Doctors’ take on ethics

On Doctors’ Day, city specialists introspect on the dos and don’ts of medical practices. They remind doctors to
be true to their profession.

* Follow the Hippocratic Oath
Dr P. Raghu Ram
Doctors’ Day is celebrated to remind physicians of the importance of ethics in their day-to-day practice. The Hippocratic Oath that we doctors take in the beginning of our career, should be the guiding factor. An important component of the Hippocratic Oath is to “keep the good of the patient as the highest priority.”

It is imperative for both patients and doctors to work together at re-establishing some of the lost trust, and truly, there could be no better day than Doctors’ Day to pledge of strengthening the unique relationship between the doctor and patient. Doctors’ Day provides an opportunity to raise public awareness about the doctor’s role in our daily lives. It is a day when people across the country acknowledge the commitment and dedication of medical and health care fraternity to society. It is indeed a significant day for doctors themselves as it provides them with an opportunity to reflect on their career and to remind themselves of practicing medicine in an ethical manner.

The writer is a senior surgeon and breast cancer specialist

* Perform self-medical audit
Dr D. Nageshwar Reddy
Doctors should perform self-medical audits to assess their performance and find out if there were any lapses on their part while discharging duties as physicians and surgeons. Medical audits will go a long way in building confidence in patients. By and large doctors follow medical ethics. Unfortunately, a minuscule five to 10 per cent of doctors throw medical ethics to the winds and focus more on the commercial element. These doctors bring ill repute to the noble profession. In the last few years, we have moved from the traditional European system of medical practice based on belief and faith to the American system, which is based on mistrust and suspicion. This is called “litigation medication.” In this system, doctors and patients look at each other with suspicion. It is high time we moved back to the European system based on belief and faith.

The writer is the chief of gastroenterology, Asian Institute of Gastroenterology

* Attend to all cases
Dr Ramesh Reddy
A doctor’s prime responsibility is to attend to patients and do whatever possible for them with available resources.
A doctor should not refuse treatment to critically ill or injured patients or turn down medico-legal cases.
Unfortunately, there has been a rise in cases where hospitals and individual doctors have turned away critically ill patients or those with medico-legal complications. This has brought ill repute to the profession. People have lost faith in the medical system and the fraternity. Things have come to such a pass that the doctor-patient confidence level is at its lowest.
By rule, doctors should not turn away patients without at least providing first aid to stabilise them. There has to be a human touch in the medical field.
The commercial element in the medical profession has to go. Patient should be able to trust doctors.

The writer is a senior professor at the Niloufer Hospital and member of the Medical Council of India (MCI)

* No experiments with drugs
Dr Roya Rozati
A patient should be able to feel safe in the hands of the doctor. The doctor should ensure that the patient gets the care he or she needs. It has become a practise among some medical professionals to experiment with medicines. This is a dangerous practice. Doctors should give appropriate medicines depending on the prognosis.

Thanks to the growing awareness among patients, doctors are now giving medicines in required quantities. There may be a few exceptions. But, by and large, Indian doctors are bound by the traditional medical ethics and the norms set by bodies like the Medical Council of India, the Indian Council of Medical Research and the Supreme Court of India.
A few years ago, doctors used to perform hysterectomies without restrictions. Now they are more careful. Even women are increasingly seeking second opinion on this type of surgery. Only when they are satisfied do they opt for hysterectomy. As far as diagnostic tests are concerned, there is a system of evaluation of patients. Based on the ailment, tests are prescribed. Some of the tests are expensive. In such cases patients feel that they are subjected to unnecessary tests. But such tests may be important.

The writer is a senior gynaecologist and clinician-scientist in infertility

* Patients must be informed about medication
Dr T. Dasaradha Rama Reddy
It is the duty of a doctor to keep the patient informed about the medical course and medication being followed. The patient should have access to all medical records so that he or she knows what is wrong and the measures the doctor has taken to treat the problem. This will build trust between the doctor and patient. In recent times, doctors have often become the target of patients and their relatives’ anger when things have gone wrong. Therefore, it is best to keep patients informed.

There are cases when the patient becomes brain dead but his other vital organs perform normally. The patient is then put on life support and kept on ventilator. The best thing to do in such cases is to keep the patient’s relatives updated about the medical status of the patient. This ensures that the ethical principle of the doctor is not questioned on a later date.

The writer is the chief orthopaedic surgeon, Yashoda Hospital, Somajiguda

* Over-treatment is unethical
Dr K. Hari Prasad
Over-treatment is as unethical a practice as under-treatment. Doctors should attend to patients with utmost care and not subject them to unnecessary treatment or diagnostic tests just to earn a few more bucks. The commercial element should not overshadow the noble and ethical principles of the medical profession.

No well-qualified and professional doctor will ever prescribe tests and medications that are not required. Over-treatment may earn the doctor and the hospital some extra cash, but the patient ends up losing, financially as well as in terms of health. Overdose of medicines and unnecessary exposure of patients to diagnostic and lab tests can have impact on health. The patient has the right to seek a second opinion from any doctor of his choice in case he feels he is being subjected to unnecessary tests or treatment. Today, multiple treatment options are available to the patients. Therefore, doctors should know that they cannot fool patients.

The writer is the CEO, Apollo Hospitals, Hyderabad