February 2013 issue

Medical ethics – Where does the buck stop?

Wikipedia describes medical ethics as a system “of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology.”

In 1955 two philosophers Thomas L. Beauchamp and James F. Childress put forward the principles of medical ethics. They identified four principles, which have become the cornerstone of medical ethics. 1. Do the best for the patient (beneficence) 2. Do no harm (non malfesance) 3. Autonomy  4. Justice.

However, with growing commercialisation and greed of medical professionals, medical ethics is a term to be referred to only in textbooks. As patients are treated as customers or guinea pigs, there is growing mistrust between doctors and patients. Regulators like Medical Council of India (MCI) and other bodies too are shrouded in controversies. So who will bell the cat?

The February 2013 issue of OIOP is on this frequently debated topic - Medical Ethics. Eminent doctors and other professionals candidly speak on the rot that has set into the system and stress upon the need for medical professionals to uphold the principles of medical ethics. We hope that the issues debated help in bringing awareness and the regulating bodies, the government and the doctors work together to rebuild the lost trust in the medical profession.

In ‘The grey areas’, Dr. G. D. Ravindran, Professor of Medicine and Medical Ethics, Head of Dept of Medicine and Medical Ethics, St. John’s Medical College, Bangalore, writes that there are no black and white solutions to ethical problems in medicine. It is a grey area through which a doctor has to wade through. Decisions made should have a solid basis on the principles of medical ethics, as he suggests how some of the road blocks can be removed and an ethical medical profession can be a reality.

In ‘Whither trust in doctor-patient relationship?’, Dr. Vijayaprasad Gopichand, community health physician, currently pursuing PhD in Public Health Ethics from the School of Public Health, SRM University, Tamil Nadu, says that good doctor-patient relationships are extremely rewarding and enriching for both the doctor and the patient. The bond can be built by communication and showing compassion towards the patient, he adds.

In ‘Ethics and law in conflict’, Dr. Lalit Kapoor, a General and GI surgeon and founder, Medico-Legal Cell, Association of Medical Consultants, Mumbai, writes that the Medical Code of Ethics is out of sync with times and the Medical Council Act is a flawed piece of legislation which needs re-crafting. He calls for a greater autonomy for the medical councils and hopes that they are kept free from political interference. Dr. Kapoor has also authored a book Better Safe than Sorry–Medico-Legal Dos and Don’ts.

In ‘The unholy trade’, Dr. Samiran Nundy and Dr. Vibha Varma, say that organ transplantation is a life saving and life enhancing procedure but is accompanied by a host of problems which involve cost, doing harm to a living donor, curbing the organ trade and deciding on an equitable and just way to distribute organs. We are still far from finding solutions to these problems.

Dr. Samiran Nundy heads the Surgical Gastroenterology and Liver Transplantation Department at Sir Ganga Ram Hospital in New Delhi and is also the Dean of the Ganga Ram Institute for Postgraduate Medical Education and Research and Editor-in-Chief of the website DrRaxa.com.

Dr. Vibha Varma is a Consultant in the department of Surgical Gastroenterology and Liver Transplantation Department at Sir Ganga Ram Hospital.

In ‘Partners in crime’, Sunita V S Bandewar, currently an independent researcher in global health and bioethics, writes that by being party to sex-selective practices, medical professionals have been contributing to strengthening cultural norms and practices that are gender discriminatory as it works against girls.

In ‘Clinical trials - shrouded in controversies’, Dr. Reba Kanungo, Dean-Research and Head of Clinical Microbiology at Pondicherry Institute of Medical Sciences, observes that clinical trials in India are raising questions on ethics. Expansion of knowledge through medical research must not lose track of the basic principles of ethics when it involves human participants, she adds. Dr. Kanungo is also the President of The Indian Association of Medical Microbiologists.

In ‘Who is a ‘next friend’, Neha Madhiwalla, coordinator of the Centre for Studies in Ethics and Rights, Mumbai, questions how an institution can be a ‘next friend’ in euthanasia cases, as she feels only a human being can produce such an altruistic response, not an institution. Madhiwalla is also the managing trustee of Chehak Trust, an organisation involved in developing community based models for education, life-skills and disability rehabilitation.

Know India Better: This issue we take our readers to the serene Meghalaya through the feature ‘In the Abode of Clouds’. Meghalaya, literally means ‘The abode of clouds’ and it does appear to be so when you see the glorious mountains bathe in the morning fog. Katie Dubey had an amazing experience exploring the exuberant state, wading through sparkling lakes, staring at alluring waterfalls, crawling through Mawsmai caves, feeling the richness of vast forests, being one with the tribal populace, admiring the beauty of the churches and wandering the streets of the busy capital town of Shillong. Katie is the author of three coffee-table books and writes for various newspapers and magazines on nature and environment.

In ‘Face to Face’, Dr. Amar Jesani speaks to Rajlakshmi Pillai about declining ethics in medical profession but hopes that with growing awareness in society regarding laws and ethics, medical professionals will make efforts to put their house in order.

 Dr. Jesani is an independent consultant, researcher and teacher in bioethics and public health. He has been researching on human rights, medical ethics and public health since three decades. He is one of the founders of the Forum for Medical Ethics Society and its journal, IJME (Indian Journal of Medical Ethics); and is presently its editor. He is also a Trustee of Anusandhan Trust, which runs CEHAT (Centre for Enquiry Into Health and Allied Themes) and CSER (The Centre for Studies in Ethics and Rights) in Mumbai and SATHI (Support for Advocacy and Training to Health Initiatives) in Pune.

General section:

In ‘India needs to stand up to China’, P. M. Kamath, currently, Director, VPM’s Centre for International Studies (Regd), Mumbai and Adjunct Professor, Department of Geopolitics and International Relations, Manipal University, opines that China in reality has gone from assertiveness to aggressiveness in its policy toward India. India, he says should regain her strength by standing up to China and assert its legitimate role in international relations. This will also win back her South Asian friends. Kamath is former Professor of Politics, University of Bombay and his book on India-China Relations for Asian Century (Gyan, 2011) deals with some issues raised in this article.

In ‘Where does your city’s garbage go?’, Disha Shetty, pursuing a post graduate diploma in Broadcast Journalism from the Asian College of Journalism, Chennai, brings you a slice of life from Kodungaiyur garbage dump yard, a part of Metropolitan Chennai. She meets children who are school dropouts and live on the waste. Her article highlights the conflict between the residents and the local municipal corporation in metros that arises due to the close proximity of dumping grounds near residential colonies which pose a health hazard to the people.

OIOP February 2013 highlights the significance of the National Science Day celebrated on February 28, each year. Arvind Gupta, a scientist and winner of the inaugural National Award for Science Popularization amongst Children in1988. emphasises the need to inculcate scientific temper in society, initiating activity based learning in schools and promoting a cost-effective science activities programme in villages and municipal schools of India. This, he says would be a lasting tribute to the vision of Sir C. V. Raman – whose work we celebrate as the National Science Day. Gupta works in IUCCA’s Children’s Science Center in Pune and shares his passion for books and toys through his popular website http://arvindguptatoys.com.

In ‘Youth Voice’ Sakshi Nanavati, who works as a Senior Executive at the Royal Bank of Scotland (Mumbai) writes on how a common culture and tradition binds Indians. Stating that an independent nation is a gift to us from ancestors, she calls upon the youth to nourish this independence to build a country that stands on the ideology of One India, One People. Sakshi is a gold medalist in MA Economics (May 2011) from SNDT University. She is a visiting faculty at ITM Institute of Management and since seven years, she has been a part of Rotaract, an international voluntary youth organisation and the youth wing of the Rotary. 

In ‘Great Indians’ we feature:

Chempakaraman Pillai, The spirited and daring fighter (1891-1934);

 

Lt General Ranjit Singh Dayal PVSM, MVC, The hero of Haji Pir (1928-2012) and

Captain Keishing Clifford Vincent Nongrum MVC, The daredevil Captain (1974-1999).

And also read our regular columns and other features. To book a copy, email to oiopfoundation@gmai.com / oiop@vsnl.net or call Nagesh Bangera, OIOP Subscription-in-charge at 022- 2353 44 00.

We look forward to your feedback.

January 2013

As we enter 2013 with new hopes and aspirations, OIOP in its January issue, takes stock of some of the pertinent socio-political issues that we have been facing, and in whose solution lie answers we seek to build a better, responsible and self sustaining society. We have focused on seven burning issues – Accountability of people in power, Corruption, Delay in Justice, Basic amenities, Holistic health, Education for all and Sustainable rural development. While accountability in every sector, especially, the government, can ensure smooth governance and scale down corruption to a large extent;transparency in every organisation will definitely help minimise corruption. Experts give their valuable opinions on how with vision and will, we can summon the strength and skill required for the much needed transformation to bring good governance. Justice delayed is undoubtedly justice denied. The need of the hour is to revamp our Judiciary and help people get speedy justice. The earlier concept of basic amenities of ‘roti, kapda and makan’ is yet to see the end result, thus making it necessary to widen the concept and include the right to food, education, employment, pension and disability benefits as the very right of individuals and work towards achieving the same. Health is another factor that requires immediate attention. Each one of us should make healthy lifestyle choices and focus on holistic health where the mind, body and spirit in equilibrium. Education is also an issue which needs to be looked at, in a broader perspective. RTE Act brings big hopes but only if the government stops interfering and allows the schools to function smoothly.

So let our New Year's resolution be to collectively work to bring the change in society, that we wish to see. Citizens need to be proactive in nation building. Only then can we hope for a corruption free, accountable, just and healthy society, where there is speedy justice, education for all, right to live a better and dignified life and sustainable villages. With this thought, we wish our readers a very Happy New Year!

Highlights of January 2013 issue ‘Looking back, Looking forward’

Lack of accountability, unbridled corruption in certain sectors, bad governance and rising discontent are undermining our republic. In the lead article ‘Enforcing Accountability’, Dr. Jayaprakash Narayan, the founder and President of Lok Satta Party, suggests solutions that can check abuse of power and usher in a more responsible and accountable system of governance.

Systematic and continuous propagation of introducing greater transparency in every organisation can minimise corruption. In ‘Still a long way for corruption to go’, N. Vittal, former Central Vigilance Commissioner, says that though the progress in weeding out corruption in a democracy is slow and frustrating, one must not lose hope.

In ‘Revamp system for speedy justice’, Krrishan Singhania, Dr. Olav Albuquerque and Madhur Kabra urge for revamping the entire system of criminal and civil jurisprudence which India has inherited from the British. Krrishan Singhania heads the Mumbai office of Singhania & Co, an all-service law firm in Mumbai which specialises in various infrastructure sectors such as aviation, shipping, power and telecom. Dr. Olav Albuquerque is a Senior Associate lawyer while Madhur Kabra is Associate lawyer in the same firm.

The earlier mantra of ‘roti, kapda and makaan’ has failed to cultivate a strong human capital resource and employ it, and secure its old age and vigour, writes Anuradha Kalhan, Lecturer, Dept of Economics, Jai Hind College, Mumbai, in ‘Five shades of grey today’, as she presses for a broader list of basic amenities to include the right to food, education, employment, pension and disability benefits.

Rather than being overwhelmed by all the available research and advice, people should take charge of their own health by making healthy lifestyle choices. In ‘A holistic way to health’, Dr. Rachna Khanna Singh, a Holistic Consultant & Lifestyle Management Expert, opines that the need of the hour is to focus on holistic health that emphasises the connection between mind, body and spirit.

The RTE Act is a right step in ensuring quality education to children but only if the government stops enforcing absurd norms and conditions on schools. It is time that the government only acts as facilitator and creates conducive atmosphere for education sector to function smoothly, writes Shantanu Gupta, Associate Director, School Choice Campaign, Center for Civil Society, in ‘ Let schools be’.

In ‘A sustainable model for rural development’, Srijan Pal Singh says that the new generation model of rural development has to cover multiple dimensions of sustainability which should include financial, ecological, social and cultural sustainability as well as being upwardly mobile and on the right track of the learning curve. The writer is an author, columnist and expert in Sustainable Development. He worked with Dr. APJ Abdul Kalam towards the evolution of the development system of PURA (Providing Urban Amenities in Rural Areas) and has co-authored the bestseller on poverty alleviation – Target 3 Billion.

In ‘Know India Better’, we feature ‘A Borderless Subcontinent’. Akul Tripathi, a media professional and freelance writer, tells of his travels by roads to the borders of India, those he intends to make and others he prays will be possible in his lifetime.

“Undoubtedly, Nehru was India’s best PM,” says Kamal Morarka, former union minister and Rajya Sabha MP in an interview with Lina Mathias, senior assistant editor, Economic and Political Weekly, where he talks about governance, governments and Parliament. Morarka is a successful industrialist, a convinced socialist, a wildlife photography enthusiast and voracious reader. He leads the Samajwadi Janata Party (Rashtriya) besides chairing non-governmental organisations (NGOs) that work in the fields of wildlife research and conservation, rural development, health and arts and crafts. 

In our general section, P. M. Kamath, formerly Professor of Politics, University of Mumbai, in his article ‘Ajmal Kasab and Imran Khan’, questions the logic in Imran Khan’s demand for executing Sarabjit Singh, soon after the hanging of terrorist Ajmal Kasab, as  the two cases cannot be equated.

Starting with this January issue, OIOP will carry an article commemorating national days. We begin with the Army Day that is celebrated on January 15^th. On this occasion, OIOP joins Brig S C Sharma (retd.) in paying tribute to the remarkable, ever alert and brave ‘Indian Soldier’.

In ‘My Transformation Transforms Nation’, Swami Swatmananda, President, Chinmaya Mission, Mumbai, explains how  transforming India can be a reality with each individual transformation - which is a self-motivated initiative to be taken.

In Youth Voice aimed at encouraging our youth to express their concerns and opinions on various issues, Lakshmi Raman, who is studying criminal justice at the Rochester Institute of Technology in the US, candidly speaks about her journey towards “self acceptance” in ‘Defining beauty’.

Great Indians features:

Pandit Ravi Shankar (1920-2012) – one of the tallest musicians produces by the country and culture; 

Thakorbhai Shah (1928-2004), veteran trade union leader and social activist; 

Lt Navdeep Singh AC (1988-2011), a brave solider who made the supreme sacrifice so that the Tricolour should continue to fly over the Gurais heights in Kashmir.

In addition, read our regular columns, features, snippets, satire and more!

To subscribe, write to Nagesh Bangera at oiopfoundation@gmail.com,oiop@vsnl.net or call – 022-2353 44 00