ETHICAL CHALLENGES OF DOCTORS IN INDIA

Our ability to safeguard healthcare workers while empowering patients will shape the ethical landscape of our healthcare system.

- By: Dr. Shilpi Agrawal, Consultant Head Neck Oncosurgery, HCG Cancer Centre, Borivali

Moral philosophy relies on ethics, which helps determine what is right, wrong and why. Ethics is not a series of static universal principles but is subjective and based on people's convictions, feelings, and cultural values. Especially in a diversified and pluralistic society such as India, such subjectivity has far-reaching influences on medical practice.

In healthcare, medical ethics is the guide to clinical practice and medical research. Four core principles form the basis of this system: respect for autonomy (respecting a patient's right to make informed decisions), beneficence (doing what is best for the patient), non-maleficence (doing no harm), and justice (providing fair and equitable access to care). These principles are the foundation of ancient vows such as the Hippocratic Oath and are now formally enshrined in contemporary professional codes adhered to by hospitals and medical centres globally.

1. Beyond Principles: Ethics in Practice

However, the actual practice of ethics in real life is never simple. In India, where doctors toil under overworking hours, limited resources, and crowded patient loads, ethical practice is not a desirable goal, it is a continuous struggle. Doctors tend to tread a tightrope, seeking to balance the best ethical ideals against institutional vulnerabilities and sociocultural pressures

Routine ethical dilemmas vary from trying to get genuine informed consent to confidentiality of patients, resisting commercialism, and negotiation with bereaved families. These ethical issues are aggravated by a rapidly deteriorating work environment for physicians. On the other hand, the Indian social structure and deeply ingrained family decision-making beliefs bring both advantages and disadvantages to moral clinical interactions.