Apparently, the advocacy of ethical care in our health care system warrants an explanation. This is a reply to a comment I received when I put a poster on my other blog seeking funds to study Medical Ethics and Law.
I thank the person who commented for an opportunity to post in this blog and for hoping that I would get the required funds.
The comment was:
"I do hope you get the funds. But I just couldn't prevent myself from asking you about the few dot points you have presented at the top of the poster.
As head of the unit reviewing (confidentially) the issues are you divulging information for your personal gain by including these in your poster campaign? Is that not unethical?
And atleast one of the issues you have raised has been dealt with in a court of law and found no medical negligence. Are you implying something else?
And are you giving verdict on the other cases pending court cases or pending completion of as yet undisclosed internal reviews?
Why are you only presenting this information when it suits to benefit you? Why not disclose all the details of these cases for the common benefit?
Faisal, explain yourself."
In explaining myself, I have to say that:
it is apparent that you are very much concerned that I might blow the whistle on the many unsafe, unethical and unacceptable practices that are carried out by healthcare professionals in the Maldives. And I certainly am addressing these issues where ever I get the opportunity and will continue to do so.
And I haven't breached any confidentially or ethical issues in my poster campaign. As 'confidentiality', 'privacy', 'patient rights', and 'medical ethics' are the terms I live by, I should know. Perhaps it is with such a limited understanding of confidentiality that you describe, that most doctors do not report cases of sexual or physical abuse to the concerned authorities, so that such child could be given better support.
As for the court case- I am indeed against the decision. The judge was given misdirection, by the doctors, for the judge to say that informed consent is unnecessary and even detrimental to treating a patient, when in fact, informed consent is a cornerstone of ethical treatment. I hope the patient party wins the case in the ongoing appeal process.
Many doctors whom I've spoken to are against fully informing a patient, of the purpose of treatment, and even the complications. Worse still they keep refusing that medical errors should be disclosed to the patient. Going on, they find no obligation towards justice and feels threatened the minute the justice system seek their expert opinion.
If I were doing this to benefit myself, I would not be pursuing medical ethics and law, but a clinical field and get rich. I stopped practicing at IGMH and joined the Ministry of Health and Family, in the Quality Improvement Division, because I did not want to work where I was not accountable, where I was let loose to practice any way I want, without any supervision, without any learning activities, and where a culture of patient centered, safe effective care was not practiced.
Maybe when you are sick and the doctor you consult writes an illegible prescription just by having a glance at you, without showing a slightest emotion of compassion or care, roughly examines you without asking your consent, without any regard to your privacy, and later go off an gossip with his colleagues about your condition in the canteen, you will realize why I find the current behavior of most health professionals unacceptable and intolerable.
I hope such matters are taken up for intense debate, specially by the Medical Association and the relevant Councils.
