Public narrative on “instant justice”: A slippery slope

The brutal gang rape and murder of a young veterinarian (now known as the ‘Disha’ case) on Nov 27, 2019 in Hyderabad, was followed by the encounter deaths of the four suspects at the hands of the Hyderabad police, on Dec 6, 2019. The rape-murder, the police killings, and the public jubilation after the killings are all not only extremely disturbing, but very intriguing

Health for all in an unequal world: Obligations of global bioethics

The theme of the joint 14th World Congress of Bioethics and 7th National Bioethics Conference Congress “Health for all in an unequal world: Obligations of global bioethics” is of critical relevance in the present global context. Although the world is better off in terms of improved health status of people by many measures than before, there exist colossal gaps across and within populations. Much needs to be done to respond to the lack of access to healthcare, poor quality of living and working conditions, and deteriorating quality of overall environment which affects more adversely the already deprived. We take this opportunity to make a few observations about the current status of affairs on this front, and offer brief analytical insights into the complex origins of the global health scenario characterised by disparities. We revisit the original conception of bioethics and suggest that it is well placed to respond to the current global crisis of inexorably widening disparities in health and wealth, and that global bioethics has an obligation to engage with this crisis.

Five years post Nirbhaya: Critical insights into the status of response to sexual assault

It is five years since the fatal gang rape of Jyothi Singh (Nirbhaya), a physiotherapy student, on December 16, 2012, in New Delhi, the capital of India. The legal and policy reforms triggered by the Nirbhaya case will remain a watershed moment in the history of efforts towards seeking justice for survivors of gender-based violence in India. The Criminal Law (Amendment) Act, 2013 and the “Guidelines and protocols: Medico-legal care for survivors/victims of sexual violence” issued by the Ministry of Health and Family Welfare in March 2014 are two landmark reforms. March 2018 marks four years since the issuance of these Guidelines and five years since the Criminal Law (Amendment) Act, 2013. Any reasonable tribute to Nirbhaya would constitute fair implementation of legal reforms, efforts to strengthen multi-sectoral response and sincere attempts to reduce crimes against women, gender and sexual minorities, and children. This paper reviews the issue, through a close study of recent cases of rape, police responses, court judgements, studies, news reporting and field-based observations. It brings forth the gaps in implementation that persist, and constitute a major obstacle in making these progressive policies and reforms effective. Given the fact that the reforms are intersectoral in nature, implementation has been particularly challenging. Lack of efficient implementation of such policies and reforms amounts to denying survivors their right to justice.

The Supreme Court of India on euthanasia: Too little, too late

On Friday, March 9, 2018 the five-judge Constitution Bench (CB) of the Supreme Court of India (SCI) chaired by Dipak Misra, the Chief Justice of India, pronounced its judgment (1) (henceforth CC judgment) granting, for the first time in India, legal recognition to “advanced medical directives” or “living wills”, ie, a person’s decision communicated in advance on withdrawal of life-saving treatment under certain conditions, which should be respected by the treating doctor/s and the hospital. It also reiterates the legal recognition of the right to “passive euthanasia”; and draws upon Article 21 – the right to life – of the Constitution of India (henceforth Constitution) (2) interpreting robustly that the “right to life” includes the “right to die with dignity”. Justices Misra and Khanwilkar disposed of the writ petition filed in 2005 by Common Cause (3) (henceforth CC petition) saying, “The directive and guidelines shall remain in force till the parliament brings a legislation in the field” (1:p 192).

Healing and dying with dignity: Where does India stand.

The articles in this special issue have emerged from work towards the sixth National Bioethics Conference entitled “Healing and dying with dignity: Ethical issues in palliative care, end-of-life care and euthanasia”. These contributions from physicians and social scientists touch upon three closely linked concepts, and raise complex ethical issues that must be faced by patients and their families, as well as by healthcare providers.

Regressive trend: MCI's approach to assessment of medical teachers' performance.

he Medical Council of India (MCI) has taken a regressive step. Its circular (No. MCI-12(1)/2015-TEQ/131880, dated September 3, 2015), which is entitled “Clarification with regard to research publications in the matter of promotion for teaching faculty in medical colleges/institutions”, is regressive and in partial dissonance with the current trends in medical science publications and norms of ethical publishing. Such an approach could have an adverse impact on the teaching faculty as it might encourage them to indulge in research misconduct. We appeal to the MCI to revisit its approach to the assessment of the performance of the teaching faculty in medical colleges and institutes. We make a strong case for the revocation of the MCI circular with immediate effect on four counts.

Access to controlled medicines for palliative care in India: gains and challenges.

It was in the early 1990s that an appeal was made, both in India and globally, for access to palliative care to be treated as a human rights issue. Over the past few years, India has witnessed robust advocacy efforts which push for the consideration of palliative care and pain management as a human right. Central to this paper is India’s Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985: its genesis, its critique, and the amendments aimed at enhancing access to the NDPS for medical care and research. I refer to the advocacy efforts in India, particularly the most recent ones, which led to the amendments to the NDPS Act, 1985 in February 2014; and the contribution of the global and local human rights discourse on palliative care to these efforts. This I situate in the overall status of palliative care in India. Towards the end, I briefly set out the agenda that should be pursued in the coming years to enhance access to controlled medicines for pain management and palliative care.