The doctor's dilemma

To understand the fundamental contradiction between doctors and the drug industry, one must realise that the medical profession has to place patient before self and should work for the maximum benefit of the patient (the concept of fidelity). Beneficence (doing good) or at least, nonmaleficience (doing no harm) are other guiding principles. In addition, doctors today are expected to engage in the advocacy for patients - identifying their needs and working for developments in human and physical resource allocations for improvement in healthcare delivery.

- BY DR. SUSIRITH MENDIS EMERITUS PROFESSOR UNIVERSITY OF RUHUNA ([e-mail])

It was not just yesterday, or the day before, that this subject was discussed. In fact, it was over a century ago that George Bernard Shaw, the famous Irish playwright, wrote the play, 'The Doctor's Dilemma' that was first staged in 1906. It was published in book-form in 1909. It was considered a 'problem play' - a form of drama that emerged during the 19th century, dealing with contentious social issues which were debated on stage.

Would you believe that 'The Doctor's Dilemma' was about moral dilemmas created by limited medical resources and the conflicts between the demands of private medicine as a business and as a vocation?

What do we see today? Not much seems to have changed between the early 1900s in England and the present day in Sri Lanka.

The whole nation now knows that of Dr. Maheshi Wijeratne, specialist neurosurgeon and consultant to the Sri Jayawardenepura Teaching Hospital (SJP TH), has been arrested, remanded and released on bail by the Chief Magistrates Court, Colombo, on a complaint filed by the Commission to Investigate Allegations of Bribery and Corruption (CIABOC). The arrest and remanding has disturbed a hornet's nest, not only in the social media, amongst patients and elite societal circles, but also, significantly within the medical community.

What is disturbing to me, having been a medical teacher for nearly 45 years and a medical ethicist for many decades, is the lack of clarity amongst the doctors about Dr. Maheshi Wijeratne's purported offence. This is the current doctors' dilemma that I have been keenly observing and the main reason for this short essay.