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Medical Ethics: for Self-regulation of Medical Profession and Practice

The pride of the medical profession is in its self-regulation on the basis of professional codes of ethics. The profession has traditionally opposed outside interference and control over its internal matters so much so that, a section with a misconceived notion of no-accountability is vehemently opposed to applying the Consumer Protection Act to medical services.

This study has examined the meaning of self-regulation, the code of ethics and its role in self-regulation, and the history and evolution of laws establishing councils for health professionals in developed countries and in India. The Medical (allopathy, Indian systems and homeopathy) and Nursing council offices for Maharashtra in Mumbai were visited to understand their functioning. The findings of this quick study of the functioning of these councils show that they have not fulfilled even some of the preliminary objectives of self-regulation for which they were established in the first place.

The study argues that the health care ethics are normally violated in the market-based health care since the section of people not having purchasing power are denied basic minimum health care. Thus, it is difficult to conceive an ethical health care service scenario without having fundamental or legal right to basic minimum health care. While recognising the great strength of the community health approach using village level workers and paramedics, it makes a strong case for formalisation of the semi-professional work of these workers through registration and other means.

The study also recommends that the functional unit of the council should be brought down at the district level. The licensing or registration provisions in the laws related to Councils should be amended to affect redistribution of the health care professionals. The control of government bureaucrats on councils should be removed, in order to make them genuinely self-regulatory. The work of Councils should be made transparent; the complainant patients should be given more rights and information, etc.

Supported by: The Independent Commission for Health in India (ICHI), New Delhi Research Team: Aditi Iyer and Amar Jesani]]