As doctors we enjoy respect in society because we are able to relieve physical and mental ailments by virtue of our education, training, and experience. We also function as counselors and educators on health-related subjects.
‘Medical ethics’ have been carved out ages ago by conscientious doctors and statesmen and women, and is defined as ‘a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy and sociology (pleases clarify). The medical profession has long subscribed to a body of ethical statements and statutes developed primarily for the benefit of the patient.
- Respect for autonomy – the patient has the right to refuse or choose the treatment
- Beneficence – a practitioner should act in the best interest of the patient.
- Non maleficence- ‘first, do no harm”
- Justice – concerns the distribution of scarce health resources, and the decision of who gets what treatment ( fairness and equality)
Other values of relevance are
- Respect for persons wherein basic international human rights laws are incorporated
- Truthfulness and honesty
As doctors, we have a higher and special stewardship to God not only in relation to patient care but also in areas related to our work environment, work ethics and practice. Christian principles to be applied to any profession and workplace are relevant to doctors as well. I would confine this article to what is increasingly being viewed as acceptable by Christian doctors working in private medical colleges.
Medical colleges are places which educate and transform young men and women into proficient, skilled ethical, committed doctors practicing the Hippocratic Oath and medical ethics. In India we have internationally acclaimed and ethical Christian medical colleges such as Christian Medical College Vellore and Christian Medical College Ludhiana, Spicer memorial Pune, Bangalore Baptist Medical College and the alumni have served sacrificially all over the country.Over the years many private colleges have sprung up. Love of money and corruption has changed medical education into a money spinning racket, run by the rich with no human values or principles. It is scary to think that thousands of spurious doctors have been created and let loose in our country which is rife with diseases old and new, preventable and not, simple and complicated, curable and incurable.
Some of the dark areas of practice in these institutions are as follows:
- Fake documents are prepared concerning period of service, so as to make candidates qualify for the posts of associate professors and professors. Doctors are pressurized to sign these, and this is more so if you head a department. This compromises the quality and capacity of doctors in general
- There are many instances where the required infrastructure is not available but the staff is required to vouch for their existence under the control of the institution. The implication is that students are not trained adequately
- Patient records are constantly being created to show a high outpatient attendance, inpatient admission, in the different wards and units, number of investigations done, number of surgeries conducted, blood transfusions made, children immunized, patients under treatment in national health programs, community interventions, camps and attendance.Institutions where healthcare is not proper, and which are shunned by the people get recognized to function.
- There is coercion to pass students who have not achieved the required standards, as it would irk the ire of the parents. Their attendance is being manipulated to make them eligible to appear for an examination. Questions are leaked, and help provided in the exam halls to answer questions.
- Unnecessary investigations are done to boost to meet the required numbers. Patients are pressurized to get admitted to fill the wards during medical inspections. Even unwarranted invasive procedures are carried out, in the guise of diagnosis and treatment. Informed consent forms for procedures are so confusingly worded and patients/ relatives are constrained to sign these, without questioning – it is just a routine documentation they are told. The common man suffers , loses money. Lives are lost unnecessarily.
- Equipment, and educational materials basically required to teach the students are not available.
- Bribery, false bills, lies breed in every possible area of the colleges.
- Part of the remuneration is still not being given in cheques/ bank payment which therefore requires less income tax to be paid
- Basic ethics of patient care are not followed. The emphasis is on profit and greed. Patients are seen merely as numbers to reach targets set by the Medical Council of India
While there are some institutions that are not totally guilty of these, sadly most are. Some of us doctors had no idea of what we were stepping into, when we joined such medical colleges just to work and teach. Some others among us felt that we could influence the management to change and adhere to all requirements and become an ethical institution, committed to train the students to its best. Some continue to justify it all , saying that today’s world being corrupt, we need not ruffle feathers but just go with the crowd; and some of us actively join hands with the management in their corrupt, profiteering ways.
The medical education scenario that has changed so rapidly poses a challenge to us . Many of us on the first instance chose to be doctors, persuaded by the love of Christ, and the example He set to us (delete). Jesus during His earthly journey as a man, did not compromise with shady situations. He advocated giving to Caeser what was due. He did not tell lies. He was the truth. He healed out of compassion and He healed freely– not out of love for money. He fought against wrong- and did not keep silent.
By being silent we are party to all the wrong doings of the institution and can never plead ignorance. Secondly we are prescribing a low standard of training to medical students in whose hands thousands are going to entrust their health in the future. They are the ones who are going to decide health policies, deal with life and death of precious children and adults. We are creating a multitude of qualified, coat clad and stethoscope adorned quacks who will be strutting along the corridors of Indian hospitals. Secondly we are sending a strong message to the world that we who bear the name of Christ are also willing to go along with all the unethical practices and values that are building up so fast
There is among us, this philosophy of keeping religion confined to the church and home and considering workplace as altogether different. If our religion is just a ritualistic way of life, there is no further discussion needed. But for the majority of Christians, who have promised to live as instructed by Jesus Christ – it is required of us to take a stand.
If we do not compromise, we may not get or keep our jobs in such institutions- although there is a very small probability that they will put up with us if our work and life are outstanding. Could we be His ambassadors in these dark shady days, daring to stand up for what is right? Would we have the inner strength not to earn our salaries through a compromised stand? Jesus said in Luke 9 25’ for what profit is it if one gains the whole world and is oneself destroyed or lost’. He did not bow down to Satan when he was tempted in the wilderness. Do we not have trust in God to supply our worldly needs- including position, authority, leadership, recognition and not go after money and position?
My intention behind this brief article to voice out aloud that which is lamented of behind closed doors, and even in the open. The situation is most often compromised as the straight and narrow way is not easy or luring. Churches and Christian leaders who are in charge of such institutions, require to again stop and take stock of what they are adhering to or even promoting. May the almighty give us clarity, conviction and wisdom and most importantly bring about within us, a change like what Zacchaeus the tax payer experienced.
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