Health – a matter of commerce

When it comes to health the consumer has no choice. The stress of illness forces her to comply with advice tendered by the doctor. This makes it the prime responsibility of the doctor to ensure that patients get a fair deal.

Alarmingly, health is now a matter of commerce, where concern for profits overshadow all other considerations. Welfare, as an important aspect of health care, is neglected by the State and has, by default, been passed on to voluntary agencies. The new economic policies, liberalising the ‘health market’, without effective and meaningful regulation, are already proving disastrous for patients.

Professional bodies and medical ethics : Indian Pharmacological Society (IPS)

It is pertinent to review the ethics of professional bodies in the light of these facts. As this editorial is being written, the 27th Annual Conference of IPS is under way at the K. E. M. Hospital in Bombay. The organisers of the conference could find no time to discuss the several ethical issues related to their specialty and the role that IPS can and should play in the marketing of drugs.

Illogical drug combinations

How is it that professors of pharmacology teach students the inherent fallacy in combining a bactericidal and bacteriostatic antibiotic and yet remain silent when ‘Pentid-Sulfa’ was marketed or cast a Nelson’s eye when cough remedies combine sub-therapeutic doses of expectorant and antitussive in the same formulation? No pharmacologist cared to take up this issue with regulating authorities such as the Drug Controller of India or the various Food and Drug agencies to cancel the licenses of companies producing such combinations. Silence on their part is not only unethi cal but also an abject surrender to these manufacturers. Most conferences are funded by the pharmaceutical industry and the inference is obvious.

One would also expect the IPS to exert itself openly in trying to usher in such practices as Prescription Audit. Model drug regimens for common ailments ought to have been publicised long ago. These would have served as the standard against which actual prescriptions and procedures issued by doctors could have been checked for fair and objective audit. The IPS has failed to make any effort in this direction or in ensuring participation by the State. and institutions in this important exercise.

Irrational use of drugs

If irrational prescription of drugs is one face of the problem, irrational consumption of drugs is another. There are no statistics on such abusage but it is fair to say that this is widespread.

The issue of licenses for the manufacture of drugs only to companies producing rational drugs and an effective Prescription Audit programme can certainly reduce the misuse of drugs but cannot substitute for the education of the public on rational treatment. Physicians bear the prime responsibility here but the professional bodies also have an important role in guiding the public on such important issues.

Recent programs on BBC’s World Service Television showed the concern of professional agencies in the United Kingdom and America on such issues as the futility of ‘non-food vitamins’ and risks from mercury amalgams in dental fillings. Periodic, official updates are provided to the public by the various professional bodies in these countries on such issues.

Why do our professional organisations drag their feet and neglect their duties?