PROFESSIONALISMIn MEDICINE

Prof. K.R. Sethuraman. MDJIPMER,

Pondicherry. India

Charaka Hippocrates

INTRODUCTION• Humanity is faced with

unprecedented threats to its health and well-being

• Changes in the health-care delivery systems frustrate ethical physicians today – These threaten the very nature of

medical professionalism

Quality of Healthcare

Would any of us accept such risks that we impose on our patients?

Priority: Patient Welfare

Priority:

Profit margin

Doctor & Patient Divided !

Declaration ofProfessional

Responsibility• Physicians’ historical commitment

to care for the sick prompted the response

• Recommitment to professionalism helps to regain public trust in medicine

• Voices from many countries call for a renewed sense of professionalism

Preamble

• Professionalism is the basis of medicine’s contract with society

• Vital to this contract is public trust in physicians

Preamble

• Trust depends on integrity of the profession and the individual

• It demands altruism - placing the interests of patients above those of the physician

Non Altruism !

Fundamental principle-1

Primacy of patients’ welfare is –

• altruism in serving the patients interest

• an extension of Beneficence

Fundamental principle-2

Patient autonomy & Respect

• Promote patients’ autonomy

• Be honest & empower them to make informed decisions

Doctor’s Loan Patients’ Debt

Source – ‘Trick or Treat’ - 2000 EQUIP India

Two thirds of Debt is due to ruinous health care expenditure in Indian villages.

“Medicare bankruptcy” is also reported in China & in the USA

Fundamental principle-3

•Social justice - eliminate discrimination in health care (by advocacy)

Access to Healthcare

Self Test - 1

Ethical sensitivity leads to professional commitment

Professional Commitments - a

Commitment to –

• Professional competence

• Scientific knowledge

• Maintaining trust by ethically managing conflicts of interest

Ethical Self Test 2

Would I mind if the transaction is known to my patients?

Professional Commitments - b

• Maintaining appropriate relationships

• Honesty with patients

• Patients’ confidentiality

• Professional responsibilities

Professional Commitments - c

Commitment to –

• Improving quality of care• Improving access to care• Just distribution of finite

resources

“For the triumph of evil it is only necessary for all the good persons to do nothing”

- Edmund Burke

Sum up – The Future of Professionalism

A strong & vibrant future depends on -

• Physicians who value and practice the basic tenets of professionalism

• Professional bodies that set and ensure quality standards for the practice of Medicine

To conclude -

• Let Us all strive to be Ethical Professionals – Professionals that India can be Justifiably Proud of…