Moral Choices for Today's Doctors

Over a period there is a tremendous change in societal norms and values towards the medical professionals. There was a time when doctors were considered next to God and patients blindly followed their advice. Rapid advances in industrialization, technology, knowledge, use of internet, artificial intelligence and easy availability of information/ mis information about the medical facts and the varied methods of medical treatment have also brought about a crisis of confidence amongst the enlightened public and the sophisticated doctors. Thus, we see that the sociological and technological advancement in last few decades have not only changed the standard of living of people but have also brought about continuing changes in healthcare.

Looking at the fast changes, the demanding patients, the regulatory issues, easy access to media, the doctors have lost their traditional relationship with the patient and are feeling the pinch through lack of trust in medical services. There are frequent incidences of violence against the medical professionals. Thus, the doctors themselves are serving under stress leading to crisis in delivery of appropriate medical/ healthcare services.

Today’s generation of doctors are “the most challenged by moral choices in perhaps a century” – and physician must break their silence or “assist the harm” that silence perpetuates because, “ there is no third choice”- former ( MS Administrator Don Berwick write in JAMA.

The ethical issues in medical practice require respect and report autonomy of the patient and provide required information about patient’s ailment and treatment options. The informed consent must include all possible complication so that patient is mentally and psychologically prepared to choose and accept the offered treatment.

Good medical practices require the doctor to be familiar with latest development in their respective field. Continuing medical education and training are vital to their development. They will have to look for updating of their knowledge, skills and practices to provide quality medical care as per expectation of their patients and society at large.

Enunciation of ethics does not automatically result in ethical practices. The ethical practices need to serve the society as a whole and this calls for undermining personal and financial interests of individual doctors. There is need to be open to facts and avoid all malpractices prevalent in the profession.

Paying Capacity of patient’s vis-a vis treatment and prescriptions is another issue the medical professionals need to know. The affordability of required medical care must be given priority towards making universal healthcare available to the entire society.

Doctors themselves are a part of the society and a society within the medical professionals. There is head to adopt blameless strategies towards their own colleagues as well as the whole society. This requires honest transactions.

Medicine will continue to evolve around societal, technical, and demographical changes. Medical profession has to identify potential challenges and respond to shape its practice accordingly. It has to aim at developing trust amongst patients, respect for human life, continuing upgradation of their skills, safety, quality and team spirit. Fundamental values like compassion, kindness and caring attitude are the required moral choice at the heart of medical practice.  

Today’s doctors must investigate the issues of what to do at certain points of time, which may not have ever been covered in their medical curriculum. Physicians must develop a team and be a part of team in health care because any doctor alone cannot do the right job. This requires interpersonal skills besides the technical skills of medical treatment. Further, it requires the medical professionals to think beyond the precincts of their own clinics/ hospitals and see themselves as part of the total healthcare system involving health professionals and the community at large. To be an effective doctor today, the doctors will have to look into the holistic aspects of healthcare as well as healthcare management. This requires that some of important issues related to health management/ hospital management viz human relations, leadership, legal and ethical issues are incorporated into the undergraduate medical syllabus itself. Those already in practice need to acquire, these professional skills through short term management development programs/ training on health and hospital management. The doctors who would be involved in management of the health institutions should take up professional course in health and hospital management. Many institutions are providing MBA / PG Diploma in such subjects and in service training to doctors to address these issues.

To conclude, todays doctors need acquiring human relations and management skills besides their technical knowledge.

Posted By :-

Dr. A. K. Khokhar, Professor
(Hospital Management) and Dean(Training), IIHMR Delhi