Expressions of equity: imbalances in the patient-clinician interaction.

This paper reports patient perceptions of inequities in the doctor-patient interaction. A mixed method study was conducted in a tertiary eye care centre in southern India to gain an insight into patient understanding and satisfaction from clinician communication. Non-participant observations enabled us to map the sequence of communication opportunities in the clinical interaction, and in-depth interviews were used to identify patient perceptions of the content and clarity of clinician communication in a clinic for patients of glaucoma, a chronic eye disease. A 60-item instrument was administered to 550 participants in the quantitative phase to explore associations between patient expectations, experience and ratings of clinician communication and satisfaction with it.

Considering ethics in community eye health planning: perspectives from an existing model.

Despite the widespread acceptance of the principles of the Alma Ata Declaration of 1978 and the subsequent amendments, health for all has remained a distant dream in many parts of the developing world. Concerns such as the economic efficiency of health systems and their reach and coverage have dominated discussions of public health, with ethics remaining at best a shadowy set of assumptions or at worst completely ignored. Similarly, questions of ethics have been taken for granted and rarely addressed directly in the design of public health models across sectors and are rarely explicitly addressed. This paper uses the experience of the L V Prasad Eye Institute’s (LVPEI) pyramidal model of eye healthcare delivery to explore ethical issues in the design and implementation of public health interventions.

Medical ethics in the media.

The mass media function both as reflector and a shaper of a society's attitudes and values and as such represent a forum within which one may understand and influence public opinion. While questions of medical ethics may be largely confined to academic and scientific spaces, their importance to society at large cannot be denied, and how issues of medical ethics play out--if at all--in the media could tell us how society understands and processes these questions. This paper uses the techniques of framing analysis and textual analysis to examine how the print media, represented by two major Indian newspapers, cover medical ethics. The study looked at all articles related to medical research over a three-month period (January-March 2007) and considered how the story was framed, what were the key threads followed, and the dominant themes focused on. The ethical frame is notable by its absence, even in articles related to controversial themes such as drug research and genetics. Discussion of ethics appears to be problematic given the adherence to traditional "news values" when covering science and medicine. The research community and the media need to pay more attention to explicitly focusing on ethics in their interactions.