Support for Advocacy and Training to Health Initiative
Action Research Center of Anusandhan trust
‘Alliance of ‘Doctors for Ethical Healthcare’
Mission
We are speaking on behalf of the large number of conscientious, rational doctors in India with a sense of
anguish and distress regarding the state of medical practice in India today. It is a fact that ethical
standards in private medical practice have been deteriorating and today, incidences of malpractices,
irrational investigations, procedures and surgeries, kickbacks for referral have reached an alarming
proportion. Medicine is increasingly getting grossly commercialized, becoming a business rather than a
noble profession, and for some an avenue for profiteering.
We would like to point out that a section of honest rational doctors across India is quite uncomfortable
with this turn of events, including the deterioration in doctor-patient relations due to gross
commercialization of medical profession. These doctors, who do ethical and rational practice, are feeling
increasingly isolated and frustrated. We strongly feel that such doctors need to take a stand and start
coming together to check medical malpractice and to uphold the noble traditions in medical profession.
Such doctors and all others, who are interested in improving this situation, need to work together to decommercialize the medical profession and work towards the goal of health for all.
We appeal to all fellow doctors who want to do rational, ethical practice, and to public health experts,
academicians, social and health activists and political decision makers, to come together towards this
end. We suggest that in order to foster rational, ethical practice, the following key steps are
required to de-commercialize the profession in the interest of ordinary people, patients and
rational doctors
We suggest that in order to foster rational, ethical practice, the following key steps are
required to de-commercialize the profession in the interest of ordinary people, patients and
rational doctor
Checking corporatization of Health care
checking corporatization of Health care and preventing conversion of medicine into a profit-centred industry. Legal curbs on unethical practices of corporate hospitals like advertisements, kickbacks,
commissions etc should be brought in.
Major regulation and rationalization of fee structure in private medical colleges.
Major regulation and rationalization of fee structure in private medical colleges. These colleges
should not be allowed to charge any donation, capitation fees.
Regulation of pharma industry, equipment industry and consumables, and nutraceutical industry
Regulation of pharma industry is urgently needed with provisions like ban on irrational
medicines and irrational Fixed Dose Combinations, promotion of quality generic medicines, mandatory
ethical pharma marketing code. The industry producing medical equipments and consumables is also one
of the drivers of commercialization of healthcare today, and needs to be appropriately regulated,
including rationalisation of MRPs. Strict regulation of manufacture and marketing of various food
supplements is also very much required, since many of these are of dubious value
Solving the practical problems of rational doctors
There is a need to move away from a market
based system which makes doctors and patients adversaries of each other. Rational, ethical doctors need
ensured supply of trained nursing staff, there should be improvement in the implementation of acts like
PCPNDT etc. and capping the amount of compensation in medico legal cases. Clinical Establishment Act
2010 should exempt outpatient clinics from infrastructural requirements, and the existing provisions
related to mandatory emergency medical care should be appropriately modified.
Regulation of Private medical sector with rationalization of care and transparent, accountable regulatory bodies
Regulation of Private medical sector with rationalization of care and transparent, accountable
regulatory bodies: Given the background of failure of self-regulation in India, we endorse the need for
social regulation of the private medical sector, for which legal framework needs to be enacted and
implemented in all states with the following provisions:
- Separate, autonomous multi-stakeholder public regulatory body (including representatives of doctors and civil society organisations) with transparent functioning for implementation of the act.
- Inclusion of Standard Charter of Patient’s Rights, District level appellate bodies and autonomous grievance redressal system for doctors and patients.
- Standard Treatment Guidelines, Minimum Standards which should be in accordance with the Indian situation, and keep in mind the concerns of smaller hospitals and genuinely not-forprofit health care institutions.
- Proper standardization of rates, transparency in rates with appropriate implementation.
Reconstitution of Medical Council of India on democratic lines, it’s transparent and accountable functioning
Reconstitution of Medical Council of India on democratic lines, it’s transparent and accountable
functioning, bringing Trust Hospitals and Corporate Hospitals under the control of MCI.
Universal Health Care
We should help initiate a process of government policy for moving towards a publicly funded and
organised system of Universal Health Care, and inclusion into this system as required, sections of the
private providers who are committed to de-commercialised, rational, ethical practice. This would be a
major step for de-commercialisation of health care, which would be immensely beneficial for both
ordinary people and rational doctors. The State must accept health as a fundamental human right and
take the responsibility for health of the people. It should improve and expand the existing Public Health
System while making it transparent, accountable and patient friendly. Government should spend
substantial funds for provision of healthcare.
We urge all fellow ethical and rational doctors, who may be feeling isolated and might not be visible
today, but are present in significant numbers all over India, to join us in the movement for rational, ethical
practice: ‘Say No to commercialized, unethical and irrational medicine’. In order to bring together
rational and honest doctors in such a process and to take forward the march towards equitable,
accessible, affordable, accountable and quality healthcare while addressing the concerns of conscientious
doctors, we are forming a forum ‘Alliance of ‘Doctors for Ethical Healthcare.’
We hope that together, we ethical and rational doctors of India would try to bring a phenomenal change
in the way medicine is practiced today, and we will be able to shift the focus again back to the most
important but vulnerable stakeholder – the patient!
In our professional conduct, we should formulate a pledge not to give or take kickbacks from fellow
doctors, pharmaceutical industry, vaccine industry, equipment industry or any exchange which goes
against professional medical ethics. We should also pledge to actively resist unnecessary medicines, tests,
surgeries and procedures.
ADEH Declaration
We are speaking on behalf of the large number of conscientious, rational doctors in India with a sense of
anguish and distress regarding the state of private medical practice in India today. We believe that though
many private practitioners in India are, like us, trying to do rational, ethical practice, the overall milieu in
private health care in India has been increasingly affected by unregulated, non-standardized nature of
care which has been increasingly commercialised and now corporatized. This is harmful not only to
patients but it is also oppressive to the section of doctors who want to do rational, ethical practice. There
is also the problem of consumerism in health care and the dwindling of the dialogue and trust between
doctors and patients.
We believe that this state of affairs has resulted because of wrong policies of the government, which has
systematically undermined the Public Health System and has led to increasingly commercialised relations
between doctors and patients. Thus the government has encouraged privatization of medical education,
has allowed the pharma industry to fleece the people and to sell irrational medicines and their irrational
combinations. There is a need to reverse this unbridled commercialization of health care and of doctor-patient relations.
We are for -
Curbing corporatization of Health care.
Vastly improved, democratized, accountable and expanded Public Health Services
Regulation and rationalization of fee structure in private medical colleges.
Regulation of Pharma industry, medical equipment industry and consumables.
Solving the practical problems of rational doctors – like high handed implementation of PCPNDT in which many honest doctors have suffered.
Capping the amount of compensation in medico legal cases
Honouring patients’ rights, adopting transparency regarding charges and for readiness to give enough time to patients and answer their queries.
Following standard treatment guidelines prepared by organizations in India with due consideration for local constraints
Bringing in Clinical establishment act that would protect honest and ethical doctors and would not bring in corrupt Baburaj.
Reconstitution of Medical Council of India on democratic lines, and bringing Corporate Hospitals under the control of MCI
Vastly improved, democratized, accountable and expanded Public Health Services
Regulation and rationalization of fee structure in private medical colleges.
Regulation of Pharma industry, medical equipment industry and consumables.
Solving the practical problems of rational doctors – like high handed implementation of PCPNDT in which many honest doctors have suffered.
Capping the amount of compensation in medico legal cases
Honouring patients’ rights, adopting transparency regarding charges and for readiness to give enough time to patients and answer their queries.
Following standard treatment guidelines prepared by organizations in India with due consideration for local constraints
Bringing in Clinical establishment act that would protect honest and ethical doctors and would not bring in corrupt Baburaj.
Reconstitution of Medical Council of India on democratic lines, and bringing Corporate Hospitals under the control of MCI
Joint communiqué: Right Care Alliance, Alliance of Doctors for Ethical Health Care, Slow Medicine Italy, Slow Medicine Brazil
Across the world, more and more patients, their families, their doctors, nurses and other health professionals who
care for them, are all experiencing a deepening malaise about a working environment excessively concerned with
money and profit. Medicine is in danger of losing its soul. Too much of the world has no access to basic health
care at the same time as too many people are getting care they don’t need nor would want if they were fully
informed. The sources of this are many, including the decline of professionalism, the corruption of science, the
failure to listen to communities’ understanding of their needs, the lack of democratic input into the design of health
care systems, rising economic inequality, and the trend of corporatization treating healthcare as a commodity for
profiteering. This decline has been accelerating as governments have moved away from their responsibility to help
and care for their people by increasingly leaning on a private, unaccountable healthcare sector that is driven by
greed, whether by pharmaceutical companies, medical technical industries, private insurance companies, or
vaccination industries, to name few. In the face of these problems we see an emerging movement for human health
across the globe, in many societies of varied cultures and histories, all confronting this fundamental issue of human
existence: how will be treat each other, as units in an economic production process, or as fellow mortal beings in
need of solidarity and support? We the undersigned organizations declare that we need a new kind of health care
that puts relationship ahead of the transaction, and honors the ancient calling of healers to be guides in life’s journey
for all members of the human community. We believe it is time for a renaissance in health care. Such a renaissance
should be focused on the restoration of the relationship between healers and their communities. That sacred space
needs greater protection from the forces of moneyand needs to allow science to take its proper role as the
handmaiden of human needs rather than as an instrument of profit, and to ensure that health workers are able to
offer the gift of their time as well of their knowledge. We believe that if this is to happen; humanity must take the
fundamental decision at this crucial juncture that healthcare is not a commodity but a social good.Health should be
declared a fundamental right of all citizens around the globe and the drivers of good health, such as food security,
shelter, and education must be ensured We call on all citizens concerned with the health of their families and their
communities and on all health professionals to join us in this work: to develop every action, initiative and policy that
will promote a vision of health care for the common good, a health care that is in harmony with our deeply social
nature and with our capacity for innovation, ahigh quality health care that is equitable and accessible for all,
operating within broader systems of health that promote the health of all.
