Should Medical Ethics be Part of Medical Syllabus in Undergraduates in India

Posted by Sunil Shroff on Mon, Oct 4, 2010  
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To advance medicine and serve humanity, I think the Medical Council of India should very seriously introduce Medical ethics as compulsory subject in UG studies in all courses in health sciences in India especially in the MBBS curriculum.

Modern medicine in India is evolving in the corporate hospitals. The advent of health insurance schemes and the Govt. pitching in with their own vote capturing health insurance for BPL group, has meant that the private hospitals economy has been booming. For many  hospitals that were not to long ago struggling with their financials these schemes has worked like a booster dose of anabolic steroid.

The crumbling Govt hospitals infrastructure, the rapid turnover of newer and more expensive imaging technologies and other instrumental costs, has made healthcare  unsustainable for many state governments. The health insurance schemes for BPL means many of the deliverables in Govt hospitals are outsourced to private chain of hospitals.  Many middle class Indians are taking out health insurance for themselves and their families knowing the state of affairs. So private medicine is here to stay, The GDP contribution of Private healthcare is now higher than the Govt. contribution. 

While this has been happening we have over the last decade also seen rapid erosion of our medical ethics. The code practice as advertised by Medical Council of India’s website is totally out of sink with the ground reality. Some stark common examples are as follows-

1. Referral kick-backs are now accepted mode of practice in many hospitals and clinics,

2. Unnecessary admission to hospitals for trivial reasons

3. Fake billing  for never done investigations or procedures

4. Unnecessary expensive surgeries like hysterectomies, by-pass surgeries, hip surgeries and many more ,  being undertaken by many leading doctors.

5. Blatant advertisements on hoardings  by hospitals claiming extraordinary cure for ordinary problems

6. Leading national Newspapers carrying write ups about experts in guise of an article but corporate hospitals paying for them ( the so called wellness section, infertility sections in many leading newspapers)

This list unfortunately is endless. So how does a young medical student react when they see all this, how does it influence their thinking and how gullible is he to succumb to all this practices when he graduates. Is his or her moral fiber likely to crumble by the time he learns how to use the stethoscope and read X-rays. One needs to speak to some of these young minds to know how confused they feel. Many final years, if asked if they are in medicine for money or to serve -  will answer 'money.' 

Maybe a dose of medical ethics will give the student a thought process to sustain and at least some will know how to swim against the current and survive to bring back hope and dignity to the sinking profession. Medicine is a profession where the moral policing have to be all within the profession and this can only truly happen in the conscience of the physician who cares and cures the patients, otherwise the profession is doomed.



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