient’s voluntary and informed consent for the proposed management agreed upon, after having explained the risks and benefits, possible consequences of refusal by the patient, any available alternatives to the proposed course of action, as well as the immediate and long-term financial costs if possible.
  8. The nephrologist should refer to, and consult with other specialists as needed, with the consent of the patient, for the purpose of giving the best service. In case of multiple physicians, the attending physician should act as the “captain of the ship”.
  9. The nephrologist should not prescribe, dispense, manufacture or provide remedies which have not been approved by the Philippine Food and Drug Administration and/or boast of radical cure or exhibit testimonial successes for their use, without good scientific basis.
  10. The nephrologist should ensure that professional fees or honoraria should be commensurate with the services rendered as well as the ability of the patient to pay, with due consideration to the difficulty/seriousness of the case, one’s experience and expertise, and the prevailing fees in the community/hospital.
  11. The nephrologist should always declare any relevant conflicts of interest to patients – e.g. ownership of dialysis units, referrals to entities in which the Nephrologist has a financial interest, et al– and should not allow his/her judgment to be influenced by personal profit or unfair discrimination.
  12. The nephrologist should not enter into a sexual relationship with his/her current patient or into any other abusive or exploitative relationship.
  13. In compliance with the Declaration of Istanbul of 2008, the Nephrologist should not engage in nor encourage the selling and purchase of human organs for transplant purposes. Organs from living donors should be secured only with voluntary and informed consent.
  14. The nephrologist engaged in research involving human subjects should always adhere to the Codes of Ethics of the Philippine College of Physicians, the Philippine Pediatric Society, the Nuremberg Code, the Declaration of Helsinki, and Good Clinical Practice guidelines.


  1. The nephrologist should respect the rights and preferences of colleagues and other health professionals. The Golden Rule – that the nephrologist should behave towards colleagues as he/she would have them behave towards him/her – should always be the guiding principle and should be upheld at all times. Relationships among colleagues should always be one of mutual respect and cooperation with the patient’s welfare as the end goal.
  2. The nephrologist should not undermine the physician-patient relationship of colleagues in order to attract patients.
  3. The nephrologist should assist a colleague in the management of patients referred for opinion, co-management or for transfer of service.
  4. The nephrologist should willingly give free medical service to colleagues as well as their immediate dependents.
  5. The nephrologist should NOT receive any financial benefits or other incentives solely for referring patients and prescribing specific products. He/she should not indulge in fee splitting, receive commissions, referral fees and rebates nor solicit patients and professional services given by diagnostic clinics and dialysis centers.
  6. The nephrologist should deal honestly with colleagues; and should report to the Ethics Committee of PSN those nephrologists who practice unethically or incompetently or who engage in fraud or deception.


  1. The nephrologist should strive to use health care resources in the best way to benefit patients and their community.
  2. The nephrologist should not advertise nor employ propaganda schemes with the purpose of enticing patients.
  3. The nephrologist should recognize his/her important role in educating the public but should use due caution in divulging discoveries or new techniques or treatment through non- professional channels; and should warn the public of false pretensions and fraudulent practices that may cause injury or death to patients. Likewise, the nephrologist should only certify that which he/she has personally verified.
  4. The nephrologist should participate in civic actions or mercy missions anytime the need arises.


  1. The nephrologist should cooperate with and safeguard the interests, reputation and dignity of individuals in the paramedical fields as long as they do not violate their respective ethics.
  2. The nephrologist should not allow technical and pharmaceutical industries to use his/her name in the promotion of equipment, drugs and other medical products for commercial purposes except in scientific meetings, journals, and research.
  3. The nephrologist should not solicit monetary/financial support or any personal services for self-serving ends.
  4. The nephrologist’s practice pattern should not be influenced by his/her relationship with the pharmaceutical industry.
  5. The Nephrologist should adhere to the PCP Guidelines for Educational Symposia, the PCP Conduct of Sponsorship by Pharmaceutical Companies during PCP conventions and the Department of Health-Administrative Order 2015-0053 on “Implementing Guidelines on the Promotion and Marketing of Prescription Pharmaceutical Products and Medical Devices.”


  1. The nephrologist should prioritize the promotion and advancement of health when posting in social media.
  2. The nephrologist should ensure that all information posted, liked or shared on social media are accurate and should benefit the Filipino community.
  3. Patients’ confidentiality and privacy should be maintained at all times. The Nephrologist should value patients’ dignity and privacy by not taking selfies, groufies or videos during patient encounters. These include patients’ body parts, surgical specimens or pictures that show patients in the background without their consent.
  4. The Nephrologist should not use online platforms to rant or bash patients and other health professionals.


  1. The nephrologist may join a group practice with other medical specialists provided the professional ethics of each subspecialty is observed at all times.
  2. Professional fees may be collected as a group or individually, depending upon the agreement of both parties and patients.
  3. Patients should be fully informed about the capabilities and expertise of the members of the group, the clinics or the dialysis centers.
  4. The nephrologist should, in situations when he/she is acting for a third party, ensure that the patient has full knowledge of that situation.


  1. This Code of Ethics will be posted in the PSN website and will be distributed to all members of the Philippine Society of Nephrology upon approval by the PSN National Board of Trustees.
  2. Ethical practices should be observed in all PSN activities including training programs, continuing medical education activities, research and community service.
  3. Violation of any provisions of the code will constitute unethical practice and will be held as ground for sanctions from the PSN. Sanctions may be classified as: (1) reprimand, (2) suspension, or (3) expulsion from PSN, based on guidelines set by the Ethics Committee. All violations should be reported to the Ethics Committee, who will have the authority to review the cases and make appropriate recommendations to the PSN National Board of Trustees.
  4. The Code of Medical Ethics of the Philippine Medical Association, Philippine College of Physicians and the Philippine Pediatric Society will cover events or provisions not included in this Code.
  5. This Code of Medical Ethics can be amended anytime by the National Board of Trustees of the Philippine Society of Nephrology upon the recommendation of the Council of Past Presidents.


 [an updated version of the Hippocratic Oath]

Adopted by the 2nd General Assembly of the World Medical Association, Geneva, Switzerland, September 1948 and amended by the 22nd World Medical Assembly, Sydney, Australia, August 1968 and the 35th World Medical Assembly, Venice, Italy, October 1983 and the 46th WMA General Assembly, Stockholm, Sweden, September 1994 and editorially revised by the 170th WMA Council Session, Divonne-les- Bains, France, May 2005 and the 173rd WMA Council Session, Divonne-les-Bains, France, May 2006 and amended by the 68th WMA General Assembly, Chicago, United States, October 2017 


I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;

THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;

I WILL RESPECT the autonomy and dignity of my patient;

I WILL MAINTAIN the utmost respect for human life;

I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;

I WILL RESPECT the secrets that are confided in me, even after the patient has died;

I WILL PRACTISE my profession with conscience and dignity and in accordance with good medical practice;

I WILL FOSTER the honour and noble traditions of the medical profession;

I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;

I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;

I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;

I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;

I MAKE THESE PROMISES solemnly, freely, and upon my honour.