Ethical issues in health care sector in India
The Indian healthcare scenario presents a spectrum of contrasting landscapes. At one end of the spectrum are the glitzy steel and glass structures delivering high tech Medicare to the well-heeled, mostly urban Indian. Issues in health care sector, the issue of ethics and economic efficiency in the provisioning and delivery of services becomes complex in the Indian context where health indicators are poor. In an attempt to explore this issue, this round table article first provides an overview of the field of ethics in health care, the health care sector in India and its facilities, the key institutional actors and finally, the key ethical issues concerning the different players in health care - the physician, the bio-pharmaceutical industry, and the chemist.
Traditional vaccine trials rely on large sample populations and natural infection processes. A quicker, cheaper, but riskier method, called Controlled Human Infection Model studies (CHIMs), has also been in practice for some time. India has been blessed with a glorious code on medical ethics since the days of Caraka and Susruta (circa 600 BC). This Ayurvedic code embodies the criteria for a good teacher and who should study medicine. It also offers counsel on behaviour with patients and their relatives and pointers that can be used by us when dealing with such issues as brain death and organ transplantation. Especially striking is the emphasis on transcending the needs of the body, mind and intellect in order to reach a state where the cycle of birth - death - rebirth is broken.
This ancient code is reflected in the codes set up by Buddhism and Jainism - offshoots from the Hindu faith. The Islamic code of ethics was not as well defined in India. Based on the teaching in the Koran, the Muslim doctor was expected to do all he could to save life and promote morality.
Modern Indian doctors appear to have forgotten their ancient heritage. The Medical Councils in New Delhi and the various states have failed to ensure a high moral standard in the medical profession.
A defined curriculum in ethics exists in medical schools that follow a longitudinal pattern in teaching ethics to the medical undergraduates. Heterogeneity still exists in the planning of the curricula, teaching, and assessment methods. These curricula suit the cultural and religious set up of that particular country. Although case-based discussion is a well-known teaching strategy, there exist numerous innovative and cost-effective active teaching strategies
