Ethics deals with right and wrong conduct, with what we ought to do and what we should refrain from doing. This is important in every department of life, but in case of medical care it is a matter of life and death. MCI has laid down code of ethics for doctors. Medical Council of India has published the detailed code of ethics (Part III, Section 4 of the Gazette of India, dated 6th April 2002 (Amended till February 2016). The exhaustive list contains ideal profession conduct, ethics and etiquette that should be maintained by a doctor. MCI has not said a word on the issues that concern the dignity, respect or protection of the life of doctors.
The Code of conduct
A physician shall not make use of his / her name as subject of any form or manner of advertising through any mode either alone or in conjunction with others, which is of such a character as to invite attention to him or to his professional position, skill, qualification, achievements, attainments, specialties, appointments, associations, affiliations or honours. A doctor shall not give any approval, recommendation, endorsement, certificate, report or statement with respect to any drug, medicine, nostrum remedy, surgical, or therapeutic article, apparatus or appliance or any commercial product for use in connection with his name, signature, or photograph. Public declaration of charges, printing of self-photograph or any such material of publicity in the letterhead or on sign board of the consulting room or any such clinical establishment shall be regarded as acts of self-advertisement and hence unethical. Advertising Standards Council of India (ASCI) code further prohibits the Drugs and Magical Remedies publicity by doctors.(Objectionable Advertisements).
A medical practitioner shall not receive any gift from any pharmaceutical or allied healthcare industry and their sales people or representatives. A medical practitioner shall not accept any travel facility inside the country or outside, including rail, air, ship, cruise tickets, paid vacations etc. from any pharmaceutical or allied healthcare industry or their representatives for self and family members for vacation or for attending conferences, seminars, workshops, CME programme etc as a delegate. A medical practitioner shall not accept individually any hospitality like hotel accommodation for self and family members under any pretext. A medical practitioner shall not receive any cash or monetary grants from any pharmaceutical and allied healthcare industry for individual purpose in individual capacity under any pretext. Funding for medical research, study etc. can only be received through approved institutions by modalities laid down by law / rules / guidelines adopted by such approved institutions. A physician may patent surgical instruments, appliances and medicine or Copyright applications, methods and procedures. However, it shall be unethical if the benefits of such patents or copyrights are not made available in situations where the interest of large population is involved. A physician should not run an open shop for sale of medicine for dispensing prescriptions prescribed by doctors other than him or for sale of medical or surgical appliances. It is not unethical for a physician to prescribe or supply drugs, remedies or appliances as long as there is no exploitation of the patient. A physician shall not give, solicit, or receive nor shall he offer to give solicit or receive, any gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient for medical, surgical or other treatment. A doctor shall not participate in or be a party to act of division, transference, assignment, subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment. The prescribing or dispensing by a physician of secret remedial agents of which he does not know the composition or the manufacture or promotion of their use is unethical and as such prohibited. This also entails the practice of cross pathies. The physician shall not aid or abet torture nor shall he be a party to either infliction of mental or physical trauma or concealment of torture inflicted by some other person or agency in clear violation of human rights. Practicing euthanasia shall constitute unethical conduct. A team of doctors shall declare withdrawal of support system, if so considered expedient.
While doctors need to work purely in the interest of society in general and patients in particular, his decent lifestyle cannot be grudged. Many doctors say ‘The clause on advertisement contradicts the right to recover investment made in the infrastructure of the hospital or clinic, inputs during medical education or even enjoyment of a decent life like any other professional. Even if luxurious lifestyle is frowned upon, can one question the right of doctors leading a life of reasonable comfort and assets? If advertisement is not made how people will come to know what facilities a hospital provides and it will lead to denial of their utilization! Poor standards of majority of doctors, long working hours but less time spent with each patient, less pay, less time with family, hassle from management, rocketing costs of medical indemnity etc. is well known. The growing dis-connect between doctor and patient relationship and their respective expectations has contributed to the looming shortage of physicians in our country.’ The doctors further question ‘Why should only doctors work in the villages with no amenities, look after the poor and the downtrodden, and work round the clock without any time of their own? A lawyer charges lakhs of rupees per hour of his/her time, but the doctor is supposed to work round the clock without any return!
There should be a widespread awareness campaign to drive the mandates laid down by MCI as well as the ways to save the honour and life of the doctors.