Is Medical Ethics On The Decline?

A 50 year old woman was diagnosed with uterine cancer after Dilation and Curettage (D&C) by a male gynecologist and he insisted on removing the affected part. The woman’s children were not happy with the diagnosis. They visited another gynecologist, this time a female. She said that there was nothing wrong with the woman’s womb and the uterus need not be removed. That was 20 years ago. The woman today is hale and hearty without any gynecological problem.

More recently since the government provides insurance under the aegis of the Rajiv Gandhi Jeevan Dayi Yojana in Maharashtra, doctors have greedily gone ahead and removed the uterus of even younger women. Has medical ethics today gone to the dogs? 3 doctors try to uphold the medical profession despite misuse by some of their own colleagues.

Last century has seen a lot of progress in the medical field. During the turn of the century with the advancement in the field of computers, development has been achieved in the field of surgery. Dr. Ameya Joshi informs that in his field of endocrinology progress has been happening at a great pace, with genetics and molecular biology aspects leading.

Dr. Devendra Save enlightens about the advances in the psychiatric field, “Many discoveries have been made in psychiatry. It is still in the infancy stage and there is a long way to go. But in the last 15 years psychiatry has seen drastic advancement and within the last 10 years there has been tremendous advancement. The results of these advancements will be seen in the next 5-10 years. Researches on schizhophrenia, bipolar disorder, etc. have been seen more in the last few years.”

Dr. Pratibha Patil enumerates the advances in the field of gynecology, “In Vitro Fertilization (IVF) has been around for some time now. In the last few years, these techniques have advanced. Surrogate mothers have also increased in the last few years because in couples the women’s uterus could be damaged or ovaries may not function properly. Some career-oriented women after marriage postpone motherhood. After 35 the rate of pregnancy for such women drastically drops. So such women freeze their fertilized embryo for future use. Robotic surgeries are being performed for ovarian and cervical cancers. These are precision surgeries. The consultants can even perform these surgeries long distance due to advances in the computer technology!”
Medical Ethics: With the advancement in medicine and surgery, many doctors have grown greedy and have weaned away from ethical practice. Dr. Joshi explains the ideal behavior of doctors, “The patient should be given advice about all available options, advantages and disadvantages of each treatment modality. The educated patient will automatically refuse the unwanted and make the correct choices.”

Dr. Save also agrees that some doctors do not care about medical ethics. He says, “But I would not say that it is happening rampantly. I do admit that some doctors are prescribing tests and medicines, which are not required, but they are few in number. The onus lies on the doctor and depends on how he listens to his conscience.”

Dr. Patil concurs, “Most of doctors today perform caesarean section, when they could have managed normal delivery. This is because if the woman goes into labour, the child is born after some time. Labour is a long process. The doctors save time this way and use the time for other patients. This way the doctors can also charge the patients more. Caesarean section costs more than normal delivery.”
Regarding the commitment of the doctors and hospitals, Dr. Joshi is diplomatic. He says, “The spectrum is huge and all types of people are there. It’s more of human nature than anything else.”

Dr. Save considers that most doctors are committed. He opines, “I think most of the doctors are working extremely hard, always ready to treat the patients. Their commitment helps them to succeed in their profession and grow in it.”

Attitude of Patients: With the commitment of the doctors and hospitals on the decline, it is imperative that patients get themselves educated about the diagnostic and treatment modalities. Patients should also learn to ask the right questions about their condition and the line of treatment. Dr. Joshi is happy that the awareness and curiosity is increasing. He adds, “Rather than blankly saying yes, it would be better to know about the problem and the treatment. This also would encourage me to know multiple aspects and improve on my learning curve.”

Dr. Save disappointed that there is little awareness of patients about this field. He regrets, “The patients, who come to meet me, come with misconceptions and good conceptions also. But their approach is respectful because I explain to them their condition. Most of them are less informed. Their education about psychiatric disorders in India is very low. They have a lot of misconceptions about treatments. They think that the treatment that I will give them will worsen their situation. They also think that they are going to be drowsy. But many medicines to overcome these side-effects have already been discovered and being used by me and others in this profession. Proper education and creation of awareness from the government machinery would be really helpful in this field. I have to repeat everything to each and every patient. This counseling should be done by counselors, like it is done abroad. But we do not have the man-power.”

This article was initially published in Eve’s Times magazine and has been reproduced here with the permission of the editor, Swati Amar.