Updated texts on medical ethics

Rimpi Gupta, Editor: C M Francis, Medical Ethics as per revised MCI curriculum. 4th edition. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2020, pp 220, Rs 295 (paperback), ISBN 978-93-89188-62-2. Olinda Timms, Biomedical Ethics AETCOM companion for medical students. 2nd edition. New Delhi: Elsevier – RELX India Pvt. Ltd; 2019. 284 pp, Rs 450 (paperback), ISBN 978- 81-312-5965-8.

The first National Award for Medical Humanities in Indore: A report

REPORT The first National Award for Medical Humanities in Indore: A report. Sunil K Pandya DOI: 10.20529/IJME.2020.022 Introduction Dr Apoorva Pauranik1, retired Professor of Neurology and Consultant Neurophysician from the Mahatma Gandhi Memorial Medical College (MGMMC) and the affiliated Maharaja Yeshwant Rao Holkar Hospital (MYH) in Indore, Madhya Pradesh, is the Director of Pauranik Academy […]

Confidentiality vs harm to another

Dr. Bawaskar’s sensitivity in this matter deserves applause (1). The principle of confidentiality dictates that what is discussed by doctor and patient remains between them and should not be divulged to anyone else without the patient’s express consent.

Something is rotten in our medical colleges

Marcellus’ observation in Shakespeare’s Hamlet (1) that “Something is rotten in the state of Denmark.” (Act 1, Scene 4) could well be applied to medical education in India today. and could be followed up by repeating another statement earlier in the play, “and I am sick at heart.” (Act 1, Scene 1).

Puzzling silence of the British Medical Association

I support wholeheartedly the argument of Drs Chisholm and Sheather (1) in their essay in IJME that silence is not an option in times of conflict; but suggest that there are other situations in which this principle applies. Since the authors have referred to the World Medical Association (WMA) in their essay, I request them to favour us with their opinion on the deafening silence maintained by the British Medical Association on the troubling issue of Dr Ketan Desai being elected President of the WMA despite his being on trial in a court of law in India for corruption.

Henry Molaison's operation for epilepsy: a case study in medical ethics

Dr. William Beecher Scoville, an eminent American neurosurgeon of the 1940s, offered to treat Mr Molaison for his intractable epilepsy. During the operation, he removed large portions of both of Mr. Molaison’s temporal lobes. Such an operation had never been performed earlier as the function of these parts of the brain was not clearly understood and neurosurgeons such as Dr. Wilder Penfield of Canada feared they could cause grave damage to the patient. Mr. Molaison developed severe loss of memory to the extent that a few minutes after meeting someone, he had no recollection of the meeting and he could not find his way to his own home. Mr. Dittrich, grandson of Dr. Scoville, has analysed the operation on Mr. Molaison’s brain against the background of neurosurgery in the 1940s. This essay discusses the ethical aspects of Dr. Scoville’s operation in the light of current understanding and practice

Reviewer's rejoinder: Who will take responsibility?

The task of a book reviewer is to convey to readers the gist of the book and the reviewer’s educated feelings on its contents. Where the reviewer finds a discrepancy or observes representations that cause apprehension, duty demands that these be pointed out. This is the basis for my using quotations from Ms Sujatha Rao’s book and tagging them with statements based on my own understanding and experience

India's health system: No lessons learned

Ms Kanuru Sujatha Rao studied post-graduate history at Delhi University. She has a Master’s Degree in Public Administration from Harvard University. She joined the Indian Administrative Service in 1974 and belonged to the Andhra Pradesh cadre. She has dealt with health and family welfare in the Government of Andhra Pradesh and in the Government of India. She won plaudits as the Secretary, Department of AIDS Control and Director General, National AIDS Control Organisation (NACO). Some of her work there is described in Chapter 4 (pp 201-297).

At last – a home grown ethics text.

Olinda Timms, Biomedical ethics. New Delhi: Reed Elsevier India, 2016, Paperback, 407 pages, Rs 400.00, ISBN978-81-312-4415.9 At long last we have a homegrown text on biomedical ethics that we can be proud of, and recommend to teachers and students alike.

Guidelines for stem cell science and clinical translation.

The International Society for Stem Cell Research has released its updated guidelines for stem cell research in order to provide “assurance that stem cell research is conducted with scientific and ethical integrity and that new therapies are evidence-based.” The guidelines were updated by a Guidelines Update Task Force consisting of twenty-five scientists, ethicists and experts in health care policy from nine countries. The chairpersons of this task force are Jonathan Kimmelman, George Daley and Insoo Hyun. There is no representative from India; the only person of Indian origin on it, Mahendra Rao, represents The New York Stem Cell Foundation.

'Living in the clouds of a vain illusion': The decline and fall of clinical autopsies

Autos is Greek for oneself and opsis refers to the act of viewing; combined into autopsy, the word refers to the act of seeing for oneself.1,2 Historically, autopsies have been crucial to our understanding of the natural history of disease and the efficacy of our attempts to treat them. They have also humbled us by showing our shortcomings and errors. Campos and Rocha have reviewed autopsies over the past 4000 years and have highlighted their pedagogical value.3 In the era preceding Roentgen, autopsies were an unparalleled means for learning pathology. Works of great masters such as Giovanni Battista Morgagni (1682–1771) and Rudolph Virchow (1821–1902) were based on meticulous autopsies; Virchow added the use of the microscope. Carl Rokitansky (1804–78), working at the Allgemeine Krankenhaus in Vienna, performed 30 000 autopsies personally and supervised many more, making his institute one of the most respected training centres in pathology in Europe.1,2 The names of two early clinicians, who used autopsies to understand disease, come to mind. Pierre Charles Alexandre Louis (1787–1872) studied enteric fevers and distinguished typhoid from other causes of fevers. He correlated the intestinal lesions termed Peyer’s patches (after Johann Conrad Peyer [1653–1712] who had described them in the 1670s) with typhoid and used medical statistics to lay the foundation of what we now term evidence-based medicine.4 The surviving volumes of autopsy notes by William Osler at McGill University, the Montreal General Hospital and Philadelphia General Hospital, stand witness to his enthusiasm and competence in extracting the last bit of information from his subjects. His genius lay in correlating autopsy findings with clinical features to build unforgettable descriptions of several diseases. The lessons learnt in the autopsy room were disseminated to his students at dissections, through papers, books and at meetings.

Disarming honesty and one life well lived.

Dr Samiran Nundy’s foreword to the book sums up its contents accurately. Let me quote just one paragraph from it to give you the flavour of this autobiography: “…I started reading the book on a Friday and by Sunday I had finished it and was absolutely enthralled. The opening page sets the tone of this book which is full of optimism and gratitude of what life has given to the author – work when young, guidance and protection from mistakes during operations, a disdain for money and ‘good health to enjoy the evening of his life’. His prayers have been answered.”

The functioning of the Medical Council of India analysed by the Parliamentary Standing Committee of Health and Family Welfare.

On March 8, 2016, the 92nd report on the functioning of the Medical Council of India (MCI) was placed before both Houses of Parliament by Professor Ram Gopal Yadav, Chairman of the Parliamentary Standing Committee of Health and Family Welfare.

Are you appearing for an interview for an academic position.

This March (2015), I was privileged to be part of a selection committee at a national institute. We interviewed candidates for several posts of Assistant Professor, Associate Professor and Professor. Since the institute is highly reputed, there were several applicants for each post, from all parts of India. Working from 8 a.m. to 7 p.m. on four weekends, we studied the competences and capabilities of hundreds of candidates. When a series of candidates disappointed the 12 or more members of the committee and the two independent observers appointed by the institute to ensure fairness and justice, there was general depression in the room. When—as was usual on most days—one or two or three outstanding candidates appeared, there was joy. These young scientists were so good that they would have been grabbed by any of the major scientific institutes anywhere in the world. The cumulative experience of all the committee members and consequent discussions at lunch breaks resulted in some ideas that might help those aspiring to appointments in our major organizations.

Do goliwaale daaktar.

efore commencing the review, I must point out that the author, Dr Nita Mukherjee (PhD), and her husband, Achintya, are good friends of mine. I was permitted a reading of the entire text of this book before it was published. My wife, Shubhada, and I were able to help Nita in a small way when she was carrying out research on Dr Sanghvi’s years at the Grant Medical College and Sir Jamsetjee Jejeebhoy Hospital in Bombay.

Making medical care and research rational and affordable.

Expenditure on insurance, consultations, the multitude of tests ordered by the doctor, and very expensive drugs make the treatment of illness a great burden. Should the patient need admission to a hospital and, worse, an intensive care unit, the load becomes almost unbearable. Medical research has moved from the domain of the single keen observer to that of highly qualified experts working in laboratories containing costly equipment. The budget for these projects now runs into lakhs or crores of rupees.

Integrating ethics and neuroscience research.

Mr. Barrack Obama, President, United States of America, has appointed a Commission consisting of eminent persons in the fields of medicine, science, ethics, religion, law and engineering to advise him on bioethical issues arising from advances in biology, medicine and related areas of science and technology. It is of interest that the Commission includes Dr. Raju Kucherlapati, geneticist at the Harvard Medical School, as a member. The research staff of the commission includes Maneesha Sakhuja. Ruqayyah Abdul-Karim, Rahul Nayak, Abbas Rattani and Abena Yeboa are included among the interns. Guest presenters to the Commission include Anjan Chatterjee (neurologist), Miyoung Chun (scientist), Ushma Neill (clinical investigator) and Pamela Sankar (ethicist).

Dr Bashir Mamdani MD 1945 – 2014.

Dr. Bashir Mamdani hailed from Tanga in Tanzania. Like many others at the time, he came to India in search of education and graduated in medicine from the Seth GS Medical College and King Edward VII Memorial Hospital in Bombay. He obtained his MBBS in 1965.