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ETHICS
9.1. MEDICAL ETHICS
In medical sector the overcharging is rampant, be it in terms of prescription of unnecessary diagnostic tests,
prescription of expensive medicines, inflation of hospital bills or insurance company frauds. Recently, NPPA’s
decision to put a price cap on knee implants also shows degrading medical ethics as hospitals and doctors were
indulging in unethical profiteering. The ethical issues in such unfair pricing can be as follows:
Low trust - patient-doctor trust is reducing as awareness is increasing about medical malpractices. To reduce
trust gap, initiative like Poona Citizen Doctor Forum could be taken where public database of ethical doctors
is created by patients.
Shift from service orientation to commercialization – Doctors are given inducements to prescribe expensive
drugs which prompts them to prescribe it even when they are not needed.
Professional misconduct – It is considered as an unethical conduct under Indian Medical Council
(Professional Conduct, Etiquette and Ethics) Regulations, 2002.
Undermine reputation – It not only undermines reputation of individual doctor or hospital but also hurts
image of India as provider of high quality & affordable healthcare to foreign patients.
Unfair – It is unfair for the patients who may slip down in poverty due to high expenditure on healthcare
services. It is also an unfair trade practice as it forces industries to collude with hospitals to maintain sales
and remain in competition.
Promotes greed – Although hospitals should have some margins as it provides facilities such as sterilization,
storage etc. yet margins can’t be exorbitant and irrational. In NPPA report, the average margin on a full set
of orthopaedic implant seems to be 313 per cent.
Information asymmetry – At times lack of detailed brief about the benefits or limitations of the new
technology, patient opt for the newer and costlier technology just on doctor’s word
As, patient trusts the doctor for his most important thing, that is life, doctors should feel their inherent
responsibility to follow the following medical ethics:
Patient’s first – Health care is a noble art where doctors should compassionately treat people irrespective of
class, nationality, gender, caste etc.
Fair charges – which should be known to the patient in advance
Values of care and trust – Doctors should develop trust with patients and support the patients
psychologically through polite interactions
Transparency – regarding various treatments available and pros and cons of the same so that patient can
make informed decision
Confidentiality – personal information shared by patient in the course of treatment should not be disclosed
by the physician
Professionalism and beneficence- A physician should uphold the dignity and honour of his profession where
his prime objective should be service to humanity
Sympathy – The doctor should be sensitive to the patient’s pain and sufferings during treatments
This is not to say that doctors should charge bare minimum. Medical practitioners also have a legitimate right to
appropriate levels of remuneration but balance needs to be struck between professional virtues and business
considerations.