Ethics divorced from the medical profession was once unthinkable as the lay and learned reposed their faith in the practitioners of medicine. But this has changed dramatically of late. The sparse resources of the state do not allow rights-based basic healthcare to the large population. There is, therefore, a growing dependence on private doctors, hospitals, and alternative medicine, and, of course, the ubiquitous quack.
It is small wonder that the medical calling, often characterised as noble, is infested with malpractices, perfunctory healthcare, commissions and exploitative drug companies. The daunting difficulties of the medical system can be addressed if a reasoned and balanced assessment is made of the situation, as is done in Dr. Kamal Kumar Mahawar’s The Ethical Doctor .
The author, a consultant general and bariatric surgeon with the U.K.’s National Health Services, does not pretend to offer a one-size-fits-all panacea for the plethora of problems ailing the domestic health system, but the tightly-written tome addresses a range of issues and he spells out the concept of an ethical doctor, navigating topics such as unnecessary tests and treatments, cuts and commissions, drug companies and appliance manufacturers, touts, false claims, quacks, regulators and the way forward to retrieve the system before it falls into perpetual sickness.
“Faith is the first cure,” was engraved on the door of “our old family doctor in Kolkata,” Dr. Mahawar says, adding that if the doctor was alive, he would have been disheartened to learn that the last couple of decades have seen a near complete collapse of faith in his profession. This is best borne out in the way patients seek multiple opinions. Reputed cardiologist and former vice-chancellor of Manipal University B.M. Hegde has rightly railed against the tendency to diagnose and treat patients with a tinted glass of reductionism with the symptoms determining a huge list of invasive investigations and specialists treating only the reports and not the human being. Patients have become commodities in this marketplace, routinely exchanged for money.
Dr. Mahawar suggests a radical reform of the Medical Council of India (MCI). His suggestions include a medical register detailing every qualified doctor, a renewed practical code, a culture of self-audit among doctors, and an exit test for all new entrants given the variable level of medical education in different parts of the country. It is surprising that the author has not taken note of the Parliament panel report in March that excoriated the functioning of the MCI and asked for a National Medical Commission Bill to overhaul medical regulation. The draft bill outlined a new authority to register and monitor doctors and to regulate medical education. The report rebuked the medical fraternity’s privilege of self-regulation.
The book is a sober reminder to fellow medics to cure themselves of short-term gains and scale a few pinnacles of ethical practices to save their profession from potential downfall.
The Ethical Doctor; Dr. Kamal Kumar Mahawar, HarperCollins, Rs. 350.
G. Srinivasan retired from The Hindu in 2013. He keeps his passion for writing alive through freelancing.
