Nature of Medical Ethics
Medical ethics, a branch
of ethics, deals with moral decisions in various aspects of medicine. The
Hippocratic oath is the most enduring tradition in medicine that has been the
guiding ethical code for physicians since ancient Greece, and has eventually
become the basis of all medical ethics. In its most compelling portions, it
emphasizes the profundity of the medical agreement, the patient dignity, the
confidentiality of the transaction, and the physician's responsibility to guard
against abuse or corruption of his or her knowledge and art. It also exhorts the
physicians to honor the rules of their profession and expose those who do not
follow the high standards of conduct.
Ethical Decline of Profession
In the recent past, however, there has been
a sharp decline in the ethical conduct of the medical practitioners all over the
world. The 'dollar' is adored deity and the profession has been both privatized
and commercialized. Materialistic influence has also led to the general belief
that gratification of senses is the only way of enjoyment. This has produced
highly selfish mentality and resultant exploitation of the patients without
spiritual concept of life. The effect of this trend is seen in India also.
Causes of Ethical Decline
In India, many factors are responsible for the deterioration of morality in
the medical practice.
A large initial investment is
required to set up a clinic, a hospital or a medical institute; and it is
thought appropriate to charge heavy fees from the patients as a means of
recovering the cost.
Now a days there is increased
awareness in the patient community about their legal rights. Thus doctors
have a fear of getting charged, by consumer or other courts, for criminal
negligence in treating the patients. Money required to plead the case may be
substantial and hence the hospital charges are high.
The patient approaches a doctor
with mixed feeling of faith and fear, of hope and hostility. This inevitably
leads to distorted doctor-patient relationship with high chances of
Many doctors do not (or cannot) offer
the best line of treatment to the patients:
Firstly because, some are ill
trained. They themselves are not fully aware of recent advances in the treatment
and management of the disease.
Secondly, many doctors do not have
standard treatment facilities in their own clinics or hospitals. Instead of
referring the patients to an institute where such facilities are available, the
treating physicians do not inform about such facilities for fear of 'losing the
Ethical Decline Unwarranted and Unfortunate
indeed difficult to understand why doctors today do not follow simple ethical
practices. The doctors are educated and privileged class of people. They have
enough prestige and are respected everywhere. Why can they not feel the
suffering of patients? Even at the sad plight of the suffering humanity they
don't desist from exploiting the poor. Some blame the prevalent system of
medical education, while others try to put the responsibility on patients
themselves. Most of the doctors, as well as literate class of people, seem not
to bother about corruption in medical field any more. This is a grave situation.
This 'modern' individualistic attitude and total lack of concern for the need of
value-system in the life does not augur well for the future of medical scene in
India. The declining moral trend indicates unhealthy inter human relationship.
Appeal for political intervention, seeking help from Judiciary, or trying to
rectify the situation through Medical Associations and Councils have proved to
be of no avail.
Swami Vivekananda's Guidelines on Ethics
Despite honest attempts by the government, professional bodies, and
non-governmental organizations, the decline in morality is not under check. In
such a situation more radical and original approach is required. Such an
approach that appeals to the spirit of humanity and which is universal in its
extent is found in Vedanta as elaborated by Swami Vivekananda. For him all
secular aspects, individual or social, were 'spiritual', and hence equally
Practice of Unselfishness
Swami Vivekananda successfully attempted to apply transcendental (spiritual)
ethics to the empirical (worldly) plane of existence and created a new theory of
ethics of universal relevance in the contemporary world.
The basis of
ethics, according to Swami Vivekananda is to become more and more selfless:
"Whether men understand it or not, they are impelled by that power behind to
become unselfish. That is the foundation of morality. It is the quintessence of
all ethics, preached in any language, or any religion, or by any prophet in the
world. "Be thou unselfish", "Not 'I', but 'Thou'" - that is the background of
Recognition that I and Thou are One
is more clearly brought out in Swami Vivekananda's other lectures: "Ethics
cannot be derived from the mere sanctions of any personage, however great and
divine he may have been. That you and I are not only brothers -every literature
voicing man's struggle towards freedom has preached that for you -but that you
and I are really one. This is the dictate of Indian philosophy. This oneness is
the rationale of all ethics and spirituality. Every religion preaches that the
essence of all morality is to do good to others. What is the reason that I
should be moral? Know through Vedanta that whomsoever you hurt, you hurt
yourself, they are all you… Herein is morality. Here, in Vedanta alone, is
morality explained. The others teach you, but cannot give you its reason."
Giving up Privileges
With these convictions based on his knowledge of Vedanta, Swamiji was very
much grieved to see people seeking privileges on the grounds of wealth,
muscle-power, or intellect. He said:
"There is the still subtler and more
powerful privilege of intellect; because one man knows more than others, he
claims more privilege."
And he further added,
"Apply the same
idea to the modern world: excess of knowledge and power, without holiness, makes
human beings devils. Tremendous power is being acquired by the manufacture of
machines and other appliances, and privilege is claimed today as it never has
been claimed in the history of world. That is why the Vedanta wants to preach
against it, to break down this tyrannizing over the souls of men."
doubt, revival of medical ethics is fraught with many difficulties, but despite
many constraints we should continue to work hard to break the stranglehold of
these privileges. One can not do away with the difference between doctors and
the patients; however, as Swami Vivekananda has said, 'But what can be attained
is elimination of privilege. That really is the work before the whole world.'
Paying our obligation to the society
Swami Vivekananda has said
that everyone (including the physician) has a social obligation to consider. At
the expense of the patients and the society he is able to complete his
education. It is his duty to repay that 'loan' as selfless service to the
'Serve with the knowledge that in serving other person we
serve no other but God Himself', he maintained.