Time to inculcate medical ethics among doctors

The recent strike by the junior doctors of the government hospitals in Karnataka is indefensible and a huge slur on the medical fraternity. Although there may be cause for distress among the junior doctors, striking work cannot be an ethical option for the following reasons.
This profession is chosen by medical aspirants broadly to fulfil a need to serve those who are suffering and unwell. The motivation is essentially altruistic and all other considerations are secondary to that of the patient. Such ethical behaviour is the cornerstone of the doctor-patient relationship and abandoning the patient in the act of striking work is unacceptable and against the tenets of the medical profession.
It is for this reason that doctors take an oath and ‘profess’ to a lofty standard of ethical practice at the beginning of their careers.
The terms and conditions of their employment in government hospitals have clearly been agreed to at the time of recruitment. The doctors may have legitimate work-related problems and needs, but striking work is not a method to address them. There is always the option to resign and seek work elsewhere if unsatisfied. Alternatively, they can bring these problems to those in authority and seek redressal of grievances and wage hikes through discussion and negotiation. To hold the vulnerable patient hostage in such situations is the lowest, most deplorable act and cannot be allowed in civilised society.
The judges of the high court were right in condemning such unethical practice by the doctors and recommending stern action. Since government hospitals are run by the state and medical officers employed by them are duty bound to extend medical assistance, any patient who is denied care due to the strike is being denied his right to health by the state, as part of his Constitutional Right to Life (Art 21).
He can seek constitutional remedy by filing a writ petition under Article 226, which fixes the liability for public wrong on the State which failed in the discharge of its duty to protect the fundamental rights of its citizens.

Victims are voiceless

The tragedy is compounded in our country by the fact that government hospitals are used by the most vulnerable fraction of the population. The economically, educationally backward citizens, deprived of choices in healthcare are the voiceless victims in this disgraceful debacle. It is on their behalf that we must condemn this action by members of our medical fraternity and raise awareness so that it does not recur.
Having said this, it can be a wake-up call to the ministry of health to lift the work standards as well as standards of care in our much maligned government hospitals so that it may attract talent and transform itself leading to a more equitable distribution of health resources in India.
Medical colleges have to include ‘Medical Ethics’ as a compulsory subject in the undergraduate curriculum to inculcate appropriate ethical behaviour in medical doctors. The Indian Medical Council Regulations 2002 (Professional Conduct, Etiquette and Ethics) should be read by all doctors along with the declaration to be undertaken at the time of registration. The absence of enforcement and awareness is a stumbling block to be overcome so that the reputation of the profession can be defended.

(The writer is a medical consultant and ethicist)

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