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Oct-Dec2001-9(4)
LETTER FROM SEWAGRAM
Medical ethics beats drug
company lures
SP Kalantri
The Academy of Medical Sciences, Nagpur organised a
workshop on medical ethics on September 8 and 9, at the Udyog bhavan, Nagpur.
Fed up with several 'me too workshops', the Academy wanted to do something
different this year. Several doctors felt that medical ethics was a topic worth
discussing in today's times.
However, some members were not sure if others would
find the theme sufficiently interesting to make them forgo their practice on a
weekend. Why would private consultants spend 12 hours discussing such issues?
And would they come once they knew there was no pre-workshop banquet, that they
would be served simple vegetarian meals, without alcohol? That what they would
get from the organisers would be a pen and writing pad? Would they agree to dig
their own pockets to pay workshop fees because the academy wanted to keep
sponsors out?
Daunting austerity, a potentially uninspiring
theme, according to some. One member even wondered if the Academy made the wrong
decision by agreeing to host such a workshop. But some felt strongly on the
subject. Doctors today lack formal training in medical ethics. Yet they
constantly encounter situations, which call for more than their medical skills.
Few doctors feel able to address the ethical dilemmas they face in their
practice. There are few, if any, role models to guide them. Doctors and patients
are locked in a relationship of mutual suspicion. Practicing medicine was no
longer a pleasure. A debate on ethics would be the first, small step towards
restoring the ailing doctor-patient relationship. It was also felt that a
workshop could lead to setting up a group, in Nagpur, to discuss these issues.
The workshop did not interest doctors when it was first announced. Some argued
that ethicists were armchair critics - too naive to understand the compulsions
of kickbacks. They did not want 'the brigade of self-appointed guardians of
medical morality' to induce a guilt in their mind. How candid! However, interest
gradually picked up and on September 9, the academy's president was at his wit's
end trying to convince doctors that he wouldn't be able to enroll them even if
they offered to pay extra registration fees - imagine, tickets for a workshop on
ethics being sold in black!
Meanwhile, extensive discussion had taken place on
the workshop's contents - most of this by email. One thing everyone was agreed
upon was that talks should be short; there would be no sermonising. The idea was
to get delegates to talk on the issues raised by each presentation.
"But what if an eerie silence greets a speaker
after he finishes his talk? What if the doctors are put off?" Such last-minute
fears plagued the organizers on the eve of the workshop. Some even thought of
planting questions to get things started. They were proved wrong by the
participants, whose hands would shoot up even before the speaker stopped. It was
a testament to the depth of their pent-up feelings waiting to be
expressed, the many doubts they wanted to share with open-minded colleagues.
Scientific meetings in Nagpur rarely witness such passion. Some could barely
conceal their emotions. Heated arguments broke out on the ethics of testing
hospital patients for HIV, whether the spouse of a patient with HIV should be
informed, what is the doctor's responsibility when relatives ask to keep bad
news from the patient… (The next issue of the journal will have a more complete
report on the workshop's discussions.)
Seventy-four doctors enrolled themselves for the
workshop. Fifty-eight actually attended, of them seven were women. There were 25
surgeons, 22 physicians, 10 pathologists, four radiologists, four
gynaecologists, two paediatricians, and a psychiatrist. Only five doctors from
medical colleges - a comment on what teachers of medicine think of the subject.
Incidentally, a drug company had organised an excursion for doctors and their
families on September 9. Still, forty-four doctors resisted the temptation and
sat till the end! The workshop concluded with a resolution to form an ethics
discussion group in Nagpur. The academy showed that an important academic
activity could be conducted with simplicity, and, more important, without
assistance from the drug industry.
One delegate later said: "Today I understood what
Mother Teresa had said a decade ago, that medicine is a vocation. It is not a
profession and it is not a business."
The day before the workshop started, Nagpur newspapers were buzzing with news of the death following surgery of a resident doctor in Government Medical College. The media controversy revealed little of what actually happened. What possible connection does this have to the workshop? Well, is there a system in place for investigating such tragedies, identifying the problem, taking action and making the findings public - all within a reasonable time period? The public's faith in the medical profession depends on such a system.
Dr SP Kalantri,3,
Vivekanand Colony, MGIMS campus, Sevagram (Dist. Wardha) 442102. Email:spkalantri@usa.net.