| Indian Journal of Medical Ethics | ||||||
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FROM THE PRESS Medicine
merchants Few US doctors know that their prescribing
practices are available to pharmaceutical manufacturers for a fee. Drug makers
buy information from pharmacies, the government and the American Medical
Association to compile 'prescriber profiles', to sway doctors' prescribing
habits. The AMA generates $20 million annually by selling biographies of every
American doctor. Of the $13.9 billion that drug companies spent
promoting their products last year, 87 percent was aimed at the one million
doctors, nurse practitioners and physicians' assistants who can prescribe some
medications. Marketers say they use the reports to help
determine which doctors should be offered certain perks. Sheryl Gay Stolberg and Jeff Gerth: Medicine
merchants / tracking the doctors high-tech stealth being used to sway doctor
prescriptions, New York Times, November 16, 2000 Cross-border trade Patients undergoing dialysis in Germany received a
circular from an organisation based in the Czech Republic offering kidney
transplants without waiting lists from live donors. In Germany, 12,000 of the
50,000 patients receiving dialysis are waiting for a transplant. The Czech
Republic does not yet have a law forbidding organ trade. Since 1997, German law
bans any trade in human organs or attempts to solicit trade. Annette Tuffs:
German doctors condemn kidney offer BMJ November 18, 2000. Just an error in paperwork A 25-year-old woman
admitted to the Sawai Man Singh Hospital, Jaipur, for the removal of kidney
stones ended up losing her uterus when her records were confused with those of
another patient with the same first name. When surgical staff were asked why
their preparations were so elaborate for relatively minor surgery, they told the
patient to shut up, and administered her anaesthesia. The mix-up was noticed
when the woman's husband read the patient slip after she was brought out of the
operating theatre. P Kaushal: Rajasthan docs goof up, remove
woman's uterus, Indian Express, November 20 2000 Pay up or else A worker suffers a stroke in the office and is
rushed to a private charitable hospital but dies shortly after. His relatives
cannot claim his body till they paid up Rs 30,000, borrowing from friends and
neighbours. Consumer activists say managements resort to this
tactic, harassing grief-stricken relatives to claim their dues. Hospital
authorities say this is a misunderstanding. "There are emergency tests, despite
which the patient dies. Relatives blame the hospital for the death and refuse to
pay." The judge of Mumbai's consumer court says a consumer court has already
ruled that there is nothing legally wrong with the practice. Rekha Dixit: Withholding bodies to extract
pound of flesh, The Times of India , January 20, 2001. Radiation overdoses A study by the Bhabha Atomic Research Centre measured radiological doses
for 12 different examinations in 40 hospitals in the country, and found wide
variations. Children received the same doses as adults, which sometimes meant
they got more than five times the necessary dose. Correspondent: Unjustified exposure to radiation: study, Asian Age,
February 23, 2001. Test new drugs on the poor The US-based Discovery Laboratories had planned a placebo-controlled study
in Latin America of sinapultide, a new drug for treating idiopathic respiratory
distress syndrome in premature newborn infants. A control group of 325 babies
would have received a placebo instead of available surfactants, as a result of
which many would have died unnecessarily. The trial would have the Helsinki
Declaration, which requires that new treatments be tested against the best
current method. The company's Dr R Capetola said the study planned three arms:
sinapultide, an already-approved surfactant drug (beractant), and a placebo.
Alternative trial designs were rejected as likely to increase the length of the
study, resulting in thousands of additional deaths and debilitating lung
conditions among infants. Following public protest, the trial was modified to
include an active control. Fred Charatan: Surfactant trial in Latin American infants criticised BMJ
March 10, 2001. Public Citizen press release:http://www.citizen.org/hrg/PUBLICATIONS/1564.htm) How did she get that idea? A 50-year-old woman in Puri, Orissa, wrote to the prime minister and the
National Human Rights Commission saying she is ready to sell one of her kidneys
to save her husband who is suffering from cancer. Mustari Biwi begs every day to
provide a meal for her family. Affected by the cyclone last year, she received
no relief. "I wrote to the chief minister and district commissioner
seeking financial help but got no responses, so I decided to sell my kidney and
arrange the money," she said. Bibhuti Mishra: Woman offers kidney to save husband, Mid-day,
March 12, 2001. A rap on the knuckles The Maharashtra Medical Council Act of 1965 gives the council powers to
deregister doctors found guilty of negligence or malpractice. Of the 162 cases
registered against doctors till date, no doctors have been deregistered. A few
have been suspended, and a number are being heard at present. John Manjali: No doctor deregistered for negligence, Asian
Age, March 22, 2001. Innovative solutions One year ago, municipal hospitals in Mumbai raised fees for registration
and for minor tests, and imposed new charges for various surgical procedures -
as well as for delivery of a third child. The result: a discernible drop
in the number of patients attending the out-patient department as well as for
in-patient treatment. Some patients slip away before they get discharged.
Instead of seeing this as a symptom of people's desperation, some hospitals plan
to deal with the problem by advancing the time of check-out so it doesn't
coincide with visiting hours. Rajiv Sharma: Case of the vanishing patients leaves civic hospitals
baffled: over 100 patients who have refused to pay new medical fees are
'missing', Indian Express , March 22, 2001. Slow and steady On February 13, six people who underwent cataract surgery at the KJ Somaiya
Hospital in Mumbai lost their eyesight after contracting an infection. A state
government inquiry found infection prevention practices, and records,
inadequate. A senior opthalmologist states that quick action could have saved
some people's sight, but the hospital did not have the facilities, nor did it
refer the patients elsewhere. At a press conference on March 21, the hospital's
dean insisted that the infection must have come "from some extraneous source",
but that the management was considering giving compensation to those who lost
their vision. Express News Service: Hospital didn't err: Somaiya dean, Indian
Express, March 22, 2001. |
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