Why Indian healthcare desperately needs ethics

If the market valuation of a corporate hospital, under the scanner for overcharging and alleged negligence, is any indication, these are minor issues for potential buyers, who still see scope for making a profit. It also means that corporate healthcare in the country is a business like any other — purely driven by market forces and profit, and not ethical and rational practice of medicine.

At a time when the doctor-patient relationship is strained and commercialisation of health is becoming rampant, a group of doctors have come together to raise the flag of ethical healthcare. This is an important development because it originates from within the medical community and not from other quarters. Working under a loosely formed network called Alliance of Doctors for Ethical Healthcare, they recently held a meeting at the All India Institute of Medical Sciences (AIIMS) in Delhi.

After brainstorming for two days, the alliance finalised an agenda for doctors, patients, the government and hospitals. Hitting the root causes of commercialisation directly, the alliance has appealed to hospitals to stop imposing revenue generation or "conversion" targets of any kind on doctors and ensure transparency in all components of bills. Hospitals must also stop all forms of commissions and kickbacks.

Doctors have been urged not to accept gifts, sponsorships or any financial or non-financial incentives from drug and medical device companies. They should also not give or take commission or referral charges for patient referrals, and become whistle-blowers, exposing malpractices.

The alliance has asked patients to seek appropriate care and ask doctors for information relevant to their condition. More importantly, patients should not demand any procedure based merely on hearsay or advertisements. Whenever major procedures are advised (in a non-emergency situation), patients should use discretion and seek a second opinion. While patients must have a dialogue with their doctors, they should refrain from violence if the response is not fair.

The goal of ethical healthcare can’t be achieved without changes in policies related to medical education, cost regulation of drugs, implants and medical devices. For this, the panel recommended that fees in private medical colleges be legally capped at an amount that’s not higher than that charged by government colleges.

Government health facilities should not be handed over to private hospitals in the garb of publicprivate partnership. While it’s necessary to develop a system of Universal Health Care (UHC) in every state, it should be done without commercial insurance playing a key role, according to the alliance.

The movement for ethical healthcare has just begun and the Alliance has about 170 members who have formally joined, but there are others supporting it.

“The scepticism is realistic and justified because the menace of keeping healthcare as a commodity has virtually reached the point of no return. But we will continue to advocate ethical healthcare and come out with position papers on issues like misuse of procedures,” said Dr Arun Gadre, one of the founders of the alliance.

(Courtesy of Mail Today)

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