Charter on medical professionalism

I must congratulate the editorial team for an extremely readable April-June 2002 issue (1), relevant to the practice of medicine in India today.

I was particularly interested in the comments of Professor Ed Pellegrino on the Hippocratic Oath, because of a research project by a group of physicians from America, Canada and nine countries in Europe. Begun about three years ago, the aim of the project was to draft a charter on medical professionalism, a document that is being hailed as a modern version of the Hippocratic Oath.

As the charter acknowledges, the modern-day doctor is ‘confronted by an explosion of technology, changing market forces, problems in health-care delivery, bioterrorism and globalisation’. One of the drafting physicians, retired orthopaedic surgeon and former dean of the McGill medical school, Richard Cruess, comments that the charter is designed to say: “Look, times are really tough, but this is what we as physicians stand for, and we’re going to try.” His wife of 48 years, endocrinologist Sylvia Cruess, who also formed part of the drafting team, says, “Professionalism had not been in any way referred to in the medical literature, which is rather appalling, seeing that we think we’re professionals.”

Hence, high on the list are concerns of commitment to integrity and honesty, reducing and reporting medical errors, avoiding conflicts of interest with insurance companies and pharmaceutical firms and the fair distribution of health care resources. Three fundamental principles and a set of 10 commitments are outlined.

The charter appeared in print for the first time in the February 5, 2002, Annals of Internal Medicine and simultaneously in The Lancet and may be viewed by logging on to the following Web address: http://www.annals.org/issues/v136n3/full/200202050-00012.html, under the title ‘Medical Professionalism in the New Millennium: A Physician Charter’.

Obviously, the word ‘international’ applies, as of now, to the industrialised world from which the drafters come, but there is call to ‘physicians from every point on the globe to engage in dialogue about the charter’, to respond to the question: ‘Does the document represent the traditions of medicine in cultures other than those in the West, where the authors of the charter have practiced medicine?’ Some of the readers of IME may be interested in responding from the Indian viewpoint.