Monday, November 23, 2015
Doctors’ ethics and “industrial action”
By Nihal D. Amerasekera
Hippocrates is often called the father of modern medicine. He wanted the medical practitioners to maintain ethical standards. He wrote down the ethical guidelines between the 5th and 3rd Century BC. Although the world has changed much since the days of Hippocrates his oath has remained a beacon for doctors until the present day.
The earliest reference to certification of doctors in England goes back to 1411 but the body called the General Medical Council was born in 1858. The General Medical Council (GMC) regulates British doctors through the Medical Act. The Council comprises doctors and lay people. It registers doctors for UK practice, sets professional standards, regulates basic medical education, and manages doctors' fitness to practice.
We have the medical trade unions like the British Medical Association and the GMOA who represent the doctors when there is a conflict between the profession and the government.
Mostly, conflicts between doctors and the government arise due to pay or conditions of service or both.
The provision of healthcare in a country like the UK is a joint venture between the Government, hospital, doctor and the patient. So the responsibility for healthcare has multiple limbs. If the relations between any of the partners in this contract breaks down, the patient suffers. If the government fails to meet its contract with the doctor then it makes strike action more ethically justifiable. Society must be willing to support the doctors by paying them a proper wage. Here we assume the doctors are reasonable in their demands. As the Journal of Medical Ethics points out “Little harm can accrue from shattering a somewhat antiquated myth of sainthood and injecting a good dose of realism”
On the other hand doctors have a duty of care to their patients. If a patient dies as a direct consequence of strike action is it morally justified? Does that amount to medical negligence when the GMC can take appropriate action? Should the striking doctors make contingency plans for medical emergencies or is that the responsibility of the hospital and the government?
If the doctors strike purely to improve patient care in their refusal to put patients lives at risk. Does it make strike action justifiable?
The doctors too have lives to lead with professional and family commitments. They have bills to pay and have a right to a decent wage and a reasonable quality of life. Their long years of study and onerous routines must be adequately remunerated.
Provision of free healthcare is an enormous burden to any government. In their attempts to economise the government will inevitably try to slash healthcare costs and doctors pay will not be exempt from the cuts. This will result in conflict and recurrent disputes.
As you see there are more questions than answers. I would ask for your opinion on this ethical dilemma that would be a recurrent problem to the medical profession worldwide.
Should doctors go on strike?