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The code would subsequently be submitted to all the relevant Central Ministries.Getty images/istockphoto  

Can an individual doctor advertise, have a website to promote her practice to compete with aggressively marketed corporate hospitals? Should the donation of cadaver organs be made mandatory for all? Is it important for medical students to study ethics throughout the duration of the MBBS course?

The Indian Medical Association (IMA) says yes to all these questions.

Marking a bold departure from the existing code of ethics that covers the medical profession, the IMA — an umbrella voluntary body that counts more than 2.5 lakh, or about a third, of the country’s doctors as its members — is in the process of redefining the code in order to ensure a much more contemporary outlook.

“The current code of medical ethics by the Medical Council of India dates back to 2002,” said Ravi Wankhedkar, IMA president.

“Much has changed in the medical field since then and many relevant topics do not find a mention in the present code. Therefore, we felt it was necessary to brainstorm on this aspect,” he said, adding that IMA would be releasing a handbook on the redefined code of medical ethics to its members at the association’s annual cultural festival in Pune this weekend. The code would subsequently be submitted to all the relevant Central Ministries – health, medical education, law and justice and the MCI – for consideration.

24 topics

The handbook would comprise 24 topics that either need to be reviewed or find no mention in the current code. For example, the current MCI norms do not allow doctors to publicise their practice through any type of advertising.

“Big private hospitals are constantly promoting their set ups through advertisements in all mediums. How will individual doctors, especially those who have just begun practice, survive such competition,” wondered Dr. Wankhedkar, adding that the IMA believes that any publicity material should be ethical and approved after scrutiny by the respective State medical councils.

IMA’s handbook also looks at the topic of ‘end of life’.

“After much discussion, we are of a view that doctors cannot give consent for deciding on pulling the plug. We are against physician-assisted suicide. This decision can only be taken by relatives,” said Dr. Wankhedkar.

Ethical issues around Assisted Reproductive Technology and surrogacy also find a mention in the handbook and the IMA states that doctors should ethically ensure that surrogates and egg donors are not exploited.

The IMA also recommends that cadaver organ donations must be made compulsory for all unless an individual specifically states that he or she does not want to become an organ donor.

Viewing this recommendation as a ‘utopian solution’, the IMA acknowledges that this particular suggestion may trigger a fierce debate.

Cadaver organ donations are currently carried out in India only when an individual has explicitly expressed a wish to donate or with the consent of immediate relatives in cases of brain death, creating a shortage of cadaver organs for transplants.

“We have a long waiting list of patients for organ transplants,” said Dr. Srikumar Vasudevan, chairman of IMA’s ethics committee. “India carries out a high number of living donor transplants as compared to cadaver organ donations,” he observed. “A revamp has been due for long.”

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