Modern technology can cure the disease but cannot heal the patient-Prof. Rehana Kamal


 SMDC’s 2nd International Medical Conference-IV

Modern technology can cure the disease but
cannot heal the patient - Prof. Rehana Kamal

Boundaries between physicians and patients are
vague which needs to be well defined - Dr. Robyna Irshad

LAHORE: Medical Ethics figured prominently during the Second International Medical Conference organized by Shalamar Medical & Dental College from February 2-4, 2018. Apart from invited guest speakers Prof. John Lantos and Prof. Vugar Mammadov from Azarbijan, there were special sessions on Medical Ethics. Shalamar Medical & Dental College, it may be mentioned here has already established a Department of Bioethics headed by Dr. Sarosh Saleem.

The session on Bioethics held on February 3rd was chaired by Prof. John Lantos while Dr. Sarosh Saleem was the moderator. Experts in the panel discussion on “Professionalism and Boundaries for healthcare professionals” included Prof. Rehana Kamal, Dr. Robyna Irshad and Dr. Mustafa Aslam all from Aga Khan University, Karachi. Participating in the discussion Dr. Rehana Kamal emphasized the importance of communication skills among the healthcare professionals. She was of the view that it is the dialogue which heals. Good physician has to have a dialogue with the patient. We need to heal the patient rather than curing the disease. Modern technology, she opined, may cure the disease but will never heal the patient. Dialogue offers a feeling of well-being.

Prof. Rehana Kamal along with Dr. Robyna Irshad and Dr. Mustafa Aslam the guest speakers
at the session devoted to Professionalism and Medical Ethics during the Second International
Medical Conference
of Shalamar Medical & Dental College held recently.

Continuing Dr. Rehana Kamal said that talking to the patient helps develop a relationship. It will be helpful. Modern Medicine has its own limitations and one should never completely rely on technology. With the use of technology, the disease may be cured but the patient does not feel better. The patient, Dr. Rehana Kamal said need trust, confidence, sympathy and dependability. It is only dialogue which will provide comfort to the patients suffering from chronic diseases. Doctors need to learn how to have an effective dialogue. One learns with stories and learns how to talk properly. How you say was much more important than what you say. One must break the bad news in a nice way. You have to convince the patient never to work for a tyrant if you are treating a terrorist. Similarly while treating war veterans and patients undergoing cardiac surgery or any other major surgical procedures, one has to take their consent. It is important to tell the patient truth, what are the chances of complications and mortality are and convince the patient to take chance if the chances of cure are bright. She concluded her presentation with a quotation that “Good physicians cure disease, brilliant physicians heal the patient.”

Dr. Robyna Irshad talked about vague boundaries in digital communication with the patient. These boundaries between the physician and the patients, she opined, are not well defined. At times the relationship creates biases. She then referred to a recent incident at AKUH wherein a physician sent a friendship message to a patient who consulted him a few days ago. She complained of sexual harassment and the physician was relieved of his duties at the healthcare facility. Physicians, she opined, do have personal interaction with the patients as both of them become a part of the family. Doctors become part of the collective decision while managing a patient, patient might like you to talk to the treating physician. We as physicians are in power, patients are sick and they do not have information. They expect the treating physician to provide them the required information but the physicians should not exploit this power. Learn how to handle the patients without exploiting your power. It is normal for physicians to go to weddings in patient’s families but the relationship boundaries should be clear. If there is no contact and relationship between the physicians and patients, how their children will get married because at times, the proposals come from patients in their relatives. However, the situation has changed a lot and business interests of medical profession, has deprived them from the status like that of a God which they used to enjoy in the past as now everybody is challenging you, she remarked.

Dr. Mustafa Aslam in his presentation stated that it is extremely difficult to treat feelings satisfactorily. It is norrmal to attend private parties and ceremonies. Healthcare professionals have to improve their competence and skills. We need to have some sort of self-regulation and monitoring. Physicians should have no personal relationship with the patient’s except professional relationship. Physicians must remain update with latest developments in medicine, update their professional skills, have good relations with the patients, colleagues, be honest and prove to be trustworthy. They must respect patient’s right to confidentiality. There should be clear boundaries keeping in view the cultural perspectives and religious beliefs. Moral character, she opined is found by one’s actions.

During the discussion it was pointed out that professional ethics is the core component of professionalism. It is extremely difficult to deal with emotions satisfactorily. Development in modern medicine has added lot of confusion. Developments in modern medicine like telemedicine has some benefit in certain specialties like radiology but one should be aware of their limitations. At times refusing a gift from the patient can be very unpleasant. Patient is very vulnerable. One does not know how they will react to refusal to accept a gift. Be careful. Young doctors should start thinking how they should behave. At times some physicians get emotional attachment with some Paediatric patient’s which helps in their speedy recovery. Dr. Sarosh Saleem stated that generally doctors are advised to remain away from emotions. One should not take out emotions from doctor-patient relationship but be careful and do not cross the lines.

Dr. Maryam discussed the importance of clear decision making pathways. Environment in which we work matters a lot. Disease and death does affect the physicians as well and at times it does break them. Avoid to share all the details with the patient, help each other how to handle a particular situation and address the issues faced. One should also be accessible to change. She also informed the participants of the session about the formation of a Bioethics Group in Lahore. It brings people interested in ethics together and they discuss these issues. Ethical issues in fact start with the dissection hall. Bioethics group are functioning at Aga Khan University Hospital Karachi since long and Karachi Bioethics Group is also quite active which holds its meetings regularly at different institutions which provides a platform to discuss and debate ethical issues.

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