Lao Jiao: Sg Docs Lack Discipline

[makapaaa]

<TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR>July 28, 2009
DOCTORS AND ETHICS
</TR><!-- headline one : start --><TR>Enforced discipline a must for doctors too
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<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->WHEN I first joined the teaching staff of the medical faculty of the University of Singapore in the early 1960s, I was struck by the lack of discipline in the faculty and laissez-faire attitude in the hospitals.
A lecture meant for some 100 students would often be attended by a handful. Students posted to wards for clinical work were often nowhere to be found. Some doctors blatantly neglected their duties, failing to respond to calls. Senior staff, on whose shoulders fell the ultimate responsibility of patient care, would ignore their supervisory role. Some students acquired an arrogance upon graduating, believing that they were society's saviours when they in fact owed society a debt because their studies were heavily subsidised by taxpayers.
It was a small, tightly knit community where it was hard to offend one without offending several others. Consequently, not many students or doctors wished to upset the apple cart and preferred the status quo rather than work for improvement.
In general, there are two types of mistakes made by doctors: those that result from obvious negligence, perpetrated with full knowledge; and those that happen despite good intentions, conscientiousness and diligence.
The human body is unlike a machine - the management of a condition may be seemingly correct but may not yield the expected result. Such human fallibility is noted mainly in hindsight. It is the intentional negligent conduct that should concern us.
Emphasising ethics and professionalism may make a difference and guide some students towards being good doctors; it may not work on others. Medical students and doctors, like other professionals, need to have discipline enforced upon on them.
Dr Ong Siew Chey

 

[makapaaa]

<TABLE border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR>Cultural differences may be behind contrast in docs' ethical standards
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<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->I REFER to the lively debate concerning doctors' ethics.
I think that all parties concerned would agree that the conduct and ethics of doctors need to be held to a higher standard than the law. They are bound by the Hippocratic Oath - Above all, do no harm.
In the context of the current debate, it is interesting to consider the cultural issue of East versus West. In the West, there is more focus on the individual and his rights. In the East, the focus is more on the system and on the need to conform. Would focusing on the system inadvertently neglect the individual?
Foreign-trained doctors may have had professors who stressed the ethics of care. These professors may also have experienced first-hand the financial consequences of their failings.
In Singapore, it may be difficult to find members of the same profession willing to testify against each other, let alone break the silence on ethical or conduct issues. The concern about the lack of transparency and implicit bias rings true.
I believe that only when doctors are aware that there are hard consequences for their actions and avenues of redress for the patient will they exercise care in their conduct and ethics towards the patient.
Ethan Lee

 

[wikiphile]

The Hippocratic oath means shit to most doctors here, the $$ Oath means more to them

I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods OF FORTUNE, FAME AND GREED, and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant:
To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money NOT to give him a share of mine, and to regard his offspring as UNequal to my brothers in male lineage and to teach them this art–if they desire to learn it–with outrageous fees and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken the oath according to FINANCIAL law, but to no one else.

I will apply dietic measures for the benefit of the sick according to THEIR FINANCIAL ability and MY COLORED judgment; I will keep them from harm and injustice (unless they are in contradiction with my neligence insurance policies).

I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect UNLESS THEY PAY UP. Similarly I will not give to a woman an abortive remedy AS PER SAME CIRCUMSTANCES AS PER THE FIRST SENTENCE. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work SO LONG AS NO HARM COMES TO ME.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice BUT NOT MY FEES, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves UNLESS THEY ARE VERY NAP.

What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about OR BE SUED.

If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.