The Hindu : National : Need for debate on medical ethics, Abraham Verghese

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Saturday, Jul 16, 2005

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Need for debate on medical ethics, Abraham Verghese

By Our Staff Reporter

VELLORE: With the advancement of research in medical technology, the need has arisen for balancing such research with a healthy debate on ethical issues, according to Abraham Verghese, Director and Marvin Forland Distinguished Professor, Centre for Medical Humanities and Ethics, University of Texas Health Science Centre, San Antonio, U.S.

A centre for medical ethics is a bit unusual not only in India but in the U.S. It is part of the increasing push in the U.S. medical schools to incorporate values in the medical system. Ethical issues did arise when test tube babies and organ transplants were introduced, but the real problem came only with the introduction of the Human Genome Project with its immense potential for predicting — after birth or while still being in the foetal stage — the age at which a child would get diseases, and what type of diseases it was likely to contract at different ages of its life. With the project of mapping genes proceeding with great amount of success, "we have to think and debate on what we are going to do with the data from the Human Genome Project in the light of the ethical and social implications of the knowledge of such information," said Dr. Verghese. He was addressing a press conference arranged here on Friday by the Christian Medical College Hospital, where he later gave a talk on medical ethics to doctors.

Dr. Verghese said ethical medical practice had to conform to four norms, the most important of which was "patient autonomy," which granted the patient the right to get treated or not, and the right to accept or reject a certain type of treatment. For instance, he said patients following certain sects of Christianity did not accept blood transfusion. In extreme cases where the treatment was painful, there had been instances in the U.S. where the patient did not want to live. Doctors faced dilemmas when the patients refused treatment while the close relatives compelled the doctors to treat them. In such cases, the doctors gave first preference to the choice of the patient, the second to that of the spouse and the third to the view of the other relatives.

The second norm to be addressed is "beneficence," implying that all actions of physicians should be aimed at the good of the patient. The third was "non-malfeasance", which meant that the doctor should ensure that his approach did not result in a wrong being done to the patient. The fourth was the spirit of generosity and service, the most ideal for a doctor.

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