Is accepting travel support from a medical-equipment manufacturer for an educational seminar unethical?
Can I take a medical journal from a pharmaceutical company or will it be construed as a bribe?
These were some of the questions thrown up at Heal India’s one-day national seminar on Medical Ethics, held in Delhi today.
The amendment to the Indian Medical Council (professional conduct, etiquette and ethics) Regulations, banning doctors and medical associations from accepting gifts, hospitality and travel from the pharmaceutical industry has started a lively debate on what can be construed a bribe and what can’t.
“The criticism is because of the uncertainty in interpreting the word ‘gift’, in this context, without any supporting definition in the Medical Council Act,” said Supreme Court advocate Sudhir Mishra.
“The new regulations will target gifts for commercial promotion, not educational and research processes,” said Dr Ketan Desai, president, Medical Council of India (MCI).
“Complaints can be made to the state medical councils, and in the absence of one, to the MCI,” he added.
Some doctors said that in a professional relationship between doctors and the pharma industry, there should no room for gifts, big or small.
However, most felt that certain leverage should be given, as in France, where gifts up to Euro 29 are allowed, or the US, where the limit is under USD 100.
What everyone unanimous agreed to, however, was that stringent regulations are needed.
“In medicine, the pharmaceutical companies don’t sell directly to patients,” said Dr Amar Jesani, coordinator, Centre for Studies in Ethics and Research, Mumbai.
“Doctors decide what patients should have. So, it is doctors who influence the market forces,” he added. “They should not take favours of any kind,” added Dr Jesani.
In a letter to the Union Health Secretary Sujatha Rao today, Dr Desai asked the ministry to, “Kindly take up the matter with all other appropriate authorities in the government, such as the ministry of chemical and fertilisers, drugs controller general of India and drugs technical advisory board for incorporation… (of new code of ethics), in all rules and regulations regulating to the pharmaceutical and allied healthcare industry.”
Unlike in other professions, medical ethics touch our lives directly.
“If you buy an insurance policy, you may complain for a few days, but if you get a bad medical procedure done, your life could be at risk,” said Shivinder Mohan Singh, managing director, Fortis Healthcare.