Doctors are facing increasing challenges
The establishment of ethics committees (EC) to approve research protocols for human experiments was first recorded in international guidelines in the first revision of the Declaration of Helsinki (Helsinki II, 1975). The requirement that ECs monitor clinical research was first introduced in the 1980 Indian Council of Medical Research (ICMR) Policy Statement for Ethics.
ECs were later made a requirement also in the international ethical guidelines for biomedical research involving humans, drawn up by the body established by the World Health Organization, the Council of International Organizations of Medicine (CIOMS).
ECs are made up of diverse backgrounds such as doctors, social workers, lawyers, chartered accountants and business people who bring diverse experience and knowledge to the table. Their responsibilities include safeguarding the rights, safety and well-being of people participating in clinical trials.
They also review and approve protocols related to the suitability of investigators, facilities, methods, and adequacy of data used to obtain and document informed consent from subjects. In addition, they ensure the adequacy of confidentiality protection.
For some time I was the EC member of CARE Hospital, Banjara Hills, Hyderabad. Other members came from different backgrounds. The chairman was a retired judge of the Telangana High Court, with six doctors, two professors, one of political science and one of pharmacology as members, and a businessman.
An interesting experience for all members at that point in our lives to be asked to research material on the role of ethics in healthcare systems and tested by a team sent by the Central Drug Standards and Control Organization. make sure we had actually studied and understood the material!
One of the most fundamental ethical principles of human experimentation is that the experimenter must first ensure that the participants in the experiment are willing to undergo any procedure. Informed consent is the principle that volunteers participating in an experiment must fully understand the procedure to be performed, be aware of all the risks involved, and only then give their consent.
While Indian ECs have started to liberalize themselves appropriately, there is still a lot to be done. What is needed now is a mechanism and protocol to monitor all ECs, enable better operations, including on-site monitoring, etc.
An interesting development in recent times has been the renewed interest shown by the central and state governments in alternative systems of medicine such as Ayurveda, Siddha, Homeopathy and Unani.
The Ayurvedic system, which includes surgical procedures, is referenced in the Sushruta Samhita, one of the oldest and most important surviving ancient medical texts. Sushruta, the author of the Samhita, was the world’s first surgeon and is called the “Father of Surgery”.
Since ancient times, tribal settlements such as the Red Indians in America were served by traditional and spiritual healers called “medicine men”. They were supposed to have supernatural powers and the ability to cure diseases and control spirits.
Likewise, traditional African medicine encompasses a number of disciplines, including indigenous herbalism and spirituality. A very significant feature in Africa is that healers do not accept payment until the treatment is completed and proven to be effective. Traditional healers and medicines made from indigenous plants play a crucial role in the treatment of millions of Africans.
Unani medicine is a Perso-Arabic traditional medicine practiced in Muslim culture in South Asia and present-day Central Asia. Although pseudoscientific, it has a significant following that swears by its effectiveness.
The National Institute of Unani Medicine, located in Bangalore, is an autonomous organization under the Ministry of Ayush (Ayurved, Unani Siddha and Homeopathy), Government of India, engaged in teaching, training and research in the Unani system. The Central Council for Medical Research, another independent organization under the same ministry, is running an experimental program in the Program for the Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), which is run by the Directorate General of Health Services. , Government of India.
The Siddha system of healing is a traditional discipline that originated in South India and is considered one of the oldest systems of medicine in the country. Many of the principles of this ancient system are still relevant to modern practitioners. Breathing exercises such as Pranayama, which have gained great popularity in recent decades, are also part of the system, which gives great importance to the combined use of herbs, plants and minerals.
Another system of alternative medicine is homeopathy, which was originally developed by the German physician Samuel Hahnemann in the 18th century. It is internationally recognized as an effective system, as it is followed by about 300 million people in 70 countries, especially in Northern Europe, where life expectancy is one of the highest in the world.
It is often observed that professional professionals, real or so-called, such as doctors, lawyers, astrologers, chartered accountants, differ considerably. Another unfortunate feature is the way such professionals trash each other to impress clients and begin their meeting with a client by completely reversing the advice given by a previous colleague.
This is probably why the concept of a “second opinion” has come about. At the end of the day, whether a medicine works, regardless of what system has described it, or whether or not the advice from the professionals we just mentioned is helpful or not, depends on the faith one has in the person.
My colleague and fellow batchmate BS Lamba, whose service included working at the World Health Organization (WHO), does not believe in medical treatment at all! A great believer, indeed, in the saying that time is a great healer! Also tongue in cheek they say that recovery takes a week with the medicine and seven days without!
A truly sincere physician, to whom the patient’s welfare is paramount, is like the physician who once said to a patient, in response to an anxious inquiry whether the prescribed medicine is working: “I have studied medicine. you have, the books I have read say this is the right prescription. Now, does the medicine work or not , I can’t honestly tell you. Let’s both pray to God and hope for the best.”
Many of the problems, as seen in last week’s episode, are also caused by the patients. For example, have you heard of the boy who went to the doctor complaining that he thought he had delusions? It is precisely for such patents that sensible doctors give a placebo that works surprisingly well when the disease is imaginary.
Considering the importance of health and medical care especially in a country like India and the astronomical figures being faced in the earnings of doctors in India and abroad, it is fervently hoped that the District Medical Associations, National and International levels would join hands with the State and Central Governments and build hospitals where doctors’ equipment, treatment and credentials would be the best in the world, and services would be strictly limited to those below the poverty line. line.
According to Oscar Wilde, morality is the standard by which other people are judged. Thus, it is easy to sit on the sidelines, far from all the long hours, tense moments and frustrations associated with the work of doctors, and freely criticize the medical profession.
On the other hand, it must also be admitted that there is more than a little truth in what has been said earlier in this article about the straight and narrow path of doctors. In the end, it all boils down to the word “the doctor heals himself!”.
There is this story about a doctor and a dentist who shared a receptionist who was very beautiful. The dentist was leaving for a 10-day vacation. After hearing that “an apple a day keeps the doctor away,” he presented the receptionist with ten apples to keep the doctor away during that time!
(The writer is former Chief Secretary, Government of Andhra Pradesh) (The views expressed in this column are those of the author. The facts and opinions expressed herein do not reflect the views of The Hans India)