Vol , Issue Date of Publication: June 19, 2026
DOI: https://doi.org/10.20529/IJME.2026.038

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The ethics of ‘batting’ in Indian medical training: Avoidance, moral injury, and structural violence

Meghnil Chowdhury
Abstract:

"Batting" — the informal practice of diverting or discharging patients to avoid clinical responsibility — is a pervasive yet inadequately examined feature of Indian medical training. This commentary examines batting as an ethical failure operating at individual, cultural, and structural levels. Drawing on the concepts of the hidden curriculum, moral injury, and structural violence, it argues that batting both harms patients and deforms professional identity. Hidden curricula normalise avoidance as competence; trainees internalise these norms under hierarchical pressure, sustaining moral injury that shapes clinical practice well beyond training. Diffused accountability structures shield institutions from responsibility, rendering patient harm invisible. Addressing this requires embedding ethical accountability into training through cultural reform, transparent audits, trainee protection, and regulatory oversight by bodies such as the National Medical Commission. Confronting batting is essential to uphold medicine's social contract, protect patient safety, and embed responsibility as a daily practice rather than an aspirational value.


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©Indian Journal of Medical Ethics 2026: Open Access and Distributed under the Creative Commons license ( CC BY-NC-ND 4.0),
which permits only non-commercial and non-modified sharing in any medium, provided the original author(s) and source are credited.

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