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Shaukat Ali Jawaid
 

Professional Ethics and
Pakistan 
Cardiac Society 

ShaukatJawaid

At a time when unethical practices are rampant in the medical profession as well as the pharmaceutical industry, it is heartening to note that there are some conscious physicians among the cardiologists who not only feel it bad but have also started talking about it in the meetings. Last year it was Prof. Kalimuddin Aziz who commenting on some of the presentation in the conference had remarked that speakers should present their original work rather than showing the slides of material available on the internet. Prof. Saulat Siddique had remarked that the organizers should schedule few papers in a session, monitor the timings and ensure that no speaker takes more time so that there is some time left for questions and discussion. Speaking at another meeting he was also very critical of company sponsored presentations in the meeting and urged the organizers to uphold professional ethics.

This year at the CARDIO CON 2014, first it was Prof. Bilal Zikarya Chief Executive of Punjab Institute of Cardiology who speaking in the first scientific session remarked that Pakistan Cardiac Society has its own priorities. Even after so many years we have not developed a Registry and we have no data as to how many interventional procedures including primary PCI are being performed in the country. Dr. Asad Pathan from Taba Heart Institute in his presentation emphasized the importance of internal and external monitoring to ensure quality of service being provided to the patients but everybody, he pointed out, seems to be more interested in things other than academics. Prof. Khawar Kazmi from Aga Khan University in his presentation remarked that nobody was interested in academics and research work but people seem to be more interested in elections and becoming President of the Society. There was hardly any work being done in the field of preventive cardiology because people think if prevention was given importance, the supply line of patients might dry up and how they will be able to install additional Cath Labs which brings more money.

There were quite a few other delegates who expressed displeasure at the backdrop on the stage with various Pharma company names and products which is quite unethical. Even one of the speakers in the session devoted to Statins, showed numerous slides with the brand of a product by one of the multinationals but when it was pointed out, Dr. Shahid Junejo was gracious enough to have apologized immediately saying that he took these slides from the internet.

One would like to thank all the above mentioned eminent cardiologists for speaking the truth and emphasizing the importance of upholding professional ethics. Their views may not be liked by some of their own colleagues but it is a testimony to the fact that there are a few whose conscious is still alive and they feel no hesitation to point out if there is something wrong and unethical. The mere fact that there is some realization among a few augurs well and it is hoped that they will be able to influence others as well to ensure that Pakistan Cardiac Society in its future conferences will try to be more ethical.

There are certain things which are quite common with the conference organizers in various disciplines of medicine and Pakistan Cardiac Society is no exception. Most often the meetings start late, then there is no time management, the chairpersons or moderators of the session seldom ensure that the speakers finish their presentations in time, the last speakers are forced to rush and while time is wasted in lucky draws etc., there in no time given for questions and discussion. When I pointed towards this at the end of the first scientific session, the moderator of the session was kind enough to allow few questions and later in every session at least audience was given chance to ask questions.

It is almost twenty years ago when I had interviewed Dr. Mathews an eminent interventional cardiologist and former President of Asia-Pacific Association of Interventional Cardiology from India who has been conducting workshops and training Pakistani cardiologists in various interventional procedures. In this interview, he had given details how they succeeded in establishing a Registry in India. He had also given details as to how many interventional procedures someone must assist, then do under supervision before he/she is allowed to work independently. But even till today, we have no such system in place, nobody in the Pakistan Cardiac Society seems to be interested to set up such a registry. We also have a separate organization i.e. Pakistan Society of Interventional Cardiology and like all other societies they are also more interested in holdings meetings and that is all.

Founders of Pakistan Cardiac Society like late Col. M.H. Shah and Dr. Ali Muhammad Chaudhry from whom I have learnt a lot during my professional career, were more interested in academics and research. They had a different vision how the Pakistan Cardiac Society affairs will be run and managed. However, the younger generation which later assumed the affairs of Pakistan Cardiac Society, except a few, most were more interested in social get together rather than academics and upholding professional ethics. Over the years, it is painful to see the addition of unethical practices at the medical conferences. There is much more emphasis on organizing the Pharmaceuticals Bazar at the conference venue, they hold Public Awareness Sessions at Five Star Hotels where public is always missing. This is not the first time it has happened. I had pointed about it earlier as well but without any success. At the CARDIO CON 2014 while there were some very informative and interesting presentations by a few speakers, there were live telecast of some interventional procedures from different Cath Labs for which the organizers in general and Prof. Khalida Soomro in particular must he commended but as regards upholding professional ethics, it left much to be desired. It could be, she did not get enough co-operations from some of her colleagues. There is an overall deterioration in the society wherein academics, research, moral values and professional ethics have all gone into the background while economic interests of people who are infected with materialistic virus has overshadowed everything else. Pakistan Heart Journal has been revived and is now being regularly published. Not only that, they have also been able to preserve archives of numerous past issues, a commendable effort for which credit goes to Prof. Hafeezullah Khan. However, as regards upholding professional ethics, it is not possible till such time that Pakistan Cardiac Society gets a leadership which is sincere, dedicated, interested in academics and not only believes but also practices ethics that one can see some positive change. Otherwise this show of annual and biennial Melas, social get-togethers overshadowed by pharmaceutical Bazaars will continue. There will always be few people sitting in the scientific sessions and more roaming around and gossiping at the hospitality suites and stalls set up by the Pharmaceutical Trade and Industry. National Bioethics Committee (NBC) formed by the Government of Pakistan has prepared and published Guidelines on Physicians Interaction with the Pharmaceutical Trade & Industry which have also been approved by the PM&DC as well as Ministry of Health. This comprehensive document covers everything including medical conferences and those who are interested can get guidance from that. These guidelines are available on the NBC website as well as website of Pulse International:

http://www.pulsepakistan.com/images/Pulse/NBC_Guidelines.pdf

Its printed copies are also available from Pakistan Medical Research Council Islamabad where the Secretariat of National Bioethics Committee is located.

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