off record
Shaukat Ali Jawaid

Selection and election
of cheats to coveted positions


Unethical practices have become so common amongst the healthcare professionals and the Pharma trade and industry that it has eroded the image of the profession which once used to be considered as “Noble”. While previously it was the press and the society at large which was highlighting these issues but now it the saner, conscious and God fearing among the medical profession itself who are speaking loudly about these unethical practices and wish it to be checked without any further delay. You go to any medical conference, event these days and invariably one hears about medical ethics. In the recent past the chief guests at the CPSP Convocation at Karachi, Medical Education conference at Fatima Jinnah Medical College for Women Lahore and at the AEME Conference at University of Health Sciences, Prof. S.M. Rab, Prof. Kh. Saadiq Husain and Engineer Syed Imtiaz Hussain Geelani Chairman of the Higher Education Commission respectively, all highlighted the unethical practices and emphasized upon the healthcare professionals to uphold professional ethics because they often fall short of the expectations. HEC Chairman even suggested that there was a need to administer a heavier dose of medical ethics in medical education besides teaching and training of healthcare professionals.

More recently last week it was the turn of Prof. I.H. Bhatti, the hot headed eminent neurosurgeon of Pakistan who retired as Director of JPMC many years ago. He was invited to give a talk on Medical Ethics and Institutional Development in the plenary session of the JPMC’s Golden Jubilee Symposium. Prof. Bhatti lived up to his reputation and while making the presentation, he did not mince words and spoke his heart out. He has a great weakness that he speaks nothing but the truth which at times is not palatable for many, that is why he is not a very popular man even within the medical profession. He does not know anything about diplomacy and has always refused to compromise and taken a stand even against his worst adversaries under any circumstances. Advancing age has not at all diminished his spirits. Young man, Prof. Bhatti said thinks while an old man remembers. Hence he started his speech by narrating two incidents. In the first case, he said, he made a proposal at the meeting of Pakistan Society of Neurosurgeons many years ago that we need to constitute an Ethics Committee which should monitor its members and ensure ethical medical practice. This, he said, created a riot at the conference. Many participants spoke against the proposal saying that there was no need for such a committee as it will curb our independence and even might victimize us. Many people shouted and this proposal was thrown away and never considered again.
In the second incident more recently, Prof. Bhatti remarked, he was approached by a medical institution with a request to help them form an Ethics Committee for their institution and formulate guidelines for the faculty and the management. The result was a 28-page hand book prepared by me with a presentation. However, after few days I was told by the management of the medical institution that “the environment was not conducive to adopt these guidelines”. Later on I found out that all the computer software’s the medical institution was using were pirated and the institution was very much involved in receiving and giving kickbacks to doctors. Accepting those guidelines would have meant lot of additional cost to the institution besides loss of business. Almost every medical institution in the country in public as well as private sector was involved in receiving or giving commissions, kickbacks in one way or the other, he remarked.
Continuing Prof. Bhatti said that Honesty, Truthfulness and Morality are extremely important in medical ethics but we lie and cheat without fear and guilt. We resent it when someone stops us from cheating. We clap and appreciate when someone from amongst us cheats and we take pride in electing and selecting those who cheat to coveted positions in the society and within the medical profession. He then referred to the Child Neglect, Child abuse and crime against women in the society which are rampant. The highest number of pornographic material available on the internet which is of Pakistani origin says enough about our moral values. Medical Ethics, Prof. Bhatti opined, was all about moral principles that apply to values and judgments to the practice of medicine. We are not a democratic society and nor we will ever be a democratic society. The Tamasha that we have witnessed in the country during the last six years in the name of Democracy says it all. We all know how various authorities facilitated and pushed those who were Neither Saadiq Nor Ameen in the Assemblies. In a democratic set up, all citizens enjoy equal opportunities, freedom of action and speech and there is absence of discrimination. We cannot allow this because we have special laws for non-Muslims. We are a religious state leading towards Theocracy. There is discrimination between Muslims and Non-Muslims. We do not allow same opportunities to the Non-Muslims. We need a Code of Ethics which is not in conflict with Quran and Sunnah, Shariah. All the four Fiqahs or Mazahibs which are different from Deen, have many similarities and there is not much difference. But interpretation of Shariah by different Mazahibs might create problems. Islam, he said was the first religion which gave importance to respect for persons, Truthfulness and Honesty.
Prof. Bhatti also referred to the code of ethics prepared by the PM&DC a few years ago, formation of the National Bioethics Committee by the federal government. It has two sub-committees i.e. Research Ethics Committee and the Health Care Ethics Committee but what they have done so far, he was not aware of hence cannot comment on that. CBEC at SIUT has been involved in the teaching and training of healthcare professionals in bioethics for the last few years under the guidance of Prof. Farhat Moazam while a few other medical institutions were also involved in training in bioethics, running Diploma as well as Masters programme in bioethics. It is these people who in the days to come are likely to take this movement forward. Now many institutions are involved in creating awareness about medical ethics, offering advice which will lead to detection and then reporting of unethical practices. Hopefully it will improve the accountability of the medical profession thereby improving the healthcare delivery system. More recently the formation of Sindh Healthcare Commission 2013 was a welcome step by the Sindh Government. It will also go a long way in improving the standard of medical practice besides increasing accountability. Eventually it will also improve medical ethics in the country, Prof. Bhatti remarked.{jcomments on}

© Professional Medical Publications. All rights reserved.