Doctors must refrain from unethical practice, Self projection - Prof. Majeed Chaudhry


Medical Education and Medical Ethics Session at PSIM Conference
Doctors must refrain from unethical practice, 
Self projection - Prof. Majeed Chaudhry
Follow structured way of examining a patient; enhance
communication between trainers and the trainees
Knowledge, Skills, Aptitude & Value system are
important Pillars of Medical Education-Javed Iqbal

Lahore: Prof. Majeed Chaudhry along with Prof. Bikharam Devarjani and Prof. Munir Azhar chaired the session devoted to Medical Education and Medical Ethics during the PSIM conference held here from March 12-15, 2020. Prof. Majeed Chaudhry was the first speaker who talked about Ethical Considerations in Doctor-Patient relationship.

Prof. Majeed Chaudhry alongwith Prof. Bikaram, Prof. Munir Azhar and Dr. Afzal Javed
chairing one of the sessions during the PSIM conference.

Prof. Majeed Chaudhry Principal Lahore Medical & Dental College in his presentation first gave a historical background of various codes of medical ethics which were prepared by World Medical Association, Helsinki declaration of 1964 and also talked about the Islamic Code of Medical Ethics which relates back to the 7th Century. He then discussed various unethical practices like self projection by the doctors, gaps in doctor patient communication, and the practice issues and pointed out why doctors get involved in self projection. It is done mostly by those who suffer from some inferiority complex. Visiting Cards with A. Professor, Lamp posts for self projection, advertisements on Railway stations, advertisement regarding frequent change of address, announcement for going and return from Umra, WhatsApp messages and advertisements, some suffer from camera hunger were all highlighted with examples. He laid emphasis on having a structured way of examining a patient. It is extremely important what to say to the patient, how to say it and when to say it. For example asking a patient to whether he or she would like to die in a hospital or at home was highly uncalled for and unethical.


Prof. Majeed Chaudhry

Continuing Prof. Majeed Chaudhry also talked about non-operating surgeons, multiplication of figures in research studies and results. Some employ Touts to arrange for patients, others talk about non-existence of complications. He made a passionate plea to the healthcare professionals never to talk ill of their colleagues whenever they see a patient. We all see patients who have already been seen by some other colleague. He also highlighted the referral system wherein those referring the patient expect some share whether it is for consultation or investigations. Ethical practice by the healthcare professionals at present leaves much to be desired because we do not have good role models. He advised his colleagues to refrain from unethical practices, reinforce our training system and ethical requirements. Communication on the part of trainer and trainees need to be enhanced, he added.

Prof. Javed Iqbal

Prof. Javed Iqbal former Principal of Quaid-e-Azam Medical College was the next speaker in this session. He discussed ethical obligations of medical teachers and students. He pointed out that to develop a character, fresh medical graduate’s need Knowledge, Skill, Aptitude but the fourth dimension of medical education was value system. It is imperative that education must generate a value system. If you talk to the doctors they complain of non-existence of service structure, more duty hours, less respect, litigations, less time for their family. The patients wish the doctors to be polite, listen to them carefully, examine them thoroughly, explain well, and answer their queries. He was of the view that the traditional curriculum must include all that what the society wants from us. However, what is happening is that we are producing illiterate graduates. There are good students and bad students. They are skilled but insensitive. They have knowledge but they are unable to solve the problems. They are successful rather than service oriented. There are some relationship problems. It is the duty of us the senior members of the medical profession to connect this missing link.

Continuing Prof. Javed Iqbal narrated the six important values which should be given due consideration. The first one was to consider epigenetic factors in teaching. It should be stress free, overcome the challenging environment, and do not label the students. We should not be judgmental but provide learning environment. Second was to ensure evidence based clinical practice. Thirdly respect every human being. The good old Chota Model was no more working in training of healthcare professionals. We must try to find out reasons for absenteeism in the lectures. It the speaker is good, makes the lectures interesting, students will come. Fourth we must give emphasis on Continuing Medical Education and Faculty Development. Teaching must be relevant to the problems encountered. Then comes Righteousness and finally think about Equality and Equity. He concluded his presentation by stating that we need to work on values, introduce and promote the culture of tolerance instead of blaming. Promote the culture of service. Students do what they see us doing hence we must present ourselves as good role models, he remarked.


Prof. Seema Daud spoke on Ethics in Clinical Research. She described the four well known principals of Medical Ethics including Autonomy, Justice, and Beneficience. She also described in detail the Syphilis trials on Black Americans, use of under trial prisoners for research in the past which lead to the Helsinki declaration. She also highlighted the importance of informed consent of research subjects. Dr. Saqib Bajwa talked about ethical relationship with pharmaceutical industry and referred to various unethical practices.

Group photograph taken during the PSIM conference shows some of the invited guest
speakers with participants.

During the discussion Mr. Shaukat Ali Jawaid Chief Editor of Pakistan Journal of Medical Sciences and a former Founder Member of National Bioethics Committee formed by the Government of Pakistan pointed out that the Islamic Principles of Medical Ethics was somewhat different from the four principles practiced in the developed world. Dr. Hassan Hathout an obstetrician and gynaecologist from Kuwait wrote a book on Islamic Code of Medical Ethics in 1967. Prof. Aziz Sachidina from Virginia University in United States has also done lot of work on Islamic Medical Ethics. For example in the West there is too much emphasis on patient’s autonomy. One cannot treat a patent without their consent but in Islamic Medical Ethics, if a patient is suffering from an infectious diseases and he or she can become a risk for the community, these patient have got to the treated and their autonomy comes to an end when it affects other members of the community. Regarding physicians interaction with the pharma trade and industry, he stated that NBC has prepared Guidelines on this which were approved by the PM&DC and the Federal Government. This is a very comprehensive document which takes care of almost every issue including CME, organizing academic activities and holding of medical conferences. It needs and awaits implementation. This document is available on the NBC website for those interested.