Moral and legal duties

Issue: BCMJ, vol. 43, No. 7, September 2001, Page 380 Letters

With reference to my letter published in your March issue [BCMJ 2001;43(2): 68] and Dr Mador’s comments that appeared in June [BCMJ 2001;43(5): 263] I would like to remind readers, physicians, and patients alike, that our Canadian medical insurance system is fundamentally different from that in Great Britain. (I am unaware of the legal implications in other countries.)

On being admitted to a National Health Service hospital in Great Britain, the patient enters a contract with the NHS for medical care. In Canada the patient’s contract is still with his or her personal physician. The state is under no obligation to provide medical care, but merely to pay the physician’s bill. The failure of a consulting physician in the NHS to attend a patient under his care is indeed a reprehensible lapse of a moral duty, but in the case of an attending physician in a Canadian hospital is also a breach of a legal contract.

—Michael Alms, MB 

Michael Alms, MB. Moral and legal duties. BCMJ, Vol. 43, No. 7, September, 2001, Page(s) 380 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply