The Academy of Medical Sciences, Nagpur organised a workshop on medical ethics on September 8 and 9, at the Udyog bhavan, Nagpur. Fed up with several ‘me too workshops’, the Academy wanted to do something different this year. Several doctors felt that medical ethics was a topic worth discussing in today’s times.
However, some members were not sure if others would find the theme sufficiently interesting to make them forgo their practice on a weekend. Why would private consultants spend 12 hours discussing such issues? And would they come once they knew there was no pre-workshop banquet, that they would be served simple vegetarian meals, without alcohol? That what they would get from the organisers would be a pen and writing pad? Would they agree to dig their own pockets to pay workshop fees because the academy wanted to keep sponsors out?
Daunting austerity, a potentially uninspiring theme, according to some. One member even wondered if the Academy made the wrong decision by agreeing to host such a workshop. But some felt strongly on the subject. Doctors today lack formal training in medical ethics. Yet they constantly encounter situations, which call for more than their medical skills. Few doctors feel able to address the ethical dilemmas they face in their practice. There are few, if any, role models to guide them. Doctors and patients are locked in a relationship of mutual suspicion. Practicing medicine was no longer a pleasure. A debate on ethics would be the first, small step towards restoring the ailing doctor-patient relationship. It was also felt that a workshop could lead to setting up a group, in Nagpur, to discuss these issues. The workshop did not interest doctors when it was first announced. Some argued that ethicists were armchair critics – too naive to understand the compulsions of kickbacks. They did not want ‘the brigade of self-appointed guardians of medical morality’ to induce a guilt in their mind. How candid! However, interest gradually picked up and on September 9, the academy’s president was at his wit’s end trying to convince doctors that he wouldn’t be able to enroll them even if they offered to pay extra registration fees – imagine, tickets for a workshop on ethics being sold in black!
Meanwhile, extensive discussion had taken place on the workshop’s contents – most of this by email. One thing everyone was agreed upon was that talks should be short; there would be no sermonising. The idea was to get delegates to talk on the issues raised by each presentation.
“But what if an eerie silence greets a speaker after he finishes his talk? What if the doctors are put off?” Such last-minute fears plagued the organizers on the eve of the workshop. Some even thought of planting questions to get things started. They were proved wrong by the participants, whose hands would shoot up even before the speaker stopped. It was a testament to the depth of their pent-up feelings waiting to be expressed, the many doubts they wanted to share with open-minded colleagues. Scientific meetings in Nagpur rarely witness such passion. Some could barely conceal their emotions. Heated arguments broke out on the ethics of testing hospital patients for HIV, whether the spouse of a patient with HIV should be informed, what is the doctor’s responsibility when relatives ask to keep bad news from the patient… (The next issue of the journal will have a more complete report on the workshop’s discussions.)
Seventy-four doctors enrolled themselves for the workshop. Fifty-eight actually attended, of them seven were women. There were 25 surgeons, 22 physicians, 10 pathologists, four radiologists, four gynaecologists, two paediatricians, and a psychiatrist. Only five doctors from medical colleges – a comment on what teachers of medicine think of the subject. Incidentally, a drug company had organised an excursion for doctors and their families on September 9. Still, forty-four doctors resisted the temptation and sat till the end! The workshop concluded with a resolution to form an ethics discussion group in Nagpur. The academy showed that an important academic activity could be conducted with simplicity, and, more important, without assistance from the drug industry.Medical ethics beats drug company lures
One delegate later said: “Today I understood what Mother Teresa had said a decade ago, that medicine is a vocation. It is not a profession and it is not a business.”
The day before the workshop started, Nagpur newspapers were buzzing with news of the death following surgery of a resident doctor in Government Medical College. The media controversy revealed little of what actually happened. What possible connection does this have to the workshop? Well, is there a system in place for investigating such tragedies, identifying the problem, taking action and making the findings public – all within a reasonable time period? The public’s faith in the medical profession depends on such a system.
(Published in Issues in Medical Ethics, October 2001)
