The History of Medical Ethics in India

Photo by Naveed Ahmed on Unsplash ABSTRACT India has had a solid standard for medical ethics since the birth of Ayurvedic holistic science over 5000 years ago. The country’s views healthcare policy, counsel how to deal with patients, and what constitutes good behavior within profession stem from ancient outlines practice. These “codes conduct” were heavily influenced religious spiritual practices, emphasizing sanctity life transcending needs body. With time, however, care evolved through shifting priorities in education governmental pressures. once-cherished referred less often, while malpractice issues have steadily increased. There is need an open discussion why this spike happening country that used condemn it improving ethics, limiting role profits, returning traditional philosophies curricula could help. INTRODUCTION Currently, largest number bioethics units any country, reflecting importance ethical Indian society. centers do not affiliate schools, yet they serve as spaces bioethical discourse. Psychiatric Society (IPS) was first address escalating cases. Other major organizations (e.g., Medical Association Council India) followed, stressing standardized ethics. Some formed symposiums organized conferences these concerns.[1] been several calls revisit classic their focus concept life-death-rebirth. Toward end, modern doctors reminded physicians existed fortune or status but welfare patients. altruistic teachings came seminal texts, cornerstone India’s medicine. Happiness “healer” come out showing compassion all living beings prolonging precious gift life.[2] In contrast, novelist, Shashi Tharoor, speaking current state practice, recently remarked: “India underdeveloped highly developed one advanced decay.”[3] Taking closer look at caused core values system change so drastically involves evaluating evolved. This paper examines development principles, influence across subcontinent, commercialization, government’s instability. then lists some measures taken counteract brought corruption. l. Western Influence practices when French, Portuguese, British arrived India. They almost completely reinvented system. based spirituality stripped away replaced concepts.[4] Established standards no longer taught, resulting deference moral beliefs. Coupled increase misconduct, general population lost trust leaders.[5] Before medicine, Carakha Sumhita, millennia-old Sanskrit text detailing Ayurveda, helped establish guidelines. A passage sums up time: “He who medicine creatures, rather than gain gratification senses, surpasses all.”[6] Sumhita’s ahead its centuries before became subject own right. Healthcare predicated aphorisms students internalized business models, many nations. caste system, established generations ago, permeated every aspect South Asian society except Healers tended ignore conventions adhering individual’s caste. Instead, treated patients if family incorporated elements dealing making misconduct rare phenomenon. case two centuries.[7] To become practicing physicians, committed consecration ceremony prove standing people serve.[8] Their schooling prepared them designed “give back,” monetary gain. taught school affect mentality carry them. lack training may fault underlying corruption levels now plague space 110 percent rise negligence cases year.[9] pinpoint occurred, we must our time period. After colonization, curriculum.[10] fact, 1998, only college India, St. John’s Bangalore, even addressed curriculum.[11] Graduates left ill-equipped cropped once made into field. As result, think consequences pertaining families. suggest curriculum changes linked rising “When large corrupt unethical, can you expect be honest?”[12] topic arises regularly discussions answer lies education. Reverting encourages recognize solve problems contemporary ll. Privatization Tuition argue global capitalism subcontinent’s problems, began descent nepotism, loss prestige, privatization colleges.[13] just 50 schools are public, under private.[14] Through changing policies, private increasingly for-profit like other businesses.[15] Despite having more shortage doctors, primarily due low enrollment rates high university fees. While there 202 means 5 million per school.[16] Christian College, top-ranked Vellore, acceptance rate 0.25 percent, 100 seats students.[17] Now hovers around percent. minimal progress easier get acceptance; still long way go equalizing access rife corruption, bribes accepted guise “donations” new devoid methods.[18] Nepotism industry qualifications significant. 2010, 69 hospitals colleges reported selling exam papers students, most employed staff lied about clinical experience.[19] cheating scandal 2013 involving universities, purchased falsified entrance results. Not unqualified placements secured, legal action government did materialize.[20] Dr. Anand Rai, physician protective hiding following death threats being whistleblower subsequently “...the next generation cheat deceive enter classroom.”[21] effects felt far beyond borders - also happens world’s exporter 47,000 currently United States.[22] lll. Hospital shift “United States” focus, another serious problem emerged. recent past, hailing rural villages often poverty quality health public hospitals. trained costs usually fully subsidized.[23] keeping old tradition believed aid matter circumstance. shifted towards maximizing profitability, opportunities poor vanished. Chains rapidly replacing ones. purchasing model consolidate centralized subsidiary.[24] results significant savings. Instead passing savings reduced pricing, fulfill key objective privatized businesses: maximize profitability. contend inflated prices turned facilities cost, plummeted. distrust discourage cannot afford seeking it. devolved point whereby remaining overrun huge numbers unable hugely institutions. This, coupled workers substandard training, created deplorable conditions. lV. Corruption condition reflects failing make matters worse, hire graduates untrained meet India's urgent qualified doctors. Many resorted employing shortage. According (IMA), 45 those practice formal training.[25] IMA close 700,000 biggest hospitals, diagnosing, treating, operating, neither nor experience so. large-scale forgery ring, broken 2011, revealed buyers pay little US dollars degree non-existent college. “cleared” practice.[26] It estimated 50,000 fraudulent degrees past decade. Government level widespread, placement school, “graduate” fake degrees, sell licenses. V. Solutions topics, raised centers, seriously professionals taking steps misconduct. five die each year negligence.[27] By requiring complete comprehensive Acute Critical Care Course (ACCC), specialists estimate reduce deaths much areas.[28] intensive two-year course contains detailed methods built off knowledge walks crucial errors. Even small errors, such poorly inserted IV fluid minor surgery mishap, threatening. thoroughly covers mandated.[29] ACCC unfortunately widely spread lot areas. For now, continue avoidable deaths, implementation program seems slow. effective addressing cases, them.[30] One possible solution growth unethical offer incentives ethically sound decisions. start increasing slots available government-run schools. Less student debt would lead overbilling strategy Tamil Nadu, where centrally sponsored scheme approved induction additional 3,496 MBBS colleges.[31] More studying subsidized competition lowers inclination toward deceit profiteering. Another incentive accountability transparency. background doctor operating should information, including successful surgeries versus unsuccessful ones personal negligence. encourage keep clean record and, turn, train will preserve improve reputation. information kept monitored parts method.[32] eliminating recording reverting digital use ultimate aim, take implement takes account e-signatures verifiable witnesses. CONCLUSION history leadership undergone changes. relatively decimated levels. principles question. leaders trying multi-faceted facing industry, obvious undertaking inventive solutions. Prioritizing education, de-privatizing offering affordable options, ability high-quality care. Adding back foster workforce dedicated serving [1] Deshpande, SmitaN. 2016. “The UNESCO Movement Bioethics Education Scenario.” Journal Psychiatry 58 (4): 359. https://doi.org/10.4103/0019-5545.196722. [2] Mukherjee, Ambarish, Mousumi Banerjee, Vivekananda Mandal, Amritesh C. Shukla, Subhash Mandal. 2014. “Modernization Ayurveda: Brief Overview Initiatives.” Natural Product Communications 9 (2): 1934578X1400900. https://doi.org/10.1177/1934578x1400900239. [3] 2020. Eubios.info. https://www.eubios.info/EJ102/EJ102E.htm. [4] Arnold, David, ed. 2000. “Western Medicine Environment.” Cambridge University Press. 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(2021) Students Can’t Earn Admission Merit, Buy Way In.” 19, https://www.npr.org/2019/08/04/745182272/when-students-in-india-cant-earn-college-admission-on-merit-they-buy-their-way-i. [15] https://timesofindia.indiatimes.com/india/how-medical-colleges-in-india-became-a-business-one-policy-change-at-a-time/articleshow/69707594.cms [16] Muula A. (2006). Every Croatian journal, 47(4), 669–672. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080437/ [17] Miglani, Andrew MacAskill, Steve Stecklow, Sanjeev. 2015. “Why Are Plagued Fraud.” Mint. June https://www.livemint.com/Politics/BDGOx3SApU3QbsRMjZUK9M/Why-Indias-medical-schools-are-plagued-with-fraud.html. [18] Clark, J. “Indian System Is Broken, Reuters Investigation Finds.” BMJ 350 (jun18 3): h3324–24. https://doi.org/10.1136/bmj.h3324. [19] Reuters. “Special Report Why Fraud,” 16, 2015, sec. 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