[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Medical ethics](https://durgical.com/en/medical-ethics/) › [Practising medicine in Colombia](https://durgical.com/en/medical-ethics/areas/professional-law/) › An ill, substance-impaired or incompetent colleague: what to do # An ill, substance-impaired or incompetent colleague: what to do - Topic If a colleague cannot practise safely, the duty to patients requires action: protect them first, then help the colleague and inform whoever must act. Updated Nov 13, 2026 ## Key points - Patient first: a colleague who cannot practise safely must not treat. - Helping the colleague and reporting are not opposites: do both. - Loyalty between doctors (Law 23, art. 29) does not justify silence in the face of risk. - Formal route: head of department or management and, if it persists, the medical ethics tribunal (art. 74). - Looking after one's own health is a professional duty (World Medical Association). ## What it is A doctor is «impaired» when a physical or mental illness, use of alcohol or other substances, exhaustion or a lack of competence prevents practising with reasonable safety. The problem sets two duties against each other: loyalty to the colleague and protection of patients. Professional ethics resolves the conflict in favour of patients, without abandoning the colleague. The World Medical Association asks doctors to look after their own health, to be prepared to report conduct contrary to ethics to the authorities and, as a profession, to make sure colleagues can give safe care, with help and treatment kept separate from disciplinary processes. Colombia has no specific law on impaired doctors; the general duties apply: do not exceed one's own capacity (Law 1164 of 2007, art. 37), do not cover for illegal practice (Law 23 of 1981, art. 53) and the route of the ethics tribunals, which act on their own initiative or on anyone's complaint (Law 23, art. 74). Loyalty between colleagues (Law 23, art. 29) is no reason to stay silent. ## Step by step - If there is an immediate risk (for example, a colleague intoxicated on shift), stop them from treating and make sure someone else takes over the patients. - Separate facts from rumour: note what was seen, when and with what consequences for patients. - Talk to the colleague in private, respectfully and without accusations, and offer help to seek treatment. - Inform the head of department or medical management, who can reorganise the work and activate support. - If the risk persists or harm occurred, file a complaint with the regional medical ethics tribunal. - Keep the colleague's confidentiality from third parties: inform those who must act, not the corridors or social media. ## In clinical practice - A resident smells alcohol on a specialist before surgery: the priority is that they do not operate; the conversation about help comes afterwards. - A burnt-out colleague makes repeated prescribing errors: the department can adjust workload and shifts, and she can get care without stigma. - A doctor who lends a name or signature so that someone without a degree can practise is covering for illegal practice, an express breach of Law 23 (art. 53). - The doctor who treats a colleague as a patient keeps that secret like any other; the World Medical Association asks that they not be required to report more than for other patients. ## Legal framework in Colombia - Law 23 of 1981, art. 29 (loyalty), art. 53 (no covering for illegal practice) and art. 74 (the ethics-disciplinary process starts on the tribunal's initiative or on anyone's complaint). - Law 1164 of 2007, art. 37: competent practice (not taking on work beyond one's capacity) and good name (the team's limitations may be mentioned when necessary and fair for the good of third parties). - No specific Colombian rule on programmes for impaired doctors was found; this page does not claim one. - Official texts verified on 2026-11-13 on funcionpublica.gov.co and minsalud.gov.co. ## Test yourself Think of the answer, then tap the question to see it. ## What does a doctor do first on seeing an intoxicated colleague about to treat patients? Stop them from treating and make sure another professional takes over the patients; the conversation, the help and the report come afterwards. ## Who may file a complaint with a medical ethics tribunal in Colombia? Any person or entity; the tribunal may also act on its own initiative, with at least summary evidence of the facts (Law 23 of 1981, art. 74). ## What does Law 1164 of 2007 say about mentioning a colleague's limitations? They must not be mentioned to undermine the colleague's rights, except when necessary and fair for the good of third parties (art. 37, right to a good name). ## What does the World Medical Association recommend about help for doctors with health problems? That prevention, early help and intervention be available separately from any disciplinary process, and that a doctor treating a colleague need not report more than for other patients. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/medical-ethics/an-ill-substance-impaired-or-incompetent-colleague-what-to-do/) ## Elsewhere in DurgiPedia - [Burnout in health workers](https://durgical.com/en/behavioral-science/burnout-in-health-workers/) - [Compassion fatigue, moral injury and the second victim](https://durgical.com/en/behavioral-science/compassion-fatigue-moral-injury-and-the-second-victim/) - [Addiction concepts: reward, tolerance, dependence and withdrawal](https://durgical.com/en/behavioral-science/addiction-concepts-reward-tolerance-dependence-and-withdrawal/) ## Connections ## Related 4 - [Relations between doctors: case conferences, consultations and criticising a colleague (Law 23 of 1981, arts. 19 to 32)](https://durgical.com/en/medical-ethics/relations-between-doctors-case-conferences-consultations-and-criticising-a-colle/) - [The medical ethics tribunals: process and sanctions](https://durgical.com/en/medical-ethics/the-medical-ethics-tribunals-process-and-sanctions/) - [Medical error: disclosure and apology](https://durgical.com/en/medical-ethics/medical-error-disclosure-and-apology/) - [Professionalism and the virtues of a doctor](https://durgical.com/en/medical-ethics/professionalism-and-the-virtues-of-a-doctor/) [← All of medical ethics](https://durgical.com/en/medical-ethics/) Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal. Sources: [WMA International Code of Medical Ethics (2022), paras. 28 and 37](https://www.wma.net/policies-post/wma-international-code-of-medical-ethics/) (World Medical Association, 2022); [WMA Statement on Physicians Well-being (revised 2025)](https://www.wma.net/policies-post/wma-statement-on-physicians-well-being/) (World Medical Association, 2025); [Ley 23 de 1981, arts. 29, 53 and 74](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=68760) (Función Pública, Gestor Normativo, 1981); [Ley 1164 de 2007, art. 37](https://www.minsalud.gov.co/Normatividad_Nuevo/LEY%201164%20DE%202007.pdf) (Ministerio de Salud y Protección Social, 2007). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. 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