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SaudiMOH Saudi_MohSaudiMOH937 MOHPortalwww.moh.gov.sa

Law of Practicing Healthcare Professions

Issued under the Royal Decree No. M/59 dated 04/11/1426H and its implementing regulation issued by the ministerial resolution No.

4080489 dated 12/01/1439H.

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Law of Practicing Healthcare Professions

Regulations of Practicing Healthcare Professions

Kingdom of Saudi Arabia No. 4040489 Ministry’s Office (275) Date: 02/01/1439H Attachments:

Ministerial Resolution

The Minister of Health, based on the powers conferred upon him, having examined Law of practicing health care professions issued by the Royal Decree No. (M/59) dated 04/11/1426H, having considered Article No. (43) of law of practicing health care professions stipulates that the Minister of Health shall issue the Law’s implementing regulations and as dictated by the

public interest. The following decisions were taken:

First: Approving the implementing regulations of law of practicing health care professions in the form attached to this resolution.

Second: This resolution shall be effective from the date of its issuance and shall be published in the Official Gazette and the website.

Minister of Health Tawfiq Bin Fawaz Al Rabiah

(Signed)

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Law of Practicing Healthcare Professions

Chapter (1) Profession Practice License

Article (1): The following words and expressions – wherever mentioned herein – shall have the meanings stated below, unless the context requires otherwise. Health Practitioner Any person licensed to practice the health professions including the following categories: physicians, dentists, pharmacists, health technicians in radiology, nursing, anesthesiology, laboratory, pharmacy, optics, epidemiology, artificial limbs, physiotherapy, dental care and prosthodontics, computed tomography (CT), nuclear medicine, laser devices and operations, and psychiatrists, social workers, dietitians and specialists of public health, gynecology, first aid, speech and hearing therapy, vocational rehabilitation, occupational therapy, medical physics and other health professions agreed upon between the minister of health, minister of civil service and Saudi Commission for Health Specialties. Minister: Minister of Health Ministry: Ministry of Health Commission: Saudi Commission for Health Specialties The Regulation: 1-1 The commission shall update the health professions and issue the list of health practitioner

whenever necessary. It shall submit its recommendations to Minister of Health for approval in order to coordinate with Minister of Civil Service to agree on the same. Noting that, the commission is concerned with approving the health specialties that are considered branches of any health profession.

Article (2): a- It is strictly forbidden to practice any health profession without obtaining a license from the

ministry. b- To practice a health professions, the following conditions have to be met: 1. Obtain the qualification required for the profession from any medical college, college of

pharmacy, college of applied medical sciences, health college or health institute or any other qualifications required for practicing health professions that are recognized by the commission or obtain a certificate from abroad that is recognized by the commission.

2. A practitioner must complete the mandatory internship prescribed by the commission and should be medically fit.

3. Registration in the commission according to the prescribed requirements. 4. Not to be previously convicted in a crime against honor or honesty unless heshe was

rehabilitated. c- Employment in government authorities on health professions jobs is considered a license for

practicing the profession provided that registration in the commission shall be fulfilled.

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Law of Practicing Healthcare Professions

The Regulation: 2-1 The health practitioner shall be granted the license by the Ministry of health affairs directorates

in regions and governorates, and the practitioner of alternative medicine is granted the license by the National Center for Complementary and Alternative Medicine.

2-2 A fixed-term license may be granted and the requirements of the Commission shall be fulfilled for the following categories, provided that their qualifications shall be approved:

A- Visiting health practitioners or the like. B- Practitioners hired during the classification process 2-3 The alternative medicine may only be exercised under a license from the National Center

for Complementary and Alternative Medicine and according to the specific controls and conditions. In this case, the practitioner of alternative medicine shall be subject to the professional responsibilities set out in this Law, Unauthorized persons shall be referred to the competent authority in accordance with criminal responsibility.

2-4 A compulsory training for the practitioner must have been undertaken under the direct supervision of a licensed practitioner in the same professional field.

2-5 The competent health authority shall be notified by the commission in case of incorrect certificates and documents under which it was hired, so as to be included in the non-hiring and non-licensing list, and the competent health authority shall exclude him and finalizes the deportation procedures for non-Saudis. If the private right is claimed, he shall be referred to the competent authority.

2-6 Obtaining of registration and classification from the Saudi Commission for Health Specialties and approval of the Minister of Education to work in the private health institution by the consultants from university faculty members shall be considered as a license to practice the profession in the private health sector.

2-7 The health practitioners contracted by the medical operating companies to work in government health facilities shall not be appointed until they have been classified and registered by the commission, and their appointment shall be deemed a license to practice the profession.

2-8 The experience requirements for the health practitioners working in government agencies shall be determined in accordance with regulations and rules that are consistent with the health professions regulation and civil service law.

2-9 The regulations relevant to exercising the profession stipulated in the law of private health institutions, Law of Pharmaceutical Preparations and Installations, the Law of Fertilization and Embryology Unit and infertility treatment and their implementing regulations shall be taken into account when licensing health practitioners to work in any of these institutions or establishments. The requirements of qualifications and experience shall be determined in accordance with the commission’s regulations and guidelines issued to determine the criteria for acceptance of qualification and experience.

2-10 A practitioner who has been convicted of any crime against honor or trust shall not be granted a license to exercise the health profession nor shall be renewed unless rehabilitated under a decision of the competent authority.

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Law of Practicing Healthcare Professions

Article (3): 1- The healthcare profession’s practicing license term shall be determined by the Implementing

Regulations of this Law. Any practitioner who has been suspended from practicing the profession for two consecutive years– for purposes other than studying or training in the profession– may resume practice only after renewal of the relevant license.

2- Provisions for recruitment, registration and licensing of visiting physicians shall be provided for in the implementing regulations.

The Regulation: 3-1 The license for employees in government authorities shall be valid as long as the health

practitioner is on the medical work, and the renewal of the professional registration shall be considered by the commission at the end of its office.

3-2 The private health institutions employees’ license term shall be equivalent to the professional registration term with the commission. If there is any change in the workplace during the period of professional registration without changing the specialty, the registration shall remain in force.

3-3 The license renewal shall be issued in accordance with the requirements referred to in Articles (2& 3) of this Law.

3-4 The license shall be deemed cancelled in the following cases: 1- If a period of six months has been elapsed from the date of the license issuance without

actual practice. 2- If the license of the private health institution in which he works is cancelled or the

employment contract of the company by which he was recruited is terminated unless he has been transferred to a licensed health institution, or the licensed physician period of visit is elapsed.

3- If the health practitioner changes his specialty without the approval of the Ministry of Health.

4- If a decision is issued by the competent authority to suspend or cancel the license. 5- Death of the licensee. 3-5 Health practitioner must apply for renewal of a license granted before the expiry of at least

one month. 3-6 The health practitioner shall be subject to the disciplinary responsibilities set forth in this Law

if he continues to work after the end of the license granted to him. 3-7 Visiting health practitioners are recruited in accordance with the following rules: 1- The visiting health practitioner must have a license to practice the profession in the country

of origin. 2- The recruitment of the visiting health practitioner shall be limited the hospitals and

polyclinics set up for the visiting health practitioner’s area of specialty and potentials. 3- The visiting health practitioner should have rare disciplines or new techniques required in

the Kingdom. 4- The visiting health practitioner should not be sentenced by a legal limit, criminal judgment,

because of medical error or was deported from the Kingdom for reasons related to health professions.

5- Upon determining the visit duration, sufficient time should be taken into account to evaluate the medical procedures undertaken during the visit.

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Law of Practicing Healthcare Professions

6- The health facility shall guarantee the payment of compensation stipulated in a final judgment in case of medical error issued by the visiting health practitioner in case of the insurance coverage’s unavailability or insufficiency.

7- A consultant or specialist physician of the private health institution shall be mandated to accompany the visiting physician or health practitioner provided to be of the same specialization or the hospital’s medical director in the absence of physicians or practitioners of the same area of specialty, and shall be mandated by the following tasks:

A- Receive and process patients. B- Sharing the visiting health practitioner in diagnosis, treatment plan and surgical

procedure. C- The cases shall be followed-up by the health practitioner after the departure of the

visiting health practitioner and the necessary measures shall be taken to deal with the complications that may result from the method of treatment or surgery.

8- The visiting health practitioner’s request shall be submitted to the health affairs directorate to which the health institution is affiliated and the following shall be attached therewith:

A- A copy of the visiting health practitioner’s certificates and curriculum vitae. B- The program of the visit includes lectures and workshops to be presented by the visiting

health practitioner. C- An acknowledgement of visiting health practitioner to work according to the regulations

in force in the Kingdom and respect Islamic principles. D- An acknowledgment of the accompanying health practitioner by approving to be

mandated to accompany the visiting health practitioner, as well as agreeing to follow up the sick cases, handling complications and to make his statements before the investigative committees and the competent judicial authorities regarding medical errors resulting from diagnosis, treatment or surgery.

9- A copy of the visiting health practitioner’s certificates and curriculum vitae shall be sent to the commission for evaluation.

10- After the commission approval to recruit the visiting health practitioner, the following shall procedures shall be carried out: A- The approval to recruit the visiting health practitioner shall be granted by the

ministry or the competent health affairs directorate. B- After the arrival of the visiting health practitioner and after finalizing all the procedures

stipulated in this regulation, a temporary license shall be issued to him to work in the private health institution and license expires at the end of the visit.

Article (4): The minister may, as dictated by the public interest, limit granting license to practice any of the professions provided for in this Law to Saudis only. The Regulation: 4-1 The license to practice the profession may be restricted to Saudi practitioners for any of the

health professions mentioned in Article 1 of this Law, provided that sufficient number thereof is available in the Kingdom, in a region or for reasons approved by the Minister.

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Law of Practicing Healthcare Professions

Chapter (2) Health Practitioner’s Duties

Section (1) General Duties of Health practitioners

Article (5): Health practitioner practices his profession in the interest of the individual and the society within the scope of respecting the human right to life, safety and dignity, taking into consideration the customs and traditions prevailing in the Kingdom, refraining from exploitation. The Regulation:

5-1 The patient’s right should be health practitioner respected in accordance with the Sharia’s principles and the approved medical criteria.

5-2 Health professions practicing code of ethics and other guides approved by the commission apply to health practitioners.

5-3 Health practitioner shall be prohibited to photograph or publish surgeries or remedial procedures unless the following controls are available:

A- Written consent of the patient. B- Approval of the health facility. C- For approved scientific purposes. D- Not to violate public morals and profession ethics.

Article (6): The health practitioner shall be committed to assist the competent authorities in performing their duties to protect public health and to prevent threats in peace and war.

Article (7): A- The health practitioner shall work to develop his knowledge, follow up scientific evolutions

and new discoveries in his area of specialty, and the managements of health establishments shall facilitate his attendance at seminars and courses in accordance with the controls assigned by the Commission.

B- The health practitioner should not practice the methods of diagnosis and treatment that are scientifically unrecognized or prohibited in the Kingdom.

The Regulation: 7-1 Knowledge shall be developed by attending conferences, scientific and training seminars,

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Law of Practicing Healthcare Professions

lectures, research participation and providing sources of information for health practitioners. This shall be taken into consideration when considering promotions, re-registration or renewal of the license to practice the profession.

7-2 Knowledge advancement controls shall be defined by the commission to the health practitioner and health facilities managements provided to include hours of continuous health education, training accredited hours and the type of courses required in the health practitioner’s area of specialty, and these controls shall be published in the appropriate manner. The health facility shall enable the health practitioner to complete the prescribed hours of continuing education in a manner consistent with the health practitioner’s commitment to patients.

Article (8): The health practitioner who learns or becomes aware of a patient or injured person in a critical condition shall provide all possible assistance or ensure that he receives required care. The Regulation: 8-1 The health practitioner shall provide urgent medical care to the patient who requires such

care in accordance with his available potentials without asking his fees in advance. If the patient requires further medical care which cannot be offered by the health practitioner, then the health practitioner shall communicate with the concerned entities to find a way to transport him to the nearest appropriate health facility for treatment.

Article (9): A- Healthcare shall always be in the interest of patients, and the health practitioner shall do his best to all patients. B- A health practitioner may not, except in emergencies, practice an act beyond his specialty or potentials. The Regulations: 9-1 The health practitioner shall not practice any medical procedure that does not achieve the

desired benefit to the patient, even if there is no harm pertaining thereof, such as prescription of unnecessary drugs or examinations or to the patient’s referral to inpatient section if his condition was not at risk.

9-2 The health practitioner is obliged to work in accordance with the medical powers “privileges” and the job description given to him according to the commission’s classification and registration.

9-3 The employer shall highlight the powers in writing and comply therewith.

Article (10): A- A health practitioner is strictly forbidden- save as in cases prescribed by the implementing

regulation- from advertising or promoting himself directly or by mediation. B- A health practitioner is prohibited from indicating on signs, cards, prescriptions or

advertisements, academic titles or specialties he has not obtained in accordance with relevant rules.

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Law of Practicing Healthcare Professions

The Regulations: 10-1 Without prejudice to the provisions of article 31 of the Law of private health institutions and

its executive regulations, a health practitioner shall refrain from promotion and advertising by various means, such as promoting himself or making advertisements of a commercial nature that are not based on scientific grounds or contrary to the profession’s ethics.

Article (11): A health practitioner, upon examination of a patient suspected to have incurred a crime related injury or to have an infectious disease, shall immediately notify the competent security and health authorities. The Minister shall issue a decision designating diseases that must be reported, the authorities to be notified and procedures that must be followed in this respect. The Regulation: 11-1 A health practitioner, upon examination of a patient suspected of being criminally injured,

shall prepare a detailed report covering the expected length of recovery and a precise injury description signed by two physicians accredited by the health establishment.

11-2 The competent authority in the Ministry shall designate the communicable diseases to be reported, the competent authority to be notified, and establish the appropriate preventive and curative rules and procedures. The Minister shall issue a decision, and the same shall be updated periodically provided to be available to all health practitioners.

11-3 The health practitioner shall comply with the decisions and instructions governing the reporting of infectious diseases and notification shall be reported to the competent authorities directly or through the facility employing the health practitioner.

Article (12): A health practitioner may not practice more than one healthcare profession, nor may he practice any other profession the practice that conflicts with healthcare professions. He is prohibited to request, accept or take a commission or reward, and also he is strictly forbidden to receive any benefit in return for promoting or strictly prescribing certain medications, or equipment or directing patients to a particular pharmacy, hospital, laboratory or the like. The Regulation: 12-1 A health practitioner may not exercise more than one health profession even if he has

qualified to do so. 12-2 A health practitioner is prohibited to obtain any material or in-kind benefit from pharmaceutical

or medical equipment companies for the purpose of promotion or marketing, and to force the patient towards a specific product or service against the patient.

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Law of Practicing Healthcare Professions

Article (13): A health practitioner may not, in non-emergency situations, conduct examinations, treatment in return or free of charge in pharmacies or places not designated for such purpose.

Article (14): A health practitioner is prohibited from: A- Employ unlicensed healthcare professionals or provide assistance to any person illegally

practicing a healthcare profession. B- Retain drugs and vaccinations in the workplace contrary to instructions issued by the

Ministry, except for pharmaceutical facilities. C- Sell drugs to patients, except in pharmaceutical facilities, or sell medication samples under

any circumstances. D- Facilitate a patient’s access to any undue or unlawful privilege or benefit, whether material

or otherwise. E- Accommodate patients in places other than those designated for this purpose, except in

emergencies. F- Use diagnosis or treatment equipment prohibited in the Kingdom.

The Regulation: 14-1 A health practitioner is prohibited from issuing incorrect or exaggerated reports in order to

give the patient sick leave, health certificate or any other benefit. 14-2 A health practitioner may retain unexpired drugs which are not assigned for sale or first

aid provided to be properly maintained and stored in his workplace to be dispensed free of charge in emergency cases.

14-3 A health practitioner is prohibited from using unauthorized diagnosis or treatment equipment.

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Section (2) Duties of health practitioner toward patients

Article (15): A health practitioner shall exert due diligence in diagnosis, utilizing appropriate technical methods and any specialists or assistants the case may require and provide the patient, upon his request, with reports on his condition and test results, taking into account accuracy and objectivity in this regard. The Regulation: 15-1 In this vein, the regulations governing the issuance of medical reports on sick leave,

fitness, reports relevant to criminal injuries, death certificates and other official reports shall be complied with.

15-2 The health practitioner, who is aware of the lack of means or specialties required for diagnosing and treating the case, use due care regarding the patient referral to facilities where necessary capabilities are available.

Article (16): A health practitioner may, other than in serious or emergency cases, apologize for the treatment

of a patient for professional or acceptable personal reasons. 16-1 An apology based on differences of religion, color, sex or race is not acceptable. 16-2 A health practitioner may, before apologizing for follow-up treatment, ensure that the

patient is not harmed and inform the competent authority to ensure the continuation of the treatment plan.

Article (17): An attending health practitioner shall, if he sees a need for a second opinion, alert the patient or his family thereof and shall agree to seek assistance from other healthcare professionals if so requested by the patient or his family. The heath practitioner may propose names of health practitioners he deems fit for consultation. If the attending health practitioner decides that there is no need to consult another health practitioner or disagrees with his opinion upon consultation, he shall have the right to discontinue treatment, with no obligation to give justification therefor. 17-1 A health practitioner shall introduce himself to the patient, his specialty and scientific

degree upon launching treatment. 17-2 If the patient’s diagnosis or treatment requires other specialties or diagnosis means, the

health practitioner shall clarify thereof and the grounds for doing so.

Article (18): A health practitioner shall be committed to, after explaining the therapeutic or surgical condition

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Law of Practicing Healthcare Professions

and implications thereof, alert the patient or his family to the necessity of following the instructions provided and warn them of the seriousness of the consequences of failing to follow said instructions. A physician may, in cases of incurable or life threatening diseases, decide, as his conscience dictated, whether it is appropriate to inform the patient or his family of the fact of his disease, unless prohibited to do so by the patient or if the patient designates a person to be exclusively informed. The Regulation: 18-1 A health practitioner shall explain to the patient, his family or a person designated by the

patient the possible side effects pertaining to the therapeutic or surgery procedure. 18-2 A health practitioner shall not divulge the patient’s medical secrets the details of his

medical condition except to the patient himself, his family or a person designated by the patient.

Article (19): No medical intervention may be performed except with the consent of the patient, his representative or guardian if the patient is legally incompetent. As an exception, a health practitioner must in cases of accidents, emergencies or critical cases requiring immediate or urgent medical intervention to save the patient’s life or an organ thereof or to avert severe damage that might result from delay, where the timely consent of the patient, his representative or guardian is unattainable– intervene without waiting for such consent. Under no circumstances may the life of a terminally ill patient be terminated even if so requested by the patient or his family. The Regulation: 19-1 The consent of the rational and adult patient must be obtained, whether a man or a woman,

or his representative or if the patient is legally incompetent prior to any medical intervention in accordance with the content of the Royal Decree No. M/2428/4 dated 29/07/1404H based on the decision of Council of Senior Scholars No. 119 dated 26/05/1404.

Article (20): A physician assigned to conduct a medical examination on a deceased body may not report death except after ascertaining the cause of death, based on his medical expertise. The physician however, may not provide such report if the death is suspected to be caused by a criminal act. In such case, he must immediately notify the competent authorities. The Regulation: 20-1 A thorough medical examination shall be conducted by the physician, prior establishing

the death, to ensure that the body vital functions are stooped through clinical examination and other technical means. A death report may only be issued after ascertaining by the technical means and death time shall be recorded.

20-2 When traces of injury or toxicity were suspected, the physician shall: A- Notify the responsible department in the health facility in which he is employed, which in

turn notifies the competent security authorities in an official manner.

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B- Confirm injuries under a medical report delivered to the competent security authorities. C- A physical examination, at the time of body revisit, shall be carried out by the forensic

physician, when summoned, and if he deemed that the autopsy is required to prove the cause of death, he shall request the security authorities to issue an order of autopsy while retaining all evidences related to the deceased such as clothes, ballistics and the like.

Article (21): A health practitioner shall maintain the confidentiality of information obtained in the course of his practice and may not disclose it except in the following cases: A- If disclosure is for the following purposes:

1- Reporting a case of death resulting from a criminal act or to prevent the commission of a crime; in which case, disclosure may only be made to the competent authorities.

2- Reporting communicable or epidemic diseases. 3- A practitioner rebuts accusations pertaining to his competence or practicing of his

profession made by the patient or his family. B- If the patient agreed in writing to disclose the secret, or if disclosure to the patient’s family

is useful for his treatment. C- If so ordered by a judicial authority.

Article (22): A physician shall be strictly prohibited to abort a pregnant woman unless it is necessary to save her life. However, abortion may be carried out if pregnancy has not completed four months and conclusively established that the continuation of such pregnancy will have serious consequences on the mother’s health, based on a decision by a medical committee formed in accordance with terms and conditions specified in the Implementing Regulations of this Law. The Regulation: 22-1 the decision of Council of Senior Scholars No. 140 dated 20/06/1407H includes the

following controls: 1- Pregnancy may not be aborted in all its stages except for legitimate justification and

within very narrow limits. 2- If the pregnancy is in the first phase, which is forty days, and if it’s abortion by a legitimate

interest or limiting expected harm, abortion may be valid. However, abortion during this period for fear of hardship in raising children or fear of being unable to pay for their living, education, for their future or parents are satisfied with their number of children, then abortion is impermissible.

3- Abortion shall be impermissible if it is a clinging substance or embryo until a reliable medical committee decides that the continuation of such pregnancy will have serious consequences on the mother’s health, therefore, abortion may be valid after exhausting all means to avoid such risks.

4- After the pregnancy enters in the 3rd phase and after completion of four months, abortion is impermissible until determined by collection of specialists that keeping the fetus in

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