Standing on ceremony: On Charak Shapath and medical education

An overemphasis on a ritualistic oath does not aid quality medical education

Updated - May 06, 2022 01:50 am IST

Published - May 06, 2022 12:06 am IST

Observance of rituals largely serves a symbolic function; they are infused with meaning that gives a semblance of human-made order to the vagaries of nature. But pushing the meaning beyond the symbolism is fraught with danger. Standing on ceremony, particularly, does not quite fit in with the roles and the responsibilities of a medical professional, and the Charak Shapath row in Tamil Nadu, in which a top official of a government medical college was put on a waitlist, has clearly dragged one ceremony beyond its original intent and purpose. While things came to a head with the suspension of the dean of Madurai Government Medical College, the controversy has been brewing since February, when the minutes of the National Medical Commission’s (NMC) discussions with medical colleges were leaked. One of the points read: “No Hippocratic Oath. During white coat ceremony, the oath will be Maharishi Charak Shapath.” The Charak oath appears as part of Charaka Samhita, an ancient text on Ayurveda, and seeks to, much like the Hippocratic Oath, lay down the ground rules for the practice of medicine for a student. While it emphasises compassion, and the scientific and ethical practice of medicine, it also highlights certain values embedded in the cultural and social ethos of the time of Charaka, and seen today as retrograde. References to caste, old-style subjugation of student to a guru, and gender bias have been flagged since. Though it was later clarified that the oath was not compulsory, there were valid concerns about projecting it as a substitute for the Hippocratic Oath.

In the English version that was read out at Madurai Medical College, there were two references that are repugnant — ‘Submitting myself to my Guru (teachers) with complete dedicated feeling,’ and ‘I, (especially a male doctor) shall treat a woman only in the presence of her husband or a near relative’. The rest of the oath stresses, in simple language, the very principles of the Hippocratic Oath, including serving the sick, a pleasant bedside manner, and not being corrupt. Subsequent investigations have revealed that the dean was not even part of the decision to substitute the Charak Shapath for the Hippocratic Oath (the Students’ Council claimed responsibility), and he has since been reinstated. But launching severe action for what might have been just procedurally deviant, rather than a crime or violation of ethics, seems a knee-jerk reaction, or worse, the pursuit of a political agenda. The focus should rather be on ensuring quality medical education, inculcating in students a scientific temper, and a sense of service to patients. While Tamil Nadu has often rightly argued for States’ autonomy in a federal structure, this act adds little heft to that critical issue. For the NMC, even more so, the stress should not be on the bells and whistles, but rather on the quality of education.

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