Issues with the Medical Ethics in India

Syllabus: Applications of Ethics

Source: TH

Context: The article highlights systemic issues in medical ethics oversight in India.

What is Medical Ethics?

Medical ethics addresses ethical choices in healthcare, defining what is right or wrong within a specific cultural context. It governs the responsibilities of healthcare providers, including doctors, hospitals, and other professionals, towards patients and society at large.

Issues with the Medical Ethics in India:

• Informed Consent: Often not obtained adequately or at all from patients, especially in clinical trials involving vulnerable populations.

• Patient Privacy: Lack of stringent measures to protect patient data and confidentiality.

• Conflicts of Interest: Instances where doctors have financial interests in treatments or procedures they recommend E.g., involvement of senior doctors of Apollo hospitals in the organ trade racket.

• Doctor-Patient Trust: Erosion due to the commercialization of healthcare and lack of transparency.

• Regulatory Oversight: Weak enforcement and compliance with ethical guidelines, leading to abuses in clinical trials and patient care.

• Inequitable Access: Disparities in healthcare delivery and access to treatments based on socio-economic factors.

Provisions of the Code of Medical Ethics:

Provisions | Description

Character of Physician | A physician must uphold the dignity and honour of the profession. They should be upright, instructed in healing, pure in character, diligent in caring, modest, sober, and patient.

Maintaining Good Medical Practice | Physicians should continuously improve their medical knowledge and skills, sharing benefits with patients and colleagues. They must practice methods based on scientific principles.

Maintenance of Medical Records | Every physician must maintain indoor patient records for at least 3 years from the start of treatment.

Use of Generic Names of Drugs | Physicians should prescribe drugs using generic names whenever possible to ensure rational prescription and usage.

Exposure to Unethical Conduct | Physicians have a duty to expose incompetent, corrupt, dishonest, or unethical conduct within the profession, without bias.

Obligations to the Sick | While not obliged to treat every patient, physicians should not arbitrarily refuse treatment, especially in emergencies. They may advise seeking another physician’s service when appropriate.

Other Measures Needed:

• Boosting Medical Humanitarianism: Provide regular training and support to enhance doctors’ empathy and compassion towards patients.

• Respectful Interaction: Encourage effective communication between doctors and patients, promoting familiarity with patient histories and routines to revive the concept of ‘family doctors’.

• Focus on Emergency Medicine (EM): Introduce dedicated EM residents trained to handle tough situations, manage charged environments, and deliver difficult news effectively in emergency rooms and trauma centres.

• Enforcement of Ethical Guidelines: Ensure strict adherence to ethical guidelines and cultural sensitivity among physicians and hospital ethical committees.

• Ensuring Doctor Confidence: Implement measures for doctor safety such as security guards, CCTV cameras, and displaying patient interaction guidelines in regional languages within hospitals.

Insta Links:

• Medical Ethics: ‘Cash-for-Kidney’ scam

Mains Links:

Case Study:

Dr. X is a leading medical practitioner in a city. He has set up a charitable trust through which he plans to establish a super-specialty hospital in the city to cater to the medical needs of all sections of society. Incidentally, that part of the State had been neglected over the years. The proposed hospital would be a boon for the region. You are heading the tax investigation agency of that region. During an inspection of the doctor’s clinic, your officers have found out some major irregularities. A few of them are substantial which had resulted in considerable withholding of tax that should be paid by him now. The doctor is cooperative. He undertakes to pay the tax immediately. However, there are certain other deficiencies in his tax compliance that are purely technical in nature. If these technical defaults are pursued by the agency, considerable time and energy of the doctor will be diverted to issues that are not so serious, urgent, or even helpful to the tax collection process. Further, in all probability, it will hamper the prospects of the hospital coming up. There are two options before you: Taking a broader view, ensuring substantial tax compliance, and ignoring defaults that are merely technical in nature. Pursue the matter strictly and proceed on all fronts, whether substantial or merely technical. As the head of the tax agency, which course of action will you opt for and why? (250 words)