Upholding medical ethics within the ambit of doctor-patient relationships
Vitalio Angula The Hippocratic oath, the earliest expression of medical ethics in the western world, establishes principles of medical ethics which are of paramount importance in the world today. One such principle is the special position a doctor holds with regard to his/her patients. Within the borders of the Republic of Namibia, health professionals are guided under the auspices of the Health Professional Councils of Namibia’s Ethical Guidelines for Health Professionals of 2010. In respect of the former it is clear that the Hippocratic oath forms the basis of what health professionals the world over and Namibia in particular would regard as the standard norm in ensuring the profession upholds its stature and rightful place within society as a whole. But alas, things are not always as they seem or rather things are not always as they should be. In her autobiography titled “Making a difference”, Dr Libertina Amathila, a medical doctor and who served as Deputy Prime Minister of Namibia, narrates an experience of her time in Tanzania, while doing her internship, where a certain surgeon would not heed to her call about a patient in distress, who was about to deliver, because his credentials compared to hers, he believed, outranked her not only in status but in judgement as well, and because he was “pompous about being called doctor and living in clouds of self-importance”. According to Dr Amathila, the woman in need ended up losing her baby although her life was spared. Such negligence, according to Dr Amathila, “should not happen without retribution”. These are the extremes of what happens when doctors, who by virtue of their professions sometimes do hold the key to life or death, fail to abide by the ethos they have sworn to abide by. It is in this regard that I would like to bring forth a rather dangerous trend that many Namibians through the administering of a survey have testified to having experienced. Many a time complaints regarding the medical fraternity have been limited to public hospitals and healthcare centres – however from the survey administered it seems that private healthcare practitioners have also jumped on the bandwagon or maybe they have just managed to keep their non-adherence to the standards of medical ethics under the radar. It has become common knowledge within society that medical practitioners seem to be more concerned with making money by seeing as many patients in a day as possible, and often times treat with disdain or rather lack of empathy patients who enquire further on the treatment they are receiving. This lack of empathy is usually communicated to the patient via the doctor’s body language that the patient is wasting their time, being difficult or attempting to be ‘woke’ when ‘patients exercise their right to comprehensive medical advice in a way the patient can best understand, which in the end erodes the good doctor/patient relationship on which good professional practice depends.’ Chapter 7, section 3.2 of the ethical guidelines for health professionals 2010 states, ‘patients also have a right to information about any condition or disease from which they are suffering. This should be presented in a manner easy to follow and use and should include information about a diagnosis, the prognosis, treatment options, outcomes of treatment, common or serious side-effects of treatment, likely time scales of treatment and costs where relevant. A health professional should always give patients basic information about treatment they propose or provide.’ Another rather dramatic and debatable transgression that medical practitioners, especially those in the employ of the state are guilty of, is the insistence on payment of the hospital levy even when the patient is not immediately able to furnish such payment, which is clearly against the ethos articulated in the guidelines that all citizens have a right to “receive timely emergency care at any healthcare facility that is open regardless of one’s ability to pay”. There is sufficient evidence that the medical fraternity within the Namibian State is found wanting or rather lacking with regard to upholding the very ethics which they have sworn to abide by, with regard to showing compassion to patients and creating opportunities to translate feelings of empathy and sympathy, recognizing that they are in a position of power over patients and not abusing that power for the benefit of their egos, listening and respecting patients’ opinions and having a positive disposition that demonstrates courtesy to human dignity, patience and tolerance. It is in this regard that I implore medical practitioners to take very seriously the words of Louis Lasagna as re-written in 1964 that, “I will remember that there is art to medicine as well as science, and that warmth, sympathy and understanding may outweigh the surgeon’s knife or the chemist’s drug.” * Vitalio Angula is a Namibian socio-political commentator and an advocate for ethics across all disciplines.
2018-01-19 09:59:03 8 months ago