Medical and Religious Ethics - Book Report/Review Example

1 Topic: Book review/ My Own Country: A Doctor’s Story. of the ) Book review/ My Own Country: A Doctor’s Story. Discuss truth telling in health care ethics from the perspective of religion In real life situations, medical and religious ethics often clash. From the secular perspective, the syllabus of health care ethics should be one, but there are many religions and their ethical perspectives are not only different, but they often clash. For the health care provider it is a situation of clash within the clash. Religious beliefs are sensitive subjects to discuss. The interference of religion in any area, be it politics or medicine, often invites serious differences. A Catholic nurse may be angrily rebuked by a Bishop for allowing surgery to save the pregnant woman’s life but blessings from a religious authority is not going to save the nurse from the possible legal wrangles. Moreover, the Bishop is not going to reimburse attorney’s fees. In the long run telling truth pays. If the choice of the nurse clashes with that of the doctor, it is better to take doctor’s opinion in writing on the patient’s health care sheet. Also do not hesitate to record your opinion on the same sheet. The nurse will have to carry out the assigned responsibility as per the advice of the doctor, as hospital discipline demands it. The strength of the moral authority is more but the rules of medical science can never be ignored. Religious interventions make the issue confusing, complicated and arbitrary. Autonomy is an important feature of American culture. One person taking the decision is perfect. When two persons are involved in the process of decision making, difference of opinions occur. When there are three persons with strong conflicting views, decision making with the pleasure of all is impossibility. Your right to honor your beliefs does not allow you exercise authority over the belief system of the other. A patient may demand treatment that is not in line with the treatment modalities and religious conscience of the provider. The provider cannot be forced to give treatment and the patient will have to look out for alternative care options. The scope of morality and ethics is wide and is liable for multiple interpretations. If there is no willing provider of medical care within hundreds of miles, medical issues take a new dimension and humanitarian considerations come to the fore But what if the advance directives say that one does not want to be kept alive by these means? The advance medical directives of patients who have serious ailments and are terminally ill need to be honored, whatever is the moral standard prevailing in the society or administered by the Catholic preachers. In the case of a brain-injury patient, with no chances of recovery, how long the patient needs to be sustained on artificial food and hydration when the husband of the patients takes the stand that she would have wanted to die, as there are no chances of her survival? Patient’s wishes shall be honored in majority of the cases and artificial food and hydration shall be morally optional. Did the ethical demands placed on clinicians during the AIDS pandemic? If the pandemic is not treated by the doctors, who else will do that job? The doctor is like the soldier in the war-front in such extraordinary situations when the health of a large number of people is in peril. A soldier does not think about his own life and is willing to make the ultimate commitment- the life itself and will perform the duty. The challenge before Dr. Abraham Verghese was more or less the same. He had the genuine heart of the Christian and he hailed from India, the land known for piety and charitable disposition, then in the thick of the Bible-belt to challenge AIDS. Dr. Vergehse (1995) asks the question “What was the point in coming to America to train if I wound up in a little Bombay or little Manila?” (p. 19), which is the pointer to his ambition to succeed as the medical practitioner in America. AIDS patients are intensely shattered individuals psychologically and society is not sympathetic to their plight. The first reaction of even the medical practitioner is to shun the patients afflicted with AIDS. Dr. Verghese narrates his own ethical dilemma when he sets on the mission with readiness to treat the patients from the deadly virus, the curse of the devil, against the advice of his fellow doctors, and the fears expressed from his wife as for his health. He becomes “the AIDS doctor”. His medical center became the “Miracle Center”. The ethical demands placed on clinicians during the AIDS pandemic are one thing. But the willing devotion to duty by the doctor, and in the case of Dr. Verghese, it was a passion and he considered devotion to the unfortunate people afflicted with AIDS was devotion to the Supreme Self. He knew his self-imposed responsibilities very well. His story pictured the life of a dedicated doctor and the strains of practicing medicines and how he incorporated it in to his day to day time table of the medical practitioner. On the one side was the doctor’s chamber and on the other side the chamber of death in which the patients entered with regularity. In US all medical data is mostly treated as confidential and protected under the law. The information related to AIDS is sensitive as such those medical records are out of bounds, other than to the patient and the attending physician. But health care providers are duty-bound to provide the information to public health authorities. This is part of their ethical demand as providing such information is in national interest. When breaching confidentiality is in the interest of the patient, it is permitted without the legal penalty. Dr. Verghese was working for a noble cause, but he must be having some psychological tensions. His family members certainly lived in constant psychological fear as there were many cases of HIV-infected health care workers. 3. How would you have advised Dr. Verghese during his time in Johnson City, Tennessee? I will not advise him; I just salute him. He is the wonder doctor of East Tennessee town. Does a self-starter need somebody else’s advice? Fear and love were a great combination for the AIDS patients under his care. Dr. Verghese was a fearless medical professional and he loved serving such unfortunate patients, without caring for the safety of his life. The spirit of an ordinary medical practitioner would break when he sees a number of patients dying under his care and the reports of health care personnel getting afflicted with AIDS. To read about ethical consideration when they study medicine is one thing for the medical students, as they may have to answer some questions about medical ethics in their examinations to get qualified as medical practitioners. But when they face the ground realities, come face to face with the AIDS syndrome, the scenario is different. As Dr. Vergehse hailed from India, his first task was to build patient-doctor relationship as he was the medical practitioner born and educated in the third world. He rose to become a renowned medical practitioner with his qualities of head and heart and wrote a couple of brilliant, insightful books on the medical subject, with the human touch that continue to provide information and inspiration as to how to take care of the AIDS patients. He worked with missionary zeal giving solace to the patients losing the battle with AIDS and those who were on the path of recovery would advise Dr. Verghese to create a time-frame, amidst his busy practicing schedule to go on a lecture tour of medical colleges and other forums like NGOs to disseminate the practical knowledge that he has gained in treating the AIDS cases. This will be of immense use to humankind and for the cause of treating and eradicating AIDS. Instead of advising Dr. Varghese, I would have loved to share to tell the facts related to his life. In the initial stages, none was willing to share his compassion and commitment for the cause of AIDS patient, both within and outside his professional community. He first tried to spot and identify the psyche of irrationality that drives people’s fear of this disease and disability. He proved how professional commitment can make marriage and parenting successful, notwithstanding high demands on his time. AIDS is a serious ailment and the physicians do not have magic capsules to treat it. To establish proper rapport with the patient, he has to be a philosopher. I think he is one when we try to grasp this observation. Dr. Verghese (1995) writes “I look up at the stars. I feel connected: legs to earth, shoulders to sky. I squint my eyes and see the lines that link stars to make constellations, feel their umbra extend down to me, connecting me with this parcel of land I stand on. (p.428) His cross on the neck and Christ in the heart must have provided him constant inner strength to serve his patients. He perfectly understood the human factor in terminal diseases. My final request to Dr. Verghese! Create a few Dr. Vergheses before you call it quits, if at all quitting is possible for you from this profession, which the call of humankind and which keeps your heart ever engaged. To some service is a way of life, and Dr. Verghese is one of them. Reference List Verghese, Abraham (1995).My Own Country: A Doctor’s Story; New York; Vintage Read More