On the absence of a doctor’s dilemma in India: Reflections on impatient violence

On June 10, 2019, Mohammed Sayeed, a 75-year-old patient was admitted to the Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal (1). He died that night due to a cardiac arrest and this led to a scuffle between the patient’s family and duty doctors. In retaliation, the doctors refused to discharge the body, asserting that since the family claimed it was a suspicious death, a post-mortem was required. A mob arrived, and in the confrontation, a doctor was injured. The medicos struck work. Doctors and medical associations across the country have voiced unanimous support for the doctors, and called for protective legislation against the violence of the public. As a consequence of these nationwide doctors’ protests, the Supreme Court has now proposed a law that protects doctors by severely punishing those who attack them (2). Meanwhile, it does seem as if such attacks are increasing

Storm in a teacup? General implications of the Cochrane crisis

The crisis that has emerged around the expulsion of Peter Gøtzsche from the Cochrane Board seems at first sight to be the outcome of a typical power play. However, the structural issues that have led to the crisis have emerged in a more technical criticism. These include lack of transparency, lack of cooperation of the pharma industry and hostility of institutions. Thus, the watchdog institution for efficacy and effectiveness of pharmaceutical drugs has itself now been hobbled by inefficacy and lack of effectiveness in its operation. What the confrontation shows us is how little control or understanding we (ordinary people) have over what we are given as curative and preventive biomedicine. It demonstrates how we are ignorant about the treatment of our sick bodies by expertise, pharmaceutical industry and medical institutions. The problem is not one of a particular evil actor. It is a problem of our medical culture. While we struggle to find our way through this overall historical situation, we need to listen to ethical experts like Peter Gøtzsche who are willing to stick their necks out and speak the truth.

Seeking to correct the psychiatric perspective.

The book under review provides a detailed criticism of the contemporary practice of psychiatry. It documents the unparalleled extent of the use of psychotropic drugs, their unacceptable risk, the irrational disease categories, and the lack of a proper evidence base. It traces meticulously the different ways in which the pharmaceutical industry influences professional guidelines through money, prestige, and scientifically corrupt means. This review provides an overview of the book’s arguments and recommendations and concludes with a comment on its scope and limitations.

Reflections on discrimination and health in India.

his is a speculative paper on the structure of caste-based discrimination in India. It sketches the field by a) proposing four empirical and historical examples of discrimination in different medical situations; b) suggesting an analytical framework composed of domain, register, temporality and intensity of discrimination; c) proposing that in the Indian historical context, discrimination masks itself, hiding its character behind the veneer of secular ideas; d) arguing that discrimination is not some unfortunate residue of backwardness in modern society that will go away, but is the force of social hierarchy transforming itself into a fully modern capitalist culture. The paper then arrives at the understanding that discrimination is pandemic across India. The conclusion suggests that in India today, we need proposals, hypotheses and arguments that help us establish the ethical framework for meaningful empirical research that sociological studies of medical ethics and the epidemiology of discrimination can pursue. Its method is that of logical and speculative argument based on experience, with examples of different forms of discrimination to clarify the point being made. No specific research was undertaken for this purpose since the paper is not empirically based.

Critical perspectives on the NIMH initiative “Grand Challenges to Global Mental Health”.

In July 2011 Nature carried a Comment titled “Grand Challenges to Global Mental Health”announcing research priorities to benefit people with mental illness around the world. The essay called for urgent action and investment. However, many professionals, academics, and service user advocate organisations were concerned about the assumptions embedded in the approaches advocated and the potential for the project to do more harm than good as a result. Nature refused to print a letter (sent on 20th August 2011) protesting against the issue, citing ‘lack of space’ as the reason. This letter is an effort to critique the initiative through wide participation and consensus